Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA.
Pediatr Infect Dis J. 2013 Mar;32(3):217-21. doi: 10.1097/INF.0b013e31827ca763.
Many enteric pathogens disproportionately affect young children. However, higher incidences of laboratory-confirmed illness may be explained, at least in part, by higher rates of medical care-seeking and stool sample submission in this age group. We estimated the overall number of bacterial enteric illnesses among children <5 years old in the United States caused by Campylobacter, Escherichia coli O157, nontyphoidal Salmonella, Shigella and Yersinia enterocolitica.
We used a statistical model that scaled counts of laboratory-confirmed illnesses from the Foodborne Diseases Active Surveillance Network up to an estimated number of illnesses in the United States, adjusting for the surveillance steps needed for an illness to be laboratory diagnosed (medical care sought, stool sample submitted, bacterial culture performed, laboratory tested for pathogen, laboratory test sensitivity).
We estimated that 5 bacterial enteric pathogens caused 291,162 illnesses each year among children <5 years old, resulting in 102,746 physician visits, 7830 hospitalizations and 64 deaths. Nontyphoidal Salmonella caused most illnesses (42%), followed by Campylobacter (28%), Shigella (21%), Y. enterocolitica (5%) and E. coli O157 (3%). The estimated annual number of physician visits ranged from 3763 for E. coli O157 to 44,369 for nontyphoidal Salmonella. Nontyphoidal Salmonella was estimated to cause most hospitalizations (4670) and deaths (38).
Bacterial enteric infections cause many illnesses in US children. Compared with the general population, enteric illnesses among children <5 years old are more likely to be diagnosed. However, overall rates of illness remain higher in children after adjusting for underdiagnosis in both groups.
许多肠道病原体在幼儿中不成比例地流行。然而，实验室确诊病例的更高发病率至少部分可以解释为该年龄组寻求医疗保健和提交粪便样本的比率较高。我们估计了在美国 5 岁以下儿童中由弯曲杆菌、大肠杆菌 O157、非伤寒沙门氏菌、志贺氏菌和耶尔森氏菌引起的细菌性肠道疾病的总病例数。
我们使用了一种统计模型，根据食源性疾病主动监测网络报告的实验室确诊病例数量进行了扩展，以估计美国的疾病数量，并根据疾病进行实验室诊断所需的监测步骤进行了调整（寻求医疗保健、提交粪便样本、进行细菌培养、实验室检测病原体、实验室检测敏感性）。
我们估计，5 种细菌性肠道病原体每年导致 5 岁以下儿童发生 291162 例疾病，导致 102746 次就诊、7830 次住院和 64 例死亡。非伤寒沙门氏菌引起的病例最多（42%），其次是弯曲杆菌（28%）、志贺氏菌（21%）、耶尔森氏菌（5%）和大肠杆菌 O157（3%）。估计每年就诊次数从大肠杆菌 O157 的 3763 次到非伤寒沙门氏菌的 44369 次不等。非伤寒沙门氏菌估计引起的住院和死亡人数最多（4670 例和 38 例）。
细菌性肠道感染在美国儿童中引起许多疾病。与一般人群相比，5 岁以下儿童的肠道疾病更有可能被诊断。然而，在调整两组人群的漏诊率后，儿童的总体疾病发病率仍然较高。
