Csukás Z, Töró K, Jankovics I, Rozgonyi F, Sótonyi P
Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, H-1089 Budapest, Hungary.
Acta Microbiol Immunol Hung. 2001;48(2):129-41.
The potential role of microbial agents was investigated in 13 cases of Sudden Infant Death Syndrome and in 9 non-SIDS cases in Budapest between September 1996 and May 1998. Autopsy, histological examination and microbiological tests were performed on samples of blood, cerebrospinal fluid, pharyngeal samples and lung tissue from infants under one year died suddenly, without previous diseases. The multifactorial pathomechanism of SIDS was suggested by the isolation of toxin producing Staphylococcus aureus-, Enterobacteriaceae and Candida albicans strains in large number and by the detection of Parainfluenza Type 2 virus antigen. S. aureus proved the predominant bacteria in the SIDS cases. Nasopharyngeal microbial flora and S. aureus carrier of 100 age matched healthy infants were tested during the same period. S. aureus was isolated from 54% of SIDS cases and 37% from healthy infants /OR = 1.986 (95% Confidence interval = 0.55-7.33), p = 0243/. The enterotoxin and TSST-1 toxin producing activity of S. aureus showed the characteristic difference. The toxigenic S. aureus was detected in 46% of SIDS cases and 16% of healthy infants /OR = 4.5 (95% CI = 1.15-17.72), p = 0.010/. The distribution of toxigenic and nontoxigenic isolates was 86% in SIDS cases and 43% in healthy infants /OR = 7.875 (CI = 0.78-191.89), p = 0.041/.
1996年9月至1998年5月期间，在布达佩斯对13例婴儿猝死综合征病例和9例非婴儿猝死综合征病例中微生物制剂的潜在作用进行了调查。对1岁以下无既往疾病突然死亡婴儿的血液、脑脊液、咽拭子样本和肺组织样本进行了尸检、组织学检查和微生物学检测。大量产毒素的金黄色葡萄球菌、肠杆菌科细菌和白色念珠菌菌株的分离以及2型副流感病毒抗原的检测提示了婴儿猝死综合征的多因素发病机制。金黄色葡萄球菌被证明是婴儿猝死综合征病例中的主要细菌。同期对100名年龄匹配的健康婴儿的鼻咽微生物菌群和金黄色葡萄球菌携带者进行了检测。54%的婴儿猝死综合征病例中分离出金黄色葡萄球菌，健康婴儿中为37% /比值比=1.986（95%置信区间=0.55 - 7.33），p = 0.243/。金黄色葡萄球菌产生肠毒素和TSST - 1毒素的活性显示出特征性差异。46%的婴儿猝死综合征病例中检测到产毒金黄色葡萄球菌，健康婴儿中为16% /比值比=4.5（95%置信区间=1.15 - 17.72），p = 0.010/。产毒和不产毒分离株的分布在婴儿猝死综合征病例中为86%，健康婴儿中为43% /比值比=7.875（置信区间=0.78 - 191.89），p = 0.041/。
