2000-2009 年通过志贺毒素检测发现的康涅狄格州非 O157 型志贺毒素产生大肠杆菌的十年趋势和危险因素。

Ten-year trends and risk factors for non-O157 Shiga toxin-producing Escherichia coli found through Shiga toxin testing, Connecticut, 2000-2009.

机构信息

Emerging Infections Program, Division of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA.

出版信息

Clin Infect Dis. 2011 Aug 1;53(3):269-76. doi: 10.1093/cid/cir377.

DOI:10.1093/cid/cir377

PMID:21765075

Abstract

BACKGROUND

The epidemiology over time of non-O157 Shiga toxin-producing Escherichia coli (STEC) is unknown. Since 1999, increasing numbers of laboratories in Connecticut have been testing for ST rather than culturing for O157, enabling identification of non-O157 STEC.

METHODS

Beginning in 2000, Connecticut laboratories were required to submit ST-positive broths to the State Laboratory for isolation and typing of STEC. The ratio of non-O157:O157 from laboratories conducting ST testing was used to determine state-level estimates for non-O157 STEC. Patients with STEC were interviewed for exposure factors in the 7 days preceding illness. Incidence trends, clinical features, and epidemiology of non-O157 and O157 STEC infections were compared.

RESULTS

From 1 January 2000 through 31 December 2009, ST testing detected 392 (59%) of 663 reported STEC infections; 229 (58%) of the isolates were non-O157. The estimated incidence of STEC infection decreased by 34%. O157 and the top 4 non-O157 serogroups, O111, O103, O26, and O45, were a stable percentage of all STEC isolates over the 10-year period. Bloody diarrhea, hospitalization, and hemolytic uremic syndrome were more common in patients with O157 STEC than in patients with non-O157 STEC infection. Exposure risks of patients with non-O157 STEC infection differed from those of patients with O157 STEC infection primarily in international travel (15.3% vs 2.5%; P < .01). Non-O157 types differed from each other with respect to several epidemiologic and exposure features.

CONCLUSIONS

Both O157 and non-O157 STEC infection incidence decreased from 2000 through 2009. Although infection due to O157 is the most common and clinically severe STEC infection, it accounts for a minority of all clinically significant STEC infections. STEC appear to be a diverse group of organisms that have some differences as well as many epidemiologic and exposure features in common.

摘要

背景

非 O157 志贺毒素产生大肠杆菌（STEC）的流行病学随时间的变化尚不清楚。自 1999 年以来，康涅狄格州越来越多的实验室开始检测 ST，而不是培养 O157，从而能够鉴定非 O157 STEC。

方法

从 2000 年开始，康涅狄格州的实验室被要求将 ST 阳性的肉汤提交给州立实验室进行 STEC 的分离和分型。进行 ST 检测的实验室中非 O157：O157 的比例用于确定非 O157 STEC 的州级估计值。对患有 STEC 的患者进行了在发病前 7 天的暴露因素访谈。比较了非 O157 和 O157 STEC 感染的发病趋势、临床特征和流行病学。

结果

从 2000 年 1 月 1 日至 2009 年 12 月 31 日，ST 检测检测到 663 例报告的 STEC 感染病例中的 392 例（59%）；229 株（58%）为非 O157。STEC 感染的估计发病率下降了 34%。O157 和前 4 种非 O157 血清群 O111、O103、O26 和 O45，在 10 年期间占所有 STEC 分离株的稳定比例。与 O157 STEC 感染患者相比，O157 和非 O157 STEC 感染患者更常见血性腹泻、住院和溶血尿毒综合征。非 O157 STEC 感染患者的暴露风险与 O157 STEC 感染患者的暴露风险主要不同，主要区别在于国际旅行（15.3%对 2.5%；P<.01）。非 O157 型在一些流行病学和暴露特征上彼此不同。