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Objective To understand the etiological characteristics of bacterial diarrhea in different areas,including large cities,mid-sized/small cities and rural area,in China.Methods A cross-sectional surveillance was conducted in 17 provinces of China from 2010 to 2014.The acute diarrhea outpatients were selected from clinics or hospitals in large cities,mid-sized/small cities,including rural-urban fringe zones,and rural areas.The demographical and clinical characteristics of the patients were collected by using questionnaire,and stool samples were taken from them for laboratory detection of 17 kinds of bacteria.The differences in pathogen positive rates (PPR) and pathogen spectrum across the cases from three-type areas were compared.The different infection risk in different cases were analyzed with unconditional logistic regression model.Results In our study,we enrolled 9 253 cases from large cities,5 138 cases from rural areas and 13 683 cases from midsized/small cites.The pathogen with largest differences in infection rate across the three-type areas was Shigella (S.)flexneri (rural area:5.81％,mid-sized/small city:2.78％,large city:0.46％),followed by Aeromonas (A.) hydrophila (rural area:2.14％,mid-sized/small city:0.96％,large city:0.48％).Compared with cases in large cities,the cases in mid-sized/small cities and rural areas had higher infection risks for S.flexneri (mid-sized/small city:OR =6.481,95％CI:4.666-9.002,rural area:OR =11.304,95％ CI:8.018-15.938) and A.hydrophila (mid-sized/small city:OR=1.992,95％ CI:1.401-2.832,rural area:OR=4.083,95％ CI:2.833-5.884).The constituent ratio of diarrheagenic Escherichia coli and Salmonella increased with the urbanization development,while the ratios of Shigella and A.hydrophila had an opposite trend.S.sonnei (60.00％) was the predominant serogroup of Shigella in urban infections,while S.flexneri (77.37％) was the predominant serogroup in rural infections.Conclusion The differences in pathogen spectrum of bacterial diarrhea were obvious across large cities,mid-sized/small cities and rural areas in China,especially the differences in the infection rates of S.flexneri and A.hydrophila.
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Objective To understand the etiological characteristics of bacterial diarrhea in different areas,including large cities,mid-sized/small cities and rural area,in China.Methods A cross-sectional surveillance was conducted in 17 provinces of China from 2010 to 2014.The acute diarrhea outpatients were selected from clinics or hospitals in large cities,mid-sized/small cities,including rural-urban fringe zones,and rural areas.The demographical and clinical characteristics of the patients were collected by using questionnaire,and stool samples were taken from them for laboratory detection of 17 kinds of bacteria.The differences in pathogen positive rates (PPR) and pathogen spectrum across the cases from three-type areas were compared.The different infection risk in different cases were analyzed with unconditional logistic regression model.Results In our study,we enrolled 9 253 cases from large cities,5 138 cases from rural areas and 13 683 cases from midsized/small cites.The pathogen with largest differences in infection rate across the three-type areas was Shigella (S.)flexneri (rural area:5.81％,mid-sized/small city:2.78％,large city:0.46％),followed by Aeromonas (A.) hydrophila (rural area:2.14％,mid-sized/small city:0.96％,large city:0.48％).Compared with cases in large cities,the cases in mid-sized/small cities and rural areas had higher infection risks for S.flexneri (mid-sized/small city:OR =6.481,95％CI:4.666-9.002,rural area:OR =11.304,95％ CI:8.018-15.938) and A.hydrophila (mid-sized/small city:OR=1.992,95％ CI:1.401-2.832,rural area:OR=4.083,95％ CI:2.833-5.884).The constituent ratio of diarrheagenic Escherichia coli and Salmonella increased with the urbanization development,while the ratios of Shigella and A.hydrophila had an opposite trend.S.sonnei (60.00％) was the predominant serogroup of Shigella in urban infections,while S.flexneri (77.37％) was the predominant serogroup in rural infections.Conclusion The differences in pathogen spectrum of bacterial diarrhea were obvious across large cities,mid-sized/small cities and rural areas in China,especially the differences in the infection rates of S.flexneri and A.hydrophila.
