Serotypes, virulence genes, and intimin types of Shiga toxin (verotoxin)-producing Escherichia coli isolates from human patients:: Prevalence in Lugo, Spain, from 1992 through 1999
Serotypes, virulence genes, and intimin types of Shiga toxin (verotoxin)-producing Escherichia coli isolates from human patients:: Prevalence in Lugo, Spain, from 1992 through 1999
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DOI：
10.1128/jcm.42.1.311-319.2004
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发表时间：
2004-01-01
影响因子：
9.4
通讯作者：
Blanco, J
中科院分区：
文献类型：
--
作者：
Blanco, JE;Blanco, M;Blanco, J
我们分析了产滋贺毒素大肠埃希菌（STEC）在卢戈市Xeral-Calde医院（西班牙）腹泻或其他胃肠道病变患者粪便标本中的患病率。在调查的5，054例病例中，有126例（2.5%）检出了STEC菌株，发病率从1992年的0%逐渐增加到1999年的4.4%。STEC O 157：H7在24例（0.5%）中分离，而非O 157 STEC菌株从87例患者（1.7%）中分离。STEC菌株是（沙门氏菌和弯曲杆菌属菌株之后）第三大最常见的肠道致病性细菌。本研究共对126株人STEC分离株进行了表征。PCR检测结果显示，43株（34%）菌株携带stx（1）基因，45株（36%）菌株携带stx（2）基因，38株（30%）菌株同时携带stx（1）和stx（2）基因。共有88株（70%）分离株携带ehx 4肠溶血素基因，70株（56%）分离株具有eae紧密蛋白基因（27株为γ 1型，20株为β 1型，8株为zeta型，5株为γ 2型，3株为β 1型）。STEC分离株属于41个O血清群和66个O：H血清型，包括21个与溶血性尿毒综合征相关的血清型和30个先前在其他研究中未报告的人STEC菌株的新血清型。虽然126个STEC分离株属于81个不同的血清病理型（血清型和毒力基因之间的关联），但只有4个占分离株的31%。血清病理型O 157：H7 stx、stx（2）eae-gamma 1 ehxA最常见（13个分离株），其次是O 157：H7 stx（2）eae-gamma 1 ehxA（11个分离株）、O26：H11 stx（1）eae-beta1 ehxA（11个分离株）和O 111：H-stx（1）stx（2）eae-gamma 2 ehx 4（4个分离株）。我们的研究结果表明，STEC菌株是西班牙人类感染的重要原因，并证实在欧洲大陆，STEC非O 157菌株引起的感染比O 157：H7菌株引起的感染更常见。STEC菌株（O 157：H7和非O 157菌株）在人类患者中的高患病率及其与严重并发症的相关性，强烈支持在西班牙临床微生物实验室中使用检测STEC所有血清型的方案。
We have analyzed the prevalence of Shiga toxin-producing Escherichia coli (STEC) in stool specimens of patients with diarrhea or other gastrointestinal alterations from the Xeral-Calde Hospital of Lugo City (Spain). STEC strains were detected in 126 (2.5%) of 5,054 cases investigated, with a progressive increase in the incidence from 0% in 1992 to 4.4% in 1999. STEC O157:H7 was isolated in 24 cases (0.5%), whereas non-O157 STEC strains were isolated from 87 patients (1.7%). STEC strains were (after Salmonella and Campylobacter strains) the third most frequently recovered enteropathogenic bacteria. A total of 126 human STEC isolates were characterized in this study. PCR showed that 43 (34%) isolates carried stx(1) genes, 45 (36%) possessed stx(2) genes and 38 (30%) carried both stx(1) and stx(2). A total of 88 (70%) isolates carried an ehx4 enterohemolysin gene, and 70 (56%) isolates possessed an eae intimin gene (27 isolates with type gamma1, 20 with type beta1, 8 with type zeta, 5 with type gamma2, and 3 with type epsilon). STEC isolates belonged to 41 O serogroups and 66 O:H serotypes, including 21 serotypes associated with hemolytic uremic syndrome and 30 new serotypes not previously reported among human STEC strains in other studies. Although the 126 STEC isolates belonged to 81 different seropathotypes (associations between serotypes and virulence genes), only four accounted for 31% of isolates. Seropathotype O157:H7 stx, stx(2) eae-gamma1 ehxA was the most common (13 isolates) followed by O157:H7 stx(2) eae-gamma1 ehxA (11 isolates), O26:H11 stx(1) eae-beta1 ehxA (11 isolates), and O111:H- stx(1) stx(2) eae-gamma2 ehx4 (4 isolates). Our results suggest that STEC strains are a significant cause of human infections in Spain and confirm that in continental Europe, infections caused by STEC non-O157 strains are more common than those caused by O157:H7 isolates. The high prevalence of STEC strains (both O157:H7 and non-O157 strains) in human patients, and their association with serious complications, strongly supports the utilization of protocols for detection of all serotypes of STEC in Spanish clinical microbiology laboratories.