Khan-Mohammed Zobida, Adesiyun Abiodun A, Swanston William H, Chadee Dave D
Trinidad and Tobago, Public Health Laboratory, Federation Park, Port-of-Spain, Trinidad and Tobago.
Rev Panam Salud Publica. 2005 Mar;17(3):170-7. doi: 10.1590/s1020-49892005000300004.
To determine the prevalence and characteristics of selected enteric pathogens in diarrheic children in six counties of the island of Trinidad.
This cross-sectional study was conducted from April 1998 through March 2000. Fecal or rectal swab specimens from children (<12 years) were collected and then processed, using standard methods, to detect Salmonella spp., Shigella spp., enteropathogenic Escherichia coli (EPEC), Campylobacter spp., Yersinia spp., Cryptosporidium parvum, and parasite ova. The antibiograms of the enteropathogens were determined using the disk diffusion method.
A total of 236 samples were processed; 86 samples originated directly from 17 heath centers in two counties (St. George East and St. George West), while 150 samples were obtained from the Trinidad Public Health Laboratory, having been submitted by private practitioners and personnel from six counties in Trinidad. Of the 236 samples, 33 (14.0%) were positive for Shigella, 4 (1.7%) for Salmonella, and 1 (0.4%) for EPEC. Two of the samples (0.8%) were positive for Campylobacter jejuni, while 1 sample (0.4%) was positive for hookworm ova. All the samples were negative for Cryptosporidium parvum and Yersinia spp. With the 86 samples collected directly from the health centers, in St. George East County the frequency of Shigella was 20.0% (12 of 60), compared with 26.9% (7 of 26) for samples from St. George West County, but the difference was not statistically significant (P>0.05 with the chi-square test). For the 150 samples from the six counties that had been submitted directly to the Trinidad Public Health Laboratory, 14 of them (9.3%) were positive for Shigella, a figure statistically significantly lower than that found with the samples sampled directly from the health centers (P<0.05 with the chi-square test). Sh. sonnei was the predominant serotype detected, accounting for 28 of the 33 Shigella isolates (84.8%) recovered from the 236 samples. Overall, the frequency of detection of enteropathogens had no seasonal pattern nor relationship to the county of origin. Of the 37 isolates of Salmonella and Shigella tested for antimicrobial sensitivity, all of them were sensitive to ciprofloxacin, gentamicin, and cefotaxime. In terms of resistance, 3 of the 37 isolates (8.1%) exhibited resistance to ampicillin, 1 (2.7%) to chloramphenicol, and 1 (2.7%) to sulfamethoxazole/ trimethoprim.
Of the enteropathogens for which assays were done, Shigella sonnei was the most prevalent, and it has the highest probability of being an important etiological agent of childhood diarrhea in Trinidad.
确定特立尼达岛六个县腹泻儿童中某些肠道病原体的流行情况和特征。
本横断面研究于1998年4月至2000年3月进行。收集12岁以下儿童的粪便或直肠拭子标本，然后采用标准方法进行处理，以检测沙门氏菌属、志贺氏菌属、肠致病性大肠杆菌（EPEC）、弯曲杆菌属、耶尔森氏菌属、微小隐孢子虫和寄生虫卵。采用纸片扩散法测定肠道病原体的抗菌谱。
共处理了236份样本；86份样本直接来自两个县（圣乔治东区和圣乔治西区）的17个健康中心，而150份样本来自特立尼达公共卫生实验室，由特立尼达六个县的私人执业医生和工作人员提交。在236份样本中，33份（14.0%）志贺氏菌检测呈阳性，4份（1.7%）沙门氏菌检测呈阳性，1份（0.4%）EPEC检测呈阳性。两份样本（0.8%）空肠弯曲菌检测呈阳性，一份样本（0.4%）钩虫卵检测呈阳性。所有样本微小隐孢子虫和耶尔森氏菌属检测均为阴性。对于直接从健康中心收集的86份样本，圣乔治东区志贺氏菌检出率为20.0%（60份中的12份），圣乔治西区样本的检出率为26.9%（26份中的7份），但差异无统计学意义（卡方检验P>0.05）。对于直接提交给特立尼达公共卫生实验室的来自六个县的150份样本，其中14份（9.3%）志贺氏菌检测呈阳性，这一数字在统计学上显著低于直接从健康中心采集的样本（卡方检验P<0.05）。宋内志贺氏菌是检测到的主要血清型，占从236份样本中分离出的33株志贺氏菌中的28株（84.8%）。总体而言，肠道病原体的检出频率没有季节性模式，也与来源县无关。在对37株沙门氏菌和志贺氏菌进行抗菌敏感性测试中，所有菌株对环丙沙星、庆大霉素和头孢噻肟均敏感。在耐药性方面，37株菌株中有3株（8.1%）对氨苄西林耐药，1株（2.7%）对氯霉素耐药，1株（2.7%）对磺胺甲恶唑/甲氧苄啶耐药。
在所检测的肠道病原体中，宋内志贺氏菌最为常见，并且它极有可能是特立尼达儿童腹泻的重要病因。
