Ben Salem-Ben Nejma Imen, Hassine Zaafrane Mouna, Hassine Fredj, Sdiri-Loulizi Khira, Ben Said Moncef, Aouni Mahjoub, Mzoughi Ridha
1. Laboratory of Infectious Diseases and Biological Agents, Faculty of Pharmacy, University of Monastir TU-5000 Monastir, Tunisia ; 1. Laboratory of Infectious Diseases and Biological Agents, Faculty of Pharmacy, University of Monastir TU-5000 Monastir, Tunisia.
1. Laboratory of Infectious Diseases and Biological Agents, Faculty of Pharmacy, University of Monastir TU-5000 Monastir, Tunisia ; 3. National Reference Center for Enteric Viruses, Laboratory of Virology, CHU of Dijon, 2 Rue Angélique Ducoudray, University of Bourgogne 21000 Dijon France.
Iran J Public Health. 2014 Jul;43(7):947-60.
Diarrheal diseases can be caused by viral, bacterial and parasitic infections. This paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in Tunisian children less than five years of age.
Overall, 124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. All stools were examined for the presence of enteric pathogens.
In diarrheagenic children, 107 pathogenic bacteria were isolated (12 Salmonella spp. (9.7%) and 95 diarrheagenic Escherichia coli strains (76.6%): 29 enteroaggregative E.coli (EAEC) (23.4%), 15 enteroinvasive E.coli (EIEC) (12.1%), 17 enteropathogenic E.coli (EPEC) (13.7%), 26 enterotoxigenic E.coli (ETEC) (21%) and 2 enterohemoragic E.coli (EHEC) (1.6%). However, in the control group, 23 pathogenic E.coli strains were isolated (42.6%): 8 EAEC (14.8%), 12 EIEC (22.2%) and 3 EPEC (5.5%). Among diarrheagenic E.coli (DEC), only ETEC strains were significantly recovered from diarrheagenic children than from healthy controls (P < 0.0003). Group A rotavirus was identified in 33.9% (n=42) of diarrheagenic children and in 11.1% among the control group (n=6). Concerning norovirus, 8.9% (n=11) of the samples collected from diarrheagenic children and 9.2% (n=5) from the control group were positive. The prevalence of rotaviruses and Salmonella spp were also significantly higher in patients with diarrhea than in controls (P = 0.002 and P < 0.019, respectively). Finally, enteropathogenic parasites (Entamoeba coli and cryptosporidium Oocystes) were isolated from 4.8% and 9.2% of diarrheagenic and control children, respectively.
These results provide baseline data about the relative importance of different enteropathogens in Tunisian children.
腹泻病可由病毒、细菌和寄生虫感染引起。本文提供了关于突尼斯5岁以下儿童腹泻的病因和流行病学因素的初步情况。
总体而言，从急性腹泻患者中收集了124份腹泻粪便样本，从健康儿童中收集了54份粪便样本。对所有粪便样本进行肠道病原体检测。
在腹泻患儿中，分离出107株病原菌（12株沙门氏菌属（9.7%）和95株致泻性大肠杆菌菌株（76.6%）：29株肠聚集性大肠杆菌（EAEC）（23.4%）、15株肠侵袭性大肠杆菌（EIEC）（12.1%）、17株肠致病性大肠杆菌（EPEC）（13.7%）、26株产肠毒素大肠杆菌（ETEC）（21%）和2株肠出血性大肠杆菌（EHEC）（1.6%）。然而，在对照组中，分离出23株致病性大肠杆菌菌株（42.6%）：8株EAEC（14.8%）、12株EIEC（22.2%）和3株EPEC（5.5%）。在致泻性大肠杆菌（DEC）中，只有ETEC菌株在腹泻患儿中的检出率显著高于健康对照组（P < 0.0003）。A组轮状病毒在33.9%（n = 42）的腹泻患儿中被检出，在对照组中为11.1%（n = 6）。关于诺如病毒，从腹泻患儿中收集的样本中有8.9%（n = 11）呈阳性，对照组中有9.2%（n = 5）呈阳性。腹泻患者中轮状病毒和沙门氏菌属的患病率也显著高于对照组（分别为P = 0.002和P < 0.019）。最后，分别从4.8%的腹泻患儿和9.2%的对照儿童中分离出致病性寄生虫（结肠内阿米巴和隐孢子虫卵囊）。
这些结果提供了关于突尼斯儿童不同肠道病原体相对重要性的基线数据。
