Goto Tetsushi, Shirano Michinori
Center for Infectious Diseases, Osaka City General Hospital.
Nihon Rinsho. 2012 Aug;70(8):1343-7.
Escherichia coli (E. coli) is a bacterium that is commonly found in the gut of humans and warm-blooded animals. Most strains of E. coli are harmless. Some strains however, such as enterohemorrhagic E. coli (EHEC), can cause severe foodborne disease. It is transmitted to humans primarily through consumption of contaminated foods, such as raw meal. EHEC produces toxins, known as verotoxins. EHEC that induces bloody diarrhea leads to HUS in 10% of cases. The clinical manifestations of post-diarrheal HUS include acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. The verocytotoxin can directly damage renal and endothelial cells. Thrombocytopenia occurs as platelets are consumed by clotting. Hemolytic anemia results from intravascular fibrin deposition, increased fragility of red blood cells, and fragmentation.
大肠杆菌是一种常见于人类和温血动物肠道内的细菌。大多数大肠杆菌菌株是无害的。然而，一些菌株，如肠出血性大肠杆菌（EHEC），可导致严重的食源性疾病。它主要通过食用受污染的食物，如未煮熟的肉类，传播给人类。EHEC产生毒素，即志贺毒素。引发血性腹泻的EHEC在10%的病例中会导致溶血尿毒综合征（HUS）。腹泻后HUS的临床表现包括急性肾衰竭、微血管病性溶血性贫血和血小板减少症。志贺毒素可直接损害肾脏和内皮细胞。血小板减少症是由于凝血过程中血小板被消耗所致。溶血性贫血是由血管内纤维蛋白沉积、红细胞脆性增加和破碎引起的。
