Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
Folia Microbiol (Praha). 2021 Jun;66(3):399-410. doi: 10.1007/s12223-020-00846-w. Epub 2021 Feb 10.
Globally, it is estimated that there are 2 billion cases of diarrhoeal disease each year, with 525,000 children under the age of 5 years, dying from diarrhoea. This also affects 1 in 5 people in the UK each year. Rapid diagnosis, appropriate treatment and infection control measures are, therefore, particularly important. Currently, Public Health Wales and England Microbiology Division test for five key bacterial gastrointestinal pathogens, i.e. Escherichia coli O157 (VTEC), Shigella dysenteriae, Salmonella spp., Campylobacter spp. and Clostridioides difficile. There is, however, a poor success rate with identification of these pathogens, leaving the patient at risk from untreated infections. This study has developed effective and reliable tools with a high positive outcome for diagnosis of diarrhoeal infection. The study blindly analysed 592 samples, with the most abundant species being Shigella sonnei at 15%, and the top genus Bacteroides at 26%. Campylobacter spp. had an abundance of 4%, Clostridium difficile 3%, and Salmonella spp. 0.2%. There were also significant differences in abundance at genus level, between the Flemish Gut project and diarrhoea samples, with respect to Shigella (0.2%) and Campylobacter (0.1%). The project introduced a novel Shigella spp. (Escherichia) threshold of 5.32% to determine (Escherichia) a healthy or unhealthy community. A DMBiome model was developed to integrate the 5.32% threshold of Shigella spp., the Public Health laboratory tested pathogens, and two emerging enteropathogens. The overall positive outcome was that 89% of all samples were diagnosed with diarrhoea infections, leaving 11% unknown.
全球每年估计有 20 亿例腹泻病,其中 52.5 万名 5 岁以下儿童死于腹泻。在英国,每年也有 1/5 的人受到影响。因此,快速诊断、适当治疗和感染控制措施尤为重要。目前,威尔士公共卫生局和英格兰微生物科测试五种关键的细菌性胃肠道病原体,即产志贺毒素大肠杆菌 O157(VTEC)、志贺氏菌、沙门氏菌、弯曲菌和艰难梭菌。然而,这些病原体的识别成功率很低,使患者面临未治疗感染的风险。本研究开发了有效的可靠工具,对腹泻感染的诊断具有很高的阳性结果。该研究对 592 个样本进行了盲法分析,最丰富的物种是宋内志贺菌,占 15%,优势属是拟杆菌,占 26%。弯曲菌属的丰度为 4%,艰难梭菌为 3%,沙门氏菌为 0.2%。在丰度方面,Flemish Gut 项目和腹泻样本之间也存在显著差异,志贺菌(0.2%)和弯曲菌(0.1%)的丰度较低。该项目引入了一个新的志贺菌(大肠杆菌)阈值为 5.32%,以确定(大肠杆菌)是健康还是不健康的社区。开发了一个 DMBiome 模型,以整合志贺菌属的 5.32%阈值、公共卫生实验室检测的病原体以及两种新兴的肠道病原体。总体阳性结果是,89%的样本被诊断为腹泻感染,11%的样本未知。