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基于小儿急性胃肠炎临床表现的粪便细菌培养及病毒抗原检测的诊断价值

Diagnostic value of bacterial stool cultures and viral antigen tests based on clinical manifestations of acute gastroenteritis in pediatric patients.

作者信息

Liu L-J, Yang Y-J, Kuo P-H, Wang S-M, Liu C-C

机构信息

Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Eur J Clin Microbiol Infect Dis. 2005 Aug;24(8):559-61. doi: 10.1007/s10096-005-1373-z.

Abstract

The study presented here aimed to elucidate the diagnostic value of bacterial stool cultures and viral antigen tests when performed based on the clinical characteristics of acute gastroenteritis in infants and young children. A total of 21 (11.2%) bacterial and 74 (39.6%) viral infections affecting 187 children under the age of 3 years was investigated. Blood (p<0.001) and mucus (p=0.014) in the stool and a C-reactive protein (CRP) level of >or=50 mg/l (p=0.006) were more significantly associated with gastroenteritis of bacterial rather than viral origin. Vomiting (p<0.001) was significantly associated with viral gastroenteritis. Among children with bloody stool, culture grew a Salmonella spp. in 35% and for vomiting children, stool antigen tests detected rotavirus in 60% of cases. In conclusion, etiologic tests to determine the cause of childhood gastroenteritis according to their characteristic clinical features or laboratory test results, or both, are of low diagnostic value.

摘要

本研究旨在根据婴幼儿急性胃肠炎的临床特征,阐明粪便细菌培养和病毒抗原检测的诊断价值。对187名3岁以下儿童中发生的21例(11.2%)细菌感染和74例(39.6%)病毒感染进行了调查。粪便中有血液(p<0.001)和黏液(p=0.014)以及C反应蛋白(CRP)水平≥50mg/l(p=0.006)与细菌性而非病毒性胃肠炎的相关性更为显著。呕吐(p<0.001)与病毒性胃肠炎显著相关。在便血儿童中,35%的粪便培养出沙门氏菌属;在呕吐儿童中,60%的粪便抗原检测发现轮状病毒。总之,根据儿童胃肠炎的特征性临床特征或实验室检查结果或两者来确定病因的病原学检测诊断价值较低。

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