BACKGROUND: Intestinal infections are a significant health issue; antibiotics are essential in treating acute intestinal infections. However, evidence in the literature shows that the excessive use of antibiotics has created many threats to human health. This work aimed to study the impact of apple pectin in combination with antibiotics on treating patients with amebiasis and dysentery.
METHODS: Patients suffering from acute intestinal diseases (amebiasis and dysentery) were treated with traditional antibiotic therapy and a new formula containing antibiotics with low and high methoxylated apple pectin in a randomized block design. Four clinical trials were performed at the Infection Disease Hospital from 1998 until 2013.
RESULTS: The study demonstrated that the antibiotic-pectin formulae (APF) significantly reduced the severity of acute intestinal infection diseases and allowed patients to recover faster than conventional treatment. APF reduced the patient\'s stay in the hospital by 3.0 ± 1.0 days. The clinical trial findings demonstrated that applying APF in intestinal infection diseases helped maintain a constant concentration of the antibiotic in the blood and accelerated the clinical recovery of the patients.
CONCLUSIONS: It was concluded that using pectin with antibiotics could improve clinical outcomes in patients with acute infectious diseases. Research on elucidating the mechanisms of pectin digestion in the colon, polyphenol content, and its role in dysbiosis recovery, etc., is also considered.

In recent years, the pig industry in Xinjiang, China, has been severely impacted by outbreaks of porcine epidemic diarrhea (PED), despite vaccination efforts. In this study, we investigated the genetic characteristics of currently prevalent porcine epidemic diarrhea virus (PEDV) strains in the region. We collected 548 samples from animals with suspected PED on large-scale pig farms in Xinjiang. Of these, 258 tested positive for PEDV by RT-PCR, yielding an overall positivity rate of 47.08%. S1 gene sequencing and phylogenetic analysis were conducted on 23 randomly selected RT-PCR-positive samples. Three endemic strains of PEDV (PEDV/CH/XU/2020, PEDV/CH/XK/2020, and PEDV/CH/XA/2020) were isolated, and their complete genome sequences were analyzed for evidence of genetic recombination. Sequence comparison of the S gene indicated significant variations in the S1 gene of the Xinjiang strains compared to the vaccine strains CV777, AJ1102, and LWL, with 90.2%-98.5% nucleotide sequence identity. Notably, both the N-terminal and C-terminal domains of the S protein showed significant variation. Genetic evolutionary analysis identified the GIIa subtype as the dominant genotype among the epidemic strains in Xinjiang. Recombination analysis revealed inter-subtype recombination events in the PEDV/CH/XK/2020 and XJ1904-34 strains. These findings highlight the extensive genetic variation in the predominant GIIa genotype of PEDV in Xinjiang, which does not match the genotype of the currently used vaccine strains. These data may guide further efforts toward the development of effective vaccines for the control of PED.

OBJECTIVE: The objective was to assess the association between nutritional and clinical characteristics and quantitative PCR (qPCR)-diagnosis of bacterial diarrhoea in a multicentre cohort of children under 2 years of age with moderate to severe diarrhoea (MSD).
METHODS: A secondary cross-sectional analysis of baseline data collected from the AntiBiotics for Children with Diarrhoea trial (NCT03130114).
METHODS: Children with MSD (defined as >3 loose stools within 24 hours and presenting with at least one of the following: some/severe dehydration, moderate acute malnutrition (MAM) or severe stunting) enrolled in the ABCD trial and collected stool sample.
METHODS: June 2017-July 2019.
METHODS: None.
METHODS: Likely bacterial aetiology of diarrhoea. Secondary outcomes included specific diarrhoea aetiology.
RESULTS: A total of 6692 children with MSD had qPCR results available and 28% had likely bacterial diarrhoea aetiology. Compared with children with severe stunting, children with MAM (adjusted OR (aOR) (95% CI) 1.56 (1.18 to 2.08)), some/severe dehydration (aOR (95% CI) 1.66 (1.25 to 2.22)) or both (aOR (95% CI) 2.21 (1.61 to 3.06)), had higher odds of having likely bacterial diarrhoea aetiology. Similar trends were noted for stable toxin-enterotoxigenic Escherichia coli aetiology. Clinical correlates including fever and prolonged duration of diarrhoea were not associated with likely bacterial aetiology; children with more than six stools in the previous 24 hours had higher odds of likely bacterial diarrhoea (aOR (95% CI) 1.20 (1.05 to 1.36)) compared with those with fewer stools.
CONCLUSIONS: The presence of MAM, dehydration or high stool frequency may be helpful in identifying children with MSD who might benefit from antibiotics.

