Crotti Daniele, D'Annibale Maria Letizia
Recenti Prog Med. 2007 Nov;98(11):553-9.
The Authors relate clinical-microbiological criteria for a rational diagnosis of acute and prolonged enteritis, distinguishing between home and imported diarrheas. During 2005, 381 subjects (192 children and 189 adults) with acute diarrhea and 110 subjects (16 children and 94 adults) with prolonged diarrhea were examined. In the first group Salmonella prevailed in 11.1% of cases (10.9% among children and 11.1% among adults); Campylobacter in 9.2% (respectively 8.9% and 9.5%); other bacteria were identified in 3.2% of cases (1.0% and 3.8% respectively). Rotavirus were observed in 29.5% of children and Adenovirus in 6.2% of pediatric population. Pathogenic protozoa were observed in 1.6% of people (0.5% in children and 2.7% in adults). Among second group pathogenic protozoa prevailed in 6.4% (6.3% in children and 6.4% in adults); toxin A of C. difficile were detected in 8.5% of total cases. The Authors emphasize the importance to investigate always for Salmonella, Shigella and Campylobacter; in children with vomiting (with acute non invasive enteritis) is necessary to investigate for Rotavirus too; if the diarrhea is prolonged could be important investigate for toxin A/B of C. difficile and for protozoa with specific stains. Based on clinical and epidemiological findings other pathogens could be researched, if possible for own resources.
作者阐述了用于合理诊断急性和迁延性肠炎的临床微生物学标准,区分了本土和输入性腹泻。2005年期间,对381例急性腹泻患者(192名儿童和189名成人)和110例迁延性腹泻患者(16名儿童和94名成人)进行了检查。在第一组中,沙门氏菌在11.1%的病例中占主导(儿童中为10.9%,成人中为11.1%);弯曲杆菌在9.2%的病例中占主导(分别为8.9%和9.5%);其他细菌在3.2%的病例中被鉴定出来(分别为1.0%和3.8%)。29.5%的儿童检测到轮状病毒,6.2%的儿科人群检测到腺病毒。致病性原生动物在1.6%的人群中被观察到(儿童中为0.5%,成人中为2.7%)。在第二组中,致病性原生动物在6.4%的病例中占主导(儿童中为6.3%,成人中为6.4%);艰难梭菌毒素A在所有病例的8.5%中被检测到。作者强调始终对沙门氏菌、志贺氏菌和弯曲杆菌进行检测的重要性;对于有呕吐症状的儿童(急性非侵袭性肠炎),也有必要检测轮状病毒;如果腹泻迁延不愈,检测艰难梭菌毒素A/B和用特异性染色检测原生动物可能很重要。根据临床和流行病学发现,如果可能利用自身资源,还可研究其他病原体。