McNeely W S, Dupont H L, Mathewson J J, Oberhelman R A, Ericsson C D
University of Texas School of Public Health/Medical School, Houston, USA.
Am J Trop Med Hyg. 1996 Oct;55(4):430-3. doi: 10.4269/ajtmh.1996.55.430.
A study was done to test the effectiveness of fecal occult blood as a screening test for invasive bacterial pathogens and as a substitute for the fecal leukocyte examination in adult and pediatric cases of acute diarrhea. United States citizens studying in Mexico and Mexican children, both with acute diarrhea had their stools cultured, examined for fecal leukocytes, and tested for occult blood. Using culture results as the criterion standard for detection of bacterial agents, and fecal leukocytes for diarrhea associated with diffuse colonic inflammation, occult blood was tested for its sensitivity, specificity, and predictive value using 2 x 2 tables. Analysis of the data found that occult blood negative samples were reliable indicators of a lack of invasive bacteria in both adult and pediatric patients (negative predictive values of 87% and 96%, respectively). Positive results for either test were not reliably predictive as indicators of invasive bacteria among adults. A positive occult blood test result was significantly more sensitive than a positive fecal leukocyte test result (79% versus 42%) in detecting invasive bacteria in the pediatric patients; however, the positive predictive value was only 24%. The fecal occult blood test is an uncomplicated, low-cost test that was reliable when giving a negative result in detecting a lack of invasive bacteria in adult and pediatric patients with diarrhea. In children, a positive result on a fecal occult blood test is sensitive but not specific in detecting invasive bacterial enteropathogens. These data also indicate that a commercially available test for occult blood represents a suitable alternative to microscopic examination of fecal samples for leukocytes obtained from patients with acute diarrhea.
开展了一项研究，以测试粪便潜血作为侵袭性细菌病原体筛查试验以及在成人和儿童急性腹泻病例中替代粪便白细胞检查的有效性。在美国留学的美国公民和患有急性腹泻的墨西哥儿童的粪便均进行了培养、粪便白细胞检查以及潜血检测。以培养结果作为检测细菌病原体的标准，以粪便白细胞作为与弥漫性结肠炎症相关腹泻的检测指标，使用2×2列联表对潜血的敏感性、特异性和预测价值进行检测。数据分析发现，潜血阴性样本是成人和儿童患者不存在侵袭性细菌的可靠指标（阴性预测值分别为87%和96%）。在成人中，两种检测的阳性结果均不能可靠地预测侵袭性细菌。在检测儿童侵袭性细菌方面，潜血检测阳性结果比粪便白细胞检测阳性结果显著更敏感（分别为79%和42%）；然而，阳性预测值仅为24%。粪便潜血检测是一种简单、低成本的检测方法，在检测腹泻成人和儿童患者不存在侵袭性细菌时，若结果为阴性则是可靠的。在儿童中，粪便潜血检测阳性结果在检测侵袭性细菌性肠道病原体方面敏感但不具有特异性。这些数据还表明，市售的潜血检测试剂是对急性腹泻患者粪便样本进行白细胞显微镜检查的合适替代方法。
