Study participants and specimen acquisition
Children < 18 years of age with AGE were recruited consecutively by the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) according to the study protocol (27). Caregiver consent along with participant assent were obtained as appropriate. Children with AGE, defined as ≥3 episodes of vomiting or diarrhea in the preceding 24 hours and symptom duration <7 days, were recruited through two pediatric emergency departments (EDs) and a telephone nursing advice line in Alberta between December 2014 and August 2018. Ethics approval was provided by the University of Alberta and University of Calgary research ethics boards (Pro00050790 and REB14-1122).
Rectal swabs and stool specimens were collected from eligible children. FLOQSwabsTM (Copan Italia, Brescia, Italy) were inserted into the rectum and rotated 360º then placed into sterile sheathes. Stool specimens were collected in Fecal Collectors (V302-F, Starplex Scientific, ON, Canada). Specimens were transported at 4°C to the testing laboratory within 24h of collection and frozen immediately at -70°C until testing was performed. Specimens were analyzed within a week of arrival in the laboratory.