Aetiology

Main causative organisims include:

• Campylobacter jejuni
• Shigella spp.
• Salmonella spp.
• E. coli
• Yersinia enterocolitica
• Clostridium difficile
• Vibrio cholera (1,2)

Types of bacteria responsible for acute gastroenteritis (AGE) vary according to the geographical area:

• in developing countries
  • epidemics are caused by Vibrio cholera but the most common bacterial agent is Shigella
• in Europe
  • Campylobacter, Salmonella spp., enteropathogenic E. coli (EPEC), andenteroaggregative E. coli (EAEC) are the most common agents
  • emergence of Clostridium difficile (Cd) as a cause of community-acquired diarrheal illness has been reported, but with a relatively low burden
• in Ecuador, sub-Saharan Africa, and South Asia,
  • Shigella is common
• in China
  • Salmonella spp. (8%), diarrheagenic E. coli (5%), Campylobacter jejuni (3%), and Aeromonasspp. (2%)
• in India
  • E.coli was the most common agent of AGE followed by Shigella
  • in around 34% of cases, 2 or more pathogens were responsible for the condition, with a predominant incidence in children younger than 2 years old

Around 80% cases of traveller’s diarrhoea were caused by bacterial pathogens.

• Escherichia col, enteroinvasive E. coli (EIEC), and EAEC are seen in majority of patients
• in addition, Campylobacter, Salmonella, and Shigella play a substantial role (1)

Reference:

• (1) Bruzzese E, Giannattasio A, Guarino A. Antibiotic treatment of acute gastroenteritis in children. F1000Research. 2018;7:193.
• (2) Churgay CA, Aftab Z. Gastroenteritis in children: Part 1. Diagnosis. Am Fam Physician. 2012;85(11):1059-62.