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 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study of acute gastroenteritis in children was carried out with the aim of establishing the prevalence of human reoviruslike agent (HRLA) and its relation to other enteric pathogens in Israel. The stools of 384 children with acute diarrhea referred to a pediatric emergency service were screened for HRLA by counterimmunoelectroosmorphoresis (CIEOP) and for pathogenic bacteria. Evidence of HRLA infection was found in 65 patients (17%). The highest infection rate prevailed during the cool season (25%), with a peak prevalence (41%) in November, when both the temperature and humidity were low. A very high proportion of HRLA was found in children younger than 36 months and no HRLA infection was observed in those older than nine years. The highest prevalence occurred in infants younger than six months, a situation rarely encountered in other countries. The main clinical features of HRLA infection were fever, vomiting, dehydration, signs of upper respiratory infection and carbohydrate intolerance. Bacterial pathogens accounted for 45% of enteric infections. Shigella species predominated (28%) during the summer season, especially in older children. In 38% of the study group, no etiologic agent could be detected. None of the 50 control subjects showed evidence of viral or bacterial pathogens in stools.
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PMID:Etiology of acute gastroenteritis in children in Israel: role of human reoviruslike agent and bacterial pathogens. 22 84

Under the circumstances of limited health resources and immediate need for preventing the dehydration associated with diarrhea in infants, breastfeeding should be encouraged throughout the diarrheal episode. When this is not possible because of cessation or failure of lactation, an oral electrolyte solution should be administered. It should be sterile and provide a quantity of electrolytes not greatly in excess of 30 mEq/liter of sodium and potassium. There should be little possibility of an error in the dilution of the mixture if it is to be supplied in powdered form. Milk should be reintroduced after 24 hours and the electrolyte mix rapidly discontinued so as to minimize nutritional deficits. If no such electrolyte mixture is available, it is reasonable to alternate feedings of commercial soft drinks or bland teas with milk feedings. There should be specific instructions that the infant should be brought to the hydration center if more than 3 sequential feedings are lost by vomiting, if fever is present, or it the stools exceed the volume of 3 feedings. In general, dehydration of less than 5% of body weight can be managed by this program in the house, dehydration greater than 5% but less than 10% requires supervision by health authorities, and dehydration greater than 10% requires intravenous therapy in a hydration center. In those countries with cholera and during epidemics of shigellosis or enterotoxigenic Escherichia coli, solutions containing 90 mEq/liter of sodium should be given under ambulatory supervision. This solution should be discontinued when fecal losses moderate (less than 60 ml/kg/day) and the lower electrolyte solution (30 mEq/liter) substituted.
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PMID:A critique of oral therapy of dehydration due to diarrheal syndromes. 33 34

The Japan Research Committee of Fosfomycin was organized in the fall of 1972 to promote the basic and clinical studies on fosfomycin. First of all, a subcommittee of fosfomycin consisting of a limited number of members was organized to establish the methods of determination on its antibacterial activity and its concentration in the biological fluid, and the most applicable methods were devised. The clinical trials on its oral form in a small scale were commenced from spring in 1973, and then gradually expanded to almost all of Japan. The clinical trials on its parenteral intravenous form were also undertaken from the latter half of 1973. The basic and clinical results obtained from hospitals and institutes almost all over Japan, to which members of the above Committee belong, were presented by speakers under a hot discussion in two symposia which were held by the Japan Society of Chemotherapy; one on its oral form in June 1974, and another on its parenteral form in December 1974. I served as chairman in both of the symposia. The clinical results of fosfomycin in Japan which were mainly collected in both symposia are described below. Its antibacterial activity, and absorption and exretion will be presented elsewhere in this volume. Clinical results of its oral form: Dosage forms of fosfomycin-Ca salt, capsule and granules, were prepared for its clinical trials. It resulted effective in about 76% of 1,200 patients with infection due to gram-positive or gram-negative (Pseudomonas, Salmonella, Escherichia coli, etc.) bacteria in several fields. As far as rates of efficacy were concerned, it was more effective in surgical, urological, ophthalmic and some other fields than in internal and pediatric ones. Fosfomycin was given in a dose of 2-3 g/day for adults or 100-130 mg/kg for infants and children in most cases. Furthermore, it can be favorably mentioned that fosfomycin was proved to be effective in salmonellosis and resistant shigellosis by a certain research group specialized in the therapy of infectious enteritis. Clinical results of its parenteral form: Sterlized bulk material of fosfomycin-Na salt was prepared in a vial for clinical use. Similarly as in the case of oral form, it was applied to about 500 patients with several infections. It resulted effective in about 68% of them. This percentage was not as high because of the higher frequency of application to severe patients or patients with underlying disease. Fosfomycin was intravenously administered by one shot or drip infusion in a dose of 2-4 g/day for adults, or 100-250 mg/kg for infants and children in most cases. Adverse reactions: In oral form, the incidence of adverse reactions was about 10% but most of them were slight gastrointestinal disorders. In an extremely small number of patients a rise of SGOT and/or SGPT was observed. In parenteral form, the incidence of adverse reactions was a little higher, being about 17% including a rise of SGOT and/or SGPT, vascular pain, nausea, and vomiting, etc...
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PMID:Fosfomycin in the treatment of bacterial infections: summary of clinical trials in Japan. 83 22

