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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.
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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

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