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Etiology of acute gastroenteritis in children requiring hospitalization in the Netherlands

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Abstract

Infectious gastroenteritis causes a considerable burden of disease worldwide. Costs due to gastroenteritis are dominated by the hospitalized cases. Effective control of gastroenteritis should be targeted at the diseases with the highest burden and costs. For that, an accurate understanding of the relative importance of the different bacterial, viral, and parasitic pathogens is needed. The objective of the present study was to determine the incidence and etiology of gastroenteritis requiring hospital admission in the Netherlands. Six hospitals enrolled patients admitted with gastroenteritis for approximately one year over the period May 2008 to November 2009. Participants provided questionnaires and a fecal sample, and the hospital filled out a clinical questionnaire. In total, 143 children hospitalized for gastroenteritis and 64 matched controls were included in the study. Overall incidence of gastroenteritis requiring hospitalization was estimated at 2.92 per 1,000 children aged 0–17 years per year, with the highest incidence in children under the age of 5 years. The full diagnostic panel of pathogens could be studied in fecal samples of 96 cases. One or more pathogens were found in 98% of these cases. Co-infections were observed relatively often (40%). Viruses were detected in 82% of the samples, with rotavirus being most common (56%), bacteria in 32% and parasites in 10%. The present study emphasizes the importance of viral pathogens, especially rotavirus, in hospitalizations of children with gastroenteritis. Policies to reduce (costs of) hospitalizations due to gastroenteritis should therefore be first targeted at rotavirus.

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Acknowledgement

The authors would like to thank the staff of the hospitals for inclusion of the patients in the present study. We thank Hein Sprong, Max Heck and Ed Kuijper for the subtyping of Cryptosporidium and G. lamblia, Salmonella, and C. difficile, respectively. We are grateful to Carolien de Jager for her assistance in the preparation and during the execution of the study. Finally the authors thank Wilfrid van Pelt for his help in calculating the incidence figures and for critically reading the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, PBox 1, 3720 BA, Bilthoven, The Netherlands

    I. H. M. Friesema, E. Duizer, L. M. Kortbeek, D. W. Notermans, M. P. G. Koopmans & Y. T. H. P. van Duynhoven

  2. Department of Research & Development, Laboratory for Infectious Diseases, van Ketwich Verschuurlaan 92, 9721 SW, Groningen, The Netherlands

    R. F. de Boer & A. M. D. Kooistra-Smid

  3. Department of Pediatrics, Isala Hospital, PBox 10500, 8000 GM, Zwolle, The Netherlands

    O. F. Norbruis

  4. Department of Pediatrics, Maasstad Hospital, PBox 9100, 3007 AC, Rotterdam, The Netherlands

    D. D. L. Bezemer

  5. Department of Pediatrics, Catharina Hospital, PBox 1350, 5602 ZA, Eindhoven, The Netherlands

    H. van Heerbeek

  6. Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, PBox 95500, 1090 HM, Amsterdam, The Netherlands

    R. N. J. van Andel

  7. Department of Pediatrics, Gelderse Vallei Hospital, PBox 9025, 6710 HN, Ede, The Netherlands

    J. G. van Enk

  8. Department of Virology, Erasmus MC-Sophia Children’s Hospital, PBox 2040, 3000 CA, Rotterdam, The Netherlands

    P. L. A. Fraaij & M. P. G. Koopmans

Authors
  1. I. H. M. Friesema
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  2. R. F. de Boer
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  3. E. Duizer
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  4. L. M. Kortbeek
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  5. D. W. Notermans
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  6. O. F. Norbruis
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  7. D. D. L. Bezemer
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  8. H. van Heerbeek
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  9. R. N. J. van Andel
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  10. J. G. van Enk
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  11. P. L. A. Fraaij
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  12. M. P. G. Koopmans
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  13. A. M. D. Kooistra-Smid
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  14. Y. T. H. P. van Duynhoven
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Corresponding author

Correspondence to I. H. M. Friesema.

Additional information

This work was completed on behalf of the GEops Working Group. Additional members of the GEops Working Group are: D Hoek1, S Brandes1, J Roelfsema1, B van der Veer1, H Vennema1, G Wisselink2, E van Zanten2, MC Scholts2, K van Slochteren2, R Reimink3, P Bloembergen3, WDH Hendriks4, CJ Miedema5, MWH Wulf5, MDM Bron-Prenen6, J Bogerman8, MFC Beersma8. Superscript numbers refer to affiliations.

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Friesema, I.H.M., de Boer, R.F., Duizer, E. et al. Etiology of acute gastroenteritis in children requiring hospitalization in the Netherlands. Eur J Clin Microbiol Infect Dis 31, 405–415 (2012). https://doi.org/10.1007/s10096-011-1320-0

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