Pruksananonda Prasong, Athirakul Krairerk, Worawattanakul Mingmuang, Varavithya Wandee, Pisithpun Ampai, Kitayaporn Dwip, Anuras Sinn
Bumrungrad International Hospital, 33 Sukhumvit 3 (Nana Nuea), Bangkok 10110, Thailand.
Southeast Asian J Trop Med Public Health. 2008 May;39(3):434-42.
We report here a case series of pediatric diarrhea cases admitted to a private tertiary-care hospital in Bangkok, Thailand. Retrospective data were collected from computerized medical records of 2,001 children with diarrhea (80.9% Thai), ages birth to 14 years, admitted to our facility during 2000-2005. The most common symptom leading to admission was vomiting (34.6%), while the most common sign was dehydration (63.6%). The largest proportion was comprised of toddlers (45.4%), followed by infants (24.2%). Of the total 2,564 admissions, 1,874 (73.1%) stool samples were collected and examined for red blood cells (RBC) and white blood cells (WBC); 57.1% and 70.6% were negative for RBC and WBC, respectively. Of the 1,878 blood specimens collected for electrolytes, 21.6% show acidosis. Of 1,793 stool specimens collected, the majority revealed normal flora (72.9%). Enteropathogenic Escherichia coli (EPEC) were seen in 10.8%. Campylobacter jejuni was found in only 2.9% of specimens, while of 1,065 specimens tested for rotavirus antigen, 23.9% were positive. In addition to bacterial cultures and their anti-microbial sensitivities, factors associated with rotavirus infection, C. jejuni, and metabolic acidosis, were also explored in this study. Rotavirus infections were more likely to be associated with children older than toddlers (3-14 years old), being admitted within the first day of the symptoms, those who were more acidotic, and was more common in the first 3 months of each year. Our data were little different from community-acquired infections reported among the general population.
我们在此报告一系列泰国曼谷一家私立三级护理医院收治的小儿腹泻病例。回顾性数据收集自2000年至2005年期间入住我院的2001例腹泻儿童（80.9%为泰国人）的电子病历，年龄从出生至14岁。导致入院的最常见症状是呕吐（34.6%），而最常见体征是脱水（63.6%）。最大比例的是学步儿童（45.4%），其次是婴儿（24.2%）。在总共2564例入院病例中，采集了1874例（73.1%）粪便样本进行红细胞（RBC）和白细胞（WBC）检查；RBC和WBC阴性率分别为57.1%和70.6%。在采集的1878例用于电解质检测的血液样本中，21.6%显示酸中毒。在采集的1793例粪便样本中，大多数显示正常菌群（72.9%）。致病性大肠杆菌（EPEC）检出率为10.8%。空肠弯曲菌仅在2.9%的样本中被发现，而在检测轮状病毒抗原的1065例样本中，23.9%呈阳性。除了细菌培养及其药敏试验外，本研究还探讨了与轮状病毒感染、空肠弯曲菌和代谢性酸中毒相关的因素。轮状病毒感染更可能与学步期以上儿童（3至14岁）、症状出现第一天内入院、酸中毒程度较重的儿童有关，且在每年的前3个月更为常见。我们的数据与普通人群中报告的社区获得性感染情况差异不大。
