Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine.
Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine.
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DOI：
10.1186/s12879-017-2823-9
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发表时间：
2017-11-22
影响因子：
3.7
通讯作者：
Falchi A
中科院分区：
文献类型：
--
作者：
Minodier L;Masse S;Capai L;Blanchon T;Ceccaldi PE;van der Werf S;Hanslik T;Charrel R;Falchi A
胃肠道（GI）症状，如腹泻，呕吐，腹痛和恶心是急性呼吸道感染（ARI）的常见表现。因此，我们评估了与ARI的全科医生（GP）咨询的患者中存在GI症状相关的临床和微生物学因素。在两个冬季（2014-2016年）前瞻性收集了向全科医生就诊的ARI患者的鼻咽拭子、粪便标本和临床数据。通过定量实时PCR对12种呼吸道病原体组和12种肠道病原体的样本进行了检测。纳入的331例患者中有204例（61.6%）至少有一种呼吸道病原体阳性。69份粪便（20.8%）至少有一种病原体（呼吸道和/或肠道）呈阳性。实验室确认的肠道感染（调整后的比值比（aOR）= 3.2; 95%置信区间[CI] [1.2-9.9]; p = 0.02）或人冠状病毒（HCoV）感染（aOR = 2.7; [1.2-6.8]; p = 0.02）更可能出现GI症状。对于实验室确诊的流感患者，咨询前服用解热药物似乎可以降低发生胃肠道症状的风险（aOR = 0.3; [0.1-0.6]; p = 0.002）。ARI患者胃肠道症状的存在不能通过粪便中呼吸道病原体的检测来解释。然而，在粪便样本中检测到肠道病原体可以解释在一些ARI病例中存在胃肠道症状。需要探索解释鼻咽部HCoV存在与GI症状之间关联的生物学机制。本文的在线版本（10.1186/s12879-017-2823-9）包含补充材料，可供授权用户使用。
Gastrointestinal (GI) symptoms, such as diarrhea, vomiting, abdominal pain and nausea are not an uncommon manifestation of an acute respiratory infection (ARI). We therefore evaluated clinical and microbiological factors associated with the presence of GI symptoms in patients consulting a general practitioner (GP) for ARI. Nasopharyngeal swabs, stool specimens and clinical data from patients presenting to GPs with an ARI were prospectively collected during two winter seasons (2014-2016). Samples were tested by quantitative real-time PCR for 12 respiratory pathogen groups and for 12 enteric pathogens. Two hundred and four of 331 included patients (61.6%) were positive for at least one respiratory pathogen. Sixty-nine stools (20.8%) were positive for at least one pathogen (respiratory and/or enteric). GI symptoms were more likely declared in case of laboratory confirmed-enteric infection (adjusted odds ratio (aOR) = 3.2; 95% confidence interval [CI] [1.2–9.9]; p = 0.02) or human coronavirus (HCoV) infection (aOR = 2.7; [1.2–6.8]; p = 0.02). Consumption of antipyretic medication before the consultation seemed to reduce the risk of developing GI symptoms for patients with laboratory-confirmed influenza (aOR = 0.3; [0.1–0.6]; p = 0.002). The presence of GI symptoms in ARI patients could not be explained by the detection of respiratory pathogens in stools. However, the detection of enteric pathogens in stool samples could explained by the presence of GI symptoms in some of ARI cases. The biological mechanisms explaining the association between the presence of HCoVs in nasopharynx and GI symptoms need to be explored. The online version of this article (10.1186/s12879-017-2823-9) contains supplementary material, which is available to authorized users.
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影响因子：
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通讯作者：
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