Laboratorio de Fisiopatogenia, Departamento de Fisiología, Facultad de Medicina, Universidad, de Buenos Aires, Argentina.
IUBMB Life. 2013 Oct;65(10):827-35. doi: 10.1002/iub.1206. Epub 2013 Sep 6.
Shiga toxin (Stx) producing Escherichia coli (STEC) is responsible to bloody diarrhea (hemorrhagic colitis) and the hemolytic uremic syndrome (HUS). STEC strains carry inducible lambda phages integrated into their genomes that encode Stx 1 and/or 2, with several allelic variants each one. O157:H7 is the serotype that was documented in the vast majority of HUS cases although non-O157 serotypes have been increasingly reported to account for HUS cases. However, the outbreak that occurred in central Europe during late spring of 2011 showed that the pathogen was E. coli O104:H4. More than 4,000 persons were infected mainly in Germany, and it produced more than 900 cases of HUS resulting in 54 deaths. E. coli O104:H4 is a hybrid organism that combines some of the virulence genes of STEC and enteroaggregative E. coli specially production of Stx2 and the adherence mechanisms to intestinal epithelium. The differences in the epidemiology and presentation of E. coli pathogen meant a challenge for public health and scientific research to increase the knowledge of HUS-pathophysiology and to improve available therapies to treat HUS.
产志贺毒素（Stx）大肠杆菌（STEC）是引起血性腹泻（出血性结肠炎）和溶血尿毒综合征（HUS）的原因。STEC 菌株携带可诱导的 λ 噬菌体整合到其基因组中，编码 Stx1 和/或 2，每个都有几个等位基因变体。O157：H7 血清型是绝大多数 HUS 病例中记录的血清型，尽管越来越多的非 O157 血清型被报道导致 HUS 病例。然而，2011 年春末在中欧发生的疫情表明，病原体是大肠杆菌 O104：H4。超过 4000 人受到感染，主要在德国，产生了超过 900 例 HUS，导致 54 人死亡。大肠杆菌 O104：H4 是一种混合生物体，它结合了 STEC 和肠聚集性大肠杆菌的一些毒力基因，特别是 Stx2 的产生和对肠道上皮的粘附机制。大肠杆菌病原体的流行病学和表现的差异对公共卫生和科学研究构成了挑战，需要增加对 HUS 病理生理学的了解，并改进可用的治疗方法来治疗 HUS。
