The structure of intestinal infections in the infectious department

Background. Every year in Russia, the number of patients with acute intestinal infections of unknown etiology remains at a significant level.

Aim. To determine the current etiological structure and features of the clinical course of acute intestinal infections in the infectious diseases department of a city hospital.

Material and methods. For the period from 2017 to 2019, 181 patients with manifestations of acute intestinal infections, who were in the infectious departments of the “City Hospital No. 5, Barnaul”, were examined. The age of the patients ranged from 18 to 76 years (mean age 35.4±14.8 years), including 55.6% females and 44.4% males. The study of biological material from patients (feces) was performed using polymerase chain reaction with hybridization-fluorescence detection, bacteriological examination and serological method (indirect hemagglutination reaction) for the presence of antibodies to pathogens of acute intestinal infections (in blood serum). The statistical significance of differences was assessed by the χ2 test.

Results. Out of 181 patients with acute intestinal infections, 108 (59.7%) had the etiology of the disease, of which 54 (50%) patients had an infection of viral etiology, including in the form of monoinfection — in 45 cases, and caused by a combination of two viruses — in 9 cases. In 41 (38%) patients, acute intestinal infections of bacterial etiology were diagnosed, including a combination of two pathogens in 4 cases, and three pathogens in 1 case. 13 patients had viral-bacterial intestinal infections. As a result of the survey, on the existing list of laboratory tests, the etiology of intestinal infection was not established in 73 (40.3%) patients. In patients with acute intestinal infection of bacterial etiology, the disease proceeded more severely, with higher body temperature and colitis, in patients with intestinal infection of viral etiology — with gastroenteritis.

Conclusion. A high proportion of intestinal infections of viral etiology (up to 50%) with etiological dominance of noroviruses has been established. Among the causative agents of bacterial acute intestinal infections, Campylobacter and Salmonella prevailed.