Abstract
Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%),
Giardia duodenalis
(16.5%), and
Cryptosporidium
spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%),
Salmonella
(3%), Shiga toxin-producing
Escherichia coli
(3%), and
Entamoeba histolytica
(2.4%) were also detected. Norovirus GI/II,
Vibrio cholerae
,
Yersinia enterocolitica
, and
Clostridium difficile
toxin A/B were not detected in any patients. All pathogens were involved in coinfections except
E. histolytica
.
Giardia
(5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic
E. coli
(2.4%),
Campylobacter
spp. (2.4%),
E. coli
0157 (1.8%), and
Shigella
spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0–4 years, less in adults <40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (
P
<0.001),
Giardia
(
P
=0.006), and
Cryptosporidium
(
P
=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.