Cluster of hemolytic-uremic syndrome caused by Shiga toxin-producing Escherichia coli O26:H11
Cluster of hemolytic-uremic syndrome caused by Shiga toxin-producing Escherichia coli O26:H11
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产志贺毒素大肠杆菌 O26:H11 引起的一系列溶血尿毒症综合征
DOI：
10.1097/01.inf.0000059338.38673.ae
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
L. Patzer
中科院分区：
文献类型：
--
作者：
J. Misselwitz;H. Karch;Martina Bielazewska;U. John;F. Ringelmann;G. Rönnefarth;L. Patzer
背景大肠埃希菌O 157：H7引起的溶血性尿毒症综合征（HUS）的流行病学和临床特征已广为人知，但非产O 157：H7滋贺毒素（Stx）的大肠埃希菌引起的HUS，其致病性和耐药性均较强。大肠杆菌（STEC）的描述较少。在这里，我们报告了一组由STEC O26：H11引起的HUS病例，这是从欧洲散发的HUS病例中分离出的最常见的非O 157：H7 STEC。方法.三名年龄在13至17个月之间的儿童，生活在同一个小镇，在5天的间隔内发展出HUS。我们目前的临床和微生物学数据的患者和他们的感染菌株。结果临床病程从轻度单纯性HUS到重度HUS合并多器官受累不等。所有患者粪便中均检出血清型为O26：H11的STEC。STEC O26：H11分离株的表型和分子特征表明，这些菌株是相同的，与STEC O26不同的是，它们携带stx 2而不是stx 1基因。所有患者均无STEC O 157：H7感染的证据，无论是通过培养还是通过E。coli O 157血清学。STEC O26：H11感染的来源尚未确定。结论.我们的研究结果表明，诊断程序的基础上检测的志贺毒素基因和/或志贺毒素生产和随后的亚型的分离株，使用分子方法是必要的，以确定这种爆发引起的非O 157：H7 STEC。
Background. The epidemiology and clinical characteristics of the hemolytic-uremic syndrome (HUS) caused by Escherichia coli O157:H7 are well-known, but HUS attributable to non-O157:H7 Shiga toxin (Stx)-producing E. coli (STEC) are less thoroughly described. Here we report a cluster of HUS cases caused by STEC O26:H11 the most common non-O157:H7 STEC isolated from sporadic cases of HUS in Europe. Methods. Three children between 13 and 17 months of age, living in the same small town, developed HUS within an interval of 5 days. We present clinical and microbiologic data on the patients and their infecting isolates. Results. The clinical course ranged from mild uncomplicated HUS to severe HUS complicated by multiorgan involvement. Microbiologic investigation demonstrated STEC of serotype O26:H11 in stools of all the patients. The phenotypic and molecular characterization of the STEC O26:H11 isolates demonstrated that these strains were identical and, unusual for STEC O26, they harbored the stx2 but not the stx1 gene. None of the patients had evidence of STEC O157:H7 infection either by culture or by E. coli O157 serology. The source of the STEC O26:H11 infection was undetermined. Conclusions. Our results demonstrate that diagnostic procedures based on the detection of stx genes and/or Stx production and subsequent subtyping of the isolates using molecular methods are necessary to identify such outbreaks caused by non-O157:H7 STEC.
影响因子：
15.9
作者：
VITIELLO, A;ISHIOKA, G;CHESNUT, RW
通讯作者：
CHESNUT, RW
影响因子：
15.9
作者：
Boni, C;Bertoletti, A;Ferrari, C
通讯作者：
Ferrari, C