Escherichia coli O157:H7
Escherichia coli O157:H7
复制标题
DOI：
10.1016/s0140-6736(98)01267-7
复制
发表时间：
1998-10-10
期刊：
影响因子：
168.9
通讯作者：
Griffin, PM
中科院分区：
文献类型：
--
作者：
Mead, PS;Griffin, PM
大肠杆菌O157于1982年首次被确定为人类病原体。志贺菌是已知引起人类疾病的几种产生滋贺毒素的血清型之一，该生物体可能是通过水平获得滋贺毒素和其他毒力因子的基因而进化的。大肠杆菌O157经常在健康牛的粪便中发现，并通过受污染的食物，水和与受感染的人或动物直接接触传播给人类。人类感染与广泛的临床疾病有关，包括无症状的散毒、非血性腹泻、出血性结肠炎、溶血性尿毒综合征和死亡。由于实验室的做法各不相同，医生需要知道他们所在地区的实验室是否定期检测粪便标本中的大肠杆菌O157。抗菌药物的治疗仍然存在争议：一些研究表明，治疗可能会导致溶血性尿毒综合征，其他研究表明没有效果，甚至有保护作用。医生可以帮助预防大肠杆菌O157感染，方法是向病人提供咨询，告诉他们食用未煮熟的绞肉或未经高温消毒的奶制品和果汁的危害，以及洗手对防止肠道疾病传播的重要性，并在公共卫生当局发现异常数量的出血性腹泻或溶血性尿毒综合征病例时通知他们。
Escherichia coli O157 was first identified as a human pathogen in 1982. One of several Shiga toxin-producing serotypes known to cause human illness, the organism probably evolved through horizontal acquisition of genes for Shiga toxins and other virulence factors. E coli O157 is found regularly in the faeces of healthy cattle, and is transmitted to humans through contaminated food, water, and direct contact with infected people or animals. Human infection is associated with a wide range of clinical illness, including asymptomatic shedding, non-bloody diarrhoea, haemorrhagic colitis, haemolytic uraemic syndrome, and death. Since laboratory practices vary, physicians need to know whether laboratories in their area routinely test for E coli O157 in stool specimens. Treatment with antimicrobial agents remains controversial: some studies suggest that treatment may precipitate haemolytic uraemic syndrome, and other studies suggest no effect or even a protective effect. Physicians can help to prevent E coli O157 infections by counselling patients about the hazards of consuming undercooked ground meat or unpasteurised milk products and juices, and about the importance of handwashing to prevent the spread of diarrhoeal illness, and by informing public health authorities when they see unusual numbers of cases of bloody diarrhoea or haemolytic uraemic syndrome.