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Objective To construct a scoring system of combination of procalcitonin and C-reactive protein for diagnosis of invasive bacterial diarrhea in children. Methods The clinical data of hospitalized children with acute diarrhea were retrospectively analyzed. All of the children were divided into two groups, invasive bacterial diarrhea group and nonbacterial diarrhea group. The scoring system of combination of two markers for diagnosis of invasive bacterial diarrhea in children was constructed by means of two categories logistic regression analysis using procalcitonin and C- reactive protein as parameters. In addition,receiver operating characteristic curve(ROC)was used to evaluate the diagnostic accuracy.Results One hundred ten cases of invasive bacterial diarrhea and 108 cases of nonbacterial diarrhea were included. The levels of serum procalcitonin and C-reactive protein in invasive bacterial diarrhea group were significantly higher than those in nonbacterial diarrhea group, and there were statistical difference(P all<0.05).The area under the ROC curve(AUC)of invasive bacterial diarrhea was 0.894 when the established scoring system was used, which was higher than the AUCs when either serum procalcitonin or in C- reactive protein was used (P<0.05). The best diagnostic boundary value for combination of serum procalcitonin and C- reactive protein scoring was 0.52 with a sensitivity at 80.9% and specificity at 88.9%. Conclusions The scoring system of combination of procalcitonin and C- reactive protein has good accuracy in diagnosis of invasive bacterial diarrhea in children, and can assist the early diagnosis of the disease.
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Objective To construct a scoring system of combination of procalcitonin and C-reactive protein for diagnosis of invasive bacterial diarrhea in children. Methods The clinical data of hospitalized children with acute diarrhea were retrospectively analyzed. All of the children were divided into two groups, invasive bacterial diarrhea group and nonbacterial diarrhea group. The scoring system of combination of two markers for diagnosis of invasive bacterial diarrhea in children was constructed by means of two categories logistic regression analysis using procalcitonin and C- reactive protein as parameters. In addition,receiver operating characteristic curve(ROC)was used to evaluate the diagnostic accuracy.Results One hundred ten cases of invasive bacterial diarrhea and 108 cases of nonbacterial diarrhea were included. The levels of serum procalcitonin and C-reactive protein in invasive bacterial diarrhea group were significantly higher than those in nonbacterial diarrhea group, and there were statistical difference(P all<0.05).The area under the ROC curve(AUC)of invasive bacterial diarrhea was 0.894 when the established scoring system was used, which was higher than the AUCs when either serum procalcitonin or in C- reactive protein was used (P<0.05). The best diagnostic boundary value for combination of serum procalcitonin and C- reactive protein scoring was 0.52 with a sensitivity at 80.9% and specificity at 88.9%. Conclusions The scoring system of combination of procalcitonin and C- reactive protein has good accuracy in diagnosis of invasive bacterial diarrhea in children, and can assist the early diagnosis of the disease.
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Objective To investigate the infection situation of group A human rotavirus(HRV)among the infants and young children with diarrhea in Lanzhou city,and to observe the relation between genders and age with the viral positive rate.Methods 2 378 samples of feces in the infants and young children with diarrhea were collected in this hospital from January to December 2013.The group A HRV antigen in samples was detected by using the immunochromatographic sandwich method.The positive rates of group A HRV infection in different months were analyzed and compared with the bacterial diarrhea;the viral positive rates in different genders and ages were analyzed.Results Among 2 378 detected feces samples,the average positive rate of group A HRV was 24.1% and the highest was 39.8% during the months from October to December;the average positive rate of bacterial diarrhea was 28.2% and the highest was 38.2% during the months from July to September.The positive rate of group A HRV was 25.5% in male children patients and 22.6% in female children patients,but the difference was not statistically significant (P >0. 05).The differences in the positive rates of group A HRV among different ages had statistical significance (P <0.05).The average positive rate was highest(29.0%)in children patients aged less than 2 years old,followed by the children patients aged 2 - <4 years old,which was 21.6%.Conclusion The group A HRV has the higher infection positive rate in winter and early spring,which mainly focuses on the children patients aged less than 2 years old.
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Objective:To evaluate the efficacy and safety of rifaximin against acute bacterial diarrhea.Methods:The effect of rifaximin for the treatment of acute bacterial diarrhea was investigated in a randomized,single-blind clinical trial with control of ciprofloxacin.Patients were administered with rifaximin 0.4g tid on the first day,followed by 0.4g bid;as for ciprofloxacin 0.25g tid on the first day,followed by 0.25g bid,until the end of 3～7days treatment,respectively.Stool,blood(hepatic and renal functions),urine samples and ECG of pre-and post-treatment were assayed for safety evaluation of rifaximin in diarrhea patients.Results:29 patients in rifaximin group and 25 in ciprofloxacin group showed similar efficacy rates and recovery rates, 100% and 91.3% respectively.There was no statistic difference between the two groups related to the effectiveness.The bacterium positive rate was 64.8%(35/54)before treatment.Bacterial clearance rates were 100% and 87.5%.No statistic difference and obvious side effect in the two groups were observed.Conclusion:rifaximin is safe and effective in the treatment of acute bacterial diarrhea.