Mshana S E, Joloba M L, Kakooza A, Kaddu-Mulindwa D
Department of Medical Microbiology, Makerere University Medical School, Kampala, Uganda.
Tanzan J Health Res. 2010 Jan;12(1):100-3. doi: 10.4314/thrb.v12i1.56367.
Campylobacter species are a frequent cause of enteritis and less often of extraintestinal infections in humans. The diagnosis of campylobacter infection depends mainly on culture which is difficult and expensive to be done as routine in most clinical microbiology laboratories in the developing countries. This study was conducted to determine the sensitivity and specificity of Gram-stain of the stool in diagnosis of campylobacter infection, using culture as the gold standard. A total of 226 stool specimens were obtained from children with acute diarrhoea, attending Mulago Hospital in Kampala, Uganda. Stool smears were made and conventional Gram stain done using 0.3% carbol-fuschin as counter stain for 5 minutes. Mucous part of the stool was cultured in Charcoal Ceferaperazone Deoxycholate Agar and blood contained selective media. A total of 21 stool samples (9.3%) were positive by culture and 17 (7.5%) by Gram stain. Sensitivity and specificity of Gram stain in the diagnosis of campylobacter infection was 76% and 99.5%, respectively with positive predictive value of 94.1%. A total of 127 (56.2%) had white blood cells (WBC) in stool and there was strong association between WBC in stool and the presence of campylobacter infection (P=0.001). Gram stain is a good alternative in diagnosis of campylobacter infection in place where facilities for culture are limited.
弯曲杆菌属是人类肠炎的常见病因，较少引起肠道外感染。弯曲杆菌感染的诊断主要依赖培养，但在发展中国家的大多数临床微生物实验室，将其作为常规检测既困难又昂贵。本研究以培养作为金标准，旨在确定粪便革兰氏染色在弯曲杆菌感染诊断中的敏感性和特异性。从乌干达坎帕拉穆拉戈医院的急性腹泻儿童中总共采集了226份粪便标本。制作粪便涂片，使用0.3%石炭酸复红作为复染剂进行常规革兰氏染色5分钟。粪便的黏液部分接种于活性炭头孢哌酮脱氧胆酸盐琼脂和含血选择性培养基中培养。总共21份粪便样本（9.3%）培养阳性，17份（7.5%）革兰氏染色阳性。革兰氏染色诊断弯曲杆菌感染的敏感性和特异性分别为76%和99.5%，阳性预测值为94.1%。总共127份（56.2%）粪便中有白细胞，粪便中的白细胞与弯曲杆菌感染的存在之间存在强关联（P = 0.001）。在培养设施有限的地方，革兰氏染色是诊断弯曲杆菌感染的良好替代方法。
