Chun Peter, Lim Taek Jin, Hwang Eun Ha, Mun Sang Wook, Lee Yeoun Joo, Park Jae Hong
Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2017 Jun;20(2):107-113. doi: 10.5223/pghn.2017.20.2.107. Epub 2017 Jun 28.
This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens.
Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed.
Twenty-four patients (70.6%) were male. The mean age of the patients was 8.5±6.2 (range, 1.1-17.1) years. Six bacterial pathogens were isolated: species (spp.) (32.4%), spp. (20.6%), verotoxin-producing (14.7%), (11.8%), (8.8%), and spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with were older than those infected with verotoxin-producing (<0.05). C-reactive protein levels were higher in patients with and infections than in those with verotoxin-producing infection (<0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen.
Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.
本研究明确了当前导致儿童急性感染性小肠结肠炎（AIE）的细菌病原体，并根据不同病原体评估了临床特征及超声检查结果。
回顾性分析34例经多重聚合酶链反应（PCR）或培养进行粪便检查确诊为AIE的患者的病历，内容包括年龄、性别、临床症状、实验室数据、鉴定出的肠道病原体、超声检查结果、治疗及预后。
24例（70.6%）患者为男性。患者的平均年龄为8.5±6.2（范围1.1 - 17.1）岁。分离出6种细菌病原体： 菌属（32.4%）、 菌属（20.6%）、产志贺毒素大肠杆菌（14.7%）、 菌（11.8%）、 菌（8.8%）和 菌属（2.9%）。所有患者均出现腹痛，与病原体无关。感染 的患者比产志贺毒素大肠杆菌感染的患者年龄大（<0.05）。 菌和 菌感染患者的C反应蛋白水平高于产志贺毒素大肠杆菌感染患者（<0.05），其他临床和实验室数据在不同病原体之间无明显差异。超声检查显示根据病原体不同，肠段受累情况各异。无论病原体如何，回肠和整个结肠壁增厚是最常见的病变部位。
多种细菌可导致AIE，症状多样，但大多数儿童可自发康复。粪便样本使用多重PCR有待提高对肠道病原菌诊断的敏感性。超声检查对AIE诊断有用；还可检测疾病范围和严重程度。
