Sethi S K, Khuffash F A, al-Nakib W
Department of Microbiology, Faculty of Medicine, Kuwait University, Safat.
Pediatr Infect Dis J. 1989 Sep;8(9):593-7. doi: 10.1097/00006454-198909000-00005.
During a period of 15 months 621 hospitalized children with acute gastroenteritis and 152 control children were investigated for etiologic agents of the disease. Putative enteropathogens were identified in 86% of the patients and 10% of the controls. Common viral agents associated with gastroenteritis among children included rotaviruses (45%) and enteric adenoviruses (4%). Bacterial pathogens infecting children were Salmonella serotypes (24%), enterotoxigenic Escherichia coli (9%), Campylobacter jejuni (7%), enteropathogenic E. coli (7%), Shigella (4%) and enterotoxigenic Aeromonas sp. (1%). The highest incidence of infections was observed in the 3- to 25-month age group. Mixed infections were observed in 12% of the patients. Viral gastroenteritis was clinically mild and of short duration. Upper respiratory tract infections, vomiting and watery stools were common features. In contrast bacterial gastroenteritis was more severe; stools were frequently bloody and abdominal pain, cramps, shock, convulsions and milk intolerance were predominant clinical features. Comparative analysis revealed differential features of bacterial and viral gastroenteritis which should help clinicians to make a tentative diagnosis and to start treatment early.
在15个月的时间里，对621名住院的急性胃肠炎患儿和152名对照儿童进行了疾病病因调查。在86%的患者和10%的对照儿童中发现了推定的肠道病原体。儿童中与胃肠炎相关的常见病毒病原体包括轮状病毒（45%）和肠道腺病毒（4%）。感染儿童的细菌病原体有沙门氏菌血清型（24%）、产肠毒素大肠杆菌（9%）、空肠弯曲菌（7%）、致病性大肠杆菌（7%）、志贺氏菌（4%）和产肠毒素气单胞菌属（1%）。感染发生率最高的是3至25个月龄组。12%的患者存在混合感染。病毒性胃肠炎临床症状较轻，病程较短。上呼吸道感染、呕吐和水样便为常见症状。相比之下，细菌性胃肠炎更为严重；粪便常带血，腹痛、痉挛、休克、惊厥和牛奶不耐受是主要临床症状。对比分析揭示了细菌性和病毒性胃肠炎的不同特征，这有助于临床医生做出初步诊断并尽早开始治疗。
