Терапевтический архив (Nov 2014)
Evaluation of the efficiency of diagnostic regimens for enterohemorrhagic escherichiasis. Etiological verification of hemolytic uremic syndrome in the Russian Federation
Abstract
AIM. To evaluate the practical efficiency of the diagnostic algorithms for enterohemorrhagic escherichiasis, which are laid down by the current normative documents of the Russian Federation. MATERIALS AND METHODS. The investigators estimated the prevalence of enterohemorrhagic Escherichia coli (EHEC) infection in children with the symptoms of acute enteric infections (AEI) (archival samples) and in those aged less than 5 years with fatal evolution and a history of diarrhea and hemolytic uremic syndrome (HUS), evaluated the efficiency of bacteriological tests in HUS patients with acute EHEC infection, and comparatively analyzed the documents regulating EHEC surveillance in the Russian Federation and other countries. RESULTS. Nucleic acid amplification assay showed that the prevalence of EHEC among the hospitalized children was 1.2% (27/1269), the anamnestic registration rate for HUS among the children with fatal outcomes in AEI was 20% (5/25). The efficiency of the bacteriological diagnosis of enterohemorrhagic escherichiasis in the archival samples corresponding to the early stages of the disease in the presence of diarrhea and at the HUS development stage was 48.1% (13/27) and 6.1% (2/33), respectively. There was a potential to enhance the efficiency of the normative documents regulating the etiological diagnosis of EHEC infection in the Russian Federation. CONCLUSION. The given data substantiate the necessity of including the etiological diagnosis of EHEC infection in the list of mandatory screening studies in children with sporadic cases of hemocolitis at the early stages of the disease.