The results of autopsies performed in the pathological department of the Infectious Diseases Hospital named after. S.P. Botkin during the siege of Leningrad (from September 8, 1941 to January 27, 1944). The structure of diseases of the deceased varied during different periods of the siege of Leningrad. In the first period (September-December 1941), diphtheria, dysentery, measles, typhoid fever, and scarlet fever prevailed among the diseases. The most common causes of death in the second period (April-December 1942) were typhus, dysentery, tuberculosis, lobar pneumonia, and typhoid fever. Nosological structure in the third period of the blockade (January 1943 - January 1944): tuberculosis, dysentery, cachexia, lobar pneumonia, infectious jaundice. The discrepancy between clinical and morphological diagnoses is most often noted for the following nosology: pulmonary tuberculosis, typhoid fever, pneumonia, stomach and hepatopancreatobiliary cancer, measles, influenza. The first period of the blockade was distinguished by a high specific proportion of examination of children\'s bodies - 51.2% of all autopsies; in subsequent periods, the specific share of autopsies of deceased adults (20-59 years) increased to 76.2%. The difference in the nosological structure and age groups of those who died during different periods of the siege of Leningrad was determined by the epidemiological situation in the city, social and living conditions and medical and organizational factors. Conducted in the pathological-anatomical department of the hospital named after. S.P. Botkin during the siege of Leningrad, pathological studies made it possible to timely establish the causes of deaths and identify the peculiarities of the course of infectious diseases against the background of cachexia. Regularly held clinical and anatomical conferences contributed to the reduction of defects in the diagnosis and treatment of infectious diseases.
Изучены результаты аутопсий, проведенных в патолого-анатомическом отделении инфекционной больницы им. С.П. Боткина во время блокады Ленинграда (с 8 сентября 1941 по 27 января 1944 г.). Проанализированы данные 855 протоколов вскрытий умерших мирных жителей. Структура заболеваний умерших различалась в разные периоды блокады Ленинграда. В I периоде (сентябрь—декабрь 1941 г.) среди заболеваний превалировали дифтерия, дизентерия, корь, брюшной тиф, скарлатина. Наиболее частыми причинами смерти во II периоде (апрель—декабрь 1942 г.) явились сыпной тиф, дизентерия, туберкулез, крупозная пневмония, брюшной тиф. Нозологическая структура в III периоде блокады (январь 1943 г. — январь 1944 г.): туберкулез, дизентерия, истощение, крупозная пневмония, инфекционная желтуха. Расхождение клинического и морфологического диагнозов наиболее часто отмечено по следующим нозологиям: туберкулез легких, брюшной тиф, пневмония, рак желудка и гепатопанкреатобилиарной зоны, корь, грипп. Первый период блокады отличался высокой удельной долей исследования тел детей — 51,2% от всех аутопсий; в последующие периоды увеличилась до 76,2% удельная доля аутопсий умерших зрелого возраста (20—59 лет). Различие нозологической структуры и возрастных групп умерших в разные периоды блокады Ленинграда обусловливалось эпидемиологической обстановкой в городе, социально-бытовыми условиями и медико-организационными факторами. Проводившиеся в патолого-анатомическом отделении больницы им. С.П. Боткина во время блокады Ленинграда патоморфологические исследования позволяли своевременно устанавливать причины наступления летальных исходов и выявлять особенности течения инфекционных заболеваний на фоне истощения. Регулярно проводившиеся клинико-анатомические конференции способствовали редуцированию дефектов диагностики и лечения инфекционных заболеваний.

