Study of infectious diarrhea in the elderly

ABSTRACT

To evaluate the most common causative agents associated with infectious diarrhea in elderly and to estimate the possible changes of serum IgA that may lead to increase the susceptibility to gastrointestinal infection among them. Sixty patients were included in this study, all of them were suffering from diarrhea, admitted to Alexandria fever hospital. They were divided into two groups group I, 50 patients aged 65 years and above and group II, 10 patients aged from 20-30 years, all patients and controls were subjected to make stool culture, examination of stool for excess fats and detection of serum IgA by using ELISA technique. The results of this study showed that the percent of patients with normal inhabitant was significantly lower in group I [24%] compared to group II [70%] P= 0.004. The negative samples in stool cultures were submitted to test for IgM rotavirus; the results revealed 8 subjects of group I and 2 of group II were positive for Rota virus IgM. E-coli was present in 42% of group I and 20% of group II with no significant differences [P= 0.191], C.difficile was present in 18% of group I and 0% of group II with no significant difference [P- 0.146], Shigella was present in 16% of group I and 10% of group II with no significant difference [P= 0.628]. In group I, 86% of the patients had fat in the stool and 14% were negative, in group II, all patients were negative and this difference was statistically significant [P= 0.000]. Serum IgA ranged from 100-905 in group I with a mean of 475.15 +/- 246.2, while in group II, it ranged from 77 - 430 with a mean of 178.4 +/- 134.58. It was significantly higher in group I compared to group II, [P= 0.001]. Infectious diarrhea is an important disease in elderly. There is a higher mortality rat among them. Infectious diarrhea may be associated with abnormal immune function of old age [immuno senescence]. Certain bacterial infections are commoner among them [e.g. C.difficile, E.coli 1.57-H.7 and salmonella]