Pramita G Dwipoerwantoro, Diana Rahmi, Nastiti Kaswandhani
OBJECTIVE : Many studies have yielded critical new insights into the microbial determinants of diarrheal disease among children; however, there are limited data on the microbial determinates of acute diarrhea among children under-five in Indonesia. This study is specially targeted to determine the prevalence of various bacterial enteropathogens causing acute childhood diarrhea and to find out their respective pattern of clinical features. METHODS : This cross-sectional study included 60 children aged 1 to 5 years with acute diarrhea who were hospitalized in Dr Cipto Mangunkusumo hospital between 1 June and 30 November 2015. Clinical examinations and blood routine tests were performed in all the subjects. Stool specimens were collected and tested for bacterial enteropathogens using real-time PCR and routine stool cultures. RESULTS : Of 60 children enrolled, 69% aged 1-3 years, 53% were wasted to severe wasted, 96,7% from low income families and 69% had middle-maternal education. The clinical features were fever (93%), mucous stool (87%), vomits (63%), and abdominal pain (60%); however, infectious acute diarrhea typically had less-than-five-times diarrhea per-day (p<0.018). Twenty-nine from sixty (48,3%) children had pathogen bacteria detected by real-time PCR compare to that of only 3% by routine stool culture. They were infected by EPEC (23%), Campylobacter jejuni (17%), EIEC (13%) and ETEC (7%) respectively. Three subjects with two coinfections and two subjects with three coinfections. CONCLUSIONS : Approximately half of the children with acute diarrhea were infected by enteropathogenic bacteria. The hospital needs to improve its diagnostic apparatus in order to accurately-detect the etiology of diarrhea.