Hostname: page-component-6bf8c574d5-9nwgx Total loading time: 0 Render date: 2025-02-17T12:48:05.376Z Has data issue: false hasContentIssue false
  • English
  • Français

A microbiological investigation of acute summer gastroenteritis in Black South African infants

Published online by Cambridge University Press:  15 May 2009

Barry D. Schoub ,
A. S. Greeff ,
G. Lecatsas ,
O. W. Prozesky ,
I. T. Hay ,
J. G. Prinsloo  and
R. C. Ballard
Barry D. Schoub
Affiliation:
Department of Microbiology and Microbial Genetics Unit of the Medical Research Council, University of Pretoria, Pretoria, S.A.
A. S. Greeff
Affiliation:
Department of Microbiology and Microbial Genetics Unit of the Medical Research Council, University of Pretoria, Pretoria, S.A.
G. Lecatsas
Affiliation:
Department of Microbiology and Microbial Genetics Unit of the Medical Research Council, University of Pretoria, Pretoria, S.A.
O. W. Prozesky
Affiliation:
National Institute for Virology, Private Bag X4, Sandringham 2131, S.A.
I. T. Hay
Affiliation:
Department of Paediatrics, Kalafong Hospital University of Pretoria, Pretoria 0002, S.A.
J. G. Prinsloo
Affiliation:
Department of Paediatrics, Kalafong Hospital University of Pretoria, Pretoria 0002, S.A.
R. C. Ballard
Affiliation:
Department of Microbiology, School of Pathology, University of the Witwatersrand, and theSouth African Institute for Medical Research, Johannesburg 2001, S.A.
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A microbiological investigation of Black infants suffering from severe acute summer gastroenteritis revealed enteropathogenic agents in 30 out of 37 patients (81%). Enterotoxigenic bacteria were isolated from 15 patients (41%). A total of 16 enterotoxigenic strains were isolated, comprising 9 enterotoxigenic Escherichia coli strains secreting labile and stable toxin on their own and in combination, and labile-toxin secreting strains of Klebsiella pneumoniae (4), Enterobacter cloacae (2) and Proteus vulgaris (1). In the case of the latter three species, however, 6 out of the 7 strains were isolated from patients who were excreting other enteric pathogens, whereas only 2 out of 9 enterotoxigenic E. coli patients had concomitant infections with other pathogens. No invasive bacteria were isolated except for 2 shigella strains. Salmonella and shigella strains were found in four patients. No correlation was found between the enteropathogenicity of E. coli and its serotype. Rotavirus was observed by negative staining electron microscopy in only two patients (6%) but using a reverse complement fixation test rotavirus antigen was detected in the stool of 17 out of 35 patients (49%). The low EM detection rate may well be due to the patients being admitted for treatment late in the course of their illness when the degree of viral shedding has decreased below EM detectability. No significant difference in clinical presentation was noted between the various aetiological agents. Only one patient was being solely breast-fed compared to 16% of control non-diarrhoeic infants. Evidence of malnutrition was noted in over half of our patients.

Type
Research Article
Information
Journal of Hygiene , Volume 78 , Issue 3 , June 1977 , pp. 377 - 385
Copyright
Copyright © Cambridge University Press 1977

