Characterization of Shiga toxin-producing Escherichia coli strains isolated from human patients in Germany over a 3-year period
Characterization of Shiga toxin-producing Escherichia coli strains isolated from human patients in Germany over a 3-year period
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DOI：
10.1128/jcm.42.3.1099-1108.2004
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发表时间：
2004-03-01
影响因子：
9.4
通讯作者：
Gleier, K
中科院分区：
文献类型：
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作者：
Beutin, L;Krause, G;Gleier, K
我们调查了677株产滋贺毒素大肠杆菌（STEC）菌株，以确定其血清型、毒力基因和患者的临床体征。在STEC菌株中分布6种不同的滋贺毒素类型（1、1c、2、2c、2d和2e）。62.6%的菌株中存在内膜蛋白（eae）基因，并分为内膜蛋白α 1、β 1、γ 1、β 2、θ和eta亚型。滋贺毒素1c型和2d型仅存在于eae阴性的STEC菌株中，而2型在eae阳性的STEC菌株中更常见（P < 0.001）。肠出血性大肠大肠杆菌溶血素与96.2%的eae阳性菌株和65.2%的eae阴性菌株相关。患者的临床体征为腹痛（8.7%）、非血性腹泻（59.2%）、血性腹泻（14.3%）和溶血性尿毒症综合征（HUS）（3.5%），14.3%的患者无胃肠道疾病或HUS体征。6岁以下儿童中EAE阳性STEC感染的发生率显著高于其他年龄组（P < 0.001），而成人中EAE阴性STEC感染占主导地位。通过血清学分型和221株非运动性STEC菌株中鞭毛（fliC）基因的PCR分型，将STEC菌株分为74个O：H型。11种血清型（O157：[H7]、O26：[H11]、O103：H2、O91：[H14]、O111：[H28]、O145：[H28]、O128：H2、O113：[H4]、O146：H21、O118：H16和O76：[H19]）占所有STEC菌株的69%。我们确定了41个STEC菌株属于31个血清型，以前没有被描述为人类STEC。其中26例为intimins α 1（1种血清型）、β 1（8种血清型）、β 2（2种血清型）和eta（3种血清型）阳性。我们的研究表明，不同类型的STEC菌株在婴儿和成人患者中占主导地位，并且在人类分离株中存在新型STEC菌株。
We have investigated 677 Shiga toxin-producing Escherichia coli (STEC) strains from humans to determine their serotypes, virulence genes, and clinical signs in patients. Six different Shiga toxin types (1, 1c, 2, 2c, 2d, and 2e) were distributed in the STEC strains. Intimin (eae) genes were present in 62.6% of the strains and subtyped into intimins alpha1, beta1, gamma1, epsilon, theta and eta. Shiga toxin types 1c and 2d were present only in eae-negative STEC strains, and type 2 was significantly (P < 0.001) more frequent in eae-positive STEC strains. Enterohemorrhagic E. coli hemolysin was associated with 96.2% of the eae-positive strains and with 65.2% of the eae-negative strains. Clinical signs in the patients were abdominal pain (8.7%), nonbloody diarrhea (59.2%), bloody diarrhea (14.3%), and hemolytic-uremic syndrome (HUS) (3.5%), and 14.3% of the patients had no signs of gastrointestinal disease or HUS. Infections with eae-positive STEC were significantly (P < 0.001) more frequent in children under 6 years of age than in other age groups, whereas eae-negative STEC infections dominated in adults. The STEC strains were grouped into 74 O:H types by serotyping and by PCR typing of the flagellar (fliC) genes in 221 nonmotile STEC strains. Eleven serotypes (O157: [H7], O26: [H11], O103:H2, O91:[H14], O111:[H28], O145:[H28], O128:H2, O113:[H4], O146:H21, O118:H16, and O76: [H19]) accounted for 69% of all STEC strains. We identified 41 STEC strains belonging to 31 serotypes which had not previously been described as human STEC. Twenty-six of these were positive for intimins alpha1 (one serotype), beta1 (eight serotypes), epsilon (two serotypes), and eta (three serotypes). Our study indicates that different types of STEC strains predominate in infant and adult patients and that new types of STEC strains are present among human isolates.