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坦桑尼亚姆万扎一家三级医院中感染艾滋病毒且患有腹泻的儿童感染率较高。

High Infection among HIV-Infected Children with Diarrhea in a Tertiary Hospital in Mwanza, Tanzania.

作者信息

Seugendo Mwanaisha, Hokororo Aldofine, Kabyemera Rogatus, Msanga Delfina R, Mirambo Mariam M, Silago Vitus, Groß Uwe, Mshana Stephen E

机构信息

Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Mwanza, Tanzania.

Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania.

出版信息

Int J Pediatr. 2020 Aug 24;2020:3264923. doi: 10.1155/2020/3264923. eCollection 2020.

Abstract

causes a million of illnesses each year worldwide and can affect people of all ages. Limited data exist on the prevalence of . infections (CDI) among children below five years of age in developing countries. This study is aimed at determining the prevalence, associated factors, and outcome of the infection among children with diarrhea attending a tertiary hospital in Mwanza, Tanzania. Stool samples were collected and cultured anaerobically to isolate , followed by . toxin A and B assay and ribotyping. A total of 301 children with diarrhea were enrolled. A total of 22 (7.31%, 95% CI: 0.89-0.95) nonrepetitive stool samples were positive for . Eighteen (81%) of . isolates were toxigenic, and 16 (72.7%) had unknown ribotypes. Independent predictors of positive . were as follows: positive HIV status, hospital stay of more than four days, high stool leukocyte count, and watery stool. -positive children had significantly higher median duration of the diarrhea than those without . . Clinicians should consider . as a possible cause of diarrhea in children living in developing countries and institute appropriate management to prevent associated morbidities and mortalities. Furthermore, there is a need of joint effort to improve . diagnosis and surveillance in developing countries to establish the unknown epidemiology of CDI in these countries.

摘要

每年在全球范围内导致数百万例疾病,可影响所有年龄段的人群。关于发展中国家五岁以下儿童艰难梭菌感染(CDI)的患病率,现有数据有限。本研究旨在确定坦桑尼亚姆万扎一家三级医院中腹泻儿童艰难梭菌感染的患病率、相关因素及转归。采集粪便样本并进行厌氧培养以分离艰难梭菌,随后进行毒素A和B检测及核糖分型。共纳入301例腹泻儿童。共有22份(7.31%,95%CI:0.89 - 0.95)非重复粪便样本艰难梭菌检测呈阳性。18株(81%)艰难梭菌分离株产毒,16株(72.7%)核糖型未知。艰难梭菌检测呈阳性的独立预测因素如下:HIV阳性状态、住院时间超过四天、粪便白细胞计数高以及水样便。艰难梭菌检测呈阳性的儿童腹泻持续时间中位数显著长于未感染艰难梭菌的儿童。临床医生应将艰难梭菌视为发展中国家儿童腹泻的可能病因,并采取适当管理措施以预防相关发病和死亡。此外,需要共同努力改善发展中国家艰难梭菌的诊断和监测,以明确这些国家CDI的未知流行病学情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d3/7474756/49c92397d247/IJPEDI2020-3264923.001.jpg

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