Immune response to Escherichia coli O157:H7 in hemolytic uremic syndrome following salmonellosis
Immune response to Escherichia coli O157:H7 in hemolytic uremic syndrome following salmonellosis
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沙门氏菌病后溶血性尿毒症综合征中大肠杆菌 O157:H7 的免疫反应
DOI：
10.1007/s004670050323
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发表时间：
1997
影响因子：
3
通讯作者：
M. Somers
中科院分区：
文献类型：
--
作者：
F. Flores;K. Jabs;G. Thorne;J. Jaeger;M. Linshaw;M. Somers
大肠杆菌O 157：H7是一种产志贺样毒素的肠道致病菌，与大多数腹泻后溶血性尿毒综合征（D+HUS）有关。其他细菌病原体如沙门氏菌的感染也先于D+HUS发作，导致推测这些微生物也可能是病因。我们提出了两个孩子无关的D+HUS后沙门氏菌病。两名儿童在腹泻发作后不久，粪便培养在麦康凯琼脂上均为阴性。诊断为溶血尿毒综合征后，两名患者均重复粪便培养沙门氏菌阳性。沙门氏菌分离株的PCR扩增结果均为阴性。酶联免疫吸附试验测定E.大肠杆菌157：H7脂多糖在急性和恢复期血清样品中显示了迄今未检测到的证据。大肠杆菌157：H7感染与每次D+HUS发作同时发生。这些病例表明，仅从D+HUS儿童中分离出非产β-内酰胺酶微生物应引起怀疑同时存在未检出的产SLT微生物感染。测定对E. colio 157：H7可能是一个重要的流行病学辅助物。非产芽孢沙门氏菌的细菌感染可能代表伴随的肠道病理学而不是D+ HUS引发的感染。
Escherichia coliO157:H7, a Shiga-like toxin (SLT)-producing enteric pathogen, has been implicated in most cases of post-diarrheal hemolytic uremic syndrome (D+HUS). Infection with other bacterial pathogens such asSalmonellahas also preceded D+HUS episodes, leading to speculation that these organisms may also be etiological. We present two children with unrelated D+HUS following salmonellosis. Both children had negative stool cultures on sorbitol-MacConkey agar soon after the onset of diarrhea. After the diagnosis of HUS, both patients had repeat stool cultures positive forSalmonellaalone. Polymerase chain reactions for SLT I and II gene sequences inSalmonellaisolates were negative. Enzyme-linked imunosorbent assay for specific humoral response toE. coliO157:H7 lipopolysaccharide in acute and convalescent serum samples revealed evidence of heretofore undetectedE. coliO157:H7 infection contemporaneous with each D+HUS episode. These cases demonstrate that isolation of only non-SLT-producing microbes from children with D+HUS should raise suspicion of concurrent undetected infection with SLT-producing organisms. Assaying specific immune response toE. coliO157:H7 can be an important epidemiological adjunct. Bacterial infection with non-SLT-producingSalmonellamay represent concomitant enteric pathology rather than D+HUS-instigating infection.