Keskimäki M, Ratiner Y, Oinonen S, Leijala E, Nurminen M, Saari M, Siitonen A
National Public Health Institute, Laboratory of Enteric Pathogens, Helsinki, Finland.
Scand J Infect Dis. 1999;31(2):141-4. doi: 10.1080/003655499750006173.
The first case of haemolytic-uraemic syndrome (HUS) caused by Vero toxin-producing Escherichia coli (VTEC) which belonged to a novel serotype, Rough: K-: H49, is reported. The case was initially diagnosed as nephropathia epidemica caused by Puumala virus, but the subsequent diagnosis of HUS caused by VTEC was made after bacteriological investigation. The strain isolated fermented sorbitol produced VT2 toxin but not enterohaemolysin, nor did it carry the eaeA gene. In VTEC strains, the O antigen, the eaeA gene and enterohaemolysin production have been characterized as virulence-associated factors and believed to have an effect on pathogenesis of these strains to cause haemorrhagic colitis or HUS. The findings of this study demonstrate that there is a need for further studies to evaluate the pathogenetic mechanism of VTEC and need for easy diagnostic methods exploiting other properties than O157 antigen and non-fermentation of sorbitol to find all VTEC in human infections.
据报道，首例由产志贺毒素大肠杆菌（VTEC）引起的溶血尿毒综合征（HUS）病例，该VTEC属于一种新型血清型，粗糙型：K-：H49。该病例最初被诊断为由普马拉病毒引起的流行性肾病，但在细菌学调查后确诊为由VTEC引起的HUS。分离出的菌株发酵山梨醇，产生VT2毒素，但不产生肠溶血素，也不携带eaeA基因。在VTEC菌株中，O抗原、eaeA基因和肠溶血素的产生已被表征为与毒力相关的因素，并被认为对这些菌株引起出血性结肠炎或HUS的发病机制有影响。本研究结果表明，需要进一步研究以评估VTEC的致病机制，并且需要开发利用除O157抗原和山梨醇不发酵以外的其他特性的简易诊断方法，以便在人类感染中发现所有的VTEC。
