Cobeljić M, Mel D, Arsić B, Krstić L, Sokolovski B, Nikolovski B, Sopovski E, Kulauzov M, Kalenić S
Institute of Preventive Medicine, Military Medical Academy, Belgrade, Yugoslavia.
Epidemiol Infect. 1989 Aug;103(1):53-62. doi: 10.1017/s0950268800030351.
The presence of enterotoxigenic and enteropathogenic Escherichia coli (ETEC and EPEC, respectively) was investigated in stool specimens of 1082 preschool children with diarrhoea and in stools of 335 healthy controls in localities in southern Yugoslavia, as well as in 566 children with diarrhoea and in 231 controls living in northern part of the country, during the seasonal peak (August-November) of enteric diseases in 1986. ETEC were found in 114 (10.5%) children with diarrhoea and in 14 (4.2%) controls (P less than 0.001) in the southern part, and in 26 (4.6%) ill children and one (0.4%) well child (P less than 0.005) in the northern part of Yugoslavia. EPEC were isolated from stools of 85 (7.9%) children with diarrhoea and of 14 (4.2%) well children (P less than 0.05) in localities of southern Yugoslavia, and from 22 (3.9%) ill children and from 10 (4.3%) controls in northern Yugoslavia. Nineteen EPEC strains expressed localized adherence to HEp-2 tissue culture cells; all were isolated from stools of ill children. In southern Yugoslavia, where other enteropathogens were sought, the most commonly found agents in ill children were shigellae (17.5%), rotavirus (11.8%), ETEC, and EPEC. Potential pathogens were detected in 44.5% cases of sporadic diarrhoea and in 15.8% controls. This study revealed that ETEC were associated with acute diarrhoeal disease in Yugoslav preschool children. On the other hand, the diagnosis of EPEC-diarrhoea by routine determination of serogroup established the association of these agents with sporadic diarrhoea only in the 0-2 years age categories in all investigated localities. In the less developed southern part of Yugoslavia bacteria were the predominant causative agents of enteric illness during the seasonal peak of this disease.
1986年肠道疾病季节性高峰期（8月至11月），在南斯拉夫南部地区1082名腹泻学龄前儿童的粪便标本以及335名健康对照者的粪便中，同时也在该国北部地区566名腹泻儿童和231名对照者的粪便中，对产肠毒素大肠杆菌和肠致病性大肠杆菌（分别为ETEC和EPEC）的存在情况进行了调查。在南斯拉夫南部地区，114名（10.5%）腹泻儿童和14名（4.2%）对照者中检测到ETEC（P<0.001）；在南斯拉夫北部地区，26名（4.6%）患病儿童和1名（0.4%）健康儿童中检测到ETEC（P<0.005）。在南斯拉夫南部地区，85名（7.9%）腹泻儿童和14名（4.2%）健康儿童的粪便中分离出EPEC（P<0.05）；在南斯拉夫北部地区，22名（3.9%）患病儿童和10名（4.3%）对照者粪便中分离出EPEC。19株EPEC菌株对HEp-2组织培养细胞表现出局部黏附；所有菌株均从患病儿童粪便中分离得到。在搜寻其他肠道病原体的南斯拉夫南部地区，患病儿童中最常见的病原体是志贺菌（17.5%）、轮状病毒（11.8%）、ETEC和EPEC。在44.5%的散发性腹泻病例和15.8%的对照者中检测到潜在病原体。这项研究表明，ETEC与南斯拉夫学龄前儿童的急性腹泻病有关。另一方面，通过常规血清群测定诊断EPEC腹泻，仅在所有调查地区0至2岁年龄组中确定了这些病原体与散发性腹泻的关联。在欠发达的南斯拉夫南部地区，细菌是该疾病季节性高峰期肠道疾病的主要致病因素。
