Greatorex J S, Thorne G M
Infectious Disease Division, Children's Hospital, Boston, MA 02115.
J Clin Microbiol. 1994 May;32(5):1172-8. doi: 10.1128/jcm.32.5.1172-1178.1994.
Shiga-like-toxin (SLT)-producing Escherichia coli strains, especially serotype O157:H7, are important causes of bloody diarrhea and are associated with the development of hemolytic-uremic syndrome (HUS). Enzyme-linked immunosorbent assays (ELISAs) were developed for the serologic detection of immunoglobulin M (IgM), IgG, and IgA to Shiga toxin (ST) and SLT-I, IgG to SLT-II, and IgM and IgG reactive against E. coli O157 lipopolysaccharide (LPS). Serum samples were collected from 27 HUS patients (25 pediatric and 2 adult) and tested in the ELISAs. Of 27 patients, 10 (37%) were positive for at least one class of antibody to ST/SLT-I. None of the patients were positive for IgG antibody to SLT-II. Twenty-one of the 27 patients (78%) were positive for antibody to E. coli O157 LPS; 19 of 27 (70%) were positive for IgM, and 20 of 27 (74%) were positive for IgG. None of 48 control serum samples were positive in any of the toxin assays, and only 1 of 48 (2%) and 2 of 48 (4%) were positive for IgM and IgG, respectively, to E. coli O157 LPS. Twelve of the 24 patients (50%) from whom stool specimens were collected were positive by culture for E. coli O157. Overall, serology and culture produced confirmation of infection by SLT-producing organisms in 23 of 27 (85%) HUS patients. A combination of ELISA for antibodies to E. coli O157 LPS and culture provided evidence for 22 of 27 (82%) of these patients. The results indicate that while ELISAs for ST/SLT-I and SLT-II antibodies were of limited diagnostic value, the ELISAs for IgM and IgG to E. coli O157 LPS provided valuable and sensitive adjuncts to culture.
产志贺样毒素（SLT）的大肠杆菌菌株，尤其是血清型O157:H7，是血性腹泻的重要病因，并与溶血尿毒综合征（HUS）的发生有关。已开发出酶联免疫吸附测定（ELISA）用于血清学检测针对志贺毒素（ST）和SLT-I的免疫球蛋白M（IgM）、IgG和IgA，针对SLT-II的IgG，以及针对大肠杆菌O157脂多糖（LPS）的IgM和IgG。从27例HUS患者（25例儿科患者和2例成人患者）采集血清样本，并在ELISA中进行检测。27例患者中，10例（37%）至少一类针对ST/SLT-I的抗体呈阳性。没有患者针对SLT-II的IgG抗体呈阳性。27例患者中有21例（78%）针对大肠杆菌O157 LPS的抗体呈阳性；27例中有19例（70%）IgM呈阳性，27例中有20例（74%）IgG呈阳性。48份对照血清样本在任何毒素检测中均无阳性结果，48份中只有1份（2%）针对大肠杆菌O157 LPS的IgM呈阳性，2份（4%）针对大肠杆菌O157 LPS的IgG呈阳性。采集粪便标本的24例患者中有12例（50%）通过培养检测出大肠杆菌O157阳性。总体而言，血清学检测和培养证实27例HUS患者中有23例（85%）感染了产SLT的微生物。针对大肠杆菌O157 LPS抗体的ELISA与培养相结合，为其中22例（82%）患者提供了证据。结果表明，虽然针对ST/SLT-I和SLT-II抗体的ELISA诊断价值有限，但针对大肠杆菌O157 LPS的IgM和IgG的ELISA为培养提供了有价值且敏感的辅助手段。
