Dewi Wulandari, Rivaldi Febrian, Pramita Gayatri Dwipoerwantoro, Nia Kurniati
{"title":"使用多重实时聚合酶链反应检测印度尼西亚一家三级医院中感染人类免疫缺陷病毒和非人类免疫缺陷病毒的急性腹泻患儿的肠道病原体。","authors":"Dewi Wulandari, Rivaldi Febrian, Pramita Gayatri Dwipoerwantoro, Nia Kurniati","doi":"10.5223/pghn.2024.27.2.95","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020.</p><p><strong>Results: </strong>The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative <i>Escherichia coli</i> (25.4%), followed by <i>Campylobacter</i> spp. (11.8%), enteropathogenic <i>E. coli</i> (9.8%), Norovirus GII (7.8%), and <i>Clostridium difficile</i> (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), <i>Cryptosporidium</i> spp. (14.3%), <i>Campylobacter</i> spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). <i>Cryptosporidium</i> spp. was the only parasite found in this study and was found only in HIV-infected children. In non-HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV-infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens.</p><p><strong>Conclusion: </strong>The pattern of enteropathogens can help clinicians determine further examinations and appropriate empirical antimicrobial therapy for the patient.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948966/pdf/","citationCount":"0","resultStr":"{\"title\":\"Detection of Enteropathogens in Human Immunodeficiency Virus and Non-Human Immunodeficiency Virus-Infected Children with Acute Diarrhea in an Indonesian Tertiary Hospital Using Multiplex Real-Time Polymerase Chain Reaction.\",\"authors\":\"Dewi Wulandari, Rivaldi Febrian, Pramita Gayatri Dwipoerwantoro, Nia Kurniati\",\"doi\":\"10.5223/pghn.2024.27.2.95\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020.</p><p><strong>Results: </strong>The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative <i>Escherichia coli</i> (25.4%), followed by <i>Campylobacter</i> spp. (11.8%), enteropathogenic <i>E. coli</i> (9.8%), Norovirus GII (7.8%), and <i>Clostridium difficile</i> (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), <i>Cryptosporidium</i> spp. (14.3%), <i>Campylobacter</i> spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). <i>Cryptosporidium</i> spp. was the only parasite found in this study and was found only in HIV-infected children. 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引用次数: 0
摘要
目的:腹泻是发展中国家儿童死亡的主要原因之一。每个医疗中心的急性腹泻病因因地点、时间和人群而异。本研究旨在印度尼西亚的一家三甲医院,利用多重实时逆转录酶聚合酶链反应(RT-PCR)确定感染人类免疫缺陷病毒(HIV)和未感染 HIV 的急性腹泻患儿的病原体模式:这项横断面研究于2019年3月至2020年4月在Cipto Mangunkusumo国立医院进行:研究结果表明,58.9%的标本中多重 RT-PCR 结果呈阳性,其中感染 HIV 的儿童的阳性结果多于未感染 HIV 的儿童(70% 对 54.7%)。所有标本中共检测出 72 种肠道病原体。非艾滋病毒感染儿童急性腹泻的肠道病原体包括细菌(70.6%)和病毒(29.4%),其中以肠道聚集性大肠杆菌(25.4%)为主,其次是弯曲杆菌属(11.8%)、肠致病性大肠杆菌(9.8%)、诺如病毒 GII(7.8%)和艰难梭菌(7.8%)。艾滋病毒感染儿童的肠道病原体包括病毒(57.1%)、细菌(28.6%)和寄生虫(14.3%),其中诺如病毒 GII(24%)、隐孢子虫属(14.3%)、弯曲杆菌属(14.3%)、诺如病毒 GI(14.3%)和哮喘病毒(14.3%)。隐孢子虫属是本研究中发现的唯一寄生虫,而且只在感染艾滋病毒的儿童中发现。在非艾滋病病毒感染的急性腹泻儿童中,大多数病原体是侵袭性细菌,而在艾滋病病毒感染的儿童中,病毒和寄生虫感染较多,主要由机会性病原体引起:结论:肠道病原体的模式可帮助临床医生决定对患者进行进一步检查和适当的经验性抗菌治疗。
Detection of Enteropathogens in Human Immunodeficiency Virus and Non-Human Immunodeficiency Virus-Infected Children with Acute Diarrhea in an Indonesian Tertiary Hospital Using Multiplex Real-Time Polymerase Chain Reaction.
Purpose: Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital.
Methods: This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020.
Results: The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative Escherichia coli (25.4%), followed by Campylobacter spp. (11.8%), enteropathogenic E. coli (9.8%), Norovirus GII (7.8%), and Clostridium difficile (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), Cryptosporidium spp. (14.3%), Campylobacter spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). Cryptosporidium spp. was the only parasite found in this study and was found only in HIV-infected children. In non-HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV-infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens.
Conclusion: The pattern of enteropathogens can help clinicians determine further examinations and appropriate empirical antimicrobial therapy for the patient.
期刊介绍:
Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.