Cerquetti M, Luzzi I, Caprioli A, Sebastianelli A, Mastrantonio P
Laboratorio di Batteriologia e Micologia Medica, Istituto Superiore di Sanità, Roma, Italy.
Pediatr Infect Dis J. 1995 Jul;14(7):598-603. doi: 10.1097/00006454-199507000-00009.
To investigate the etiologic role of Clostridium difficile in childhood acute diarrhea, stool specimens from 618 children with diarrhea and 135 controls without enteric symptoms were examined by cell culture assay for the presence of free toxin B. This toxin was found in 4.2% of the fecal specimens examined without finding a significant difference between cases and controls, suggesting no causal relationship between diarrhea and the presence of free C. difficile toxin B. C. difficile strains isolated from toxin B-positive specimens were characterized by cytotoxin and enterotoxin production and by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of EDTA-extracted proteins. All but two isolates produced toxin B and toxin A and the remaining were negative for both toxins. Polyacrylamide gel electrophoresis analysis showed eight electrophoretic types, none of them was clearly related with the cases of diarrhea. The majority of isolates from children with diarrhea did not belong to types previously observed in adults with pseudomembranous colitis or antibiotic-associated diarrhea. This study provides additional evidence that C. difficile is not involved in the etiology of childhood diarrhea.
为研究艰难梭菌在儿童急性腹泻中的病因学作用，采用细胞培养法对618例腹泻儿童和135例无肠道症状的对照儿童的粪便标本进行检测，以确定是否存在游离毒素B。在所检测的粪便标本中，4.2%发现有这种毒素，病例组与对照组之间无显著差异，这表明腹泻与游离艰难梭菌毒素B的存在之间无因果关系。从毒素B阳性标本中分离出的艰难梭菌菌株通过细胞毒素和肠毒素的产生以及经乙二胺四乙酸（EDTA）提取蛋白的十二烷基硫酸钠-聚丙烯酰胺凝胶电泳进行鉴定。除两株分离株外，其余均产生毒素B和毒素A，其余两株两种毒素均为阴性。聚丙烯酰胺凝胶电泳分析显示有8种电泳类型，其中没有一种与腹泻病例有明显关联。大多数来自腹泻儿童的分离株不属于先前在患有假膜性结肠炎或抗生素相关性腹泻的成人中观察到的类型。这项研究提供了更多证据表明艰难梭菌不参与儿童腹泻的病因。
