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首页> 外文期刊>Scandinavian journal of gastroenterology. >Screening of patients with acute infectious diarrhoea: evaluation of clinical features, faecal microscopy, and faecal occult blood testing.
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Screening of patients with acute infectious diarrhoea: evaluation of clinical features, faecal microscopy, and faecal occult blood testing.

机译：急性感染性腹泻患者的筛查：临床特征评估，粪便显微镜检查和粪便潜血测试。

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BACKGROUND: For optimal management of acute infectious diarrhoeal diseases, it is necessary to utilize a screening process to distinguish between invasive and non-invasive diarrhoeas. The aim of this study was to compare the diagnostic utilities of clinical features, faecal microscopy (FM), and faecal occult blood testing (FOBT) in distinguishing invasive diarrhoeas from non-invasive ones. METHODS: A total of 1008 patients with acute diarrhoea were evaluated. Rectal swabs were cultured for Salmonella, Shigella, and Vibrio species; rectal swabs from 109 of these patients were also examined for Campylobacter, enterotoxigenic Escherichia coli, and rotavirus species. Isolation of faecal enteropathogens served as the gold standard. FOBT was performed with a commercial modified guaiac test. Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and likelihood ratio were compared. RESULTS: Among the 1008 patients 402 with a single identified enteropathogen were available for analysis. Invasive and non-invasive enteropathogens were isolated from 262 (65.2%) and 140 (34.8%) cases, respectively. The presence of visible blood in faeces was almost a pathognomonic sign of invasive diarrhoea but had poor sensitivity. Clinical features were useful but inadequate in differentiating patients with non-bloody diarrhoea (74% of patients) into invasive and non-invasive categories. The sensitivities, specificities, PPVs, and NPVs of FM and FOBT were 75%, 77%, 58%, 88%, and 85%, 68%, 53%, and 91%, respectively. CONCLUSION: The presence of visible blood in faeces is a highly specific clinical feature of invasive diarrhoea but suffers from low sensitivity. In non-bloody diarrhoea FOBT is a valuable screening test and is comparable to FM, particularly when interpreted in the clinical context.
机译：背景：为了对急性传染性腹泻疾病进行最佳管理，有必要利用筛选过程来区分侵入性和非侵入性腹泻。这项研究的目的是比较临床特征，粪便显微镜（FM）和粪便潜血测试（FOBT）在区分侵入性腹泻和非侵入性腹泻方面的诊断效用。方法：对1008例急性腹泻患者进行了评估。培养直肠拭子中的沙门氏菌，志贺氏菌和弧菌种。还检查了这些患者中109名的直肠拭子是否存在弯曲杆菌，肠毒素性大肠杆菌和轮状病毒。粪便肠病原菌的分离是金标准。 FOBT用商业改良的愈创木脂测试进行。比较了特异性，敏感性，阳性预测值（PPV），阴性预测值（NPV），准确性和似然比。结果：在1008例患者中，有402个具有单一鉴定的病原菌可用于分析。分别从262（65.2％）和140（34.8％）例病例中分离出侵入性和非侵入性肠病原体。粪便中可见的血液几乎是侵袭性腹泻的病理标志，但敏感性较差。临床特征是有用的，但不足以将非血性腹泻患者（占患者的74％）分为侵入性和非侵入性类别。 FM和FOBT的敏感性，特异性，PPV和NPV分别为75％，77％，58％，88％和85％，68％，53％和91％。结论：粪便中存在可见血液是侵袭性腹泻的高度特异性临床特征，但敏感性低。在非血性腹泻中，FOBT是一种有价值的筛查测试，与FM相当，尤其是在临床环境中进行解释时。

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