Siddons C A, Chapman P A
Public Health Laboratory, Sheffield.
J Med Microbiol. 1993 Dec;39(6):408-15. doi: 10.1099/00222615-39-6-408.
Cases of culture-confirmed clinically typical haemorrhagic colitis caused by verocytotoxin-producing (VT+) Escherichia coli O157 and age- and sex-matched control patients were examined for antibodies to E. coli O157. Serum samples from 28 cases and 34 patients in control group 1 were examined for VT1- and VT2-neutralising antibodies, E. coli O157 agglutinating antibodies, and by an enzyme immunoassay (EIA) technique for IgG antibodies against smooth lipopolysaccharide purified from E. coli O157 and for IgG antibodies against whole intact E. coli O157 cells. Differences between antibody titres were significant when compared by a Wilcoxon two-sample test for E. coli O157 agglutinating antibodies (p < 0.05) and IgG antibodies against whole cells (p < 0.001). The whole-cell EIA was used further to examine faecal samples from 93 cases and 47 patients in control group 2 for IgA antibodies. Elevated levels of faecal IgA specific for E. coli O157 were found in 59 (63.4%) of 93 cases but in only 10 (21.2%) of 47 control patients (p < 0.001); follow-up faecal samples from five cases all showed marked rises in levels of IgA that appeared to coincide with cessation of excretion of the organism. Detection of specific faecal IgA with a whole-cell EIA, although requiring further evaluation, may be a useful addition to tests currently available for the diagnosis of infection by VT+ E. coli O157.
对由产志贺毒素（VT+）大肠杆菌O157引起的经培养确诊的临床典型出血性结肠炎病例以及年龄和性别匹配的对照患者进行了大肠杆菌O157抗体检测。检测了28例患者和对照组1中34例患者的血清样本，以检测VT1和VT2中和抗体、大肠杆菌O157凝集抗体，并采用酶免疫测定（EIA）技术检测针对从大肠杆菌O157纯化的光滑脂多糖的IgG抗体以及针对完整大肠杆菌O157细胞的IgG抗体。通过Wilcoxon双样本检验比较抗体滴度时，大肠杆菌O157凝集抗体（p<0.05）和针对全细胞的IgG抗体（p<0.001）存在显著差异。进一步使用全细胞EIA检测了对照组2中93例患者和47例患者的粪便样本中的IgA抗体。在93例患者中有59例（63.4%）检测到大肠杆菌O157特异性粪便IgA水平升高，而在47例对照患者中只有10例（21.2%）检测到（p<0.001）；5例患者的随访粪便样本均显示IgA水平显著升高，这似乎与该菌排泄停止相一致。尽管全细胞EIA检测特异性粪便IgA需要进一步评估，但它可能是目前用于诊断VT+大肠杆菌O157感染的现有检测方法的有益补充。
