Abstract
Introducción
El rotavirus es la principal causa de diarrea grave en niños menores de 5 años, y ocasiona una elevada morbilidad y mortalidad a escala mundial. El objetivo de este trabajo ha sido conocer la epidemiología de los virus entéricos que se declaran en el Sistema de Notificación Microbiológica de Cataluña (SNMC), rotavirus y adenovirus 40-41, y valorar la importancia que tienen en el contexto de la enfermedad entérica.
Material y métodos
Se han revisado retrospectivamente las declaraciones que realizan los laboratorios de los hospitales que participan en el SNMC durante los años 1995-2002. Los casos de gastroenteritis aguda se han diagnosticado por detección de antígeno en heces. Las variables analizadas han sido: edad, sexo, mes y año de aislamiento. Como métodos estadísticos se han utilizado el test de la ?2 y test de Fisher; las proporciones se han comparado utilizando la prueba binomial y el nivel de significación estadística se ha establecido en 0,05.
Resultados
Se han detectado 6.708 (94,3%) rotavirus y 409 (5,7%) adenovirus 40-41. Las gastroenteritis agudas virales han presentado mayor morbilidad en niños pequeños menores de 2 años: el 76 y el 68% de rotavirus y adenovirus, respectivamente, se han concentrado en este grupo de edad. El rotavirus se ha aislado principalmente en invierno (68%), mientras que el adenovirus, aunque se ha presentado estable en todas las estaciones, ha sido más frecuente en otoño (35,2%). Respecto a las enteritis, bacterianas y virales, vigiladas en el SNMC, el rotavirus y el adenovirus han supuesto la segunda y la cuarta causa etiológica, respectivamente, en los niños menores de 5 años, después de Campylobacter y Salmonella.
Conclusiones
De los diferentes virus que pueden causar gastroenteritis aguda, hay otros virus con frecuencias elevadas, como calici-virus y astrovirus, que no se buscan sistemáticamente, por lo que hay que valorar las frecuencias con prudencia. A pesar de esto, el rotavirus es la principal causa de la gastroenteritis viral, y afecta principalmente a edades tempranas de la vida, sobre todo a niños de 1 a 11 meses, con un claro predominio en invierno. Respecto al adenovirus 40-41, se ha presentado preferentemente en niños menores de 2 años y con mayor frecuencia en otoño. La vacunación contra el rotavirus es prioritaria para poder disminuir el alto índice de morbilidad y mortalidad que ocasiona esta enfermedad.
Palabras clave: Rotavirus, Adenovirus entérico, Gastroenteritis viral
Abstract
Introduction
Rotavirus is the main cause of severe diarrhea in children aged less than 5 years, leading to elevated morbidity and mortality worldwide. The aim of the present study was to determine the etiology of enteric viruses reported to the Catalan Microbiology Notification System (CMNS) (rotavirus and adenovirus 40-41) and to evaluate the importance of these viruses in enteric disease.
Material and methods
We retrospectively reviewed the notifications made from 1995-2002 by the laboratories of hospitals participating in the CMNS. Cases of acute gastroenteritis (AGE) were diagnosed by antigen detection in stools. The variables analyzed were: age, sex, month, and year of isolation. Statistical analysis was performed using the X2 test and Fisher's test and proportions were compared using the binomial test. The level of statistical significance was set at 0.05.
Results
Rotavirus was detected in 6708 cases of AGE (94.3%) and adenovirus 40-41 in 409 (5.7%). Viral AGE produced greater morbidity in children aged less than 2 years with 76% of cases caused by rotavi-rus and 68% of those caused by adenovirus 40-41 occurring in this age group. Rotavirus was isolated mainly in winter (68%), while adenovi-rus, although stable throughout the seasons, was more frequent in autumn (35.2%). Of cases of bacterial and viral enteritis detected by the CMNS, rotavirus was the second etiological agent and adenovirus the fourth in children aged less than 5 years after Campylobacter and Salmonella.
Conclusions
Of the various viruses that can cause AGE, some are highly frequent, such as calcivirus and astrovirus, which are not systematically detected and consequently the frequencies reported in the present study should be interpreted with caution. Nevertheless, rotavirus is the main cause of viral AGE, affecting small children, especially infants aged 1-11 months, with a clear predominance in winter. Adenovirus 40-41 mainly affects children aged less than 2 years and is more frequent in autumn. Vaccination against rotavirus should be a priority to reduce the high rates of morbidity and mortality caused by this disease.
Key words: Rotavirus, Enteric adenovirus, Viral gastroenteritis
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