Cennimo David, Abbas Atif, Huang David B, Chiang Tom
Veterans Affairs New Jersey Health Science Center, Department of Internal Medicine, Division of Infectious Diseases, 385 Tremont Avenue, East Orange, NJ 07018, USA.
J Med Microbiol. 2009 Apr;58(Pt 4):403-407. doi: 10.1099/jmm.0.005793-0.
This case-control study examined the prevalence of enteroaggregative Escherichia coli (EAEC), its genes and elicited inflammatory response, and the stool characteristics of adult patients with and without acute diarrhoeal illness presenting to an urgent-care clinic in the USA. A total of 1004 individual stool specimens (253 from patients with acute diarrhoeal illness and 751 from patients without diarrhoeal illness) were collected between 1 June 2003 and 30 June 2008. EAEC was identified as the sole cause of acute diarrhoeal illness in 6 % (n=15) of patients and in 2 % (n=15) without diarrhoeal illness. Control patients (n=15) were similar to case patients (n=15) for age, gender and co-morbidities. The EAEC genes aggR, aap, aat, astA and/or set1A were identified more frequently in case patients compared with control patients (P <0.05). aggR-positive EAEC elicited higher levels of interleukin (IL)-1ra, IL-6, IL-8 and tumour necrosis factor-alpha compared with aggR-negative EAEC during co-incubation with HCT-8 cells. Patients with EAEC diarrhoea and isolates with the genes aggR, aap, aatA, astA or set1A had stools characterized by gross mucus and the presence of faecal leukocytes (P <0.05). These results indicate that EAEC is a potential cause of acute diarrhoeal illness affecting patients presenting to an acute-care clinic in the USA and suggest that aggR, aap, aatA, astA and set1A may be markers for virulence.
这项病例对照研究调查了美国一家紧急护理诊所中患有和未患有急性腹泻病的成年患者的肠聚集性大肠杆菌（EAEC）的流行情况、其基因及引发的炎症反应，以及粪便特征。在2003年6月1日至2008年6月30日期间，共收集了1004份个体粪便标本（253份来自急性腹泻病患者，751份来自无腹泻病患者）。EAEC被确定为6%（n = 15）的急性腹泻病患者和2%（n = 15）无腹泻病患者急性腹泻病的唯一病因。对照患者（n = 15）在年龄、性别和合并症方面与病例患者（n = 15）相似。与对照患者相比，病例患者中更频繁地检测到EAEC基因aggR、aap、aat、astA和/或set1A（P <0.05）。与HCT - 8细胞共孵育时，aggR阳性的EAEC比aggR阴性的EAEC引发更高水平的白细胞介素（IL）-1ra、IL - 6、IL - 8和肿瘤坏死因子 - α。患有EAEC腹泻的患者以及分离出aggR、aap、aatA、astA或set1A基因的菌株，其粪便特征为有大量黏液和粪便白细胞（P <0.05）。这些结果表明，EAEC是影响美国一家急性护理诊所患者的急性腹泻病的潜在病因，并提示aggR、aap、aatA、astA和set1A可能是毒力标志物。
