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[小肠结肠炎耶尔森菌所致主动脉瘤:三例新病例及文献复习]

[Aortic aneurysms due to Yersinia enterocolitica: three new cases and a review of the literature].

作者信息

Mercié P, Morlat P, N'Gako A, Phéline P, Bézian M C, Gorin G, Lacoste D, Bernard N, Loury I, Midy D, Baste J C, Beylot J

机构信息

Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, Bordeaux.

出版信息

J Mal Vasc. 1996;21(2):68-71.

PMID:8755183
Abstract

We report three cases of mycotic aortic aneurysms due to Yersinia enterocolitica. In all cases, serogroups are O:9. The three patients more than 70 year-old men with immunodeficiency underlying conditions allowing bacterial graft (neoplasia, diabetes mellitus, dysimmunitary syndrome, hematologic diseases). The six cases of the literature were clinically, biologically and epidemiologically similar. The strains of Y enterocolitica responsible for septicemia are especially serogroups O:9. This is probably due to particular virulence factors in this serogroup (phagocytosis resistance gene: yopH, ypkA et yop E) (yop: Yersinia outer membrane proteins). The presence of a pYV plasmid (plasmid yersinia virulence), found in Yersinia pathogen strains, lead to bacterial proliferation in the tissues. The authors discuss pathophysiological mechanisms involved in arterial bacterial graft following an Y. enterocolitica infection.

摘要

我们报告了3例由小肠结肠炎耶尔森菌引起的霉菌性主动脉瘤病例。所有病例的血清群均为O:9。这3例患者均为70岁以上男性,有免疫缺陷等基础疾病,使得细菌得以植入(肿瘤、糖尿病、免疫失调综合征、血液系统疾病)。文献报道的6例病例在临床、生物学和流行病学方面与之相似。导致败血症的小肠结肠炎耶尔森菌菌株尤其以血清群O:9为主。这可能是由于该血清群中存在特定的毒力因子(抗吞噬基因:yopH、ypkA和yop E)(yop:耶尔森菌外膜蛋白)。在致病性耶尔森菌菌株中发现的pYV质粒(耶尔森菌毒力质粒)的存在,导致细菌在组织中增殖。作者讨论了小肠结肠炎耶尔森菌感染后动脉细菌植入所涉及的病理生理机制。

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