Community-acquired Escherichia coli Enteritis in Korean Children: The Clinical Application of a Stool Polymerase Chain Reaction Assay

Application of a Multiplex Polymerase Chain Reaction Test for Diagnosing Bacterial Enteritis in Children in a Real-Life Clinical Setting

This study aimed to determine the subjects for bacterial multiplex polymerase chain reaction (mPCR) testing and to interpret the mPCR test results based on patients' clinical symptoms and diagnoses. The medical records of 710 pediatric patients who underwent a bacterial mPCR test were retrospectively reviewed. Clinical characteristics and mPCR test results were compared between patients with positive (n = 199) and negative mPCR test results (n = 511) and between patients with invasive pathogens (n = 95) and toxigenic pathogens (n = 70). Positive mPCR test results were significantly associated with older age (p < 0.001), diagnosis of acute gastroenteritis (p = 0.021), presence of hematochezia (p < 0.001), and absence of cough (p = 0.004). The diagnosis of acute gastroenteritis (p = 0.003), presence of fever (p = 0.027) and diarrhea (p = 0.043), and higher C-reactive protein levels (p = 0.025) were significantly associated with the identification of invasive pathogens in patients with positive mPCR test results. Thus, selective bacterial mPCR testing should be performed based on the patients' clinical symptoms and diagnoses, and the results should be interpreted in consideration with identified pathogens.

Causes of acute gastroenteritis in Korean children between 2004 and 2019

Since the 2000s, the major causes of acute gastroenteritis in children in Korea have been identified by classifying the pathogens into viruses, bacteria, and protozoa. For viruses, the detection rate is 20%-30%, and norovirus is being increasingly detected to account for the majority of viral gastroenteritis cases. In addition, despite the dissemination of the rotavirus vaccine, many rotavirus infections persist, and its seasonal distribution is changing. The detection rate of bacterial pathogens is 3%- 20%, with Escherichia coli and Salmonella spp. infections being the most common, while the incidences of Bacillus cereus and Campylobacter spp. infections are gradually increasing. Owing to intermittent outbreaks of gastroenteritis caused by individual bacteria as well as the inflow of causative bacteria, such as E. coli, Vibrio spp., and Campylobacter spp., from overseas, continuous surveillance of and research into the characteristics and serotypes of each bacterium are needed.

Self-disinfecting surfaces and infection control

According to World Health Organization, every year in the European Union, 4 million patients acquire a healthcare associated infection. Even though some microorganisms represent no threat to healthy people, hospitals harbor different levels of immunocompetent individuals, namely patients receiving immunosuppressors, with previous infections, or those with extremes of age (young children and elderly), requiring the implementation of effective control measures. Public spaces have also been found an important source of infectious disease outbreaks due to poor or none infection control measures applied. In both places, surfaces play a major role on microorganisms' propagation, yet they are very often neglected, with very few guidelines about efficient cleaning measures and microbiological assessment available. To overcome surface contamination problems, new strategies are being designed to limit the microorganisms' ability to survive over surfaces and materials. Surface modification and/or functionalization to prevent contamination is a hot-topic of research and several different approaches have been developed lately. Surfaces with anti-adhesive properties, with incorporated antimicrobial substances or modified with biological active metals are some of the strategies recently proposed. This review intends to summarize the problems associated with contaminated surfaces and their importance on infection spreading, and to present some of the strategies developed to prevent this public health problem, namely some already being commercialized.