Detection of Salmonella, Campylobacter, Shiga toxin-producing E. coli and Shigella/EIEC by culture and a multiplex PCR panel in pediatric patients with acute diarrheal illness

Abstract

Acute diarrhea is the second most common cause of child deaths worldwide. We investigated Salmonella species (spp.), Campylobacter spp., Shiga toxin-producing Escherichia coli (STEC) and Shigella spp./enteroinvasive E. coli (EIEC) in stool samples of 741 pediatric patients with acute diarrheal illness. Between January 2017 and October 2017, 741 stool specimens were tested by the BD Max Enteric Bacterial Panel (EBP) assay and conventional culture. Campylobacter spp., Salmonella spp. and E. coli O157:H7 were detected in 10 (1.3%), 20 (2.7%) and two (0.3%) stool specimens by culture, respectively. Campylobacter spp., Salmonella spp., Shiga toxin and Shigella/EIEC were detected in 46 (6.2%), 37 (5.0%), 20 (2.7%) and three (0.4%) stool specimens by the BD Max EBP assay, respectively. The percentage of detected pathogens was 4.3% (32/741) by culture. Use of the BD Max EBP assay identified an additional 112 pathogens, thereby increasing the frequency to 15.1% (112/741). Empirically, 58 patients received antibiotics and 43 patients underwent probiotic and/or symptomatic therapy. We concluded that nucleic acid amplification testing markedly improves the detection rates of bacterial stool pathogens and offers rapid results.