References

REFERENCES

Cruickshank, J. G., Zilberg, B. & Axton, J. H. M. (1975). Virus particles and gastroenteritis in Black and White children in Rhodesia. South African Medical Journal 49, 859.Google ScholarPubMed
Davidson, G. P., Bishop, R. F., Townley, R. R. W., Holmes, I. H. & Ruck, B. J. (1975). Importance of a new virus in acute sporadic enteritis in children. Lancet i, 242.CrossRefGoogle Scholar
Dean, A. G., Ching, Y. C., Williams, R. G. & Harden, L. B. (1972). Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhoea in children in Honolulu. Journal of Infectious Diseases 125, 407.CrossRefGoogle Scholar
Department of Statistics, Pretoria (1974). Untitled publication. Government Printer, Pretoria, South Africa.Google Scholar
Echeverria, P., Blacklow, N. R. & Smith, D. H. (1975). Role of heat-labile toxigenic Escherichia coli and reovirus-like agent in diarrhoea in Boston children. Lancet ii, 1113.CrossRefGoogle Scholar
Edwards, P. R. & Ewing, W. H. (1972). Identification of Enterobacteriaceae, 3rd ed. Minneapolis: Burgess Publishing Company.Google Scholar
Gorbach, S. L. & Khurana, C. M. (1972). Toxigenic Escherichia coli: A cause of infantile diarrhoea in Chicago. New England Journal of Medicine 287, 791.CrossRefGoogle ScholarPubMed
Gross, R. J., Scotland, S. M. & Rowe, B. (1976). Enterotoxin testing of Escherichia coli causing epidemic infantile enteritis in the U.K. Lancet i, 629.CrossRefGoogle Scholar
Guerrant, R. L., Brunton, L. L., Schnaitman, T. C., Rebhun, L. I. & Gilman, A. G. (1974). Cyclic adenosine monophosphate and alteration of Chinese hamster cell morphology: a rapid sensitive in vitro assay for the enterotoxins of Vibrio cholerae and Escherichia coli. Infection and Immunity 10, 320.CrossRefGoogle ScholarPubMed
Guerrant, R. L., Moore, R. A., Kirschenfeld, P. M. & Sande, M. A. (1975). Role of toxigenic and invasive bacteria in acute diarrhoea of childhood. New England Journal of Medicine 293, 567.CrossRefGoogle ScholarPubMed
Kane, J. G., Chretien, J. & Garagusi, V. F. (1976). Diarrhoea caused by Candida. Lancet i, 335.CrossRefGoogle Scholar
Kapikian, A. Z., Cline, W. L., Mebus, C. A., Wyatt, R. G., Kalica, A. R., James, H. D., van Kirk, D., Chanock, R. M. & Kim, H. W. (1975). New complement-fixation test for the human reovirus-like agent of infantile gastroenteritis. Lancet i, 1056.CrossRefGoogle Scholar
Kapikian, A. Z., Kim, H. W., Wyatt, R. G., Cline, W. L., Arrobio, J. O., Brandt, C. D., Rodriguez, W. J., Sack, D. A., Chanock, R. M. & Parrott, R. H. (1976). Human reovirus-like agent as the major pathogen associated with ‘winter’ gastroenteritis in hospitalized infants and young children. New England Journal of Medicine 294, 965.CrossRefGoogle ScholarPubMed
Konno, T., Suzuki, H. & Ishida, H. (1975). Reovirus-like agent in Japanese infants with gastroenteritis. Lancet i, 918.CrossRefGoogle Scholar
Lancet (1975). Editorial. Rotaviruses of man and animals. i, 257.Google Scholar
Lombardi, G. H., Roseto, A. M., Stamboulian, D. & Oro, J. G. B. (1975). Viruses of infantile gastroenteritis in Argentina. Lancet ii, 1311.CrossRefGoogle Scholar
Nalin, D. R., McLaughlin, J. C., Rahaman, M., Yunus, M. & Curlin, G. (1975). Enterotoxigenic Escherichia coli and idiopathic diarrhoea in Bangladesh. Lancet ii, 1116.CrossRefGoogle Scholar
Rowe, B., Gross, R. J. & Scotland, S. M. (1976). Serotyping of E. coli. Lancet ii, 38.Google Scholar
Rudoy, R. C. & Nelson, J. D. (1975). Enteroinvasive and enterotoxigenic Escherichia coli. American Journal of Diseases of Childhood 129, 668.CrossRefGoogle ScholarPubMed
Ryder, R. W., Sack, D. A., Kapikian, A. Z., McLaughlin, J. C., Chakraborty, J., Rahman, A. S. M.M.Merson, M. H. Merson, M. H. & Wells, J. G. (1976). Enterotoxigenic Escherichia coli and reovirus-like agent in rural Bangladesh. Lancet i, 659.CrossRefGoogle Scholar
Sack, R. B. (1975). Human diarrhoeal disease caused by enterotoxigenic Escherichia coli. Annual Review of Microbiology 29, 333.CrossRefGoogle ScholarPubMed
Sack, R. B. (1976). Serotyping of E. coli. Lancet i, 1132.CrossRefGoogle Scholar
Sack, R. B., Hirschhorn, N., Brownlee, I., Cash, R. A., Woodward, W. E. & Sack, D. A. (1975). Enterotoxigenic Escherichia coli-associated diarhhoeal disease in Apache children. New England Journal of Medicine 292, 1041.CrossRefGoogle ScholarPubMed
Schoub, B. D., Jacobs, Y. R., Robins-Browne, R. M., Koornhof, H. J., Lecatsas, G. & Prozesky, O. W. (1976a). Experimental techniques in the determination of the aetiology of acute infantile gastroenteritis. South African Journal of Medical Sciences 3, 213.Google Scholar
Schoub, B. D., Koornhof, H. J., Lecatsas, G., Prozesky, O. W., Freiman, I., Hartman, E. & Kassel, H. (1975). Viruses in acute summer gastroenteritis in Black infants. Lancet i, 1093.CrossRefGoogle Scholar
Schoub, B. D., Lecatsas, G. & Prozesky, O. W. (1977). Antigenic relationsip between human and simian rotaviruses. Journal of Medical Microbiology. 10, 1.CrossRefGoogle Scholar
Schoub, B. D., Nel, J. D., Lecatsas, G., Greeff, A. S., Prozesky, O. W., Hay, I. T. & Prinsloo, J. G. (1976 b). Rotavirus as a cause of gastroenteritis in Black South African infants. South African Medical Journal 50, 1124.Google ScholarPubMed
Serény, B. (1955). Experimental Shigella keratoconjunctivitis: a preliminary report. Acta microbiologica Academiae scientiarum hungaricae 2, 293.Google ScholarPubMed
Spence, L., Fauvel, M., Bouchard, S., Babuik, L. & Saunders, J. R. (1975). Test for reovirus-like agent. Lancet ii, 322.CrossRefGoogle Scholar
Spencer, I. W. F. & Coster, M. E. E. (1969). The epidemiology of gastro-enteritis in infancy. South African Medical Journal 43, 1391, 1438, 1446.Google Scholar
Wadström, T., Kettis, A. A., Habte, D., Holmgren, J.Meeuwisse, G., Möllby, R. & Söderlind, O. (1976). New enterotoxigenic bacteria isolated. British Medical Journal i, 1401.CrossRefGoogle Scholar