Abstract
Scanty information is available on ST-induced diarrhea in industrialized countries. We have screened for STEC 541 children (mean age 43 months, range 0-180 months) from 5 different Italian towns, with acute diarrhea using an Elisa method (1). This is the largest series of children screened for STEC in an industrialized country. All STEC strains were also testes by the suckling mouse assay (SMA) together with 90 strains negative in the Elisa. A total of 31 STEC (5.7%) were detected: 26 were positive in both tests, 4 only in the SMA, 1 only in the Elisa. The concordance was 96%, the sensitivity of Elisa was 87%. The highest rate of STEC isolation was found in spring and autumn. Mean age of children with STEC was 22 months, range 0-63 months. 48% of children with STEC had previously ingested potentially contaminated food, 16% had the previously contact with diarrheal subjects. Clinical features of children were dehydration (25%), fever (28%), vomiting (12%), abdominal pain (36%). In 36% of children other enteric pathogens were found associated with STEC. Values of fecal osmolarity and anion gap were consistent with a secretory type of diarrhea in 79% of children. Mean duration of diarrhea was 5 days. All but one patient did eventually well with oral rehydration therapy; one required parenteral rehydration. In conclusion: 1) the incidence of STEC induced diarrhea is higher in Italy than in other industrialized countries. 2) The Elisa test is a rapid and convenient tool to screen large numbers of strains. 3) Younger children are more susceptible to STEC-diarrhea then older children. 4)Clinical features are less severe in industrialized then in developing countries.
1. Thompson M. et al. J. Clin. Microbiol. 20, 59, 1984
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Guarino, A., Alessio, M., Tarallo, L. et al. EPIDEMIOLOGY AND CLINICAL FEATURES OF HEAT-STABLE ENTEROTOXIN PRODUCING E.COLI (STEC) IN ITALIAN CHILDREN WITH DIARRHEA SCREENED BY AN ELISA TEST. Pediatr Res 22, 234 (1987). https://doi.org/10.1203/00006450-198708000-00125
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DOI: https://doi.org/10.1203/00006450-198708000-00125