Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
PLoS Negl Trop Dis. 2010 Aug 3;4(8):e768. doi: 10.1371/journal.pntd.0000768.
Diarrhea is an important cause of morbidity and mortality in all regions of the world and among all ages, yet little is known about the fraction of diarrhea episodes and deaths due to each pathogen.
METHODOLOGY/PRINCIPAL FINDINGS: We conducted a systematic literature review to identify all papers reporting the proportion of diarrhea episodes with positive laboratory tests for at least one pathogen in inpatient, outpatient and community settings that met our inclusion and exclusion criteria. We identified a total of 25,701 papers with possible etiology data and after final screening included 22 papers that met all inclusion and exclusion criteria. Enterotoxigenic Escherichia coli and V. cholerae O1/O139 were the leading causes of hospitalizations. In outpatient settings, Salmonella spp., Shigella spp., and E. histolytica were the most frequently isolated pathogens.
CONCLUSIONS/SIGNIFICANCE: This is the first systematic review which has considered the relative importance of multiple diarrhea pathogens. The few studies identified suggest that there is a great need for additional prospective studies around the world in these age groups to better understand the burden of disease and the variation by region.
腹泻是全世界所有地区和所有年龄段发病率和死亡率的重要原因，但对于每个病原体导致的腹泻发作和死亡的比例知之甚少。
方法/主要发现：我们进行了系统的文献回顾，以确定所有报告在符合我们的纳入和排除标准的住院、门诊和社区环境中，至少有一种病原体的实验室检测呈阳性的腹泻发作比例的论文。我们总共发现了 25701 篇可能有病因数据的论文，经过最终筛选，包括 22 篇符合所有纳入和排除标准的论文。肠毒素性大肠杆菌和霍乱弧菌 O1/O139 是导致住院的主要原因。在门诊环境中，沙门氏菌、志贺氏菌和溶组织内阿米巴是最常分离出的病原体。
结论/意义：这是首次对多种腹泻病原体的相对重要性进行的系统综述。确定的少数研究表明，全世界非常需要在这些年龄段进行更多的前瞻性研究，以更好地了解疾病负担和地区差异。
