Tomar B S
Institute of Pediatric Gastroenterology, S.M.S. Medical College, Jaipur.
Indian J Pediatr. 2001 Jul;68 Suppl 3:S8-18.
Gastrointestinal infections are the significant cause of childhood morbidity and mortality worldwide. Gastrointestinal infections reflects the balance between the intrinsic virulence factors of the enteropathogens and host mechanisms which defend against enteric infections. Host defense factors include gastric acidity, intestinal motility, the normal indigenous intestinal microflora, mucous secretion, and specific mucosal and systemic immune mechanisms. Majority of GI infections are self limited so on one hand antibiotics are not needed and on the other hand the irrational use of antibiotics produces resistant strains. Acute diarrheal diseases which are one of the important intestinal infections, in majority of the cases are viral and have short course. Antibiotics are recommended only in specific cases and in immunocompromised individuals. Gastrointestinal disease is one of the most common manifestations of HIV infection. The gastrointestinal tract contains abundant quantities of lymphoid tissue and is likely to function as a reservoir of HIV infection, a site of profound immune dysregulation, and a target for opportunistic infections. In this situation specific antibiotics are indicated.
胃肠道感染是全球儿童发病和死亡的重要原因。胃肠道感染反映了肠道病原体的内在毒力因子与抵御肠道感染的宿主机制之间的平衡。宿主防御因素包括胃酸度、肠道蠕动、正常的肠道固有微生物群、粘液分泌以及特定的黏膜和全身免疫机制。大多数胃肠道感染是自限性的，因此一方面不需要使用抗生素，另一方面不合理使用抗生素会产生耐药菌株。急性腹泻病是重要的肠道感染之一，在大多数情况下是病毒性的，病程较短。仅在特定病例和免疫功能低下的个体中推荐使用抗生素。胃肠道疾病是艾滋病毒感染最常见的表现之一。胃肠道含有大量淋巴组织，很可能成为艾滋病毒感染的储存库、严重免疫失调的部位以及机会性感染的靶器官。在这种情况下，需要使用特定的抗生素。
