Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine
Abstract Background Gastrointestinal (GI) symptoms, such as diarrhea, vomiting, abdominal pain and nausea are not an uncommon manifestation of an acute respiratory infection (ARI). We therefore evaluated clinical and microbiological factors associated with the presence of GI symptoms in patients con...
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doaj-23bb6a9bfae84e0eb62884b9758112202020-11-25T01:38:37ZengBMCBMC Infectious Diseases1471-23342017-11-0117111110.1186/s12879-017-2823-9Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicineLaetitia Minodier0Shirley Masse1Lisandru Capai2Thierry Blanchon3Pierre-Emmanuel Ceccaldi4Sylvie van der Werf5Thomas Hanslik6Remi Charrel7Alessandra Falchi8EA7310, Laboratoire de Virologie, Université de Corse-InsermEA7310, Laboratoire de Virologie, Université de Corse-InsermEA7310, Laboratoire de Virologie, Université de Corse-InsermInstitut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136Pasteur Institute, Virology Department, Epidemiology and Physiopathology of Oncogenic Viruses UnitUMR CNRS 3569Sorbonne Université, UPMC Université Paris 06, Institut Pierre-Louis d’Épidémiologie et de Santé Publique (IPLESP UMRS 1136)UMR “Emergence des Pathologies Virales” (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP) & Fondation IHU Méditerranée Infection, APHM Public Hospitals of MarseilleEA7310, Laboratoire de Virologie, Université de Corse-InsermAbstract Background Gastrointestinal (GI) symptoms, such as diarrhea, vomiting, abdominal pain and nausea are not an uncommon manifestation of an acute respiratory infection (ARI). We therefore evaluated clinical and microbiological factors associated with the presence of GI symptoms in patients consulting a general practitioner (GP) for ARI. Methods Nasopharyngeal swabs, stool specimens and clinical data from patients presenting to GPs with an ARI were prospectively collected during two winter seasons (2014-2016). Samples were tested by quantitative real-time PCR for 12 respiratory pathogen groups and for 12 enteric pathogens. Results Two hundred and four of 331 included patients (61.6%) were positive for at least one respiratory pathogen. Sixty-nine stools (20.8%) were positive for at least one pathogen (respiratory and/or enteric). GI symptoms were more likely declared in case of laboratory confirmed-enteric infection (adjusted odds ratio (aOR) = 3.2; 95% confidence interval [CI] [1.2–9.9]; p = 0.02) or human coronavirus (HCoV) infection (aOR = 2.7; [1.2–6.8]; p = 0.02). Consumption of antipyretic medication before the consultation seemed to reduce the risk of developing GI symptoms for patients with laboratory-confirmed influenza (aOR = 0.3; [0.1–0.6]; p = 0.002). Conclusions The presence of GI symptoms in ARI patients could not be explained by the detection of respiratory pathogens in stools. However, the detection of enteric pathogens in stool samples could explained by the presence of GI symptoms in some of ARI cases. The biological mechanisms explaining the association between the presence of HCoVs in nasopharynx and GI symptoms need to be explored.http://link.springer.com/article/10.1186/s12879-017-2823-9Acute respiratory infectionGastrointestinal symptomsEnteric pathogensInfluenza virusGeneral practitioner |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Laetitia Minodier Shirley Masse Lisandru Capai Thierry Blanchon Pierre-Emmanuel Ceccaldi Sylvie van der Werf Thomas Hanslik Remi Charrel Alessandra Falchi |
spellingShingle |
Laetitia Minodier Shirley Masse Lisandru Capai Thierry Blanchon Pierre-Emmanuel Ceccaldi Sylvie van der Werf Thomas Hanslik Remi Charrel Alessandra Falchi Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine BMC Infectious Diseases Acute respiratory infection Gastrointestinal symptoms Enteric pathogens Influenza virus General practitioner |
author_facet |
Laetitia Minodier Shirley Masse Lisandru Capai Thierry Blanchon Pierre-Emmanuel Ceccaldi Sylvie van der Werf Thomas Hanslik Remi Charrel Alessandra Falchi |
author_sort |
Laetitia Minodier |
title |
Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine |
title_short |
Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine |
title_full |
Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine |
title_fullStr |
Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine |
title_full_unstemmed |
Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine |
title_sort |
clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2017-11-01 |
description |
Abstract Background Gastrointestinal (GI) symptoms, such as diarrhea, vomiting, abdominal pain and nausea are not an uncommon manifestation of an acute respiratory infection (ARI). We therefore evaluated clinical and microbiological factors associated with the presence of GI symptoms in patients consulting a general practitioner (GP) for ARI. Methods Nasopharyngeal swabs, stool specimens and clinical data from patients presenting to GPs with an ARI were prospectively collected during two winter seasons (2014-2016). Samples were tested by quantitative real-time PCR for 12 respiratory pathogen groups and for 12 enteric pathogens. Results Two hundred and four of 331 included patients (61.6%) were positive for at least one respiratory pathogen. Sixty-nine stools (20.8%) were positive for at least one pathogen (respiratory and/or enteric). GI symptoms were more likely declared in case of laboratory confirmed-enteric infection (adjusted odds ratio (aOR) = 3.2; 95% confidence interval [CI] [1.2–9.9]; p = 0.02) or human coronavirus (HCoV) infection (aOR = 2.7; [1.2–6.8]; p = 0.02). Consumption of antipyretic medication before the consultation seemed to reduce the risk of developing GI symptoms for patients with laboratory-confirmed influenza (aOR = 0.3; [0.1–0.6]; p = 0.002). Conclusions The presence of GI symptoms in ARI patients could not be explained by the detection of respiratory pathogens in stools. However, the detection of enteric pathogens in stool samples could explained by the presence of GI symptoms in some of ARI cases. The biological mechanisms explaining the association between the presence of HCoVs in nasopharynx and GI symptoms need to be explored. |
topic |
Acute respiratory infection Gastrointestinal symptoms Enteric pathogens Influenza virus General practitioner |
url |
http://link.springer.com/article/10.1186/s12879-017-2823-9 |
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