THE ETIOLOGY OF GASTROENTERITIS IN INFANTS AND CHILDREN, WITH EMPHASIS ON THE OCCURRENCE OF SIMULTANEOUS MIXED VIRAL-BACTERIAL INFECTIONS

Abstract

Over a 3-year period, 117 episodes of gastroenteritis occurring in 112 children in North Carolina were studied virologically and bacteriologically. A bacterial agent alone and a viral agent alone were isolated in 25% and 12% of cases, respectively. Simultaneous mixed viral-bacterial infections occurred in another 12%. These findings are in accord with data reported by other workers in North America and Europe. There was a definite seasonal pattern: 82% of all viral isolations were in the summer months, and most of the cases of diarrhea without demonstrable pathogens occurred in winter. Bacterial pathogens, however, were isolated at a rather constant rate throughout the year. The peripheral white blood count was not found to be helpful in predicting the etiologic agent involved. A significantly greater excretion rate of all infectious agents was found in children 6 months old and younger (43 pathogens from the specimens of 51 patients) in comparison to that observed in the older age group (38 pathogens from the specimens of 66 patients). Also, twice as many simultaneous mixed viral-bacterial infections occurred in children under 6 months of age as in all other age groups together. The need for repeat bacterial cultures and the examination of both throat and anal specimens for maximal recovery of viral agents in cases of gastroenteritis is apparent.