Shiga Toxin-Producing Escherichia coli Infections in Germany †.
Shiga Toxin-Producing Escherichia coli Infections in Germany †.
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德国产志贺毒素的大肠杆菌感染†。
DOI：
10.4315/0362-028x-60.11.1454
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发表时间：
1997
影响因子：
2
通讯作者：
R. Lissner
中科院分区：
文献类型：
--
作者：
H. Karch;H. Huppertz;J. Bockemühl;H. Schmidt;A. Schwarzkopf;R. Lissner
与德国维尔茨堡的两家儿童医院合作开展了一项前瞻性研究，以评估儿童中产滋贺毒素大肠杆菌（STEC）感染的发病率和临床表现。1991 ~ 1995年，对2788例肠炎患儿粪便标本进行STEC调查。使用与滋贺毒素1（Stx 1）和滋贺毒素2（Stx 2）基因互补的引物，使用PCR筛选来自粪便的STEC培养物。PCR阳性样品进一步进行菌落印迹杂交，并对探针阳性菌落进行血清分型，分析是否存在毒力基因。STEC感染率从1991年的0.4%上升到1994年的2.8%。1995年，感染人数几乎保持不变（2.5%）。STEC感染与大多数患者的疼痛性非血性腹泻有关。在这项研究中，35名粪便含有STEC的患者中，只有9名（25.7%）具有O 157菌落，其中3名（8.6%）为O 157：H7，6名（17.1%）为发酵山梨醇的O 157：H-。在1994/1995年的另一项研究中，我们的实验室通过粪便中的STEC培养证实了来自德国的88例HUS患者的STEC病因，并通过血清学分析证实了另外20例HUS病例的STEC病因。在HUS患者粪便中的菌株中，78%属于血清群O 157。最常分离的非O 157血清群是O26和O 111。这些结果表明，当分析出血性腹泻，溶血性尿毒综合征，或痛苦的非出血性腹泻患者的粪便，非O 157：H7菌株的发生时，应考虑经典的微生物分析未能产生一个标准的肠道病原体，如弯曲杆菌。E.大肠杆菌O 157：H7、沙门氏菌。志贺氏菌或者耶尔森氏菌。
A prospective study was carried out in collaboration with two children's hospitals in Würzburg, Germany to assess the incidence and clinical manifestations of infections due to Shiga toxin-producing Escherichia coli (STEC) in children. Between 1991 and 1995, stool samples from 2788 children with enteritis were investigated for the occurrence of STEC. STEC cultures from stools were screened using PCR with primers complementary to Shiga toxin 1(Stx1) and Shiga toxin 2 (Stx2) genes. PCR-positive samples were further subjected to colony blot hybridization and probe positive colonies were serotyped and analyzed for the presence of virulence genes. There was an increase in the incidence of STEC infections from 0.4% in 1991 to 2.8% in 1994. In 1995 the number of infections remained nearly unchanged (2.5%). Infection with STEC was associated with painful nonbloody diarrhea in most patients. Among the 35 patients in this study with stools containing STEC, only 9 (25.7%) had O157 colonies of which 3 (8.6%) were O157:H7 and 6 (17.1%) were sorbitol-fermenting O157:H-. In an additional study in 1994/l995, STEC etiology in 88 patients with HUS from Germany was confirmed in our laboratories by culture of STEC from stools, and in 20 additional HUS cases by serological analysis. Of the strains from stools of HUS patients, 78% belonged to serogroup O157. The most frequently isolated non-O157 serogroups were O26 and O111. These results demonstrate that when analyzing stools of patients with bloody diarrhea, HUS, or painful nonbloody diarrhea, the occurrence of non-O157:H7 strains should be considered when classical microbiological analysis fails to yield a standard enteric pathogen, such as Campylobacter . E. coli O157:H7, Salmonella . Shigella , or Yersinia .