Orlandi P P, Magalhães G F, Matos N B, Silva T, Penatti M, Nogueira P A, Silva L H Pereira da
Centro de Pesquisa em Medicina Tropical, Porto Velho, RO, Brazil.
Braz J Med Biol Res. 2006 Apr;39(4):507-17. doi: 10.1590/s0100-879x2006000400011. Epub 2006 Apr 3.
In the present study, 470 children less than 72 months of age and presenting acute diarrhea were examined to identify associated enteropathogenic agents. Viruses were the pathogens most frequently found in stools of infants with diarrhea, including 111 cases of rotavirus (23.6% of the total diarrhea cases) and 30 cases of adenovirus (6.3%). The second group was diarrheogenic Escherichia coli (86 cases, 18.2%), followed by Salmonella sp (44 cases, 9.3%) and Shigella sp (24 cases, 5.1%). Using the PCR technique to differentiate the pathogenic categories of E. coli, it was possible to identify 29 cases (6.1%) of enteropathogenic E. coli (EPEC). Of these, 10 (2.1%) were typical EPEC and 19 (4.0%) atypical EPEC. In addition, there were 26 cases (5.5%) of enteroaggregative E. coli, 21 cases (4.4%) of enterotoxigenic E. coli, 7 cases (1.4%) of enteroinvasive E. coli (EIEC), and 3 cases (0.6%) of enterohemorrhagic E. coli. When comparing the frequencies of diarrheogenic E. coli, EPEC was the only category for which significant differences were found between diarrhea and control groups. A low frequency of EIEC was found, thus EIEC cannot be considered to be a potential etiology agent of diarrhea. Simultaneous infections with two pathogens were found in 39 diarrhea cases but not in controls, suggesting associations among potential enteropathogens in the etiology of diarrhea. The frequent association of diarrheogenic E. coli strains was significantly higher than the probability of their random association, suggesting the presence of facilitating factor(s).
在本研究中，对470名72个月以下出现急性腹泻的儿童进行了检查，以确定相关的肠道病原体。病毒是腹泻婴儿粪便中最常发现的病原体，包括111例轮状病毒（占腹泻病例总数的23.6%）和30例腺病毒（6.3%）。第二组是致泻性大肠杆菌（86例，18.2%），其次是沙门氏菌属（44例，9.3%）和志贺氏菌属（24例，5.1%）。使用聚合酶链反应（PCR）技术区分大肠杆菌的致病类别，可鉴定出29例（6.1%）肠致病性大肠杆菌（EPEC）。其中，10例（2.1%）为典型EPEC，19例（4.0%）为非典型EPEC。此外，有26例（5.5%）肠聚集性大肠杆菌、21例（4.4%）产肠毒素性大肠杆菌、7例（1.4%）肠侵袭性大肠杆菌（EIEC）和3例（0.6%）肠出血性大肠杆菌。比较致泻性大肠杆菌的频率时，EPEC是腹泻组与对照组之间发现有显著差异的唯一类别。EIEC的检出频率较低，因此不能认为EIEC是腹泻的潜在病因。在39例腹泻病例中发现了两种病原体的同时感染，而对照组未发现，这表明腹泻病因中潜在肠道病原体之间存在关联。致泻性大肠杆菌菌株的频繁关联显著高于其随机关联的概率，提示存在促进因素。
