Association of atypical enteropathogenic Escherichia coli (EPEC) with prolonged diarrhoea
Association of atypical enteropathogenic Escherichia coli (EPEC) with prolonged diarrhoea
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DOI：
10.1099/jmm.0.45719-0
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发表时间：
2004-11-01
影响因子：
3
通讯作者：
Bergh, K
中科院分区：
文献类型：
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作者：
Afset, JE;Bevanger, L;Bergh, K
本病例对照研究的目的是调查非典型肠致病性大肠杆菌（EPEC）的患病率及其在挪威5岁以下儿童中引起腹泻的可能作用。除了常规检测外，还对实验室收到的疑似胃肠炎儿童粪便标本（n = 251）进行了eae、bfpA和stx基因PCR分析，以确定是否存在EPEC。从妇幼保健中心招募的健康儿童（n 210）的标本仅进行EPEC分析。将EPEC分离株（eae（+），stx（-））分为典型（bfpA（+））和非典型（bfpA（-）），并进行0：K血清群检测。腹泻持续时间的信息记录在调查表和转诊表中。非典型EPEC患者37例（14.7%），健康对照组21例（110.0%）[比值比（OR）= 1.4，P = 0.3]。只有三个分离株，都来自患者，属于EPEC血清群。1例患者有典型的EPEC。89例腹泻持续时间大于或等于14天的患者中有20例（22.5%）为非典型EPEC。非典型EPEC和长期腹泻之间的关联（OR = 2.1，P = 0.04）是由女性患者的高患病率（40.6%）引起的。总之，发现非典型EPEC在患者中的流行率略高于对照组，与腹泻无任何总体显著相关性。然而，观察到与腹泻持续14天或更长时间的显著相关性，这一发现可能表明非典型EPEC在长期疾病中的作用。
The aim of the present case control study was to investigate the prevalence of atypical enteropathogenic Escherichia coli (EPEC) and its possible role in causing diarrhoea among children < 5 years of age in Norway. Stool specimens received in the laboratory from children with suspected gastroenteritis (n = 251) were, in addition to routine testing, analysed for the presence of EPEC by PCR of the eae, bfpA and stx genes. Specimens from healthy children (n 210) recruited from Maternal and Child Health Centres were analysed for EPEC only. EPEC isolates (eae(+), stx(-)) were classified as typical (bfpA(+)) or atypical (bfpA(-)), and were tested for 0 : K serogroup. Information on duration of diarrhoea was recorded in a questionnaire and from referral forms. Atypical EPEC was diagnosed in 37 patients (14.7%) compared to 21 (110.0%) of the healthy controls [Odds ratio (OR) = 1.4, P = 0,3]. Only three isolates, all from patients, belonged to EPEC serogroups. One patient had typical EPEC. Twenty (22.5%) of 89 patients with diarrhoea lasting greater than or equal to 14 days had atypical EPEC. The association between atypical EPEC and prolonged diarrhoea (OR = 2.1, P = 0.04) was caused by a high prevalence among female patients (40.6%). In conclusion, atypical EPEC was found to be slightly more prevalent in patients than controls, without any overall significant association with diarrhoea. However, a significant association was observed with diarrhoea lasting 14 days or more, a finding that may indicate a role for atypical EPEC in prolonged disease.