[儿童患者粪便中乳铁蛋白的存在作为艰难梭菌的指标]。

Sylwia Dąbrowskal, Urszula Demkow, Edyta Podsiadły
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引用次数: 0

摘要

住院儿童艰难梭菌感染病例呈上升趋势。尽管与成人不同,儿童在患病后很少出现并发症,但已报告了由该病原体引发的持续性腹泻病例和由此引起的死亡率。目前的重要问题是如何区分定植和感染,限制了艰难梭菌感染(CDI)在这一年龄组的正确诊断。本研究的目的是评估儿童粪便中乳铁蛋白作为确认艰难梭菌感染的炎症标志物的存在。方法:对77份粪便标本进行检查。在55株毒素A/B或艰难梭菌致毒菌株和15株非致毒艰难梭菌中,7株来自健康儿童。粪便标本检测采用实验室常规方法:自动VIDAS艰难梭菌毒素a和b试验(法国bioMerieux)、培养和GDH试验。粪便中的乳铁蛋白已通过ELISA IBD-SCAN检测(Techlab, Blacksburg, VA)确定。用VITROS 5600检测CRP蛋白。结果:55例CDI患儿中检出乳铁蛋白的占45.5%(25/55)。在30例(54,5%)CDI患者中,未发现炎症生物标志物。在15名非毒性菌株培养的患者中,1名儿童存在乳铁蛋白。CDI在6-11岁儿童中检出率最高(51%)。2013-2014年CDI病例呈上升趋势。没有观察到各组儿童CRP水平升高频率的差异,也没有观察到乳铁蛋白和CRP之间存在的相关性。结论:乳铁蛋白是一种肠道炎症生物标志物,可能是区分艰难梭菌感染和定植的有用工具。需要更多的研究,包括临床观察。
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[Presence of lactoferrin in faeces as the indicator of Clostridium difficile in pediatric patients].

Introduction: Number of infection caused by Clostridium difficile in hospitalized children is increasing. Even though children unlike adults seldom develop complications after being ill, cases of persistent diarrhoea triggered by this pathogen and mortality from this origin have been reported. At present the important problem constitute differentiation between the colonization and infection limiting the proper diagnosis of C. difficile infections (CDI) in this age group. The aim of this study was to evaluate the presence of lactoferrin in faeces as the inflammatory marker confirming C. difficile infections in children.

Methods: Seventy seven samples of faeces where examined. Among them in 55 toxin A/B or C. difficile toxinogenic strain and in 15 nontoxinogenic C. difficile had been detected, 7 were collected from healthy children. Stool samples were tested with the use of method routinely applied in laboratory: automatic VIDAS C. difficile Toxin A&B test (bioMerieux, France), culture and GDH test. Lactoferrin in stool has been identified with ELISA IBD-SCAN test (Techlab, Blacksburg, VA). The CRP protein was detected with VITROS 5600.

Results: Among 55 children with CDI lactoferrin was detected in 45,5% (25/55) of them. In 30 (54,5%) CDI patients the inflammatory biomarker was not identified. In 15 persons with nontoxinogenic strain cultured, one child had lactoferrin present. CDI was detected most frequently (51%) in 6-11 years old children. The increase of CDI cases was observed in period 2013-2014. Neither differences in frequency of raised CRP level in examined groups of children nor correlation between presence of lactoferrin and CRP was observed.

Conclusions: Lactoferrin an intestinal inflammatory biomarker may be a useful tool in distinguishing between C. difficile infection and colonization. More studies including clinical observations are needed.

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