Ludwig Kerstin, Sarkim Volkan, Bitzan Martin, Karmali Mohamed A, Bobrowski Christoph, Ruder Hans, Laufs Rainer, Sobottka Ingo, Petric Martin, Karch Helge, Müller-Wiefel Dirk E
Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Universität Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
J Clin Microbiol. 2002 May;40(5):1773-82. doi: 10.1128/JCM.40.5.1773-1782.2002.
Ninety-five household contacts (aged 2 months to 73 years) of patients with enteropathic hemolytic-uremic syndrome (HUS) were investigated for the presence of immunoglobulin (Ig) G antibodies to Shiga toxins Stx2 and Stx1 by Western blot assay. Thirty-one percent of the household contacts and 19% of 327 controls had anti-Stx2 IgG (heavy and light chain [H + L]), 5 and 8%, respectively, had anti-Stx1 IgG (H + L), and 3 and 2%, respectively, had both anti-Stx2 and anti-Stx1 IgG (H + L). The incidence of infections with Stx-producing Escherichia coli (STEC) was determined based on the following diagnostic criteria: STEC isolation, detection of stx gene sequences, free fecal Stx in stool filtrates, and serum IgM antibodies against E. coli O157 lipopolysaccharide. Evidence of STEC infection was observed in 25 household contacts, of whom 18 (72%) were asymptomatic and represented a potential source of infection. Six of 13 (46%) household contacts with Stx2-producing E. coli O157:H7 in stool culture developed anti-Stx2 IgG (H + L), compared to 71% of Stx2-associated HUS cases. In individuals showing anti-Stx2 IgG (H + L), the antibody response was directed against the B subunit in 69% of household contacts and 71% of controls, in contrast to 28% of HUS patients. In this investigation controls had a significant increase of the median of IgM antibodies to O157 lipopolysaccharide (LPS) with age, up to the fifth decade. The lack of disease in household contacts with B subunit-specific antibodies, as well as the significantly higher median of anti-O157 LPS IgM antibodies in controls beyond 4.9 years of age, suggests a protective role for anti-Stx and anti-O157 LPS antibodies.
采用蛋白质印迹法对95名肠病性溶血尿毒综合征（HUS）患者的家庭接触者（年龄2个月至73岁）进行了检测，以确定其是否存在抗志贺毒素Stx2和Stx1的免疫球蛋白（Ig）G抗体。31%的家庭接触者和19%的327名对照者有抗Stx2 IgG（重链和轻链[H + L]），分别有5%和8%的人有抗Stx1 IgG（H + L），分别有3%和2%的人同时有抗Stx2和抗Stx1 IgG（H + L）。产志贺毒素大肠杆菌（STEC）感染的发生率根据以下诊断标准确定：STEC分离、stx基因序列检测、粪便滤液中的游离粪便Stx以及抗大肠杆菌O157脂多糖的血清IgM抗体。在25名家庭接触者中观察到STEC感染的证据，其中18名（72%）无症状，是潜在的感染源。13名粪便培养中产Stx2的大肠杆菌O157:H7的家庭接触者中有6名（46%）产生了抗Stx2 IgG（H + L），而与Stx2相关的HUS病例中这一比例为71%。在显示抗Stx2 IgG（H + L）的个体中，69%的家庭接触者和71%的对照者的抗体反应针对B亚基，相比之下，HUS患者中这一比例为28%。在本次调查中，对照者抗O157脂多糖（LPS）的IgM抗体中位数随年龄显著增加，直至第五个十年。具有B亚基特异性抗体的家庭接触者未发病，以及4.9岁以上对照者抗O157 LPS IgM抗体中位数显著更高，这表明抗Stx和抗O157 LPS抗体具有保护作用。
