Etiology of Childhood Infectious Diarrhea in a Developed Region of China: Compared to Childhood Diarrhea in a Developing Region and Adult Diarrhea in a Developed Region.
Etiology of Childhood Infectious Diarrhea in a Developed Region of China: Compared to Childhood Diarrhea in a Developing Region and Adult Diarrhea in a Developed Region.
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中国发达地区的儿童感染性腹泻的病因：与发达地区的发展中心和成人腹泻相比。
DOI：
10.1371/journal.pone.0142136
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Jing H
中科院分区：
文献类型：
--
作者：
Wang X;Wang J;Sun H;Xia S;Duan R;Liang J;Xiao Y;Qiu H;Shan G;Jing H
在中国看来，发达地区和欠发达地区在经济、社会特征和卫生方面存在很大差异。需要对两个地区的感染性腹泻进行比较研究。收集3组腹泻患者：北京(发达地区)和河南省(欠发达地区)的5岁儿童≤和北京18岁以上的成人。采用问卷调查和粪便标本检测16种肠道病原菌。我们从发达地区招募了1422名儿童和1047名成年人，从发展中地区招募了755名儿童。发达地区儿童病毒阳性率为32.98%，成人阳性率为23.67%。儿童最常见的病原体是轮状病毒，成人最常见的病原体是诺沃克病毒。发达地区儿童细菌分离率为13.92%，发展地区儿童细菌分离率为29.14%。差异最大的是志贺氏菌，占50.79%，是经济发达地区的优势致病菌，而发达地区仅占1.45%。当地的发展水平与致泻性大肠埃希氏菌(DEC)类别之间没有显著关系。但不同年龄段人群的DEC有显著差异：两地儿童的DEC以致病性大肠埃希菌(EPEC)和肠聚集性大肠埃希氏菌(EAggEC)为主，成人以产肠毒素大肠杆菌(ETEC)为主。志贺氏菌和沙门氏菌感染的症状相似，如血便、白细胞(WBC)、红细胞(RBC)阳性和发热，可能导致误诊。小肠结肠炎耶尔森菌和产志贺氏毒素的大肠杆菌(STEC)感染在北京首次报道。中国发达地区与发达地区儿童细菌性腹泻病原学有较大差异。
In China, great differences in economy, social characteristics and hygiene exist between developing and developed regions. A comparative study of infectious diarrhea between two regions was needed. Three groups of diarrheal patients were collected: children ≤5 year-olds from Beijing (developed region) and Henan Province (developing region), and adults over 18 year-olds from Beijing. A questionnaire was used to survey and feces samples were examined for 16 enteropathogens. We enrolled 1422 children and 1047 adults from developed region and 755 children from developing region. Virus positive rates were 32.98% for children and 23.67% for adults in developed region. The most prevalent pathogen for children was rotavirus whereas for adults was norovirus. Bacterial isolation rates were 13.92% for children from developed region, while 29.14% for children from the developing regions. For the greatest difference, Shigella accounted for 50.79% and was the dominant pathogen in the developing region, whereas in the developed region it was only 1.45%. There was no significant relationship between the local levels of development with diarrheogenic Escherichia coli (DEC) categories. But it was seen the notable differences between the population with different age: enteropathogenic E.coli (EPEC) and enteroaggregative E.coli (EAggEC) were the primary classes of DEC in children from both regions, whereas it was enterotoxigenic E.coli (ETEC) in adults. The symptoms of Shigella and Salmonella infection, such as bloody stools, white blood cells (WBC) and red blood cells (RBC) positivity and fever were similar in children, which may lead to the misidentification. Yersinia enterocolitica and shiga toxin-producing E.coli (STEC) infections were firstly reported in Beijing. There was a large difference in etiology of bacterial diarrhea between children in developing and developed regions of China.