Acute bacterial gastroenteritis: 729 cases recruited by a Primary Care national network

Objective: To determine the main clinical and epidemiological features of bacterial gastroenteritis in our environment. Patients and methods: An observational study of a Spanish population in 17 Autonomous Communities. Questionnaires of children with a stool positive culture to bacteria were collected over a one year period. A bivariate analysis was performed on the variables involved, as well as two multivariate models (for antibiotic treatment variables, and comparison Campylo-bacter/Salmonella). Results: A total of 729 bacterial gastroenteritis episodes were recorded in the 17 Spanish autonomous regions, of which 41.2% were girls and 58.8% boys. The median age was 3.41 years old (interquartile range 1.55 to 6.72). The bacteria isolated were 59.9% Campylobacter, 31.8% non-Typhi Salmonella, 2.7% Aeromonas, 2.4% Yersinia, and 1.5% had more than one strain. Most infections (70%) were direct contacts, and food poisoning was less probable (25.9%). Salmonella is significantly less frequent than Campylobacter in children under the age of 3 years (adjusted OR 0.61; 95% CI: 0.43 to 0.86; P = .005), and Campylobacter is more frequent in rural areas (adjusted OR 1.48; 95% CI: 1.07 to 2.07; P = .012). Antibiotic was prescribed in 33.2% of cases. There was a greater significant difference if stools contained blood or mucus (adjusted OR 1.53; 95% CI: 1.04 to 2.27; P = .031), if the symptoms lasted more than 7 days (adjusted OR 2.81; 95% CI: 2.01 to 3.93; P < .000), or if the child was admitted to hospital (adjusted OR 1.95; 95% CI: 1.08 to 3.52; P = .027). Conclusions: The aetiology of bacterial diarrhoea in paediatrics is typical of that of a developed country. The transmission mechanism is mainly direct, and more cases than appropriate are treated with antibiotics. (C) 2016 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. All rights reserved.