Pediatric Medicine Research Center, Qom University of Medical Sciences, Qom, Iran.
Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran.
BMC Infect Dis. 2024 May 22;24(1):512. doi: 10.1186/s12879-024-09372-3.
Diarrhea is a common disease in immunocompromised patients and can be associated with greater morbidity and even mortality. Therefore, the present study was designed to determine the prevalence of Aeromonas spp., Campylobacter spp., and C. difficile among immunocompromised children.
This study was conducted on 130 stool samples from patients with diarrhea who had defects in the immune system and were referred to Hazrat Masoumeh Children's Hospital in Qom. Demographic information, clinical symptoms, immune status, and duration of chemotherapy were also recorded for each child. DNAs were extracted from the stool, and then direct PCR assays were done by specific primers for the detection of Aeromonas spp., Campylobacter spp., and toxigenic C. difficile, including tcdA/B and cdtA/B genes. Co-infection in patients was also evaluated.
60.8% and 39.2% were male and female, respectively, with a m ± SD age of 56.72 ± 40.49 months. Most cases of immunocompromised states were related to Acute Lymphocytic Leukemia (77.7%) and Non-Hodgkin Lymphoma (14.6%). 93.1% of patients were undergoing chemotherapy during the study. Among patients, most clinical symptoms were related to bloody diarrhea (98.5%) and fever (92.3%). Based on PCR, 14.6, 9.2, and 1.5% were positive for Aeromonas spp., C. difficile, and C. jejuni, respectively. Among the C. difficile-positive cases, the tcdA gene was only detected in one patient. In total, three co-infections were identified, which included Aeromonas spp./C. difficile (tcdA), C. jejuni/C. difficile, and C. jejuni/Aeromonas spp.
This is the first study in Iran to investigate the simultaneous prevalence of some pathogens in immunocompromised children with diarrhea. Because Aeromonas spp., Campylobacter spp., and C. difficile are not routinely detected in some laboratories, infections caused by them are underappreciated in the clinic. Our results showed that these pathogens are present in our region and can cause gastroenteritis in children, especially those with underlying diseases. Therefore, increasing the level of hygiene in some areas and controlling bacterial diarrheal diseases should be given more attention by health officials.
腹泻是免疫功能低下患者的常见疾病，可导致更高的发病率，甚至死亡率。因此，本研究旨在确定免疫功能低下儿童中产气单胞菌、弯曲菌和艰难梭菌的流行情况。
本研究纳入了 130 例来自免疫缺陷患者腹泻粪便样本，这些患者来自于库姆的侯赛因·礼萨儿童医院。每位患儿的人口统计学信息、临床症状、免疫状态和化疗持续时间均被记录。从粪便中提取 DNA，然后通过针对产气单胞菌、弯曲菌和产毒艰难梭菌（包括 tcdA/B 和 cdtA/B 基因）的特异性引物进行直接 PCR 检测。还评估了患者的合并感染情况。
男女比例分别为 60.8%和 39.2%，平均年龄（m ± SD）为 56.72 ± 40.49 个月。免疫缺陷状态主要与急性淋巴细胞白血病（77.7%）和非霍奇金淋巴瘤（14.6%）有关。93.1%的患者在研究期间正在接受化疗。在患者中，大多数临床症状与血性腹泻（98.5%）和发热（92.3%）有关。基于 PCR，产气单胞菌、艰难梭菌和空肠弯曲菌的阳性率分别为 14.6%、9.2%和 1.5%。在艰难梭菌阳性病例中，仅在 1 例患者中检测到 tcdA 基因。总共有 3 例合并感染，包括产气单胞菌/艰难梭菌（tcdA）、空肠弯曲菌/艰难梭菌和空肠弯曲菌/产气单胞菌。
这是伊朗首例研究腹泻免疫功能低下儿童中一些病原体同时流行的情况。由于一些实验室不常规检测产气单胞菌、弯曲菌和艰难梭菌，因此临床上对它们引起的感染认识不足。我们的研究结果表明，这些病原体在本地区存在，并可导致儿童患肠胃炎，尤其是患有基础疾病的儿童。因此，卫生官员应更加重视提高某些地区的卫生水平和控制细菌性腹泻病。
