Acute diarrhoea in children treated in an outpatient setting in Athens, Greece

Objective: To describe the epidemiology and aetiology of acute diarrhoea am ong children treated exclusively in an outpatient setting in Greece. Methods: During 1999, children with acute diarrhoea who attended the emerge ncy department of our hospital were prospectively studied. Patients requiri ng hospitalization were excluded. Stool specimens were tested microscopical ly, for bacterial enteropathogens by standard and selective medium cultures and for rotavirus and adenovirus by latex agglutination test. Results: One hundred and thirty-two children (median age: 2 years) were inc luded in the study; an enteropathogen was detected in 63 (48%) of them. Iso lates included rotavirus (19 patients), Salmonella sp (12), Campylobacter s p (10), Aeromonas sp (9). enteropathogenic Escherichia coli (6), adenovirus (6), Giardia lamblia (4), Yersinia enterocolitica (2) and Shigella sp (1). Half of the bacterial cases occurred from August to October, and two rotav irus-associated peaks occurred during February and August. Acute diarrhoea caused by viruses affected exclusively children under six years of age, mai nly those attending day care centres. Macroscopic blood in stools was repor ted only among patients with a bacterial infection. Socioeconomic character istics were not helpful in differentiating disease due to specific enteropa thogens. Conclusions: Bacterial enteropathogens account for a significant proportion of acute diarrhoea in children treated in the outpatient setting in Greece . Rotavirus is also a frequent cause affecting mostly younger children and those attending day care centers. The presence of blood in stools and the s easonality of bacterial infections may enable their presumptive diagnosis. (C) 2001 The British Infection Society.