ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Performance of Stool-testing Recommendations for Acute Gastroenteritis When Used to Identify Children With 9 Potential Bacterial Enteropathogens.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Clinical Impact of Multiplex Molecular Diagnostic Testing in Children With Acute Gastroenteritis Presenting to an Emergency Department: A Multicenter Prospective Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- An Evaluation of Enteropathogen-Specific Disease Severity and Duration in Children With Acute Gastroenteritis.Pediatric emergency care · 2025Article
- Parent and Clinician Perspectives on Diagnostic Testing for Children With Diarrhea: A Qualitative Study.JAMA network open · 2025Article
- Factors Associated With Actionable Gastrointestinal Panel Results in Hospitalized Children.Hospital pediatrics · 2023Article
- Prevalence ofChildren (Basel, Switzerland) · 2022Article
- Enteric Pathogen Testing Importance for Children with Acute Gastroenteritis: a Modified Delphi Study.Microbiology spectrum · 2022Article
- Clinical Profiles of Childhood Astrovirus-, Sapovirus-, and Norovirus-Associated Acute Gastroenteritis in Pediatric Emergency Departments in Alberta, 2014-2018.The Journal of infectious diseases · 2022Article
- Global epidemiology of campylobacteriosis and the impact of COVID-19.Frontiers in cellular and infection microbiology · 2022Review
- Microbial Etiologies and Clinical Characteristics of Children Seeking Emergency Department Care Due to Vomiting in the Absence of Diarrhea.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Amino Acid-Based Diet Prevents Lethal Infectious Diarrhea by Maintaining Body Water Balance in a MurineNutrients · 2021Article
- Utilizing Probiotics for the Prevention and Treatment of Gastrointestinal Diseases.Frontiers in microbiology · 2021Review
- Foodborne Pathogenic Vibrios: Antimicrobial Resistance.Frontiers in microbiology · 2021Review
- [Value of serum procalcitonin combined with soluble triggering receptor expressed on myeloid cells-1 in the differential diagnosis of bacterial and viral diarrhea in children].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2020Article
- Childhood diarrhoeal diseases in developing countries.Heliyon · 2020Review
- The Impact of Age and Pathogens Type on the Gut Microbiota in Infants with Diarrhea in Dalian, China.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2020Article
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe ability to identify bacterial pathogens that necessitate specific clinical management or public health action in children with acute gastroenteritis is crucial to patient care and public health. However, existing stool-testing guidelines offer inconsistent recommendations, and their performance characteristics are unknown. We evaluated 6 leading gastroenteritis guidelines (eg, those of the Centers for Disease Control and Prevention and Infectious Disease Society of America) that recommend when to test children's stool for bacterial enteropathogens.
methodsVia 2 emergency departments in Alberta, Canada, we enrolled 2447 children <18 years old who presented with ≥3 episodes of diarrhea and/or vomiting in a 24-hour period. All participants were tested for 9 bacterial enteropathogens: Aeromonas, Campylobacter, Escherichia coli O157, other Shiga toxin-producing E. coli, enterotoxigenic E. coli, Salmonella, Shigella, Vibrio, and Yersinia. Patient data gathered at the index visit were used to determine whether guidelines would recommend testing. Sensitivity and specificity to recommend testing for children with bacterial enteropathogens were calculated for each guideline.
resultsOutcome data were available for 2391 (97.7%) participants, and 6% (144/2391) of participants tested positive for a bacterial enteropathogen. Guideline sensitivity ranged from 25.8% (95% confidence interval [CI] 18.7-33.0%) to 66.9% (95% CI 59.3-74.6%), and varied for individual pathogens. Guideline specificity for all bacterial enteropathogens ranged from 63.6% (95% CI 61.6-65.6%) to 96.5% (95% CI 95.7-97.2%).
conclusionsNo guideline provided optimally balanced performance. The most sensitive guidelines missed one-third of cases and would drastically increase testing volumes. The most specific guidelines missed almost 75% of cases.
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