TOXIN GENOTYPES AND PLASMID PROFILES AS DETERMINANTS OF SYSTEMIC SEQUELAE IN ESCHERICHIA-COLI O157-H7 INFECTIONS
TOXIN GENOTYPES AND PLASMID PROFILES AS DETERMINANTS OF SYSTEMIC SEQUELAE IN ESCHERICHIA-COLI O157-H7 INFECTIONS
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DOI：
10.1093/infdis/160.6.994
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发表时间：
1989-12-01
影响因子：
6.4
通讯作者：
KOBAYASHI, JM
中科院分区：
文献类型：
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作者：
OSTROFF, SM;TARR, PI;KOBAYASHI, JM
1987年，在华盛顿州对这种病原体进行常规监测期间，收集了93株大肠杆菌O157:H7分离株。毒素基因型和质粒谱与分离出这些菌株的93例患者中88例的临床疾病后遗症相关。88株分离菌株共观察到13种质粒模式；4种型占分离株的82%。对志贺样毒素（SLT） I和II的遗传检测显示，67例（76%）存在这两种基因，3例（3%）单独存在SLT I， 18例（20%）单独存在SLT II。溶血性尿毒症综合征或血栓性血小板减少性紫癜在18例感染仅含有SLT II基因的分离株的患者中发生7例（39%），而这些并发症在70例感染具有其他两种基因型分离株的患者中仅发生4例（6%）（相对危险度为6.8；95%可信区间为1.9,26.4）。本研究表明，在确定的时间内从单一地理区域系统收集的大肠杆菌O157:H7分离株在质粒含量和毒素基因型方面表现出相当大的多样性，并且感染菌株的毒素基因型可能影响发生微血管病变后遗症的风险。
In 1987, 93 Escherichia coli O157:H7 isolates were collected during routine surveillance for this pathogen in the state of Washington [USA]. Toxin genotypes and plasmid profiles were correlated with the clinical sequelae of illness in 88 of the 93 patients from whom these strains were isolated. Thirteen plasmid patterns were observed among the 88 tested isolates; four patterns accounted for 82% of the isolates. Genetic probing for Shiga-like toxins (SLT) I and II demonstrated the presence of both genes in 67 (76%), SLT I alone in three (3%), and SLT II alone in 18 (20%). The hemolytic uremic syndrome or thrombotic thrombocytopenic purpura developed in seven (39%) of 18 patients infected with isolates having only the SLT II gene, while these complications occurred in only four (6%) of 70 patients infected with isolates having the other two genotypes (relative risk, 6.8; 95% confidence interval, 1.9, 26.4). This study shows that E. coli O157:H7 isolates systematically collected from a single geographic region over a defined time period exhibit considerable diversity in plasmid content and toxin genotype and that the toxin genotype of the infecting strain may influence the risk of developing microangiopathic sequelae.