Intestinal infection is a common cause of digestive upset in children. To quickly cure your child, you need to pass tests and identify the true cause of the intestinal disorder. Laboratory diagnostics of intestinal infections includes an analysis of feces for a conditionally pathogenic group of microorganisms and an analysis for pathogenic flora (analysis for the dysgroup and typhoid paratyphoid group of bacteria).
Analysis of feces for dysgroup is a study of fecal masses for the presence of pathogens of intestinal infections. This group includes bacteria that are not permanent inhabitants of the intestines in healthy children and can potentially cause an infectious process. These include the causative agents of dysentery (shigella) and salmonella.
Conditionally pathogenic microorganisms (enterococci, staphylococci, clostridia, fungi), along with “beneficial” bacteria, make up the natural intestinal microflora. They are called conditional, because their ability to cause infection depends on specific circumstances: weakening of the immune system, a sharp decrease in the number of “helper bacteria” (lactobacilli, bifidobacteria), spoiled food.
In what cases should the feces be examined?
It is necessary to donate feces for a disgroup to clarify the diagnosis if an intestinal infection is suspected or as part of preventive measures.
For the development of intestinal infection, it is necessary for pathogenic microbes to enter the child’s intestines. The source of infection is the feces of an infected person. Microbial transmission can occur through contact with a sick person or carrier of the infection, through the consumption of contaminated food or water. The waterway is considered the most common.
Not all bacteria can get to the intestines – gastric juice causes the death of most of them. Since infants (especially newborns) produce small amounts of gastric juice, their risk of infection is higher. Infants may develop an intestinal infection when complementary foods are added. If complementary foods are prepared without observing sanitary rules or have not undergone heat treatment, then opportunistic microbes may be present in it.
With an intestinal infection, a child may experience the following complaints:
- stomach ache,
- nausea, vomiting,
- loose stools
- increased body temperature, chills, general weakness.
Acute intestinal infection in children can occur in the form of gastritis, enteritis or colitis, it develops quickly. Diarrhea is the body’s defense reaction to remove the pathogen. But along with liquid and abundant stools, useful substances are also lost and, if treatment is not started on time, then the child develops dehydration from profuse diarrhea and vomiting. The skin and visible mucous membranes become dry, the child becomes lethargic, the amount of urine decreases, there is no sweat and tears. The fontanelle sinks in a newborn. In very severe cases, shock and multiple organ failure develop. Babies develop dehydration much more quickly.
The indication for analysis is the detection of the carrier. These are the cases when children who have already had an intestinal infection continue to excrete a pathogenic microbe in the feces. Therefore, the analysis of feces for the intestinal group for hospitalization is an indispensable procedure if the child needs to undergo surgery and hospital treatment for another disease.
Preventive research for the carriage of pathogens of intestinal infections is also carried out in medical practitioners, food industry workers and educational institutions and is included in the mandatory annual examination.
The study of feces for dysbiosis can show whether the necessary digestive enzymes are present in the body.
How to get tested? Feces sampling rules
Before you donate feces for the intestinal group, you need to know how to do it correctly. The capture technique is not difficult. The feces should be collected in a special plastic bottle, which can be bought at the pharmacy. Before taking stool, you need to prepare the child: do not take activated charcoal, castor oil for several days, do not put rectal suppositories and do not take antibiotics. They take feces after the child goes to the toilet “a little”.
Collect feces from several places and fill one third of the container, this is about 2 cm. If you have to wait a long time for natural defecation, then feces taken from underwear (always fresh) are suitable for analysis. A dropper can be used to collect stool if the stool is very runny. Feces are taken from areas where there are many pathological impurities, such as pus, mucus, and flakes. There should be no blood in the selected material. We collect feces in the morning. There are times when the collection of feces is not required, a rectal smear is sent for analysis. It is taken in the clinic with a special swab with the child lying on its side. The taken feces or smear are handed over to the laboratory within 3 hours after the collection.
Analysis of intestinal infection in children includes bacterioscopic and bacteriological examination of feces. The bacterioscopic method shows the presence of bacteria and protozoa in the feces under a microscope. Stool bacteriological analysis is the cultivation of a colony of microorganisms.
To do this, a feces culture tank is made on a nutrient medium. By the nature of growth, the type of infectious pathogens and their concentration are determined. When pathogenic microorganisms are detected, their sensitivity to antibiotics is determined.
The most frequently asked question: “How much is the analysis done for intestinal infections?” It takes time for a colony to grow. How many days the culture will grow depends on the specific type of microbe. Data are usually obtained within 1–2 weeks.
Sometimes the analysis for the intestinal group may not be informative enough. For example, if the cause of the infection is a virus or protozoa, or if not the pathogen itself was found in the feces, but its waste. In this case, feces are donated for the polymerase chain reaction. Stool PCR detects the DNA of the pathogen, even if only one bacteria has entered the stool. The data comes in a day.
Additional diagnostic methods of investigation for intestinal infections include a blood test, a blood culture (if the child’s fever lasts more than 3 days) and a serological test (allows to detect antibodies to pathogens).
Culture of stool for pathogenic intestinal flora also differentiates intestinal infection from other conditions that can cause the same symptoms. Differential diagnosis of intestinal infection is carried out with dysbiosis and food toxico-infections. To diagnose dysbacteriosis, a feces analysis for UPF is taken.
Decryption of the received data
A healthy child has no pathogenic microorganisms in the feces, i.e. the analysis should be negative for dysgroup and salmonellosis, as well as for dysentery amoeba and typhoid paratyphoid group. Normally, there are no such simple microorganisms as intestinal Trichomonas, balantidia.
High values of pathogenic bacteria that are not part of the normal microflora are found in two cases: acute intestinal infection and bacterial carriage.
An UPF test will tell you how many of these bacteria are in 1 gram of feces. Low values of enterococci, clostridia, candida fungi and bacteroids are considered negative because for the development of infection, a certain amount of the pathogen is needed, and not just its presence. If conditionally pathogenic microflora prevails over the concentration of lactobacilli in feces, this is dysbiosis.
If an intestinal group is detected, the analysis is supplemented with a test for the sensitivity of bacteria to antibiotics.
Antibiotic susceptibility is indicated by the following letter designations
- S – sensitive (h),
- R – stable, resistant (y),
- I – moderately resistant (yy).
If the stool test came back positive, then the sick child should be isolated. With a mild course of the disease, treatment can be carried out at home. It is necessary to restore the amount of fluid lost in the feces (rehydration). The doctor prescribes antibiotic therapy. In case of severe dehydration, the child must be urgently hospitalized!
Differential diagnosis can be difficult if one disease occurs under the guise of another. In such cases, an accurate diagnosis is established based on the results of successful treatment. If the therapy is effective, the diagnosis is correct.
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