Bottone E J
J Clin Microbiol. 1978 Jun;7(6):562-7. doi: 10.1128/jcm.7.6.562-567.1978.
Infections due to biochemically typical Yersinia enterocolitica usually present as gastroenteritis, mesenteric lymphadenitis, terminal ileitis, and septicemia often with visceral abscesses. In these instances, the isolates have been biochemically typical and of well-established serotypes, namely 0:3 or 0:9 and, in the United States, 0:5 or 0:8. The recovery, recognition, and significance of biochemically and serologically atypical Y. enterocolitica in human infections has proceeded more slowly. From an analysis of the clinical histories of 20 patients infected with 21 such aberrant Y. enterocolitica, it appears that these strains are of restricted pathogenic potential, producing various clinical entities such as localized skin abscesses, conjunctivitis, self-limiting enteritis, and wound and urinary tract infections in hosts with predisposing factors. Epidemiologically, whereas episodic acquisition of atypical strains by hospitalized patients is indicative of nosocomial transmission, in the present series sporadic isolations over a 4-year period, mainly from ambulatory patients, suggest an occult reservoir in the community serviced by The Mount Sinai Hospital. In contrast to typical Y. enterocolitica, which has become well adapted in animal and human hosts, it appears that environmental strains may be in the evolutionary process of becoming adapted to humans.
由生化特性典型的小肠结肠炎耶尔森菌引起的感染通常表现为肠胃炎、肠系膜淋巴结炎、末端回肠炎和败血症，常伴有内脏脓肿。在这些病例中，分离出的菌株生化特性典型，属于已确定的血清型，即0:3或0:9，在美国则为0:5或0:8。生化和血清学特性不典型的小肠结肠炎耶尔森菌在人类感染中的发现、识别及其意义的研究进展较为缓慢。通过对20例感染21株此类异常小肠结肠炎耶尔森菌患者的临床病史分析，这些菌株的致病潜力似乎有限，在有易感因素的宿主中可引发多种临床病症，如局部皮肤脓肿、结膜炎、自限性肠炎以及伤口和尿路感染。从流行病学角度来看，住院患者偶发性获得非典型菌株表明存在医院内传播，而在本系列研究中，4年期间主要从门诊患者中散发性分离出该菌株，这表明西奈山医院所服务的社区存在一个隐匿的菌株储存库。与已很好地适应动物和人类宿主的典型小肠结肠炎耶尔森菌不同，环境菌株似乎正处于适应人类的进化过程中。
