Velasco Cerrudo A C, Barrio Gómez de Agüero M I
Servicio de Microbiología, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid.
An Esp Pediatr. 1992 Jun;36(6):423-7.
Several clinical symptoms and laboratory findings from 352 pediatric patients, seen in the Emergency Room for acute diarrhea, were evaluated in order to develop a method to predict the bacterial etiology of the diarrhea. According to the microbiology findings, the patients were classified into two groups: proven bacterial diarrhea and diarrhea of another etiology. Among all clinical symptoms recorded, only the following were found to be useful for the prediction score: fever greater than 38 degrees C (8 points), fecal mucus (8 points), over fecal blood (6 points) and the presence of fecal leukocytes in a wet mount (7 points). An alternative score useful for outpatients was developed that does not include a score for the wet mount. When the fecal leukocyte score was included and a cutoff value of 20 points was assigned, a sensitivity of 74% and a specificity of 83% were obtained. When the score for the fecal leukocytes was excluded and a cutoff value of 13 points assigned a sensitivity of 84% and specificity of 59% were obtained. These rapid and simple scores may be useful methods for predicting acute bacterial diarrhea in children.
对352名因急性腹泻在急诊室就诊的儿科患者的若干临床症状和实验室检查结果进行了评估，以便开发一种预测腹泻细菌病因的方法。根据微生物学检查结果，患者被分为两组：确诊的细菌性腹泻和其他病因的腹泻。在记录的所有临床症状中，只有以下症状对预测评分有用：体温高于38摄氏度（8分）、粪便带黏液（8分）、粪便带血（6分）以及湿片中存在粪便白细胞（7分）。开发了一种适用于门诊患者的替代评分方法，该方法不包括湿片评分。当纳入粪便白细胞评分并设定临界值为20分时，灵敏度为74%，特异性为83%。当排除粪便白细胞评分并设定临界值为13分时，灵敏度为84%，特异性为59%。这些快速简单的评分方法可能是预测儿童急性细菌性腹泻的有用方法。
