Soares Ana Teresa, Couto Catarina, Romão Patrícia, Melo Isabel Saraiva de, Braga Manuela, Diogo José, Calhau Paulo
Serviço de Pediatria. Hospital Garcia de Orta. Almada. Portugal.
Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
Acta Med Port. 2014 Sep-Oct;27(5):556-60. Epub 2014 Oct 31.
Infection by Cambylobacter occurs worldwide and represents the main cause of acute bacterial gastroenteritis within the European Union.
Determine the prevalence of Campylobacter in stool cultures from patients with gastroenteritis and study their microbiological, epidemiological, clinical, and therapeutic profiles, as well as associated complications.
Review of clinical files of patients presenting to the paediatric emergency department of a general district hospital over a 30 month period with an acute gastroenteritis and a Campylobacter isolated in a stool specimen.
Out of 216 stool cultures, 98 (45%) were positive. We identified Campylobacter in 49 (50%) cases; 30 (61%) were female. Median age was 23 months. Fourteen patients were under one year of age, 25 between one and five years old and 10 patients were over five years old. Watery diarrhea was identified in 5 (10%) patients, bloody diarrhea in 44 (90%) and mucosanguineous in 14 (29%), while 23 (47%) had fever, 14 (29%) complained of abdominal pain and 11 (22%) presented with vomiting. One patient was septic. Five patients were admitted as inpatients. Eight patients were treated with azithromycin.
This is the largest published national series on gastroenteritis by Campylobacter in children and the first in the south region. Campylobacter was the main bacteria isolated. Infection was self-resolving in the majority of cases. Nevertheless, severe forms of this infection should be considered. Increased resistance to quinolones is worrisome.
Judicious use of stool cultures allows etiological identification of bacterial gastroenteritis. The increase in Campylobacter cases reinforces the need for better control of hygiene measures in handling food products.
弯曲杆菌感染在全球范围内均有发生，是欧盟急性细菌性肠胃炎的主要病因。
确定肠胃炎患者粪便培养物中弯曲杆菌的患病率，并研究其微生物学、流行病学、临床和治疗特征以及相关并发症。
回顾一家综合地区医院儿科急诊科在30个月期间收治的患有急性肠胃炎且粪便标本中分离出弯曲杆菌的患者的临床档案。
在216份粪便培养物中，98份（45%）呈阳性。我们在49例（50%）病例中鉴定出弯曲杆菌；30例（61%）为女性。中位年龄为23个月。14名患者年龄在1岁以下，25名在1至5岁之间，10名患者年龄超过5岁。5例（10%）患者出现水样腹泻，44例（90%）出现血性腹泻，14例（29%）出现黏液血性腹泻，23例（47%）发热，14例（29%）主诉腹痛，11例（22%）出现呕吐。1例患者发生败血症。5例患者住院治疗。8例患者接受阿奇霉素治疗。
这是已发表的关于儿童弯曲杆菌性肠胃炎的最大规模全国性系列研究，也是南部地区的首个此类研究。弯曲杆菌是主要分离出的细菌。大多数情况下感染可自行缓解。然而，仍应考虑这种感染的严重形式。对喹诺酮类药物耐药性的增加令人担忧。
合理使用粪便培养可对细菌性肠胃炎进行病因鉴定。弯曲杆菌病例的增加凸显了更好地控制食品处理卫生措施的必要性。
