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Abstract：
OBJECTIVE: Diarrhea is a common disease in immunocompromised patients and can be associated with greater morbidity and even mortality. Therefore, the present study was designed to determine the prevalence of Aeromonas spp., Campylobacter spp., and C. difficile among immunocompromised children.
METHODS: This study was conducted on 130 stool samples from patients with diarrhea who had defects in the immune system and were referred to Hazrat Masoumeh Children\'s Hospital in Qom. Demographic information, clinical symptoms, immune status, and duration of chemotherapy were also recorded for each child. DNAs were extracted from the stool, and then direct PCR assays were done by specific primers for the detection of Aeromonas spp., Campylobacter spp., and toxigenic C. difficile, including tcdA/B and cdtA/B genes. Co-infection in patients was also evaluated.
RESULTS: 60.8% and 39.2% were male and female, respectively, with a m ± SD age of 56.72 ± 40.49 months. Most cases of immunocompromised states were related to Acute Lymphocytic Leukemia (77.7%) and Non-Hodgkin Lymphoma (14.6%). 93.1% of patients were undergoing chemotherapy during the study. Among patients, most clinical symptoms were related to bloody diarrhea (98.5%) and fever (92.3%). Based on PCR, 14.6, 9.2, and 1.5% were positive for Aeromonas spp., C. difficile, and C. jejuni, respectively. Among the C. difficile-positive cases, the tcdA gene was only detected in one patient. In total, three co-infections were identified, which included Aeromonas spp./C. difficile (tcdA+), C. jejuni/C. difficile, and C. jejuni/Aeromonas spp.
CONCLUSIONS: This is the first study in Iran to investigate the simultaneous prevalence of some pathogens in immunocompromised children with diarrhea. Because Aeromonas spp., Campylobacter spp., and C. difficile are not routinely detected in some laboratories, infections caused by them are underappreciated in the clinic. Our results showed that these pathogens are present in our region and can cause gastroenteritis in children, especially those with underlying diseases. Therefore, increasing the level of hygiene in some areas and controlling bacterial diarrheal diseases should be given more attention by health officials.
METHODS: This study was conducted on 130 stool samples from patients with diarrhea who had defects in the immune system and were referred to Hazrat Masoumeh Children\'s Hospital in Qom. Demographic information, clinical symptoms, immune status, and duration of chemotherapy were also recorded for each child. DNAs were extracted from the stool, and then direct PCR assays were done by specific primers for the detection of Aeromonas spp., Campylobacter spp., and toxigenic C. difficile, including tcdA/B and cdtA/B genes. Co-infection in patients was also evaluated.
RESULTS: 60.8% and 39.2% were male and female, respectively, with a m ± SD age of 56.72 ± 40.49 months. Most cases of immunocompromised states were related to Acute Lymphocytic Leukemia (77.7%) and Non-Hodgkin Lymphoma (14.6%). 93.1% of patients were undergoing chemotherapy during the study. Among patients, most clinical symptoms were related to bloody diarrhea (98.5%) and fever (92.3%). Based on PCR, 14.6, 9.2, and 1.5% were positive for Aeromonas spp., C. difficile, and C. jejuni, respectively. Among the C. difficile-positive cases, the tcdA gene was only detected in one patient. In total, three co-infections were identified, which included Aeromonas spp./C. difficile (tcdA+), C. jejuni/C. difficile, and C. jejuni/Aeromonas spp.
CONCLUSIONS: This is the first study in Iran to investigate the simultaneous prevalence of some pathogens in immunocompromised children with diarrhea. Because Aeromonas spp., Campylobacter spp., and C. difficile are not routinely detected in some laboratories, infections caused by them are underappreciated in the clinic. Our results showed that these pathogens are present in our region and can cause gastroenteritis in children, especially those with underlying diseases. Therefore, increasing the level of hygiene in some areas and controlling bacterial diarrheal diseases should be given more attention by health officials.
摘要：
目的：腹泻是免疫功能低下患者的常见疾病，可能与更高的发病率甚至死亡率有关。因此,本研究旨在确定气单胞菌属的患病率。,弯曲杆菌属。,免疫功能低下儿童中的艰难梭菌。
方法：这项研究是对免疫系统缺陷的腹泻患者的130份粪便样本进行的，这些样本被转诊到库姆的HazratMasoumeh儿童医院。人口统计信息,临床症状,免疫状态，并记录每位患儿的化疗持续时间.从粪便中提取DNA，然后通过特异性引物进行直接PCR检测气单胞菌。,弯曲杆菌属。,和产毒艰难梭菌,包括tcdA/B和cdtA/B基因。还评估了患者的共感染。
结果：男女分别占60.8%和39.2%，分别,m±SD年龄为56.72±40.49个月。大多数免疫功能低下的病例与急性淋巴细胞白血病（77.7％）和非霍奇金淋巴瘤（14.6％）有关。93.1%的患者在研究期间接受化疗。在患者中，大多数临床症状与血性腹泻（98.5％）和发烧（92.3％）有关。基于PCR,14.6、9.2和1.5％的气单胞菌属阳性。,C.艰难，还有空肠杆菌,分别。在艰难梭菌阳性病例中，仅在一名患者中检测到tcdA基因。总的来说,确定了三个共同感染，其中包括气单胞菌属。/C.difficile(tcdA+),C.空肠/C.difficile,和空肠球菌/气单胞菌属。
结论：这是伊朗首次调查免疫功能低下儿童腹泻中某些病原体同时流行的研究。因为气单胞菌属。,弯曲杆菌属。,和艰难梭菌在一些实验室中不常规检测，由它们引起的感染在临床中被低估。我们的结果显示,这些病原体存在于我们地区,可引起儿童胃肠炎,尤其是那些有潜在疾病的人。因此,提高一些地区的卫生水平和控制细菌性腹泻病应该得到卫生官员的更多关注。
方法：这项研究是对免疫系统缺陷的腹泻患者的130份粪便样本进行的，这些样本被转诊到库姆的HazratMasoumeh儿童医院。人口统计信息,临床症状,免疫状态，并记录每位患儿的化疗持续时间.从粪便中提取DNA，然后通过特异性引物进行直接PCR检测气单胞菌。,弯曲杆菌属。,和产毒艰难梭菌,包括tcdA/B和cdtA/B基因。还评估了患者的共感染。
结果：男女分别占60.8%和39.2%，分别,m±SD年龄为56.72±40.49个月。大多数免疫功能低下的病例与急性淋巴细胞白血病（77.7％）和非霍奇金淋巴瘤（14.6％）有关。93.1%的患者在研究期间接受化疗。在患者中，大多数临床症状与血性腹泻（98.5％）和发烧（92.3％）有关。基于PCR,14.6、9.2和1.5％的气单胞菌属阳性。,C.艰难，还有空肠杆菌,分别。在艰难梭菌阳性病例中，仅在一名患者中检测到tcdA基因。总的来说,确定了三个共同感染，其中包括气单胞菌属。/C.difficile(tcdA+),C.空肠/C.difficile,和空肠球菌/气单胞菌属。
结论：这是伊朗首次调查免疫功能低下儿童腹泻中某些病原体同时流行的研究。因为气单胞菌属。,弯曲杆菌属。,和艰难梭菌在一些实验室中不常规检测，由它们引起的感染在临床中被低估。我们的结果显示,这些病原体存在于我们地区,可引起儿童胃肠炎,尤其是那些有潜在疾病的人。因此,提高一些地区的卫生水平和控制细菌性腹泻病应该得到卫生官员的更多关注。
