Studies on diarrheal diseases: The multiplicity of infectious agents in the intestinal flora of puerto rican children with gastroenteritis

摘要

In 1964, the infectious agents responsible for most pediatric diarrheal diseases were largely unknown. Furthermore, mechanisms of pathogenesis had not yet been elucidated. Guardiola-Rotger et al sampled the blood and stool of more than 200 Puerto Rican infants and children with acute and chronic diarrhea. Using common techniques of the day, including bacterial culture with standardized biochemical identification, viral isolation and pooled sera neutralization, trophozoite identification, and egg counting, they reported rates of recovery of identified organisms. They found significant overlap in many subjects, yet were unable to identify an agent in 21% of acute cases and 4% of chronic cases. Furthermore, they identified organisms in 55% of asymptomatic controls. Today, our knowledge of causative agents has greatly expanded. Specific methods of testing for various pathogenic organisms are giving way to polymerase chain reaction-based assays which have high sensitivity. Endoscopy allows us to make a correlation between stool-positivity and histology in select cases. Finally, herculean efforts to map the human microbiome have provided insight into the normal inhabitants of the gut and their impact on health and disease.