Aetiology of XXXX and evaluation of viral-bacterial coinfection in @entity1 under 5  years old in China: a matched case-control study.

@entity1 @entity6835 @entity66 @entity294 @entity204 @entity5363 @entity526
UNASSIGNED: Globally, @entity66 are the second leading cause of @entity204 among @entity1 under 5  years old. Few case-control studies on the aetiology of @entity294 have been conducted in China. A case-control study on 922 @entity1 under 5  years old who presented with @entity294 and individually matched controls was conducted in China between May 2011 and January 2013. Quantitative PCR was used to analyze stool samples for 10 diarrhoeal pathogens. Potential enteric pathogens were detected in 377 (81.8%) of 461 @entity1 with @entity294 and 215 controls (46.6%, p  <0.001). Rotavirus, norovirus GII, @entity6835 and adenovirus were qualitatively associated with @entity294 . Using receiver operating characteristic curves, the optimal cutoff threshold for defining a symptomatic individual was 72, 5840, and 10(4) copies per reaction for rotavirus (odds ratio 259), norovirus GII (odds ratio 10.6) and @entity6835 (odds ratio 5.1). The attributable fractions were 0.18 for rotavirus, 0.08 for norovirus GII, 0.01 for @entity6835 and 0.04 for adenovirus. Coinfections between pathogens were common. Two pairs, rotavirus and adenovirus, and norovirus GII and Salmonella were positively associated. The co-occurrence of rotavirus and sapovirus, astrovirus, enterotoxigenic @entity526 or @entity5363 only occurred in @entity1 with disease. Coinfection was not correlated with clinical symptoms. Quantitative data are critical. Our results indicate that increased pathogen loads increase the OR between @entity294 and rotavirus, norovirus GII and @entity6835 . Coinfections with rotavirus and norovirus GII are common and occur in a nonrandom distribution. Despite testing for ten diarrhoeal pathogens, over two-thirds of cases do not have a recognized attributable cause.