Acute childhood diarrhea is one of the leading causes of childhood morbidity and mortality in sub-Saharan African countries. Entamoeba histolytica and Giardia lamblia are the common cause of childhood diarrhea in the region. However, there are only few studies on protozoa causing diarrhea in sub-Saharan African countries. This study was conducted to investigate the relative prevalence and explore risk factors of E. histolytica and G. lamblia among diarrheic children of under 5 years in a public hospital of Ethiopia. A retrospective study was conducted among diarrheic children at Hiwot Fana hospital, Ethiopia. Records of all diarrheic children less than 5 years who had sought medical treatment in the hospital from September 1, 2020 to December 31, 2022 were included. Data were collected from 1257 medical records of the children using a structured data-collection format. Data were entered into an Excel sheet and exported into SPSS version 22 for data processing and analysis. Descriptive statistical tests, Chi-square, and logistic region analysis were applied to determine predictors of protozoa infections. Of the 1257 cases, 962 (76.5%) had watery diarrhea and the remaining 239 (19.0%) had dysentery. The combined prevalence of E. histolytica and G. lamblia among diarrheic children was 11.8% (95% CI: 9.6-13.4). As the age of children increased, the frequency of these two protozoan infections was significantly increased compared to children with other causes. There were more diarrhea cases during the summer season including those associated with E. histolytica and G. lamblia. This study revealed that 1 in 10 causes of diarhhea among young children in the study area was likely caused by E. histolytica and G. lamblia. These findings call for community-based safe water and food safety interventions in order to reduce childhood diarrhea caused by protozoan infections in resource-poor settings.

UNASSIGNED: Shigella is a major cause of diarrhea in young children worldwide. Multiple vaccines targeting Shigella are in development, and phase 3 clinical trials are imminent to determine efficacy against shigellosis.
UNASSIGNED: The Enterics for Global Health (EFGH) Shigella surveillance study is designed to determine the incidence of medically attended shigellosis in 6- to 35-month-old children in 7 resource-limited settings. Here, we describe the microbiological methods used to isolate and identify Shigella. We developed a standardized laboratory protocol for isolation and identification of Shigella by culture. This protocol was implemented across all 7 sites, ensuring consistency and comparability of results. Secondary objectives of the study are to determine the antibiotic resistance profiles of Shigella, compare isolation of Shigella from rectal swabs versus whole stool, and compare isolation of Shigella following transport of rectal swabs in Cary-Blair versus a modified buffered glycerol saline transport medium.
UNASSIGNED: Data generated from EFGH using culture methods described herein can potentially be used for microbiological endpoints in future phase 3 clinical trials to evaluate vaccines against shigellosis and for other clinical and public health studies focused on these organisms.

