Nataro J P, Kaper J B, Robins-Browne R, Prado V, Vial P, Levine M M
Department of Pediatrics, University of Maryland School of Medicine, Baltimore.
Pediatr Infect Dis J. 1987 Sep;6(9):829-31. doi: 10.1097/00006454-198709000-00008.
A total of 516 Escherichia coli strains randomly isolated from coprocultures of 154 Chilean children with diarrhea and 66 controls were examined with DNA probes and tested for adherence to HEp-2 cells. Three adherence patterns were distinguished, localized, true diffuse and "aggregative." Enteropathogenic E. coli (EPEC) were detected by EPEC adherence factor probe among 86 of the 372 isolates (23%) from patients with diarrhea vs. 14 of 144 (10%) strains from controls (P less than 0.0002). Of 95 strains that manifested localized adherence, 97% were EPEC adherence factor probe-positive; thus the HEp-2 assay may serve as an alternative to the probe in identifying EPEC adherence factor-positive EPEC. True diffuse adherence was not associated with diarrhea. In contrast the aggregative pattern appears to signify a new, distinct class of diarrheagenic E. coli (enteroadherent-aggregative E. coli). The aggregative pattern was found in only 3 of 27 enterotoxigenic, 0 of 4 enteroinvasive, 0 of 2 enterohemorrhagic and 2 of 86 EPEC strains but in 84 of 253 probe-negative strains (P less than 0.00001) from patients with diarrhea; in comparison only 20 of 134 probe-negative strains from controls were aggregative E. coli (P less than 0.00001 vs. probe-negative strains from diarrhea patients).
从154名智利腹泻儿童和66名对照的粪便培养物中随机分离出516株大肠杆菌，用DNA探针进行检测，并检测其对HEp-2细胞的黏附性。区分出三种黏附模式：局限性、真性弥漫性和“聚集性”。通过EPEC黏附因子探针在腹泻患者的372株分离菌中的86株（23%）中检测到肠致病性大肠杆菌（EPEC），而对照的144株菌株中有14株（10%）检测到（P<0.0002）。在表现出局限性黏附的95株菌株中，97%为EPEC黏附因子探针阳性；因此，HEp-2检测可作为鉴定EPEC黏附因子阳性EPEC的探针的替代方法。真性弥漫性黏附与腹泻无关。相比之下，聚集性模式似乎表明是一类新的、独特的致泻性大肠杆菌（肠黏附-聚集性大肠杆菌）。聚集性模式仅在27株产肠毒素性大肠杆菌中的3株、4株侵袭性大肠杆菌中的0株、2株出血性大肠杆菌中的0株和86株EPEC菌株中的2株中发现，但在腹泻患者的253株探针阴性菌株中的84株中发现（P<0.00001）；相比之下，对照的134株探针阴性菌株中只有20株是聚集性大肠杆菌（与腹泻患者的探针阴性菌株相比，P<0.00001）。
