Gusmão R H, Mascarenhas J D, Gabbay Y B, Lins-Lainson Z, Ramos F L, Monteiro T A, Valente S A, Linhares A C
Instituto Evandro Chagas, Fundação Nacional de Saúde, Belém, Brasil.
Mem Inst Oswaldo Cruz. 1995 Nov-Dec;90(6):743-9. doi: 10.1590/s0074-02761995000600016.
Faecal samples were obtained from 190 children, aged 0 to 5 years, admitted to a public hospital in Belém, Pará, Brazil. These patients were placed in a pediatric ward with 40 beds distributed in six rooms. Cases were classified into three groups: (a) nosocomial: children who developed gastroenteritis 72 hr or later after admission; (b) community-acquired: patients admitted either with diarrhoea or who had diarrhoea within 72 hr following admission; (c) non-diarrhoeic: those children who had no diarrhoea three days before and three days after collection of formed faecal sample. Specimens were routinely processed for the presence of rotaviruses, bacteria and parasites. Rotaviruses were detected through enzyme-linked immunosorbent assay (ELISA) and subsequently serotyped/electrophoretyped. Rotaviruses were the most prevalent enteropathogens among nosocomial cases, accounting for 39% (9/23) of diarrhoeal episodes; on the other hand, rotaviruses occurred in 8.3% (11/133) and 9% (3/34) of community-acquired and non-diarrhoeic categories, respectively. Mixed infections involving rotavirus and Giardia intestinalis and rotavirus plus G. intestinalis and Entamoeba histolytica were detected in frequencies of 8.6 and 4.3%, respectively, in the nosocomial group. The absence of bacterial pathogens in this category, and the unusual low prevalence of these agents in the other two groups may reflect the early and routine administration of antibiotics following admission to this hospital. Rotavirus serotype 2 prevailed over the other types, accounting for 77.8% of isolates from nosocomial diarrhoeal episodes. In addition, at least five different genomic profiles could be observed, of which one displayed an unusual five-segment first RNA cluster. Dehydration was recorded in all cases of hospital-acquired, rotavirus-associated diarrhoea, whereas in only 57% of nosocomial cases of other aetiology. It was also noted that nosocomial, rotavirus-associated diarrhoeal episodes occur earlier (7 days), following admission, if compared with those hospital-acquired cases of other aetiology (14 days).
从巴西帕拉州贝伦市一家公立医院收治的190名0至5岁儿童中采集粪便样本。这些患者被安置在一个有40张床位、分布在6个房间的儿科病房。病例分为三组：(a)医院感染组：入院72小时或更晚后发生胃肠炎的儿童；(b)社区获得性组：入院时伴有腹泻或入院后72小时内出现腹泻的患者；(c)非腹泻组：在采集成形粪便样本前三天和后三天均无腹泻的儿童。标本常规检测是否存在轮状病毒、细菌和寄生虫。通过酶联免疫吸附测定（ELISA）检测轮状病毒，随后进行血清分型/电泳分型。轮状病毒是医院感染病例中最常见的肠道病原体，占腹泻发作的39%（9/23）；另一方面，轮状病毒分别出现在社区获得性组的8.3%（11/133）和非腹泻组的9%（3/34）中。在医院感染组中，轮状病毒与肠道贾第虫以及轮状病毒加肠道贾第虫和溶组织内阿米巴的混合感染频率分别为8.6%和4.3%。该组中无细菌病原体，且这两种病原体在其他两组中的异常低患病率可能反映了该医院入院后早期和常规使用抗生素的情况。轮状病毒2型比其他类型更为常见，占医院感染性腹泻分离株的77.8%。此外，至少可以观察到五种不同的基因组图谱，其中一种显示出异常的五片段首个RNA簇。在所有医院获得性、轮状病毒相关腹泻病例中均记录到脱水情况，而在其他病因的医院感染病例中仅为57%。还注意到，与其他病因的医院获得性病例（14天）相比，医院感染性、轮状病毒相关腹泻发作在入院后更早出现（7天）。
