Department of Pediatrics, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Int J Infect Dis. 2011 Sep;15(9):e641-5. doi: 10.1016/j.ijid.2011.05.008. Epub 2011 Jul 14.
Intussusception is the most common cause of intestinal obstruction in young children. The pathogenesis of intussusception is still not well understood. In this study the pathogens from stool specimens were investigated in children with intussusception.
Patients diagnosed with primary idiopathic intussusception were enrolled. Pathogenic bacteria and viruses were detected in the stool samples by routine culture, cell culture, polymerase chain reaction, reverse transcriptase-polymerase chain reaction, enzyme immunoassay, and electron microscopy examinations.
A total of 71 samples were analyzed during the 2-year study period. The patients ranged in age from 4 to 47 months. Viruses were detected in 56 of the 71 stool samples (78.9%). Adenovirus was found in 19 of 35 cases aged <2 years, whereas it was found in 17 of 21 cases aged ≥2 years. The majority of adenovirus isolates were non-enteric organisms generally associated with respiratory tract symptoms.
These results suggest a casual association of viral infections in children with intussusception. Adenovirus infection, especially with the primary non-enteric types, is a significant risk factor for developing intussusception in children, particularly those aged over 2 years.
肠套叠是小儿肠梗阻最常见的原因。肠套叠的发病机制尚不清楚。本研究旨在探讨小儿肠套叠粪便标本中的病原体。
纳入经临床诊断为原发性特发性肠套叠的患儿。通过常规培养、细胞培养、聚合酶链反应、逆转录聚合酶链反应、酶免疫测定和电子显微镜检查,检测粪便样本中的病原菌和病毒。
在为期 2 年的研究期间,共分析了 71 份样本。患儿年龄 4~47 个月。71 份粪便样本中 56 份(78.9%)检测到病毒。<2 岁的 35 例患儿中检出 19 例腺病毒,≥2 岁的 21 例患儿中检出 17 例。大多数腺病毒分离株是非肠型生物,通常与呼吸道症状有关。
这些结果提示病毒感染与小儿肠套叠之间存在偶然联系。腺病毒感染,特别是原发性非肠型,是儿童发生肠套叠的重要危险因素,尤其是 2 岁以上的儿童。