Ascher D P, Edusada-Corpus R
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
Mil Med. 1991 Feb;156(2):74-6.
A total of 180 patients with diarrhea, 6 years and below, were seen and evaluated in our pediatric clinic during the months of July to December, 1986. A bacterial pathogen was isolated from the stools in 24/180 (13%). The best historical factors for predictive accuracies were abrupt onset, no vomiting before the onset of diarrhea, and greater than four stools per 24 hours. The presence of fecal leukocytes was the best screening tool for stool culture positivity. The patients identified with the above three historical factors and positive for fecal leukocytes had an 83% probability of having a positive bacterial stool culture compared to only a 5% probability if any one of the factors was absent. We were able to identify a subpopulation of American dependents in a tropical environment with diarrhea who had a high probability of having a bacterial stool pathogen based on historical factors and the fecal leukocyte test.
1986年7月至12月期间，我们的儿科诊所共接待并评估了180名6岁及以下的腹泻患儿。180份粪便样本中有24份（13%）分离出了细菌病原体。预测准确率最高的病史因素为起病急、腹泻前无呕吐以及每24小时排便超过4次。粪便白细胞的存在是粪便培养阳性的最佳筛查工具。具备上述三个病史因素且粪便白细胞呈阳性的患者，其粪便细菌培养呈阳性的概率为83%；而若缺少其中任何一个因素，该概率仅为5%。基于病史因素和粪便白细胞检测，我们能够在热带环境中识别出腹泻的美国受抚养人亚群体，他们的粪便中很可能存在细菌病原体。
