Quinn T C, Bender B S, Bartlett J G
Dis Mon. 1986 Apr;32(4):165-244. doi: 10.1016/s0011-5029(86)80009-8.
The past decade has produced exciting advances in our knowledge of infectious diarrhea. The list of potential enteric pathogens continues to grow with both the identification of new organisms, e.g., E. coli serotype O157:H7, and the recognition that previously characterized microorganisms, e.g., M. avium-intracellulare, can also cause gastrointestinal disease in immunosuppressed patients. Multiple investigations have led to a greater understanding of the epidemiology and clinical features of these illnesses. Application of modern biological techniques has yielded a number of diagnostic assays that are just now becoming clinically relevant. New drugs and treatment modalities for enteric infections have been developed and are now being evaluated in clinical trials. Despite these advancements, however, many questions still remain unanswered. For example, the etiology of the debilitating diarrhea in AIDS patients in whom no known intestinal pathogen can be identified remains unknown. The mechanism of diarrhea due to Cryptosporidium, Isospora, and Giardia remains elusive. And last, will new intestinal vaccines be effective in preventing diarrheal disease? Certainly, the next decade of research in enteric diseases should prove to be even more interesting than the last.
在过去十年里，我们对感染性腹泻的认识取得了令人振奋的进展。随着新病原体（如大肠杆菌O157:H7血清型）的发现，以及对先前已确定的微生物（如鸟分枝杆菌复合群）在免疫抑制患者中也可引起胃肠道疾病的认识，潜在肠道病原体的种类持续增加。多项研究使我们对这些疾病的流行病学和临床特征有了更深入的了解。现代生物技术的应用产生了一些诊断检测方法，这些方法目前才开始在临床上发挥作用。针对肠道感染的新药和治疗方式已经研发出来，目前正在临床试验中进行评估。然而，尽管有这些进展，许多问题仍然没有答案。例如，在无法确定已知肠道病原体的艾滋病患者中，导致虚弱性腹泻的病因仍然不明。隐孢子虫、等孢子球虫和贾第虫引起腹泻的机制仍然难以捉摸。最后，新型肠道疫苗能否有效预防腹泻病？当然，未来十年对肠道疾病的研究肯定会比过去十年更加引人关注。
