腹泻儿童中产志贺毒素大肠杆菌：一项前瞻性即时检测研究。

Shiga toxin-producing Escherichia coli in children with diarrhea: a prospective point-of-care study.

作者信息

Klein Eileen J, Stapp Jennifer R, Clausen Carla R, Boster Daniel R, Wells Joy G, Qin Xuan, Swerdlow David L, Tarr Phillip I

机构信息

Department of Pediatrics, University of Washington and Children's Hospital and Regional Medical Center, Seattle, Washington, 98105, USA.

出版信息

J Pediatr. 2002 Aug;141(2):172-7. doi: 10.1067/mpd.2002.125908.

DOI:10.1067/mpd.2002.125908

PMID:12183710

Abstract

OBJECTIVE

To conduct a prospective cohort study to determine the frequency and characteristics of Shiga toxin (Stx)-producing Escherichia coli (STEC) infections in children with diarrhea attending an emergency department and a private clinic in Seattle, Washington.

METHODS

Between November 1998 and October 2001, 1851 stools were processed for STEC by sorbitol-MacConkey (SMAC) agar screening and a commercial Stx enzyme immunoassay (EIA).

RESULTS

STEC belonging to serotypes O157:H7 (n = 28), O103:H2 (n = 4), O118:H16 (n = 2), O26:H11, O111:nonmotile, O111:H8, O121:H19, and O rough:H11 (n = 1 each) were recovered from 39 (2.1%) stools. EIA and SMAC agar detected 89% and 100% of the patients with E coli O157:H7, respectively. E coli O157:H7-infected patients had significantly higher frequencies of bloody stools, fecal leukocytes, and abdominal tenderness and shorter symptom duration. Hemolytic uremic syndrome developed in 5 (18%) and none of the children infected with E coli O157:H7 and non-O157:H7 STEC, respectively (P =.30).

CONCLUSIONS

E coli O157:H7 is the predominant STEC in this population. Children infected with E coli O157:H7 have clinical presentations different from those whose stools contain non-O157:H7 STEC. Culture and Stx detection are needed to optimally detect STEC of all serotypes in stools. SMAC agar screening should not be replaced by EIA.

摘要

目的

开展一项前瞻性队列研究，以确定华盛顿州西雅图市一家急诊科和一家私人诊所中腹泻儿童产志贺毒素（Stx）大肠杆菌（STEC）感染的频率及特征。

方法

1998年11月至2001年10月期间，通过山梨醇麦康凯（SMAC）琼脂筛选和一种商业化的Stx酶免疫测定（EIA）对1851份粪便样本进行STEC检测。

结果

从39份（2.1%）粪便样本中分离出属于O157:H7血清型（n = 28）、O103:H2血清型（n = 4）、O118:H16血清型（n = 2）、O26:H11血清型、O111:无动力血清型、O111:H8血清型、O121:H19血清型以及O粗糙型:H11血清型（各n = 1）的STEC。EIA和SMAC琼脂分别检测出89%和100%的O157:H7大肠杆菌感染患者。感染O157:H7大肠杆菌的患者出现血便、粪便白细胞及腹部压痛的频率显著更高，且症状持续时间更短。分别有5名（18%）感染O157:H7大肠杆菌的儿童和无感染非O157:H7 STEC的儿童发生了溶血尿毒综合征（P = 0.30）。