Shigella, toxigenic Escherichia coli (stable toxin) and rotaviruses were frequently found among 50 children hospitalized with diarrhea studied during one year. These agents were less common among 45 controls without diarrhea, of comparable age and from the same wards as the cases reported. There was a greater frequency of respiratory symptoms in the diarrhea associated with rotaviruses. These were characterized by frequent bowel movements and vomiting and often fever. The bacterial diarrheas showed, in general, a more severe clinical picture than the viral ones. The rotaviruses had a low endemic level during April-October, but their prevalence increased in December and January; in such months these viruses were found in more than 50 per cent of the diarrheal cases.
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PMID:[Infectious agents in diarrhea of hospitalized children in Costa Rica]. 91 58

The role of shigella infection in childhood gastroenteritis was studied over a 2-year period. Shigella species were found in the faecal specimens of 70 (1%) of 7369 children with gastroenteritis, but in only 1 (0.1%) of 1130 controls. S. flexneri was the commonest isolate (51%), followed by S. sonnei (37%). Most shigella species were isolated during the winter. The prevalence of shigellosis was highest for children 1-5 years of age but equal for both sexes. Fever, abdominal cramps, vomiting, and bloody diarrhoea were the predominant clinical features. Of the shigella isolates, 73% were resistant to cotrimoxazole, 43% to ampicillin, and 41% to chloramphenicol. One-third of isolates were resistant to greater than or equal to 3 antibiotics. All isolates were susceptible to nalidixic acid. The illness was mild and self-limiting and most patients recovered without antimicrobial therapy.
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PMID:The relative importance of Shigella in the aetiology of childhood gastroenteritis in Saudi Arabia. 150 39

Shigellosis results in considerable morbidity in endemic areas, but mortality is rare in developed countries. All pediatric deaths (n = 15) in Israel following shigellosis in the past 10 years were reviewed. The patients' ages ranged from 5 months to 11 years; there were eight boys and seven girls. Three were institutionalized mentally retarded patients, 11 were healthy children. Twelve had definite clinical signs of brain death within 48 hours of onset of disease. Cause of death in all patients was consistent with toxic encephalopathy. No other systemic complication was implicated as the cause of death except for one case consistent with a "Reye-like" syndrome. Shigella species were as follows: 8 flexneri, 4 sonnei, 1 dysenteriae, and 2 were not identified. Case-control study of these patients vs surviving, hospitalized patients with shigellosis showed similar severity of fever, diarrhea, vomiting, and dehydration and similar incidence of convulsions. Headache was a prominent feature of patients who died; 5 of 7 verbal patients complained of this symptom as opposed to 2 of 20 in the control group (P less than .01). There were no significant differences in the hematological and biochemical profile (except for an increased incidence of hyponatremia in the study group), pattern of shigella species, or antibiotic sensitivity. These findings indicate that mortality from shigellosis in a developed country is due primarily to the toxic encephalopathy syndrome.
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PMID:Lethal toxic encephalopathy due to childhood shigellosis in a developed country. 159 76

