EPIDEMIOLOGY OF BACTERIAL PATHOGENS ASSOCIATED WITH INFECTIOUS DIARRHEA IN DJIBOUTI
EPIDEMIOLOGY OF BACTERIAL PATHOGENS ASSOCIATED WITH INFECTIOUS DIARRHEA IN DJIBOUTI
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DOI：
10.1128/jcm.28.5.956-961.1990
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发表时间：
1990-05-01
影响因子：
9.4
通讯作者：
ABBATTE, EA
中科院分区：
文献类型：
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作者：
MIKHAIL, IA;FOX, E;ABBATTE, EA
在东非国家吉布提进行的一项调查中，从209份粪便和100份对照粪便中回收了140种细菌病原体。以下病原体从粪便和对照粪便中分离出的频率相当：肠粘附性大肠杆菌（EAEC）（10.6%对13%），肠粘附性大肠杆菌（EAEC）（10.6%对13%），肠粘附性大肠杆菌（EAEC）（10.6%对13%）。大肠埃希菌（ETEC）（11对10%）、肠致病性大肠埃希菌（E.大肠埃希菌（EPEC）7.7%对12%; (2.9 vs3%）和空肠弯曲菌C.大肠杆菌（3.3vs5%）。令人惊讶的是，分离的EAEC菌株不对应于公认的EPEC血清群。无耶尔森氏菌，肠侵袭性E.大肠杆菌或肠出血性大肠杆菌。在本研究过程中分离了大肠杆菌。仅以下两个属仅从粪便中回收：志贺氏菌属。(7.7产气单胞菌属（Aeromonasseriagroup）占3.3%。福氏志贺菌是最常见的志贺菌。志贺氏菌属患者的平均年龄高于对照组（27岁对13岁），而弯曲杆菌属或沙门氏菌属的受试者属于较年轻的年龄组（分别为2.6岁和1.6岁）。沙门氏菌病例更常见于女性。志贺氏菌腹泻与粪便血液或粘液和白细胞有关。ETEC与恶心或呕吐无关。厌食、体重减轻和发热与沙门氏菌和气单胞菌属的分离有关。EAEC、ETEC、EPEC和志贺氏菌属对非洲用于治疗腹泻的大多数药物具有耐药性，而对所有测试细菌最有效的抗生素是诺氟沙星。我们的结论是，在吉布提在1989年，志贺氏菌和气单胞菌属物种必须被视为潜在的病原体时，他们被分离出的粪便和诺氟沙星应被认为是药物的选择，在成人治疗严重的志贺氏菌病和腹泻预防的旅行者。
During a survey examining the causes of diarrhea in the East African country of Djibouti, 140 bacterial pathogens were recovered from 209 diarrheal and 100 control stools. The following pathogens were isolated at comparable frequencies from both diarrheal and control stools: enteroadherent Escherichia coli (EAEC) (10.6 versus 13%), enterotoxigenic E. coli (ETEC) (11 versus 10%), enteropathogenic E. coli (EPEC) (7.7 veruss 12%), Salmonella spp. (2.9 versus 3%), and Campylobacter jejuni-C. coli (3.3 versus 5%). Surprisingly, the EAEC strains isolated did not correspond to well-recognized EPEC serogroups. No Yersinia spp., enteroinvasive E. coli, or enterohemorrhagic E. coli were isolated during the course of this study. Only the following two genera were recovered from diarrheal stools exclusively: Shigella spp. (7.7%) and Aeromonas hydrophila group organisms (3.3%). Shigella flexneri was the most common Shigella species isolated. Patients with Shigella species were of a higher average age than were controls (27 versus 13 yers), while subjects with Campylobacter or Salmonella species belonged to younger age groups (2.6 and 1.6 years, respectively). Salmonella cases were more often in females. Shigella diarrhea was associated with fecal blood or mucus and leukocytes. ETEC was not associated with nausea or vomiting. Anorexia, weight loss, and fever were associated with the isolation of Salmonella and Aeromonas species. EAEC, ETEC, EPEC, and Shigella species were resistant to most drugs used for treating diarrhea in Africa, while the antibiotic most active against all bacteria tested was norfloxacin. We conclude that in Djibouti in 1989, Shigella and Aeromonas species must be considered as potential pathogens whenever they are isolated from diarrheal stools and that norfloxacin should be considered the drug of choice in adults for treating severe shigellosis and for diarrhea prophylaxis in travelers.