Title: Don’t Muddy the Water: Know when to get a stool sample for acute diarrhea
题目：不要混淆：知道何时取急性腹泻患者的粪便标本
Author 作者: Andrea Tenner
翻译：葛赟 校正：肖锋

General Information:
基本信息：
•Acute diarrheal illness is a common cause of morbidity and mortality disproportionately affecting low and middle income countries
•急性腹泻是常见的导致并发症和死亡的原因，尤其在中低收入国家。
•Acute diarrhea poses the greatest threat to the immunocompromised, children, and the elderly
•急性腹泻对免疫缺陷者，儿童和老人都有极大的威胁。
•Stool samples are costly and frequently don’t provide information altering the course of treatment in acute, non-severe diarrhea
在急性非重症腹泻患者中，采集粪便标本通常代价高昂，而且经常不能提供改变治疗进程的信息。
•However, for acute diarrhea, a single stool sample should be obtained when diarrhea is associated with:
•但是，对于有下列情况的急性腹泻，取粪便标本是必须的。
•fever (≥38.5°C)
•发热（≥38.5℃）
•a severe coexisting condition in a hospitalized patient on antibiotics
•住院患者同时有需要抗生素的严重情况
•persistent diarrhea (≥14 days)
•持续腹泻（≥14天）
•profuse cholera-like watery diarrhea
•大量霍乱样水泻
•dehydration
•脱水
•dysentery
•痢疾
•an elderly or immunocompromised patient
•老年或免疫缺陷的患者
•food handlers, nursing home residents, and daycare workers
•食物处理者，家庭护理人员，日间护理人员
•The stool sample must be processed by the lab within 4 hours to directly visualize parasites and within 12 hours for routine microbiologic staining.
•粪便标本在4小时内必须送实验室直接在显微镜下观察寄生虫，在12小时内进行常规微生物染色。
Bottom Line for the EM Physician:  Use these guidelines to test stool only when helpful to patient care and avoid flushing resources down the toilet.
急诊医生应该做的是：在对患者治疗有益时，按照指南来检测粪便标本，不要把这些资源冲入下水道。
References 参考文献：
DuPont HL. Acute infectious diarrhea in immunocompetent adults. N Engl J Med. 2014 Apr 17;370(16):1532–40.
Fischer Walker CL, Perin J, Aryee MJ, Boschi-Pinto C, Black RE. Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review. BMC Public Health. 2012;12:220.