Prevalence of Diarrhea-Causing Pathogens in South Korea Analyzed Using Molecular Diagnostic Methods

Abstract

Gastrointestinal inflammation remains a prevalent global health concern. Prompt and accurate diagnosis of the condition is required to mitigate health risks in immunocompromised individuals and alleviate the economic burden linked to treatment and pathogen isolation. Challenges posed by traditional culture tests, such as long detection time and inability to isolate low-abundance organisms, can be overcome using molecular diagnostic methods, which enable rapid and precise identification of pathogens causing water and food-borne infections. To enhance infection response and improve prevention strategies, we aimed to elucidate the prevalence of diarrhea-causing pathogens by analyzing samples from an advanced general hospital, using multiplex real-time reverse transcription polymerase chain reaction. Analysis of 1,711 viral and 1,952 bacterial infection cases from November 2021 to February 2023 revealed 156 and 90 cases positive for bacterial and viral infections, respectively. The highest prevalence of bacterial and viral infections was noted in the summer. Among bacteria, Salmonella spp. had the highest co-infection rate (3 cases), followed by Campylobacter spp. and STEC/Shigella dysenteriae (stx1/stx2) (2 cases) and Plesiomonas shigelloides and enterotoxigenic Escherichia coli (1 case). Among viruses, rotavirus had the highest co-infection rate (11 cases), followed by adenovirus (9 cases), astrovirus (2 cases), and norovirus (1 case). The highest prevalence of diarrhea-causing bacteria was observed in individuals aged >70 years, followed by those aged 11-20 years and >6 years; however, the highest prevalence of viral infections was observed in individuals aged >70 years, followed by those aged <1 year. Continuous monitoring enables the assessment of age trend changes, aiding in predicting the cause and location of infectious diseases for effective prevention and quarantine measures. Our findings offer novel perspectives on viral and bacterial infections and elucidate the increasing age and concurrent infection trends, advance our comprehension of infection dynamics, and potentially facilitate refinement of clinical management and preventive strategies.