Bodhidatta Ladaporn, Lan Nguyen Thi Phong, Hien Bui Thu, Lai Nong Vinh, Srijan Apichai, Serichantalergs Oralak, Fukuda Caroline Dorworth, Cam Phung Dac, Mason Carl Jeffries
Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, Phyathai, Bangkok, Thailand.
Pediatr Infect Dis J. 2007 Apr;26(4):325-8. doi: 10.1097/01.inf.0000257426.37289.8c.
Pathogen prevalences and antimicrobial susceptibilities are essential for the rational development of preventive strategies for diarrheal diseases, but little recent information from Vietnam is available. We prospectively studied the prevalence of enteric pathogens in children less than 5 years of age with acute diarrhea and in nondiarrhea controls in a city hospital in Hanoi, Vietnam for 1 year.
Enteric bacteria and viruses were detected by standard culture methods, and enzyme immunoassay in 291 cases and 291 controls.
Detection rates of viral pathogens among cases and controls were 31% and 3% for rotavirus, 12% and 1% for astrovirus and 4% and 1% for adenovirus. For bacterial pathogens, Aeromonas, Shigella, Salmonella, Campylobacter and enterotoxigenic E. coli were isolated from cases and controls in 15% and 8%, 9% and 1%, 7% and 1%, 4% and 0%, and 3% and 0%, respectively. The isolation of bacterial and viral pathogens except for adenovirus was significantly lower in controls than cases. Fluoroquinolones were effective against most bacterial enteropathogens, but resistance was observed in 27% of Campylobacter isolates.
Viral etiologic agents especially rotavirus were the most important cause of acute diarrhea in children less than 5 years of age in Hanoi. The burden of rotavirus in young children in Hanoi warrants consideration of using the recently released rotavirus vaccine.
病原体流行率和抗菌药物敏感性对于腹泻病预防策略的合理制定至关重要,但越南近期相关信息较少。我们对越南河内一家城市医院1年内5岁以下急性腹泻儿童及非腹泻对照儿童的肠道病原体流行情况进行了前瞻性研究。
采用标准培养方法及酶免疫分析法对291例病例和291例对照进行肠道细菌和病毒检测。
病例组和对照组中轮状病毒的病毒病原体检出率分别为31%和3%,星状病毒分别为12%和1%,腺病毒分别为4%和1%。对于细菌病原体,气单胞菌、志贺菌、沙门菌、弯曲菌和产肠毒素大肠杆菌在病例组和对照组中的分离率分别为15%和8%、9%和1%、7%和1%、4%和0%、3%和0%。除腺病毒外,对照组中细菌和病毒病原体的分离率显著低于病例组。氟喹诺酮类药物对大多数细菌性肠道病原体有效,但在27%的弯曲菌分离株中观察到耐药性。
病毒病原体尤其是轮状病毒是河内5岁以下儿童急性腹泻的最重要原因。河内幼儿轮状病毒负担促使人们考虑使用最近推出的轮状病毒疫苗。