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产志贺毒素大肠杆菌与溶血尿毒综合征的暴发

[Outbreak of Shiga toxin-producing Escherichia coli and haemolytic uraemic syndrome].

作者信息

Kuijper Ed J, Timen Aura, Franz Eelco, Wessels Els, van Dissel Jaap T

机构信息

Leids Universitair Medisch Centrum, Centrum van Infectieziekten, Leiden, the Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2011;155(35):A3743.

Abstract

Enterohaemorrhagic Escherichia coli (EHEC) is a group of pathogenic Shiga toxin-producing E. coli that can cause haemorrhagic colitis and haemolytic uraemic syndrome (HUS). The disease usually occurs sporadically, but sometimes also occurs in large outbreaks such as that which recently occurred in northern Germany. EHEC infection is a zoonosis and its reservoir is in ruminant farm animals (cattle, sheep and goats). EHEC infection should be considered in patients with bloody diarrhoea, but in the course of many severe EHEC infections a picture resembling HUS may also occur. Antibiotic treatment is contraindicated because it does not reduce the duration of the disease and may have negative complications. Patients with EHEC infection may spread the bacteria and their care includes contact isolation measures with their own toilet facilities. The E. coli type O104:H4 that occurred in Germany has a combination of specific virulence characteristics. This outbreak affected many people who developed HUS and neurological symptoms following bloody diarrhoea.

摘要

肠出血性大肠杆菌(EHEC)是一群能产生志贺毒素的致病性大肠杆菌,可导致出血性结肠炎和溶血尿毒综合征(HUS)。该病通常散发发生,但有时也会出现大规模暴发,比如最近在德国北部发生的疫情。EHEC感染为人畜共患病,其宿主为反刍家畜(牛、绵羊和山羊)。血性腹泻患者应考虑EHEC感染,但在许多严重的EHEC感染过程中,也可能出现类似HUS的症状。抗生素治疗是禁忌的,因为它不会缩短病程,而且可能会产生负面并发症。EHEC感染患者可能会传播病菌,对他们的护理包括使用独立卫生间设施的接触隔离措施。在德国出现的O104:H4型大肠杆菌具有特定的毒力特征组合。此次疫情感染了许多人,这些人在出现血性腹泻后又患上了HUS和神经系统症状。

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