A total of 27,480 stool specimens from 15,548 patients with gastroenteritis were analyzed for bacterial enteropathogens during a 4-year period between 1986-89 at a major referral center in Saudi Arabia. Bacterial pathogens were isolated from 1,152 patients, Salmonella being the most frequent, followed by Campylobacter, Shigella, and Aeromonas hydrophila. The latter bacterium was found in 58 patients; seven of them were associated with other enteric pathogens, but A. hydrophila was the only organism in 51 patients. All had gastrointestinal symptoms, the most common being diarrhea (92%), followed by abdominal pain (68%), fever (37%), and vomiting (27%). Stool specimens from 1,368 control patients were negative for A. hydrophila.
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PMID:Can isolation of Aeromonas hydrophila from human feces have any clinical significance? 174 89

The authors investigated the incidence of campylobacteriosis in the population of five paediatric health communities of the Jihlava policlinic (5831 children) for a period of three years. A total of 2408 specimens faeces from 1501 subjects were examined. Campylobacter jejuni was detected in 151 subjects (10.1%), Salmonella sp. in 47 (3.1%), Shigella sp. in 18 (1.2%), Yersinia enterocolitica in 12 (0.8%) and enteropathogenic Escherichia coli in five subjects (0.3%). The total incidence of campylobacteriosis in the investigated group was 863 cases per 100,000 subjects per year. The incidence of campylobacteriosis was seasonal with a maximum during the summer months. To elucidate the source of infection and way of transmission 323 smears from animals, animal products and from the environment were made. Seventy were positive. Campylobacterosis is transmitted to man most frequently by ingestion of primarily or secondarily contamined food, by contact with animals and even interhuman transmission cannot be ruled out. The most frequent clinical symptoms of campylobacteriosis were diarrhoea, fever, abdominal pain and vomiting. Seventeen children were hospitalized. For treatment most frequently Endiaron was used and dietotherapy. Campylobacteriosis affects significantly more frequently children of gipsy origin.
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PMID:[A 3-year follow-up study of the incidence of campylobacteriosis in a pediatric population]. 209 13

Between March and July, 1987, faecal specimens from 371 diarrhoeal children reporting to four hospitals in the district of Kurunegala, Sri Lanka and from 121 controls with other diseases were investigated for enteric pathogens. All specimens were tested for Shigella spp, Salmonella spp and enteropathogenic Escherichia coli (EPEC). In addition, parasitic pathogens, heat labile enterotoxigenic Escherichia coli (ETEC LT), Campylobacter and rotavirus were sought among subsamples of the cases and controls. One or more pathogens were detected in the faecal specimens of 53.7% of the diarrhoeal children and 19.6% of the controls (P less than 0.001). Rotavirus was the most frequently identified pathogen. Cases (21.9%) were more likely to be positive for rotavirus than controls (6.5%) (p less than 0.05). Among children with diarrhoea the peak prevalence of rotavirus occurred in the 6-11 months age group. Shigella spp were the second most frequently isolated pathogens and the single most common cause of diarrhoea in children over two years of age. Again, cases (16.4%) were more likely to be infected than controls (1.7%) (p less than 0.001). Salmonella spp were isolated from 7.5% of diarrhoeal children and 3.3% of the controls (p greater than 0.10). Other pathogens had prevalence rates of less than 5%. Vomiting was associated with rotavirus diarrhoea (p less than 0.001), and fever with shigellosis (p = 0.02). In view of the different transmission routes and characteristics of the most important pathogens detected in this study it appears unlikely that a single environmental intervention can solve the public health problem posed by diarrhoeal diseases in Sri Lanka.
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PMID:Microbiological agents associated with childhood diarrhoea in the dry zone of Sri Lanka. 218 25

Two enteric bacterial pathogens were concomitantly isolated from the feces of 18 infants less than 6 months of age admitted to the Assaf Harofeh Medical Center over a 7-year period. In all but two patients stool cultures grew enteropathogenic Escherichia coli, six of serogroup 0119. The other organisms cultured were Shigella, Salmonella, Campylobacter jejuni and Aeromonas hydrophila. The usual clinical presentation was diarrhea, dehydration and vomiting of acute onset, and low grade fever. Patients with gastroenteritis due to a single agent compared with multiple pathogens had a milder course of disease, a milder degree of dehydration and acidosis, a lesser need for i.v. fluid treatment and shorter hospitalization.
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PMID:Acute gastroenteritis due to double infection with enteropathogenic Escherichia coli or Salmonella and another bacterial pathogen. 219 8


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