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首页> 外文期刊>Journal of Clinical Microbiology >Characterization of Enteric Disease in Children by Use of a Low-Cost Specimen Preservation Method
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Characterization of Enteric Disease in Children by Use of a Low-Cost Specimen Preservation Method

机译：利用低成本标本保存方法表征儿童肠疾病

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ABSTRACT Diarrhea is a leading cause of death in children under five. Molecular methods exist for the rapid detection of enteric pathogens; however, the logistical costs of storing stool specimens limit applicability. We sought to demonstrate that dried specimens preserved using filter paper can be used to identify diarrheal diseases causing significant morbidity among children in resource-constrained countries. A substudy was nested into cholera surveillance in Cameroon. Enrollment criteria included enrollment between 1 August 2016 and 1 October 2018, age of &18?years, availability of a stool specimen, and having three or more loose stools within 24?h with the presence of dehydration and/or blood. A total of 7,227 persons were enrolled, of whom 2,746 met enrollment criteria and 337 were included in this analysis using the enteric TaqMan array card. Bacterial pathogens were compared to severity of diarrhea, age, and sex, among other variables. One hundred seven were positive for enterotoxigenic Escherichia coli , of which 40.2% ( n ?=?43) had heat-labile enterotoxin (LT) and the heat-stable enterotoxin STh, 19.6% ( n ?=?21) had LT and the heat-stable enterotoxin STp, and 49.5% ( n = 53) had LT only. Major colonization factors (CFs) were present in 43.9% of enterotoxigenic E. coli (ETEC)-positive patients. Ninety-six were positive for Shigella , of whom 14 (14.6%) reported dysentery. Model-derived quantitative cutoffs identified 116 (34.4%) with one highly diarrhea-associated pathogen and 16 (4.7%) with two or more. Shigella and rotavirus were most strongly associated with diarrhea in children with mixed infections. Dried-filter-paper-preserved specimens eliminate the need for frozen stool specimens and will facilitate enteric surveillance and contribute to the understanding of disease burden, which is needed to guide vaccine development and introduction. This study confirms rotavirus, Shigella , and ETEC as major contributors to pediatric diarrheal disease in two regions of Cameroon.
机译：摘要腹泻是五岁以下儿童死亡的主要原因。存在用于快速检测肠道病原体的分子方法;但是，存储粪便标本限制适用性的物流成本。我们试图证明使用滤纸保留的干燥样品可用于鉴定腹泻疾病，导致资源受限制国家的儿童造成显着发病率。将困难嵌套在喀麦隆的霍乱监视中。注册标准包括2016年8月1日至2018年10月1日之间的入学率，＆amp的年龄; LT; 18？年，粪便样本的可用性，并且在24℃内具有三个或更多的松散粪便，存在脱水和/或血液。注册了7,227人，其中2,746人达到了2,746次达到的入学标准和337，使用Enteric Taqman Array Card纳入此分析。将细菌病原体与腹泻，年龄和性别的严重程度进行比较。肠毒素大肠杆菌的一百七是阳性的，其中40.2％（n？=Δ33）具有热不稳定的肠毒素（LT）和热稳定的肠毒素STH，19.6％（n？=Δ21）具有LT和加热稳定的肠毒素STP，49.5％（n = 53）只有。主要定植因子（CFS）以43.9％的肠毒素大肠杆菌（ETEC） - 阳性患者存在。九六为志氏菌阳性，其中14名（14.6％）报告痢疾。模型衍生的定量截止值鉴定116（34.4％），具有一个高度腹泻相关病原体，16（4.7％），具有两个或更多个。 Shigella和Rotavirus最强烈地与患有混合感染的儿童腹泻有关。干滤网保存的标本消除了对冷冻粪便标本的需求，并有助于肠道监测，并有助于了解疾病负担，这是指导疫苗开发和介绍所需的疾病负担。本研究证实了Rotavirus，Shigella和Etec作为喀麦隆两次地区的小儿腹泻病的主要贡献者。

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