Yahata Y, Misaki T, Ishida Y, Nagira M, Watahiki M, Isobe J, Terajima J, Iyoda S, Mitobe J, Ohnishi M, Sata T, Taniguchi K, Tada Y, Okabe N
National Institute of Infectious Diseases,Tokyo,Japan.
Toyama City Hospital,Toyama,Japan.
Epidemiol Infect. 2015 Oct;143(13):2721-32. doi: 10.1017/S0950268814003641. Epub 2015 Jan 20.
A large outbreak of enterohaemorrhagic Escherichia coli (EHEC) O111 and O157 occurred in Japan in April 2011. We conducted an unmatched case-control study and trace-back investigation to determine the source of EHEC O111 infection and risk factors for severe complications. Pulsed-field gel electrophoresis was performed to help define cases. A total of 86 individuals met the case definition. Of these, 40% experienced haemolytic uraemic syndrome (HUS), 24% acute encephalopathy, and 6% died. Illness was significantly associated with eating the raw beef dish yukhoe (odds ratio 19·64, 95% confidence interval 7·03-54·83), the likely food vehicle. EHEC O111 and its closely related stx-negative variants were found in the beef. HUS occurred most frequently in individuals aged 5-9 years, and this age group was significantly associated with acute encephalopathy. The prevalence of HUS and acute encephalopathy was higher than in previous non-O157-related outbreaks, indicating a high risk of severe complications.
2011年4月，日本爆发了大规模的肠出血性大肠杆菌（EHEC）O111和O157感染疫情。我们开展了一项非匹配病例对照研究和溯源调查，以确定EHEC O111感染的源头及严重并发症的危险因素。采用脉冲场凝胶电泳来辅助界定病例。共有86人符合病例定义。其中，40%出现溶血尿毒综合征（HUS），24%出现急性脑病，6%死亡。发病与食用生牛肉菜肴“生拌牛肉”显著相关（比值比19.64，95%置信区间7.03 - 54.83），“生拌牛肉”可能是食物载体。在牛肉中发现了EHEC O111及其密切相关的stx阴性变体。HUS在5至9岁的个体中最为常见，且该年龄组与急性脑病显著相关。HUS和急性脑病的患病率高于以往非O157相关的疫情，表明严重并发症的风险很高。
