Guarino A, Alessio M, Tarallo L, Fontana M, Iacono G, Gobio Casali L, Guandalini S
Department of Paediatrics, University of Naples, Italy.
Arch Dis Child. 1989 Jun;64(6):808-13. doi: 10.1136/adc.64.6.808.
We screened 569 children with acute onset diarrhoea from five Italian towns for heat stable enterotoxin produced by Escherichia coli. We compared an enzyme linked immunoabsorbent assay (ELISA) with the standard suckling mouse assay for detection of the enterotoxin. A total of 31 (5.4%) children were found who had strains of E coli that produced heat stable enterotoxin: 26 strains were positive in both tests, four only in the suckling mouse assay, and one only in the ELISA. Compared with the suckling mouse assay the sensitivity of the ELISA was 87% and the specificity was 99.8%. The mean age of the children with E coli that produced heat stable enterotoxin was 22 months. Fifteen (48%) of the children had ingested potentially contaminated food and five (17%) had a previous contact with someone with diarrhoea. The clinical picture was milder than that described in developing countries. Faecal osmolality and the osmolal gap were consistent with a secretory diarrhoea in 12 out of 15 (80%) of these children. The mean duration of the diarrhoea was five days. Heat stable enterotoxin produced by E coli is a common cause of mild diarrhoeal illness in Italian children.
我们对来自意大利五个城镇的569名急性腹泻儿童进行了筛查，以检测大肠杆菌产生的热稳定肠毒素。我们将酶联免疫吸附测定法（ELISA）与检测肠毒素的标准乳鼠试验进行了比较。共发现31名（5.4%）儿童的大肠杆菌菌株产生热稳定肠毒素：26株在两种试验中均呈阳性，4株仅在乳鼠试验中呈阳性，1株仅在ELISA中呈阳性。与乳鼠试验相比，ELISA的敏感性为87%，特异性为99.8%。产生热稳定肠毒素的大肠杆菌患儿的平均年龄为22个月。15名（48%）儿童摄入了可能受污染的食物，5名（17%）儿童此前曾与腹泻患者接触。临床症状比发展中国家描述的要轻。15名儿童中有12名（80%）的粪便渗透压和渗透压间隙与分泌性腹泻一致。腹泻的平均持续时间为5天。大肠杆菌产生的热稳定肠毒素是意大利儿童轻度腹泻疾病的常见病因。
