Bettelheim K A, Goldwater P N, Dwyer B W, Bourne A J, Smith D L
Department of Clinical Pathology, Fairfield Hospital, Victoria, Australia.
Scand J Infect Dis. 1990;22(4):467-76. doi: 10.3109/00365549009027079.
The role of Escherichia coli as a cause of sudden infant death syndrome was investigated prospectively. Strains of E. coli producing the heat labile enterotoxin (LT) or the Vero-cell cytotoxin (VT) were isolated from the intestinal contents of 21/46 infants who died from sudden infant death syndrome (SIDS). None were found in the contemporaneously sampled faeces of 24 normal live infants in the same area. Live infants were used as controls in the absence of dead infants who had not died of SIDS. This high incidence of toxigenic E. coli among the SIDS infants versus the low incidence in controls, together with the general rarity of finding such toxigenic E. coli in the community of a temperate developed country, made us conclude that there may be a causal relationship between toxigenic E. coli and SIDS. The O and H serotypes of the toxigenic E. coli associated with SIDS infants tended not to be those normally considered to be toxigenic. The toxigenicity appeared to be relatively labile. It is suggested that SIDS may be associated with the infant either acquiring these unusual types of E. coli or more likely that its normal resident E. coli acquire the plasmids to produce these toxins.
对大肠杆菌作为婴儿猝死综合征病因的作用进行了前瞻性研究。从46例死于婴儿猝死综合征（SIDS）的婴儿中的21例的肠道内容物中分离出产生热不稳定肠毒素（LT）或Vero细胞细胞毒素（VT）的大肠杆菌菌株。在同一地区同时采集的24例正常活婴的粪便中未发现此类菌株。在没有非SIDS死亡婴儿的情况下，以活婴作为对照。SIDS婴儿中产毒大肠杆菌的高发病率与对照组中的低发病率，以及在温带发达国家社区中发现此类产毒大肠杆菌的总体罕见性，使我们得出结论，产毒大肠杆菌与SIDS之间可能存在因果关系。与SIDS婴儿相关的产毒大肠杆菌的O和H血清型往往不是通常认为有毒的血清型。其毒性似乎相对不稳定。有人提出，SIDS可能与婴儿获得这些不寻常类型的大肠杆菌有关，或者更有可能是其正常定植的大肠杆菌获得质粒以产生这些毒素。
