Characteristics of O157 versus Non-O157 Shiga Toxin-Producing Escherichia coli Infections in Minnesota, 2000-2006
Characteristics of O157 versus Non-O157 Shiga Toxin-Producing Escherichia coli Infections in Minnesota, 2000-2006
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DOI：
10.1086/600302
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发表时间：
2009-08-01
影响因子：
11.8
通讯作者：
Smith, Kirk E.
中科院分区：
文献类型：
--
作者：
Hedican, Erin B.;Medus, Carlota;Smith, Kirk E.
背景大肠杆菌O 157：H7（O 157）是产滋贺毒素的大肠杆菌。大肠杆菌（STEC）血清型最常见的分离和最经常与溶血性尿毒综合征（HUS）在美国。非O 157 STEC血清型也可导致严重疾病，但其作为病原体的影响仍不确定。我们比较了通过哨点监测确定的非O 157和O 157 STEC感染的特征。监测点包括一个大都市保健组织实验室和一个服务于小城市和农村地区的医院实验室。我们从2000-2006年期间在两个研究中心进行的每次粪便培养中获得了M-M琼脂平板。通过聚合酶链反应对菌落扫描进行stx 1和stx 2筛查。E.对分离菌株进行鉴定、血清型鉴定和stx 1和/或stx 2的检测。确定了206株STEC分离株：108株（52%）为非O 157血清型，98株（48%）为O 157。在非O 157病例中，54%涉及血性腹泻，8%涉及住院治疗。至少具有stx 2的非O 157分离株并不比仅具有stx 1的非O 157分离株更容易引起严重疾病（血性腹泻、住院或HUS）。O 157病例比非O 157病例更可能涉及出血性腹泻（78% vs 54%; P < .001）、住院（34% vs 8%; P < .001）和HUS（7% vs 0%; P = .005）。当仅包括至少stx 2的分离株时，O 157病例仍然比非O 157病例更可能涉及血性腹泻（78% vs 56%; P= 0.02）和住院（33% vs 12%; P = 0.01）。STX 2不能解释STEC感染之间严重程度的差异，这表明其他因素在STEC毒力中很重要。
Background. Escherichia coli O157:H7 (O157) is the Shiga toxin-producing E. coli (STEC) serotype most frequently isolated and most often associated with hemolytic uremic syndrome (HUS) in the United States. Non-O157 STEC serotypes can also cause serious illness, but their impact as pathogens remains undefined. We compared characteristics of non-O157 and O157 STEC infections identified through sentinel surveillance.Methods. Sentinel sites included a metropolitan health maintenance organization laboratory and a hospital laboratory serving a small city and rural area. We received sorbitol-MacConkey agar plates from every stool culture performed at both sites during 2000-2006. Colony sweeps were screened for stx1 and stx2 by polymerase chain reaction. E. coli identity, serotype, and presence of stx1 and/or stx2 were confirmed on individual isolates.Results. Two hundred six STEC isolates were identified: 108 (52%) were non-O157 serotypes, and 98 (48%) were O157. Of non-O157 cases, 54% involved bloody diarrhea, and 8% involved hospitalization. Non-O157 isolates with at least stx2 were not more likely to cause severe illness (bloody diarrhea, hospitalization, or HUS) than were non-O157 isolates with only stx1. O157 cases were more likely than non-O157 cases to involve bloody diarrhea (78% vs 54%; P < .001), hospitalization (34% vs 8%; P < .001), and HUS (7% vs 0%; P = .005). When including only isolates with at least stx2, O157 cases were still more likely to involve bloody diarrhea (78% vs 56%; P=.02) and hospitalization (33% vs 12%; P = .01) than non-O157 casesConclusions. Differences in severity among STEC infections could not be explained by stx2, suggesting that additional factors are important in STEC virulence.