exudates and Diarrhea--Infantile

To describe the patterns of isolation of Aeromonas spp. and the resulting spectrum of infection, intestinal and extra-intestinal,from infants and children in an urban area in a hot and humid country from SoutheastAsia.. Retrospective review of all bacterial culture records from children below 16 years of age, from the Department of Medical Microbiology, University of Malaya Medical Centre, Kuala Lumpur, from January 1988 to December 1997. Review of all stool samples and rectal swabs obtained from children during the same period were carried out to ascertain the isolation rate of Aeromonas sp. from stools and rectal swabs. The case records of those with a positive Aeromonas culture were retrieved and reviewed.. During the study period, 84 culture samples were positive of Aeromonas spp. (stools 48, rectal swabs 36). During the same period, 1,352 stool samples were positive for at least one enteropathogen. Aeromonas spp. constituted 0.62% of all stool samples. Of the 61 cases reviewed,four patterns of colonization were observed: (a) 17 cases of mostly asymptomatic nursery newborns with a positive rectal swab; (b) 9 children with no diarrhoea; (c) 23 cases, of who seven were immunocompromised, had acute, brief watery diarrhoea without severe dehydration or disturbances of serum electrolytes. No chronic diarrhoea or bacteraemia was noted. (d) 12 cases had a mixed infection with a second enteropathogen isolated from stool samples. Three had chronic diarrhoea No extra-intestinal infection attributed to Aeromonas spp. was identified in this study.. Aeromonas was a rare cause of gastroenteritis in urban Malaysian children. It was isolated almost exclusively from gastro-intestinal tract, caused mostly by mild gastroenteritis with no serious complications. Asymptomatic stool carriage among newborns admitted to special care nursery and older children with no diarrhoea were observed.

Topics: Academic Medical Centers; Acute Disease; Aeromonas; Child; Child, Preschool; Chronic Disease; Diarrhea, Infantile; Feces; Gastroenteritis; Gram-Negative Bacterial Infections; Hospitals, Urban; Humans; Infant; Infant, Newborn; Malaysia; Population Surveillance; Retrospective Studies; Tropical Climate; Tropical Medicine; Urban Health

The objective of this study was to ascertain the extent changes have occurred in the epidemiology of human rotavirus electropherotypes from the same location 7 to 8 years after an earlier study. Genomic RNA profiles of rotaviruses from diarrhoeic children admitted to the Kuala Lumpur Hospital from April to December 1996 were determined by polyacrylamide gel electrophoresis and silver staining. A total of 179 group A rotaviruses were detected from 870 children: 175 with legible staining of all RNA segments were classified into 14 distinct electropherotypes (10 and 4 with long and short migration patterns respectively). In addition, the results revealed: high predominance of long pattern electropherotypes (94% of the total electropherotypes); most long electropherotypes with RNA profiles which all 11 RNAs migrated separately (8 of 10 electropherotypes); all short electropherotypes had segments 2 and 3 that co-migrated; presence of a very numerically dominant electropherotype (75% of all electropherotypes); frequent co-circulation of the dominant electropherotype-present throughout the study period--with other electropherotypes present for limited periods; sequential temporal appearances by similar electropherotypes. These observations were similar to that of an earlier study conducted in 1988/89. Nevertheless, the dominant electropherotype in the present study was different and not among the electropherotypes detected in the earlier study.

Topics: Diarrhea, Infantile; Electrophoresis, Polyacrylamide Gel; Feces; Humans; Infant; Infant, Newborn; Malaysia; RNA, Viral; Rotavirus; Rotavirus Infections; Silver Staining

Amongst 107 diarrheal cases studied a bacterial agent was isolated from 71 (66%) cases of which 60 (85%) were due to a single agent and the remaining 11 (15%) were of mixed infections. Enterotoxigenic Escherichia coli (ETEC) was isolated from 65 cases. Other pathogens isolated included Salmonella spp, Shigella spp and rotavirus. There was a higher isolation rate of ETEC from females and rotavirus from males. The infection rate was found to higher for the 0-2 year age group as compared to the 3-5 year age group. Amongst the ETEC isolated the STa 2 toxotype was the predominant type.

Topics: Child, Preschool; Developing Countries; Diarrhea, Infantile; Dysentery, Bacillary; Escherichia coli Infections; Escherichia coli O157; Female; Humans; Infant; Malaysia; Male; Rotavirus Infections; Salmonella Infections

A 12-month study was carried out on the molecular epidemiology of rotavirus in urban and suburban Malaysian children. Analysis of faecal samples from 973 hospitalized diarrhoeic children by polyacrylamide gel electrophoresis detected 268 rotaviruses (28%). All isolates were group A rotaviruses, which produced 22 electropherotypes: 16 (91.5%) with long RNA migration patterns and 6 (8.5%) with short patterns. One of the long-pattern electropherotypes was the predominant strain (71.1% of the total electropherotypes) isolated during this study. Although 3 other strains were detected sporadically over the study period, 16 others were present only during the first 7 months and 2 others were confined to the last 5 months. Long- and short-pattern electropherotypes were found to co-circulate extensively. There was a significant association of short-pattern electropherotypes with infection in older children. In addition, the prevalence of vomiting and mean duration of diarrhoea were significantly associated with different electropherotypes.

