Paje-Villar E, Co B G, Caradang E H, Raymundo A, Lagamayo E, Lavadia E, Rigor E, Hart C A
Department of Paediatrics, University of Santo Tomas, Manila, Philippines.
Ann Trop Med Parasitol. 1994 Feb;88(1):53-8. doi: 10.1080/00034983.1994.11812835.
In a 25-month prospective study of diarrhoeal disease in 236 hospitalized Filipino children under 12 years of age, a potential enteropathogen was detected in 235 cases (> 99%). Viruses, found in 169 cases (72%), were the predominant pathogens. Most of the virus infections [164 (69%) of the patients] were of rotavirus and 80% of these were in children under 2 years of age. Rotavirus infection was most prevalent in the cold months. Astrovirus and calicivirus were observed for the first time in the Philippines. Entero-invasive Escherichia coli (13% of patients), Salmonellae (6%) and Shigellae (3.4%) were the commonest bacterial enteropathogens. Cryptosporidium was detected in only six patients. Fever and vomiting, although significantly more prevalent in cases of bacterial diarrhoea than in viral, were not sufficiently sensitive or specific to be used to distinguish the two forms of diarrhoea. Presence of faecal leucocytes (> 5/higher-power field) proved highly sensitive (90%) and specific (84%) in detecting bacteria diarrhoea but reliance on this sign alone would have led to the misdiagnosis of one third of bacterial diarrhoeas.
在一项针对236名12岁以下住院菲律宾儿童的腹泻病进行的为期25个月的前瞻性研究中，235例（>99%）检测到潜在肠道病原体。病毒在169例（72%）中被发现，是主要病原体。大多数病毒感染[164例（69%）患者]为轮状病毒感染，其中80%发生在2岁以下儿童。轮状病毒感染在寒冷月份最为普遍。星状病毒和杯状病毒在菲律宾首次被观察到。侵袭性大肠杆菌（占患者的13%）、沙门氏菌（6%）和志贺氏菌（3.4%）是最常见的细菌性肠道病原体。仅在6名患者中检测到隐孢子虫。发热和呕吐虽然在细菌性腹泻病例中比在病毒性腹泻病例中明显更常见，但不够敏感或特异，无法用于区分这两种腹泻形式。粪便白细胞（>5/高倍视野）的存在在检测细菌性腹泻方面具有很高的敏感性（90%）和特异性（84%），但仅依靠这一指标会导致三分之一的细菌性腹泻被误诊。
