Huang David B, Okhuysen Pablo C, Jiang Zhi-Dong, DuPont Herbert L
Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Am J Gastroenterol. 2004 Feb;99(2):383-9. doi: 10.1111/j.1572-0241.2004.04041.x.
Enteroaggregative Escherichia coli (EAEC) represents an emerging pathogen that causes enteric and food-borne infectious diseases. Subgroups in many populations throughout the world are susceptible to EAEC infection. EAEC pathogenesis involves adherence to the intestinal mucosa; increased production and deposition of a mucus biofilm; and mucosal toxicity due to inflammation and cytokine release. Due to the heterogeneity of EAEC strains and differing host immune responses, not all EAEC infections are symptomatic. Recent data suggest that individuals with a homozygous genotype -251 AA single nucleotide polymorphism (SNP), in the IL-8 promoter region, are more susceptible to EAEC diarrhea. The HEp-2 cell adherent assay allows identification of EAEC's characteristic aggregative or "stacked brick" adherence pattern. Antimicrobial treatment of individuals who develop EAEC diarrhea should be individually based. Ciprofloxacin and rifaximin, compared to placebo, have been shown to significantly shorten the course of diarrhea in patients who developed EAEC infection. The objective of this review is to increase awareness of this important emerging pathogen and to discuss the epidemiology, pathogenesis, and host-pathogen factors associated with EAEC infection.
肠集聚性大肠杆菌（EAEC）是一种新兴的病原体，可引起肠道和食源性传染病。世界各地许多人群的亚组都易感染EAEC。EAEC的发病机制包括粘附于肠黏膜；黏液生物膜的产生和沉积增加；以及因炎症和细胞因子释放导致的黏膜毒性。由于EAEC菌株的异质性和宿主免疫反应的不同，并非所有EAEC感染都有症状。最近的数据表明，白细胞介素-8启动子区域具有纯合基因型-251 AA单核苷酸多态性（SNP）的个体更容易感染EAEC腹泻。HEp-2细胞粘附试验可用于识别EAEC的特征性聚集或“堆叠砖”粘附模式。对发生EAEC腹泻的个体进行抗菌治疗应因人而异。与安慰剂相比，环丙沙星和利福昔明已被证明可显著缩短发生EAEC感染患者的腹泻病程。本综述的目的是提高对这种重要新兴病原体的认识，并讨论与EAEC感染相关的流行病学、发病机制和宿主-病原体因素。
