Multiplex PCR Based Epidemiological Study for the Causes of Acute Diarrheal Disease in Adults Living in Jeju Island

Kyutaeg Lee1   Dae Soon  Kim2   Moo Sang  Chong3*   

1 Department of Laboratory Medicine, Cheju Halla General Hospital
2 Infection Control Service Team, Cheju Halla General Hospital
3 Department of Clinical Pathology, Cheju Halla University, Jeju

* Corresponding author: Tel: +82-64-741-6732, Fax: +82-64-741-6729, E-mail: chong@chu.ac.kr

Abstract

Background: We attempted to determine the characteristics of diarrheal pathogens according to species,seasonal variations, and patient age using multiplex PCR for the epidemiologic study of diarrheal disease in Jeju Island.

Methods: From March 2015 to Feb 2017, stool specimens were collected from 537 diarrheal patients older than 16 years. Multiplex PCR was used to identify pathogens and found Group A Rotavirus, enteric Adenovirus, Norovirus GI/GII, Astrovirus, Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp.,Clostridium difficile toxin B (CDB), Clostridium perfringens,Yersinia enterocolitica, Aeromonas spp.,Escherichia coli O157:H7, and verocytotoxin-producing E. coli (VTEC).

Results: Pathogens were isolated from 221 of 537 samples (41.2%); 9.3% were positive only for viral pathogens; 30.2%, only for bacterial pathogens; and 1.7%, for both viral and bacterial pathogens. Bacteria were more prevalent in spring, summer, and autumn,but viral pathogens were more prevalent in winter.Overall prevalence were Campylobacter spp. (26.7%),Clostridium perfringens (23.9%); Norovirus GII (11.4%), CDB (8.2%), Aeromonas spp. (6.3%),Group A Rotavirus (5.1%), Salmonella spp. (3.9%),Astrovirus (3.9%), Norovirus GI (3.1%), Vibrio spp (2.7%), enteric Adenovirus (1.6%), Shigella spp.(1.2%), VTEC (1.2%), and Yersinia enterocolitica (0.4%). Group A Rotavirus and Norovirus GII were more prevalent in winter and early spring. Campylobacter spp., CDB, and C. perfringens were detected frequently, without seasonal variation.

Conclusion: Bacterial pathogens are more prevalent than viruses in acute diarrhea in adults living in Jeju Island, especially in spring, summer, and autumn. Viral pathogens are prevalent in winter. Campylobacter spp., CDB, and Clostridium perfringens are the major pathogens occurring without seasonal variations. These data will be helpful in identifying diarrheal pathogens and for treatments and prevention strategies.(Ann Clin Microbiol 2018;21:1-7)

Figures & Tables

Figure 1. Sample distribution of acute diarrheal disease test according to patient’s ages. Jeju region, 2015.3-2017.2.