Karim Sabina, Begum Ferdousi, Islam Afiqul, Tarafdar Monowar Ahmad, Begum Mamtaz, Islam Md Johirul, Malik Bushra, Ahsan Md Shamim, Khatami Ameneh, Rashid Harunor
Department of Paediatric Haematology and Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka 1212, Bangladesh.
Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1212, Bangladesh.
World J Clin Cases. 2020 Jan 26;8(2):276-283. doi: 10.12998/wjcc.v8.i2.276.
Diarrhoea is a frequent symptom in children with cancer, and occurs due to a composite effect of underlying disease and immunosuppression consequent to therapy, malnutrition, and non-infective aetiologies such as mucositis. In a large proportion of cases, the aetiology of diarrhoea remains unknown but is often attributed to multiple pathogens including parasites.
To identify and describe the pathogens causing diarrhoea in Bangladeshi children with cancer.
Two cross-sectional pilot studies were conducted involving paediatric oncology patients with diarrhoea. Stool samples were collected from children who were hospitalised with or without being treated with chemotherapy during the study period, and had diarrhoea at any stage during their admission. In the first study, stool samples were tested by conventional microbiological methods and by polymerase chain reaction for parasites, and by immunoassays for . In the second study, conventional microbiology was conducted for bacteria and parasites including an enzyme-linked immunosorbent assay for antigen, and in a subset, immunoassays for .
In the first study was detected in 68.5% of samples, in 13%, in 5.6%, non-toxigenic in 22.4%, and other bacteria in 5.2%. In the second study, was detected in 10% of samples, in 4.3%, in 1.4%, in 5.1%, and other bacteria in 5.7% of samples.
These pilot data suggest that parasites are important aetiologies of diarrhoea in Bangladeshi children with malignancy. While molecular diagnostic tools detect an array of stool pathogens with greater sensitivity, conventional diagnostic methods are also useful.
腹泻是癌症患儿常见的症状，是由基础疾病、治疗导致的免疫抑制、营养不良以及诸如黏膜炎等非感染性病因的综合作用引起的。在很大一部分病例中，腹泻的病因仍不明，但常归因于包括寄生虫在内的多种病原体。
识别并描述导致孟加拉国癌症患儿腹泻的病原体。
开展了两项横断面试点研究，纳入患有腹泻的儿科肿瘤患者。在研究期间，从住院的儿童中采集粪便样本，这些儿童无论是否接受化疗，且在入院的任何阶段出现腹泻。在第一项研究中，粪便样本通过传统微生物学方法检测寄生虫，通过聚合酶链反应检测，通过免疫测定检测。在第二项研究中，对细菌和寄生虫进行传统微生物学检测，包括对抗原的酶联免疫吸附测定，在一个子集中，对进行免疫测定。
在第一项研究中，68.5%的样本检测到，13%检测到，5.6%检测到，22.4%检测到非产毒素，5.2%检测到其他细菌。在第二项研究中，10%的样本检测到，4.3%检测到，1.4%检测到，5.1%检测到，5.7%的样本检测到其他细菌。
这些试点数据表明，寄生虫是孟加拉国恶性肿瘤患儿腹泻的重要病因。虽然分子诊断工具能更灵敏地检测一系列粪便病原体，但传统诊断方法也有用。