Objective: To understand the epidemiological characteristics of diarrheagenic Escherichia (E. ) coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai and provide evidence for the development of disease control strategies. Methods: Based on multistage systematic sampling, diarrhea surveillance was conducted in 22 sentinel hospitals in Shanghai, the information about cases\' demographic, clinical, and epidemiological characteristics were collected. Stool samples were collected for the detection and typing of diarrheagenic E. coli by local centers for disease control and prevention. The positive rate of diarrheagenic E. coli in different populations and seasons from 2014 to 2021 were analyzed. Statistical analysis was conducted by using χ2 test. Results: In 15 185 diarrhea cases, 8.05% (1 222/15 185) were positive for diarrheagenic E. coli. The positive rate was higher in men (8.74%, 684/7 824) than in women (7.31%, 538/7 361). The positive rate was highest in age group 15-29 years (9.14%, 335/3 665) and the annual positive rate was highest in 2021 (10.21%, 83/813), the differences were all significant (P<0.05). In the 1 264 strains of diarrheagenic E. coli analyzed through PCR, enterotoxingenic E. coli was the most frequently identified pathogen (50.24%, 635/1 264), followed by enteroadhesive E. coli (27.93%, 353/1 264), and enteropathogenic E. coli (21.36%, 270/1 264). The positive rate of diarrheagenic E. coli showed obvious seasonality with peak in summer (13.92%, 774/5 562) (χ2=495.73, P<0.001). Conclusions: Diarrheagenic E. coli has become a prominent pathogen in infectious diarrhea cases in Shanghai, the disease can occur all the year round with incidence peak during summer and autumn. Predominant subtypes included enterotoxingenic E. coli, enteroadhesive E. coli and enteropathogenic E. coli. Targeted prevention and control strategies are needed for diarrheagenic E. coli-induced infectious diarrhea in different age groups, seasons and for different types of infections.
目的： 了解上海市肠道门诊≥15岁感染性腹泻病例中致泻性大肠埃希菌（DEC）流行特征，为DEC感染性腹泻防控策略的制定提供科学依据。 方法： 采用多阶段系统抽样方法，在上海市22家监测点医疗机构的肠道门诊开展腹泻症状监测，收集病例的人口学、临床和流行病学资料，同时采集病例粪便标本，送至医疗机构所在区CDC开展DEC检测及鉴定分型，分析比较2014-2021年不同人群和季节的DEC阳性率。统计学分析采用χ2检验。 结果： 在15 185例感染性腹泻病例中，DEC的总阳性率为8.05%（1 222/15 185）。其中男性阳性率（8.74%，684/7 824）高于女性（7.31%，538/7 361），15~29岁组人群阳性率最高（9.14%，335/3 665），2021年阳性率最高（10.21%，83/813），以上差异有统计学意义（均P<0.05）。DEC阳性PCR菌型鉴定分离出菌株1 264株中，肠产毒性大肠埃希菌为主（50.24%，635/1 264），其次是肠黏附性大肠埃希菌（27.93%，353/1 264）和肠致病性大肠埃希菌（21.36%，270/1 264）。DEC存在明显季节性流行特征，夏季阳性率最高（13.92%，774/5 562）（χ2=495.73，P<0.001）。 结论： DEC是2014-2021年上海市感染性腹泻患者重要病原体之一，引起的感染性腹泻全年均可发生，夏秋季高发，流行型别为肠产毒性大肠埃希菌、肠黏附性大肠埃希菌和肠致病性大肠埃希菌。应针对不同年龄、不同季节和不同型别的DEC感染性腹泻采取特异性的防控措施。.

BACKGROUND: Understanding the temporal and geographic distribution of disease incidences is crucial for effective public health planning and intervention strategies. This study presents a comprehensive analysis of the spatiotemporal distribution of disease incidences in Ethiopia, focusing on six major diseases: Malaria, Meningitis, Cholera and Dysentery, over the period from 2010 to 2022, whereas Dengue Fever and Leishmaniasis from 2018 to 2023.
METHODS: Using data from Ethiopian public health institute: public health emergency management (PHEM), and Ministry of Health, we examined the occurrence and spread of each disease across different regions of Ethiopia. Spatial mapping and time series analysis were employed to identify hotspots, trends, and seasonal variations in disease incidence.
RESULTS: The findings reveal distinct patterns for each disease, with varying cases and temporal dynamics. Monthly wise, Malaria exhibits a cyclical pattern with a peak during the rainy and humid season, while Dysentery, Meningitis and Cholera displays intermittent incidences. Dysentery cases show a consistent presence throughout the years, while Meningitis remains relatively low in frequency but poses a potential threat due to its severity. Dengue fever predominantly occurs in the eastern parts of Ethiopia. A significant surge in reported incident cases occurred during the years 2010 to 2013, primarily concentrated in the Amhara, Sidama, Oromia, Dire Dawa, and Benishangul-Gumuz regions.
CONCLUSIONS: This study helps to a better understanding of disease epidemiology in Ethiopia and can serve as a foundation for evidence-based decision-making in disease prevention and control. By recognizing the patterns and seasonal changes associated with each disease, health authorities can implement proactive measures to mitigate the impact of outbreaks and safeguard public health in the region.

