Enteropathogens associated with childhood diarrhea in Italy

被引:82
作者
Caprioli, A
Pezzella, C
Morelli, R
Giammanco, A
Arista, S
Crotti, D
Facchini, M
Guglielmetti, P
Piersimoni, C
Luzzi, I
Mucignat, G
Maggio, M
Giammanco, G
Taormina, S
Vizzi, E
Romoli, E
Scardellato, U
机构
[1] IST SUPER SANITA, BATTERIOL & MICOL MED LAB, I-00161 ROME, ITALY
[2] IST SUPER SANITA, LAB VET MED, I-00161 ROME, ITALY
[3] IST SUPER SANITA, LAB ULTRASTRUCT, I-00161 ROME, ITALY
[4] UNIV PALERMO, DEPT HYG & MICROBIOL, PALERMO, ITALY
[5] HOSP R SILVESTRINI, PERUGIA, ITALY
[6] PEDIAT HOSP V BUZZI, MILAN, ITALY
[7] UNIV SIENA, INST INFECT DIS, SIENA, ITALY
[8] GEN HOSP TORRETTE, ANCONA, ITALY
[9] HOSP PORDENONE, PORDENONE, ITALY
[10] UNIV PALERMO, PALERMO, ITALY
[11] HOSP ORVIETO, ORVIETO, ITALY
[12] HOSP TREVISO, TREVISO, ITALY
关键词
diarrhea; enteropathogens; etiology; epidemiology; Italy;
D O I
10.1097/00006454-199610000-00009
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Infectious diarrheal diseases remain an important cause of childhood morbidity in industrialized countries. The knowledge of the etiology and epidemiology of childhood diarrhea in a given area is needed to plan any measure designed to prevent or ameliorate diarrheal illness and to develop practice guidelines for the most appropriate stool examination procedures. Methods. We evaluated 618 children with diarrhea and 135 controls prospectively for viral, bacterial and parasitic enteric pathogens. Diarrheagenic Escherichia coli was identified by gene probes specific to different virulence factors. Stool filtrates were examined for the presence of free bacterial toxins by a cell culture cytotoxicity assay. Clinical and epidemiologic data were recorded and analyzed in relation to microbiologic findings. Results. Enteropathogens were identified in 59% of children with diarrhea and in 10.4% of asymptomatic controls. The agents mainly associated with disease were rotavirus (23.6%), Salmonella (19.2%) and Campylobacter (7.9%). Rotavirus was significantly more frequent among children observed as inpatients whereas Campylobacter was significantly more common in outpatients. Infections with diarrheagenic E. coli, Shigella flexneri, Yersinia enterocolitica, Cryptosporidium and Giardia were observed in a limited number of patients. The clinical presentation of children was not sufficiently characteristic to permit presumptive diagnosis of a specific pathogen. Conversely the presence of blood and/or leukocytes in stools had a high positive predictive value for Salmonella or Campylobacter infection. Conclusion. The results of this study will be useful for planning strategies to prevent and control diarrheal diseases in our country.
引用
收藏
页码:876 / 883
页数:8
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