Fontana M, Zuin G, Paccagnini S, Ceriani R, Quaranta S, Villa M, Principi N
Pediatric Department IV, University of Milan, Italy.
Pediatr Infect Dis J. 1987 Dec;6(12):1088-91.
We describe a two-step predictive method to assess the probability of bacterial etiology in cases of diarrhea. The patients are divided into three probability groups (high, intermediate, low) according to a clinical score. Thereafter the patients in the intermediate group are further assigned to the high or low probability group according to the presence or absence of fecal leukocytes. We developed the method in an initial series of 157 children with acute diarrhea; the reproducibility of the method was tested in a second series of 180 cases. Eighty-six percent of patients in the first series and 81% in the second were correctly classified by our method. We suggest its use, especially in pediatric practice, to identify children with the highest probability of bacterial diarrhea, thus reserving stool culture to a few selected cases because only a minority of children with diarrhea have a recognized bacterial etiology.
我们描述了一种两步预测方法，用于评估腹泻病例中细菌病因的可能性。根据临床评分将患者分为三个概率组（高、中、低）。此后，根据粪便白细胞的有无，将中间组的患者进一步分为高概率组或低概率组。我们在最初的157例急性腹泻儿童系列中开发了该方法；在第二个180例的系列中测试了该方法的可重复性。我们的方法在第一个系列中对86%的患者进行了正确分类，在第二个系列中对81%的患者进行了正确分类。我们建议使用该方法，特别是在儿科实践中，以识别细菌腹泻可能性最高的儿童，从而仅对少数选定病例进行粪便培养，因为只有少数腹泻儿童有公认的细菌病因。