UNASSIGNED: Irritable bowel syndrome (IBS) can be triggered by bacterial dysentery. This study aimed to investigate postinfectious IBS and its risk factors after the shigellosis outbreak in hospitalized patients.
UNASSIGNED: This retrospective study was conducted in 2020-2021 in referral hospitals for Shigella gastroenteritis during the 2014 shigellosis outbreak in Isfahan. The Shigella-infected group included hospitalized shigellosis patients with clinical symptoms and positive stool culture. The control group included patients matched pairwise on age and sex to the Shigella-infected group, admitted to the same hospitals in the same period with diagnoses other than shigellosis. Both groups had no history of diagnosed IBS before the outbreak. The incidence of IBS (according to Rome-III criteria) and its related factors was compared between the 2 groups 5 years after infection.
UNASSIGNED: Of 619 participants, 220 (35.5%) were in the Shigella-infected group. The 5-year incidence of IBS was 31.8% and 5.7% in the Shigella-infected and control groups, respectively. Multivariate analysis showed that shigellosis was significantly associated with increased risk of IBS (odds ratio [OR], 17.18 [95% confidence interval {CI}, 9.37-31.48]). Multivariate analysis indicated education level (OR, 4.15 [95% CI, 1.47-11.73]), diarrhea lasting >4 days (OR, 1.69 [95% CI, 1.17-2.44]), and abdominal cramps during the infection (OR, 0.27 [95% CI, .77-.95]) associated with postinfectious IBS (P < .05).
UNASSIGNED: Hospitalized patients with Shigella gastroenteritis are at increased risk of IBS within 5 years after infection. Factors such as higher education level and the absence of abdominal cramps and diarrhea persisting for >5 days during hospitalization can further increase this risk.

Norovirus (NoV) is a common pathogen that can cause infectious diarrhea. This study aimed to determine the prevalence, clinical features, and genotypes of NoV-associated diarrhea in Wuxi, China. A total of 4,416 stool samples were collected from patients with diarrhea at enteric disease clinics of sentinel hospitals in Wuxi from February 1, 2013 to December 31, 2020. Univariate and Akaike information criterion stepwise logistic regression were used to identify differences as integrated within a clinical setting (NoV positive [+] versus NoV negative [-], NoV+ versus rotavirus [RV]+, NoV+ versus bacteria+, genogroup [G] I and GII genotypes). Norovirus was detected in 9.85% of stool samples, which was greater than other tested pathogens. Excluding coinfection of NoV and other viruses or bacteria, patients infected with NoV had a lower chance of acquiring the virus in summer (P < 0.001; odds ratio [OR], 0.257; 95% CI, 0.189-0.36) when compared with patients without NoV. Patients with diarrhea infected with NoV featured nausea and vomiting (P < 0.001; OR, 2.297, 95% CI, 1.85-2.86) and loose stools (P = 0.006; OR, 2.247; 95% CI, 1.30-4.10), but less abdominal cramping (P = 0.001; OR, 0.676; 95% CI, 0.54-0.84). Patients infected with RV (P < 0.001; OR, 0.413; 95% CI, 0.25-0.68) or bacteria (P < 0.001; OR, 0.422; 95% CI, 0.26-0.67) were more vulnerable to fever than those infected with NoV. A total of 379 GII strains were detected concomitant with 48 GI strains, and there was a seasonal difference between the GI and GII genotypes. Strengthening pathogen detection for infectious diarrhea was helpful for understanding the epidemiological characteristics of infections with NoV and, potentially, for preventing disease outbreaks.