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[隐孢子虫病——急性腹泻的一个病因:鲁昂大学医院儿科病例回顾与回顾性研究]

[Cryptosporidiosis, a cause of acute diarrhea: A review and retrospective study of cases in Rouen university hospital's pediatrics department].

作者信息

Gargala G, Razakandrainibe R, Costa D, Leméteil D, Dumant Forest C

机构信息

Laboratoire de parasitologie-mycologie, CHU de Rouen, 76000 Rouen, France; CNR-laboratoire expert cryptosporidioses, CHU de Rouen, 76000 Rouen, France.

Laboratoire de parasitologie-mycologie, CHU de Rouen, 76000 Rouen, France.

出版信息

Arch Pediatr. 2017 Dec;24(12):1344-1349. doi: 10.1016/j.arcped.2017.10.002. Epub 2017 Nov 20.

Abstract

Cryptosporidium is the most important diarrhea-causing protozoan parasite, with severe health consequences for very young, malnourished children living in endemic areas and for immunocompromised individuals. Cryptosporidium is widely distributed and disease transmission can occur through person-to-person or animal-to-person contact, or contaminated food or water (drinking or swimming), leading to large outbreaks. The zoonotic Cryptosporidium parvum and the anthroponotic Cryptosporidium hominis are responsible for the majority of human cases. Specific therapy, primarily nitazoxanide, has some effect in healthy individuals, but drugs effectively preventing or controlling this disease in all clinical situations are not yet available. In France, as elsewhere in Europe, little epidemiological and molecular information is available regarding the burden of cryptosporidiosis in children. Cryptosporidium is usually not tested in all fecal samples submitted for routine parasitological examination and only tested on special request, primarily in immunocompromised patients. Between January 2007 and October 2014, out of a total of 5337 immunocompetent children with diarrhea in Rouen university hospital's pediatrics department, the prevalence of Cryptosporidium infection was 0.97 % (52 infected children). The median age of infected children was 3 years (range, 5 months to 11 years) and 80 % of the cases occurred between July and November. Thirty-six (69.2 %) and 16 (30.8 %) infections were due to C. parvum and C. hominis, respectively. The fact that the species C. parvum, mainly the IIaA15G2R1 subtype, was detected in most locally infected children suggests that cryptosporidiosis must primarily be considered as a zoonotic disease in Upper Normandy.

摘要

隐孢子虫是最重要的致腹泻原生动物寄生虫,对生活在流行地区的幼儿、营养不良儿童以及免疫功能低下的个体具有严重的健康影响。隐孢子虫分布广泛,疾病可通过人传人、动物传人接触或受污染的食物或水(饮用或游泳)传播,导致大规模疫情爆发。人兽共患的微小隐孢子虫和人源的人隐孢子虫是大多数人类病例的病原体。特异性治疗主要是硝唑尼特,对健康个体有一定疗效,但尚无在所有临床情况下有效预防或控制该病的药物。在法国,与欧洲其他地方一样,关于儿童隐孢子虫病负担的流行病学和分子信息很少。隐孢子虫通常不在所有提交进行常规寄生虫学检查的粪便样本中检测,仅在特殊要求下进行检测,主要是在免疫功能低下的患者中。在2007年1月至2014年10月期间,鲁昂大学医院儿科部门共有5337名免疫功能正常的腹泻儿童,隐孢子虫感染率为0.97%(52名感染儿童)。感染儿童的中位年龄为3岁(范围为5个月至11岁),80%的病例发生在7月至11月之间。分别有36例(69.2%)和16例(30.8%)感染是由微小隐孢子虫和人隐孢子虫引起的。在大多数本地感染儿童中检测到微小隐孢子虫物种,主要是IIaA15G2R1亚型,这一事实表明,在上诺曼底地区,隐孢子虫病必须主要被视为人兽共患病。

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