Acute bacterial gastroenteritis: 729 cases recruited by a Primary Care national network

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Abstract

Objective To determine the main clinical and epidemiological features of bacterial gastroenteritis in our environment. Patients and methods An observational study of a Spanish population in 17 Autonomous Communities. Questionnaires of children with a stool positive culture to bacteria were collected over a one year period. A bivariate analysis was performed on the variables involved, as well as two multivariate models (for antibiotic treatment variables, and comparison Campylobacter/Salmonella). Results A total of 729 bacterial gastroenteritis episodes were recorded in the 17 Spanish autonomous regions, of which 41.2% were girls and 58.8% boys. The median age was 3.41 years old (interquartile range 1.55 to 6.72). The bacteria isolated were 59.9% Campylobacter, 31.8% non-Typhi Salmonella, 2.7% Aeromonas, 2.4% Yersinia, and 1.5% had more than one strain. Most infections (70%) were direct contacts, and food poisoning was less probable (25.9%). Salmonella is significantly less frequent than Campylobacter in children under the age of 3 years (adjusted OR 0.61; 95% CI: 0.43 to 0.86; P =.005), and Campylobacter is more frequent in rural areas (adjusted OR 1.48; 95% CI: 1.07 to 2.07; P =.012). Antibiotic was prescribed in 33.2% of cases. There was a greater significant difference if stools contained blood or mucus (adjusted OR 1.53; 95% CI: 1.04 to 2.27; P =.031), if the symptoms lasted more than 7 days (adjusted OR 2.81; 95% CI: 2.01 to 3.93; P <.000), or if the child was admitted to hospital (adjusted OR 1.95; 95% CI: 1.08 to 3.52; P =.027). Conclusions The aetiology of bacterial diarrhoea in paediatrics is typical of that of a developed country. The transmission mechanism is mainly direct, and more cases than appropriate are treated with antibiotics.

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García Vera, C., García Ventura, M., del Castillo Aguas, G., Domínguez Aurrecoechea, B., Esparza Olcina, M. J., Martínez Rubio, A., & Mengual Gil, J. M. (2017). Acute bacterial gastroenteritis: 729 cases recruited by a Primary Care national network. Anales de Pediatria, 87(3), 128–134. https://doi.org/10.1016/j.anpedi.2016.04.020

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