意大利的溶血尿毒综合征与产志贺毒素大肠杆菌感染。意大利溶血尿毒综合征研究组

Hemolytic-uremic syndrome and Vero cytotoxin-producing Escherichia coli infection in Italy. The HUS Italian Study Group.

作者信息

Caprioli A, Luzzi I, Rosmini F, Pasquini P, Cirrincione R, Gianviti A, Matteucci M C, Rizzoni G

机构信息

Laboratorio di Ultrastrutture, Istituto Superiore di Sanità, Rome, Italy.

出版信息

J Infect Dis. 1992 Jul;166(1):154-8. doi: 10.1093/infdis/166.1.154.

DOI:10.1093/infdis/166.1.154

PMID:1607689

Abstract

In a 3-year prospective study, 49 Italian children with the hemolytic-uremic syndrome (HUS) were examined for evidence of infection with Vero cytotoxin-producing Escherichia coli (VTEC). Diagnosis of infection was established in 37 patients (75.5%) by the combined use of stool examination for VTEC and for free fecal neutralizable Vero cytotoxin and serum analysis for antibodies to the Vero toxins and the lipopolysaccharides (LPS) of three major VTEC serogroups (O157, O26, O111). Anti-LPS antibodies were detected in sera from 30 patients: 25 had antibody to O157 LPS, 4 to O26, and 1 to O111. In as many as 27 patients (55.1%), diagnosis of infection relied only on serologic findings, and the presence of antibody to LPS was the sole evidence of VTEC infection in 20 patients (40.8%). The use of LPS from different E. coli serogroups provided evidence that in Italy O157 strains are the most prevalent VTEC involved in HUS.

摘要

在一项为期3年的前瞻性研究中，对49名患有溶血尿毒综合征（HUS）的意大利儿童进行了检查，以寻找产志贺毒素大肠杆菌（VTEC）感染的证据。通过联合检测粪便中的VTEC、游离粪便可中和志贺毒素以及血清中针对三种主要VTEC血清型（O157、O26、O111）的志贺毒素和脂多糖（LPS）抗体，确诊了37例（75.5%）感染病例。在30例患者的血清中检测到了抗LPS抗体：25例有抗O157 LPS抗体，4例有抗O26抗体，1例有抗O111抗体。多达27例患者（55.1%）的感染诊断仅基于血清学结果，20例患者（40.8%）中抗LPS抗体的存在是VTEC感染的唯一证据。使用来自不同大肠杆菌血清型的LPS提供了证据，表明在意大利，O157菌株是参与HUS的最常见VTEC。