Bacterial infections cause most gastroenteritis cases in less affluent nations.
The most important causal agent in these countries is diarrhea-causing
(eg,enteropathogenic [EPEC], enterotoxigenic [ETEC], enteroaggregative [EAEC],enteroinvasive [EIEC], enterohemorrhagic [EHEC]).
Other bacteria that cause gastroenteritis less often include
Campylobacter, Aeromonas, Shigella,
play major roles in epidemics. Inseafood poisoning,
is associated with gastroenteritis.
Viral infections cause 30-40% of gastroenteritis cases in affluent countries.
Rotavirus accounts for about 3.5 million cases per year and as many as 110,000hospital admissions for diarrhea.
Rotavirus is the single most important cause of dehydrating diarrhea in both developed and developing countries. It produces severe diarrhea,accounting for most episodes in children younger than 2 years who requirehospitalization for diarrhea and dehydration.
Rotavirus incidence has a distinct seasonal pattern.
Rotavirus infection occurs most frequently in children aged 3-15 monthsand may occur in children as old as 24 months, although the vast majorityof children have acquired antibodies by that age.
Rotavirus is transmitted by fecal oral spread with secondary spread viarespiratory route.
Norwalk virus is responsible for outbreaks of gastroenteritis in older children andadults. Unlike rotavirus, which affects mainly children, the Norwalk virus causesillness in all age groups.
Enteric adenoviruses account for 5-20% of hospitalizations for acute diarrhea.Compared to rotavirus and Norwalk virus, enteric adenoviruses have a longer incubation period (ie, 8-10 d compared with 1-3 d), and the diarrhea associatedwith adenoviruses lasts longer (ie, 5-12 d compared with 5-7 d for rotavirus and1-2 d for Norwalk). Astroviruses and caliciviruses each account for 3-5%hospitalizations for acute diarrhea.
The most common bacterial agents in the United States are
has recently been shown to be an unrecognized cause of community-acquired diarrhea in infants in theUnited States.
affects approximately 2 million people in the UnitedStates annually.
is the most common cause of pseudomembranouscolitis, a condition often observed in patients who develop severe diarrhea during or following a course of antibiotics. Clindamycin is the most common antibiotic identified,although almost all antibiotics have been implicated.
species are the most frequent causeof gastroenteritis.