Misra Sudipta, Sabui Tapas K, Basu Swati, Pal Nishith
Department of Pediatrics, UIC College of Medicine at Peoria, Peoria, Illinois 61603, USA.
Clin Pediatr (Phila). 2007 Oct;46(8):683-8. doi: 10.1177/0009922807300700. Epub 2007 Jun 6.
The aim of this study was to document the changing clinical profile and prognosis of acute diarrhea in infants. This was a prospective observational study with follow-up. Demographic, anthropometric, and clinical data were collected in children younger than 1 year with acute diarrhea. Stool was examined under the microscope, cultured, tested for presence of reducing substance and occult blood, and subjected to electrophoresis to detect rotavirus infection. Thirty-one (91.2%) of the 34 infants were breastfed, 18 exclusively and 13 partially. Twenty-three had rotavirus infection and had slower nutritional recovery than others. There was no difference in the incidence of rotavirus infection between exclusively and partially breastfed infants. Continuation of feeds containing lactose did not affect prognosis, though 23 (67.6%) infants had reducing substance in stool. We documented a high incidence of rotavirus infection, which negatively affected growth of infants by some ill-defined mechanism. Failure of exclusive breastfeeding to protect against rotavirus infection highlights the need for universal rotavirus vaccination. Lactose malabsorption detected in many infants did not affect prognosis after acute diarrhea.
本研究的目的是记录婴儿急性腹泻不断变化的临床特征和预后。这是一项有随访的前瞻性观察研究。收集了1岁以下急性腹泻儿童的人口统计学、人体测量学和临床数据。对粪便进行显微镜检查、培养、检测还原物质和潜血的存在,并进行电泳以检测轮状病毒感染。34名婴儿中有31名(91.2%)进行母乳喂养,其中18名纯母乳喂养,13名部分母乳喂养。23名感染了轮状病毒,其营养恢复比其他婴儿慢。纯母乳喂养和部分母乳喂养的婴儿之间轮状病毒感染发生率没有差异。尽管23名(67.6%)婴儿粪便中有还原物质,但继续食用含乳糖的食物并不影响预后。我们记录了轮状病毒感染的高发生率,其通过某种不明机制对婴儿生长产生负面影响。纯母乳喂养未能预防轮状病毒感染凸显了普遍接种轮状病毒疫苗的必要性。许多婴儿检测出乳糖吸收不良,但这对急性腹泻后的预后没有影响。