Conventional and molecular methods in the diagnosis of community-acquired diarrhoea in children under 5 years of age from the north-eastern region of Poland

• The causative agents of community-acquired acute diarrhoea in children were determined.
• The number of campylobacteriosis cases in Poland may be significantly underestimated.
• Clostridium difficile may cause or contribute to diarrhoea in 14.8% of children aged >1 year.

SummaryObjectivesThe purpose of this study was to determine the main causative agents of community-acquired acute diarrhoea in children using conventional methods and PCR.MethodsStool samples were collected from 100 children under 5 years of age with acute diarrhoea during the autumn–winter period of 2010–2011. Rotaviruses and adenoviruses were detected by the stool antigen immunoassay, and Salmonella spp, Campylobacter spp, Shigella spp, Yersinia enterocolitica, Yersinia pseudotuberculosis, Clostridium difficile, enterotoxigenic Bacteroides fragilis (ETBF), and diarrhoeagenic Escherichia coli were detected by culture methods and PCR.ResultsOverall, enteropathogens were identified in 73% of the children. Bacteria, viruses, and mixed infections were noted in 37%, 24%, and 12% of diarrhoeal cases, respectively. The most common enteric pathogens were rotaviruses (31%), followed by C. difficile (17%), Campylobacter jejuni (13%), Salmonella spp (11%), and atypical enteropathogenic Escherichia coli (aEPEC) strains (10%). Compared with culture methods, PCR increased the overall detection frequency of the bacterial enteropathogens by 4%.ConclusionsThe high prevalence of Campylobacter jejuni suggests that the number of campylobacteriosis cases in Poland may be underestimated; this pathogen should be investigated routinely in children with diarrhoea. Moreover, C. difficile might be considered a causative or contributing agent of diarrhoea in 14.8% of children aged >1 year.