Laboratory investigation of outbreak of hemorrhagic colitis caused by Escherichia coli O157:H7
Laboratory investigation of outbreak of hemorrhagic colitis caused by Escherichia coli O157:H7
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大肠杆菌O157:H7引起的出血性结肠炎暴发实验室调查
DOI：
10.1128/jcm.25.6.1043-1047.1987
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发表时间：
1987
影响因子：
9.4
通讯作者：
R. Behme
中科院分区：
文献类型：
--
作者：
C. Krishnan;V. Fitzgerald;S. Dakin;R. Behme
1985年9月，安大略省伦敦爆发了严重的出血性结肠炎。某养老院共有55名居民和18名工作人员出现腹泻，17名居民（78 ~ 99岁）死亡。对来自38名患者、37名雇员和接触者以及10份尸体解剖的标本进行了所有肠道病原体调查。还将标本种植在麦康基山梨醇琼脂上。粪便提取物在Vero细胞上检测细胞毒素（FVT）。分离的大肠杆菌进行血清分型，并检测韦罗毒素和β -葡萄糖醛酸酶的产生。在38例有症状的患者中，26例FVT、产维罗毒素大肠杆菌（VTEC）或两者均阳性。在这38例患者的105例标本中，30例标本FVT和VTEC均阳性，13例标本FVT阳性，4例标本VTEC阳性。10例尸检的27例标本中没有一例FVT或VTEC阳性。所有病例均未发现其他肠道病原体。所有无症状个体FVT和VTEC均为阴性。在分离的19株VTEC中，18株为O157:H7血清型。这18株和另外2株来自前2个月内发生的散发病例的菌株在36项检测的鉴定系统中发现具有相似的生化反应。所有O157:H7血清型分离株均为β -葡糖醛酸酶阴性，对用于治疗大肠杆菌感染的抗微生物药物敏感。FVT和VTEC检测是本病实验室诊断最敏感、最特异的技术。山梨醇阴性，棉子糖阳性，β -葡萄糖醛酸酶阴性似乎是帮助检测大肠杆菌O157:H7的一致标记。
A severe outbreak of hemorrhagic colitis occurred in London, Ontario, during the month of September 1985. A total of 55 residents and 18 employees of a nursing home developed diarrhea, and 17 residents (age range, 78 to 99 years) died. Specimens from 38 patients, 37 employees and contacts, and 10 autopsies were investigated for all enteric pathogens. Specimens were also planted on MacConkey-sorbitol agar. Fecal extracts were tested on Vero cells for cytotoxin (FVT). Escherichia coli isolates were serotyped and tested for verotoxin and beta-glucuronidase production. Of the 38 symptomatic patients, 26 were positive for FVT, verotoxin-producing E. coli (VTEC), or both. Of the 105 specimens that were examined from these 38 patients, FVT and VTEC were both positive in 30 specimens, FVT only was positive in 13 specimens, and VTEC only was positive in 4 specimens. None of the 27 specimens from 10 autopsies was positive for FVT or VTEC. No other enteric pathogen was found in any of the cases. All asymptomatic individuals were negative for both FVT and VTEC. Of 19 VTEC strains that were isolated, 18 belonged to serotype O157:H7. These 18 strains and 2 more strains that were obtained from sporadic cases that had occurred within the 2 previous months were found to give similar biochemical reactions in a 36-test identification system. All isolates of serotype O157:H7 were beta-glucuronidase negative and susceptible to the antimicrobial agents that are used to treat E. coli infections. Testing for FVT and VTEC was found to be the most sensitive and specific technique for the laboratory diagnosis of this disease. Negative sorbitol, positive raffinose, and negative beta-glucuronidase tests appeared to be consistent markers for aiding in the detection of E. coli O157:H7.