Abstract
ST-producing E.Coli (STEC) is among the commonest cause of childhood diarrhea in developing Countries, whereas in industrialized Countries it is generally considered responsible only for traveler's diarrhea. Our aims were to investigate 1) the incidence of STEC diarrhea in Italy; 2) its clinical features and 3) the suitability of an ELISA method as a diagnostic tool for ST. We have screened 569 children (mean age 43 months, range 0-180 months) with acute-onset diarrhea from 5 Italian towns for STEC and compared an ELISA method (1) with the standard suckling mouse assay (SMA). This is the largest series of children screened for STEC in an industrialized Countries. Results: STEC were detected from 31 children (5.4%): 26 were positive at both tests, 4 only at the SMA, 1 only at the ELISA. Compared to the SMA, the sensitivity of the ELISA was 87%. Specificity was 99.8%. Mean age of children harbouring STEC was 22 months, range 0-62 months (p<0.05 vs mean age of the remaining 538 children). Main clinical features were dehydration (23%), fever (29%), vomiting (13%), abdominal pain (35%), “cold” symptoms (29%). Fecal osmolality and osmolar gap were consistent with secretory diarrhea in 80% of children. Mean duration of diarrhea was 5 days. In 3 cases diarrhea lasted more than 14 days. All but one patients did well with oral rehydration therapy: 1 required parenteral rehydration. In conclusion, our data show that in Italy: 1) STEC must be considered as common pathogens in children; 2) STEC cause diarrhea more often in younger children; 3) clinical features are that of a mild to moderate secretory diarrhea. Finally we showed that the ELISA test is reliable and suitable to screen large numbers of strains. 1) J.Chin.Microbiol. 20: 59, 1984.
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Guarino, A., Alessio, M., Tarallo, L. et al. 11 ELISA-DETECTED ST-PRODUCING E.COLI ARE A COMMON CAUSE OF ACUTE-ONSET DIARRHEA IN ITALIAN CHILDREN. Pediatr Res 24, 407 (1988). https://doi.org/10.1203/00006450-198809000-00034
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DOI: https://doi.org/10.1203/00006450-198809000-00034