Authors: Gauri Godbole (Gastrointestinal Department, National Infection Service, Public Health England, UK)
Gastroenteritis or infectious intestinal disease (IID) is the second most common infection seen in humans after respiratory infections in the UK. Gastroenteritis is associated with a high morbidity worldwide and leads to significant mortality in underdeveloped countries. The incidence of IID was assessed in a large community based population study conducted in the UK in 2008. The IID2 study estimated that one in four of the population suffered from an episode of IID in a year, which amounts to 17 million cases annually in the UK. The study found Campylobacter spp and enteric viruses to be the most frequent cause of gastroenteritis in the UK, however 50–60% specimens tested negative for all pathogens .
Recent advances in diagnosis have changed the landscape making it rapid diagnosis of infectious diarrhea a reality. Molecular diagnostics, specifically multiplex PCRs have been used for many years for detection of viruses, more recently the use in detection of multiple bacterial and parasitic pathogens has made it possible to improve the overall clinical management and infection control in cases of gastroenteritis. A pan-pathogen PCR on stool can detect up 22 pathogens depending on the commercial assay used, within hours of recovering the sample from the case . This methodology has significantly increased sensitivity as compared with standard culture (bacterial pathogens) and microscopy (for parasites).