García Vera César, García Ventura María, Del Castillo Aguas Guadalupe, Domínguez Aurrecoechea Begoña, Esparza Olcina María Jesús, Martínez Rubio Ana, Mengual Gil José María
Centro de Salud José Ramón Muñoz Fernández, Servicio Aragonés de Salud, Zaragoza, España.
Hospital Universitario Infantil Miguel Servet, Servicio Aragonés de Salud, Zaragoza, España.
An Pediatr (Barc). 2017 Sep;87(3):128-134. doi: 10.1016/j.anpedi.2016.04.020. Epub 2016 Sep 27.
To determine the main clinical and epidemiological features of bacterial gastroenteritis in our environment.
An observational study of a Spanish population in 17 Autonomous Communities. Questionnaires of children with a stool positive culture to bacteria were collected over a one year period. A bivariate analysis was performed on the variables involved, as well as two multivariate models (for antibiotic treatment variables, and comparison Campylobacter/Salmonella).
A total of 729 bacterial gastroenteritis episodes were recorded in the 17 Spanish autonomous regions, of which 41.2% were girls and 58.8% boys. The median age was 3.41 years old (interquartile range 1.55 to 6.72). The bacteria isolated were 59.9% Campylobacter, 31.8% non-Typhi Salmonella, 2.7% Aeromonas, 2.4% Yersinia, and 1.5% had more than one strain. Most infections (70%) were direct contacts, and food poisoning was less probable (25.9%). Salmonella is significantly less frequent than Campylobacter in children under the age of 3 years (adjusted OR 0.61; 95%CI: 0.43 to 0.86; P=.005), and Campylobacter is more frequent in rural areas (adjusted OR 1.48; 95%CI: 1.07 to 2.07; P=.012). Antibiotic was prescribed in 33.2% of cases. There was a greater significant difference if stools contained blood or mucus (adjusted OR 1.53; 95%CI: 1.04 to 2.27; P=.031), if the symptoms lasted more than 7days (adjusted OR 2.81; 95%CI: 2.01 to 3.93; P<.000), or if the child was admitted to hospital (adjusted OR 1.95; 95%CI: 1.08 to 3.52; P=.027).
The aetiology of bacterial diarrhoea in paediatrics is typical of that of a developed country. The transmission mechanism is mainly direct, and more cases than appropriate are treated with antibiotics.
确定我们所处环境中细菌性肠胃炎的主要临床和流行病学特征。
对西班牙17个自治区的人群进行一项观察性研究。收集了一年内粪便细菌培养呈阳性的儿童的调查问卷。对所涉及的变量进行了双变量分析，以及两个多变量模型分析（针对抗生素治疗变量，以及弯曲杆菌/沙门氏菌比较）。
在西班牙17个自治区共记录了729例细菌性肠胃炎发作病例，其中41.2%为女孩，58.8%为男孩。中位年龄为3.41岁（四分位间距为1.55至6.72）。分离出的细菌中，弯曲杆菌占59.9%，非伤寒沙门氏菌占31.8%，气单胞菌占2.7%，耶尔森菌占2.4%，1.5%有不止一种菌株。大多数感染（70%）是直接接触所致，食物中毒的可能性较小（25.9%）。在3岁以下儿童中，沙门氏菌的发生率明显低于弯曲杆菌（校正比值比0.61；95%置信区间：0.43至0.86；P = 0.005），弯曲杆菌在农村地区更为常见（校正比值比1.48；95%置信区间：1.07至2.07；P = 0.012）。33.2%的病例使用了抗生素。如果粪便中有血液或黏液（校正比值比1.53；95%置信区间：1.04至2.27；P = 0.031）、症状持续超过7天（校正比值比2.81；95%置信区间：2.01至3.93；P < 0.000）或儿童住院（校正比值比1.95；95%置信区间：1.08至3.52；P = 0.027），则使用抗生素的差异更为显著。
儿科细菌性腹泻的病因是发达国家的典型病因。传播机制主要是直接传播，且使用抗生素治疗的病例多于合理病例。
