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婴儿猝死综合征中的产肠毒素细菌。

Enterotoxigenic bacteria in the sudden infant death syndrome.

作者信息

Murrell W G, Stewart B J, O'Neill C, Siarakas S, Kariks S

机构信息

Department of Microbiology, University of Sydney, New South Wales, Australia.

出版信息

J Med Microbiol. 1993 Aug;39(2):114-27. doi: 10.1099/00222615-39-2-114.

DOI:10.1099/00222615-39-2-114
PMID:8345506
Abstract

Faecal samples from 123 infants who died with sudden infant death syndrome (SIDS) and from a comparative group of 52 age-matched babies were analysed for toxigenic bacteria and their toxins. Serum samples from the SIDS infants were also analysed for these toxins. A significantly higher proportion of toxigenic bacteria and their toxins were found in faecal samples of SIDS babies than in samples from the comparative group. These toxins were also found in serum from the SIDS babies. Clostridium perfringens was found in 54 (45.4%) of 119 SIDS cases compared with 10 (19.6%) of 51 healthy babies (chi 2 = 10.1, p < 0.01); C. difficile in 33 (27.7%) of 119 SIDS cases compared with 8 (14.8%) of 54 healthy babies (chi 2 = 3.43ns, p < 0.1); Staphylococcus aureus in 12 (27.3%; 66.7% enterotoxigenic) of 44 SIDS cases compared with 12 (85.7%; non-enterotoxigenic) of 14 healthy babies (chi 2 = 14.9, p < 0.001); C. botulinum in 6 (5.0%) of 120 SIDS cases compared with 0 of 53 healthy babies (chi 2 = 2.74, p < 0.1). Campylobacter jejuni, Yersinia enterocolitica, Vibrio parahaemolyticus, salmonellae and Bacillus cereus were not detected. Heat-labile toxin, lethal to mice (HLML) was found in 32 (27.1%) of 118 SIDS faecal samples compared with 5 (10.6%) of 47 healthy babies (chi 2 = 5.24, p < 0.05); cytotoxins in 38 (30.9%) of 123 SIDS faecal samples compared with 0 of 21 of healthy babies (chi 2 = 8.8, p < 0.01) and 24 (27.6%) of 87 SIDS serum samples. C. perfringens enterotoxin was detected in 33 (34.4%) of 96 SIDS faecal extracts compared with 0 of 23 of healthy babies (chi 2 = 10.94, p < 0.001), and in 27 (24.5%) of 110 SIDS serum samples. C. perfringens alpha-toxin (presumptive) was detected in 14 (17.5%) of 80 SIDS faecal extracts compared with 0 of 17 from healthy babies (chi 2 = 3.5ns, p congruent to 0.05) and in 2 (2.3%) of 87 SIDS serum samples. C. difficile toxin was detected in four SIDS faecal samples and two serum samples. C. botulinum toxin was detected in only one of 120 SIDS faecal samples compared with none of 49 from healthy babies. Staphylococcal enterotoxins were detected in 8 (19.5%) of 41 SIDS faecal samples compared with 0 of 19 from healthy babies (chi 2 = 4.278, p < 0.05), and in 4 (10.8%) of 37 SIDS serum samples.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

对123例死于婴儿猝死综合征(SIDS)的婴儿以及52例年龄匹配的对照婴儿的粪便样本进行了产毒细菌及其毒素分析。还对SIDS婴儿的血清样本进行了这些毒素的分析。发现SIDS婴儿粪便样本中产毒细菌及其毒素的比例显著高于对照组样本。这些毒素也在SIDS婴儿的血清中被发现。在119例SIDS病例中有54例(45.4%)检测到产气荚膜梭菌,而51例健康婴儿中有10例(19.6%)检测到(卡方=10.1,p<0.01);119例SIDS病例中有33例(27.7%)检测到艰难梭菌,54例健康婴儿中有8例(14.8%)检测到(卡方=3.43无统计学意义,p<0.1);44例SIDS病例中有12例(27.3%;66.7%产肠毒素)检测到金黄色葡萄球菌,14例健康婴儿中有12例(85.7%;不产肠毒素)检测到(卡方=14.9,p<0.001);120例SIDS病例中有6例(5.0%)检测到肉毒梭菌,53例健康婴儿中未检测到(卡方=2.74,p<0.1)。未检测到空肠弯曲菌、小肠结肠炎耶尔森菌、副溶血性弧菌、沙门氏菌和蜡样芽孢杆菌。在118例SIDS粪便样本中有32例(27.1%)检测到对小鼠致死的不耐热毒素(HLML),47例健康婴儿中有5例(10.6%)检测到(卡方=5.24,p<0.05);123例SIDS粪便样本中有38例(30.9%)检测到细胞毒素,21例健康婴儿中未检测到(卡方=8.8,p<0.01),87例SIDS血清样本中有24例(27.6%)检测到。96例SIDS粪便提取物中有33例(34.4%)检测到产气荚膜梭菌肠毒素,23例健康婴儿中未检测到(卡方=10.94,p<0.001),110例SIDS血清样本中有27例(24.5%)检测到。80例SIDS粪便提取物中有14例(17.5%)检测到产气荚膜梭菌α毒素(推测),17例健康婴儿中未检测到(卡方=3.5无统计学意义,p约等于=0.05),87例SIDS血清样本中有2例(2.3%)检测到。在四个SIDS粪便样本和两个血清样本中检测到艰难梭菌毒素。120例SIDS粪便样本中仅在一例中检测到肉毒梭菌毒素,49例健康婴儿中未检测到。41例SIDS粪便样本中有8例(19.5%)检测到葡萄球菌肠毒素,19例健康婴儿中未检测到(卡方=4.278,p<0.05),37例SIDS血清样本中有4例(10.8 %)检测到。(摘要截断于400字)

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