Abstract
Pediatric gastroenteritis is most commonly caused by virus, with rotavirus causing the largest proportion of infections and the most severe forms. Enteric adenovirus and astrovirus are also important pathogens. Norovirus is rarely diagnosed but probably fairly common. Campylobacter and Salmonella are the most common bacterial diarrheal pathogens. The role of diarrheagenic Escherichia coli is probably underestimated, but, with the exception of the Shiga toxin-producing E. coli, the different pathogenic groups are ill defined. Much work is needed to define these groups and their role in disease. No algorithms based on simple clinical or laboratory data are useful to guide the physician as to which stools to investigate for diarrheal pathogens, or which to examine only for virus, bacteria or parasites. New nonculture molecular or immunological methods may be used to screen stools rapidly for pathogens, but the results need to be confirmed by other methods including subtyping in order to be able to recognize, investigate and control outbreaks.
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The findings and conclusions in this paper are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Financial & competing interests disclosure
The authors have no relevant financial interests including employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties related to this manuscript
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