DOI: 10.1111/apa.17073 ISSN: 0803-5253

Aetiology, risk factors and microbiota composition in children with prolonged diarrhoea: A prospective case–controlled cohort study

Andrea Lo Vecchio, Paolo Quitadamo, Marco Poeta, Vittoria Buccigrossi, Paolo Siani, Valentina Cioffi, Danilo Ercolini, Alfredo Guarino
  • General Medicine
  • Pediatrics, Perinatology and Child Health



Prolonged diarrhoea (ProD) refers to acute‐onset diarrhoea that persists for longer than 1 week. As the aetiology, risk factors and management are poorly defined, we prospectively enrolled children hospitalised in a high‐income setting to assess these outcomes and investigate the potential role of gut microbiota.


All children aged 30 days to 14 years admitted for acute‐onset diarrhoea lasting 7–14 days were included. Children consecutively admitted in the same period for acute diarrhoea (AD) served as controls. High‐throughput sequencing of 16S rRNA gene amplicons was used to analyse stool samples from a subset of patients and healthy controls.


Sixty‐eight with ProD and 104 with AD were enrolled. Intestinal infections were the main aetiology of diarrhoea in both groups (ProD 92.9% vs. AD 97.8%). ProD children showed a higher prevalence of bacterial infections compared to AD (30.8% vs. 8.9%, p = 0.024). Neither age, host‐related factors, nor microbiome alterations were specifically linked to ProD. However, ProD children had a more severe initial clinical presentation than AD.


ProD is often the result of an unusually severe intestinal infection that runs a course longer than expected but generally resolves without further problems. No specific management or therapies should be undertaken in most cases.

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