Topics: Child; Child, Preschool; Diarrhea, Infantile; Electrophoresis, Polyacrylamide Gel; Humans; Infant; Infant, Newborn; Malaysia; RNA, Viral; Rotavirus; Rotavirus Infections

Stool samples from 836 cases with diarrhea and acute gastroenteritis from the Pediatric ward, Penang General Hospital, were examined for Cryptosporidium oocysts. A dimethyl sulfoxide modified acid fast technique was used for the identification of the parasites. 36 samples or 4.3% were found to be positive for Cryptosporidium. The prevalence of infection was higher (2.39%) in children with diarrhea and vomiting than in children with acute gastroenteritis alone (0.8%). Stool examination and cultures from the Cryptosporidium positive samples revealed no other parasites, rotavirus or enteropathogenic bacteria. This suggests that Cryptosporidium may be an important agent in the causation of diarrhea in young children. A routine laboratory examination for the detection of Cryptosporidium in the search for causal agents of childhood diarrhea in our environment may, therefore, be significant.

Topics: Acute Disease; Animals; Cryptosporidiosis; Cryptosporidium; Diarrhea, Infantile; Feces; Female; Fever; Gastroenteritis; Humans; Infant; Malaysia; Male; Parasite Egg Count; Prevalence; Vomiting

Over a period of 2 months, 35 of 69 (51%) cases of juvenile diarrhoea studied in eastern Malaysia were associated with rotavirus excretion; rotavirus associated diarrhoea occurred most commonly in the 6-24 month age group. Polyacrylamide gel electrophoresis (PAGE) of genome ribonucleic acid showed that only 4 rotavirus electropherotypes could be detected. Of those, 2 predominated and 2 were detected only once each; one of these may have been a reassortment of the two predominant electropherotypes. Analysis of the clinical features of patients excreting rotavirus subgroup 1 or 2, determined by PAGE, demonstrated that rotavirus subgroup 1 was associated with more hypotonic dehydration and need for intravenous therapy: lethargy was significantly more common among those excreting rotavirus subgroup 2.

Topics: Child, Preschool; Dehydration; Diarrhea; Diarrhea, Infantile; Electrophoresis, Polyacrylamide Gel; Feces; Female; Humans; Infant; Malaysia; Male; Rotavirus; Rotavirus Infections

Topics: Child; Child, Preschool; Diarrhea; Diarrhea, Infantile; Feces; Female; Humans; Infant; Malaysia; Male; Microbial Sensitivity Tests; Penicillin Resistance; Vibrionaceae

Topics: Adult; Campylobacter fetus; Campylobacter Infections; Child; Child, Preschool; Diarrhea; Diarrhea, Infantile; Humans; Infant; Malaysia

Topics: Acute Disease; Diarrhea, Infantile; Gastroenteritis; Humans; Infant; Malaysia

Topics: Animals; Cattle; Diarrhea, Infantile; Female; Food Hypersensitivity; Humans; Infant; Infant, Newborn; Malaysia; Male; Milk Proteins

Pneumonia and diarrhoeas are an important cause of toddler mortality and morbidity in developing countries. Of the 147 children admitted to the University Hospital at Kuala Lumpur in 1971 for pneumonia and diarrhoeas 50 (34%) were found to be suffering from protein-calorie malnutrition of varying degrees of severity. The malnourished children tended to come from poorer homes, and to have a larger number of siblings born in rapid succession when compared with normal weight children. Anemia was more common among the malnourished children. The interaction of infection and malnutrition and the social implications of these diseases are important. It is vital that hospitals in developing countries promote health in addition to their traditional curative role.

Topics: Anemia; Body Weight; Child, Preschool; Developing Countries; Diarrhea, Infantile; Family Characteristics; Hospitalization; Humans; Immunization Schedule; Infant; Infant Mortality; Infant Nutritional Physiological Phenomena; Life Style; Malaysia; Pneumonia; Protein-Energy Malnutrition; Socioeconomic Factors

Topics: Age Factors; Anti-Bacterial Agents; Child; Child, Preschool; Diarrhea; Diarrhea, Infantile; Enterobacteriaceae Infections; Escherichia coli; Escherichia coli Infections; Ethnicity; Feces; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male