产志贺毒素 2 型大肠杆菌 O104：H4 感染患者的抗志贺毒素 2 型抗体可能预测溶血尿毒综合征。
Anti-Shiga toxin 2 antibodies in enterohemorrhagic Escherichia coli O104:H4 infected patients may predict hemolytic uremic syndrome.
机构信息
Center of Internal Medicine II, University Hospital Brandenburg, Brandenburg Medical School, Brandenburg, Germany.
Department of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
出版信息
J Gastroenterol Hepatol. 2018 Jul;33(7):1353-1356. doi: 10.1111/jgh.14082. Epub 2018 Mar 12.
BACKGROUND AND AIM
An outbreak of Shiga toxin 2 (Stx2) producing enterohemorrhagic and enteroaggregative Escherichia coli O104:H4 infection in May 2011 in Germany caused enterocolitis and an unprecedented high 22% rate of hemolytic uremic syndrome (HUS). We hypothesized that anti-Stx2 IgM or IgG titers might predict HUS development.
METHODS
Thirty-two patients infected with enterohemorrhagic Escherichia coli O104:H4 (HUS: n = 23; non-HUS: n = 9) were retrospectively screened for anti-Stx2 IgM/IgG and matched with clinical data regarding HUS development, fever, superinfection, dialysis, neurological symptoms, intensive care, antibiotic treatment, and plasmapheresis.
RESULTS
Only HUS patients showed a prominent Stx2-specific humoral response in the early acute phase. Despite a strong trend towards prediction of HUS development, statistical analysis revealed no significant correlation between high IgM/IgG titers and further key clinical parameters such as fever, superinfection, neurological symptoms, antibiotic treatment, and plasmapheresis.
CONCLUSIONS
Anti-Stx2 antibodies seem to accompany or even precede HUS development.
背景与目的
2011 年 5 月，德国暴发了由产志贺毒素 2（Stx2）的肠出血性和肠聚集性大肠杆菌 O104：H4 引起的感染，导致了肠炎和史无前例的 22%的溶血性尿毒症综合征（HUS）发病率。我们假设抗 Stx2 IgM 或 IgG 滴度可能预测 HUS 的发生。
方法
对 32 例感染肠出血性大肠杆菌 O104：H4（HUS：n=23；非 HUS：n=9）的患者进行了回顾性筛选，以检测抗 Stx2 IgM/IgG，并与 HUS 发展、发热、继发感染、透析、神经系统症状、重症监护、抗生素治疗和血浆置换等临床数据进行了匹配。
结果
只有 HUS 患者在早期急性阶段表现出明显的 Stx2 特异性体液反应。尽管抗 Stx2 抗体的高滴度有预测 HUS 发展的趋势，但统计学分析显示，高 IgM/IgG 滴度与发热、继发感染、神经系统症状、抗生素治疗和血浆置换等关键临床参数之间没有显著相关性。
结论
抗 Stx2 抗体似乎伴随着或甚至先于 HUS 的发展。
Zotero 插件