Amar C F L, East C L, Gray J, Iturriza-Gomara M, Maclure E A, McLauchlin J
Health Protection Agency Centre for Infections, 61 Colindale Avenue, NW9 5EQ, London, UK.
Eur J Clin Microbiol Infect Dis. 2007 May;26(5):311-23. doi: 10.1007/s10096-007-0290-8.
The English case-control Infectious Intestinal Disease Study (1993-1996) failed to detect an enteric pathogen or toxin in 49% of cases of gastroenteritis. In the present study, polymerase chain reaction (PCR) assays were applied to DNA and cDNA generated from 4,627 faecal samples from cases and controls archived during the original study for the detection of norovirus, rotavirus, sapovirus, Campylobacter spp., Salmonella spp., enteroaggregative Escherichia coli, Cryptosporidium spp., and Giardia spp. The percentage of archived samples from cases and from controls in which at least one agent (or toxin) was detected increased from 53% in the original study to 75% and from 19 to 42%, respectively, after the application of PCR assays. Among cases, the following percentages of enteric pathogens were detected: norovirus 36%, rotavirus A 31%, sapovirus 4%, Salmonella spp. 6%, Campylobacter jejuni 13%, Campylobacter coli 2%, other Campylobacter spp. 8%, enteroaggregative E. coli 6%, Giardia spp. 2%, and Cryptosporidium spp. 2%. The present study provides additional insight into the aetiology of infectious intestinal disease in England and highlights the occurrence of viral infections in cases as well as in asymptomatic individuals. Other notable findings include the frequent presence of Campylobacter spp. other than C. jejuni or C. coli, the high frequency of multiple agents in 41% of cases and in 13% of controls, and the variation in the aetiology and rate of infection found for different age groups. The results demonstrate the greater sensitivity of PCR-based methods compared to current conventional methods.
英国病例对照感染性肠道疾病研究（1993 - 1996年）在49%的肠胃炎病例中未能检测到肠道病原体或毒素。在本研究中，聚合酶链反应（PCR）检测应用于原始研究期间存档的4627份病例和对照粪便样本所产生的DNA和cDNA，以检测诺如病毒、轮状病毒、沙波病毒、弯曲杆菌属、沙门氏菌属、肠聚集性大肠杆菌、隐孢子虫属和贾第虫属。应用PCR检测后，病例组和对照组存档样本中至少检测到一种病原体（或毒素）的比例分别从原始研究中的53%和19%增至75%和42%。在病例中，检测到的肠道病原体比例如下：诺如病毒36%、A组轮状病毒31%、沙波病毒4%、沙门氏菌属6%、空肠弯曲菌13%、结肠弯曲菌2%、其他弯曲杆菌属8%、肠聚集性大肠杆菌6%、贾第虫属2%、隐孢子虫属2%。本研究为英国感染性肠道疾病的病因提供了更多见解，并突出了病例以及无症状个体中病毒感染的发生情况。其他显著发现包括除空肠弯曲菌或结肠弯曲菌外其他弯曲杆菌属的频繁存在、41%的病例和13%的对照中多种病原体的高频率出现，以及不同年龄组感染病因和感染率的差异。结果表明基于PCR的方法比当前传统方法具有更高的灵敏度。
