Format

Send to

Choose Destination
BMC Infect Dis. 2017 Nov 22;17(1):729. doi: 10.1186/s12879-017-2823-9.

Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine.

Author information

1
EA7310, Laboratoire de Virologie, Université de Corse-Inserm, 20250, Corte, France.
2
Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France.
3
INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 56, Boulevard Vincent Auriol, 81393-75646, Paris, France.
4
Pasteur Institute, Virology Department, Epidemiology and Physiopathology of Oncogenic Viruses Unit, F-75015, Paris, France.
5
UMR CNRS 3569, 75015, Paris, France.
6
Sorbonne Paris Cité, Cellule Pasteur, Université Paris Diderot, Institut Pasteur, 75015, Paris, France.
7
Pasteur Institute, Virology Department, Molecular Genetics of RNA Viruses Unit, F-75015, Paris, France.
8
Université Paris Diderot, Sorbonne Paris Cité, Unité de Génétique Moléculaire des Virus à ARN, EA302, F-75015, Paris, France.
9
Sorbonne Université, UPMC Université Paris 06, Institut Pierre-Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.
10
Hôpital Ambroise Paré, service de médecine interne, Boulogne-Billancourt, France.
11
UFR des Sciences de la Santé Simone-Veil, Université Versailles Saint Quentin en Yvelines, Versailles, France.
12
UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille Univ - IRD 190 - Inserm 1207 - EHESP) & Fondation IHU Méditerranée Infection, APHM Public Hospitals of Marseille, Marseille, France.
13
EA7310, Laboratoire de Virologie, Université de Corse-Inserm, 20250, Corte, France. falchi@univ-corse.fr.

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.

KEYWORDS:

Acute respiratory infection; Enteric pathogens; Gastrointestinal symptoms; General practitioner; Influenza virus

PMID:
29166867
PMCID:
PMC5700681
DOI:
10.1186/s12879-017-2823-9
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center