从康提儿童医院5岁以下儿童的腹泻粪便中分离出致泻性大肠杆菌的流行情况

Dr. Kirtika Gautam
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摘要

背景:致泻性大肠杆菌引起的腹泻是包括尼泊尔在内的发展中国家的主要卫生问题。尽管在尼泊尔尚无致泻性大肠杆菌引起的儿童腹泻的精确数据。据估计,大约25%的儿童死亡与腹泻有关。因此,本研究旨在评估5岁以下儿童由致泻性大肠杆菌引起腹泻的发生率。这项研究在Maharajgunj的Kanti儿童医院(KCH)进行。在2018年3月至2018年8月期间,共招募了200个样本。方法:采用Mac Conkey琼脂平板培养所有腹泻粪便标本。在37摄氏度下孵育24小时后。如果产生乳糖发酵(LF)粉红色菌落,则通过不同的生化试验进行进一步的验证试验。不管是不是大肠杆菌。如果是大肠杆菌,则进一步在Mac Conkey山梨醇(MSA)琼脂上传代培养,分离致泻性大肠杆菌。第二天如果发现非山梨醇形成(NSF)菌落,则确定为致泻性大肠杆菌。因为大多数其他大肠杆菌菌株和其他肠杆菌都能发酵山梨醇,但致泻性大肠杆菌不发酵山梨醇,而且是非山梨醇发酵的无色菌落。结果:在所有入组病例中,20例(10%)为致泻性大肠杆菌。庆大霉素、氯霉素和第三代头孢菌素对致泻性大肠杆菌的疗效为100%。结论:本病以2岁以下儿童多见。致泻性大肠杆菌被发现是5岁以下儿童腹泻的重要原因。提高卫生意识可减少腹泻的发生。
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Prevalence of diarrheageanic E. coli isolated from diarrheal stool from Children under 5 years of age at Kanti Children’s Hospital
Background: Diarrhea caused by diarrheagenic E.coli are major health problem of developing countries including Nepal.Though precise data on childhood diarrhea by diarrheagenic E.coli in Nepal is not available. It has been estimated that approximately 25% of  child death are associated with diarrhea.This study was thus carried out to evaluate the  incidence of diarrhea by diarrheagenic E.coli in children under 5 years of age. The study was conducted at  Kanti Children’s hospital (KCH), Maharajgunj.  A total of 200 samples were enrolled between March 2018 to August 2018. Methods: All the diarrheal stool samples were cultured on Mac Conkey agar plate. After 24 hours of incubation at 37  degree celcius. If it produce Lactose Fermenting (LF) pink coloured colonies  further confirmatory test was done by different biochemical test. Whether it was E. coli or not.If it was E.coli then further sub cultured on Mac Conkey Sorbitol (MSA) agar to isolate diarrheagenic E. coli. Next day if there seen Non Sorbitol Formenting (NSF) colonies, it was identified as diarrheagenic E. Coli. because most other E.coli strains and other Enterobacteria ferment sorbitol but diarrheagenic E.coli do not ferment Sorbitol and is non sorbitol fermenting colourless colonies. Results: Out of total enrolled cases, 20 (10%) were diarrheagenic E. coli. Gentamycin, Chloramphenicol and third generation Cephalosporin showed 100% efficacy against diarrheagenic  E.coli . Conclusion: The incidence of disease  was more prevalent in children below 2 years. Diarrheagenic E. coli were found to be a significant cause of diarrhea under 5 years of age. Awareness of improving hygiene reduce the episode of diarrhea.
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