Saxén H, Tarkka E, Hannikainen P, Nikku R, Rautio M, Siitonen A
Children's Hospital, University of Helsinki, Finland.
Clin Infect Dis. 1996 Nov;23(5):1038-42. doi: 10.1093/clinids/23.5.1038.
Two hundred four appendiceal isolates for Escherichia coli from 146 patients with either inflamed appendices (IA) (110 patients) or noninflamed appendices (NA) (36 patients) were characterized. Strains with P fimbriae were detected in 27% of IA and 31% of NA whereas type 1C-fimbriated strains were found only in IA (13%). Four serotypes, three with K5 antigens (O18:K5, O25:K5:H1, and O75:K5:H-) and one with K1 antigen (O75:K1:H7), were isolated only from IA (20 [18%] of 110); O25:K5:H1 was the most common serotype (isolated from 11 IA [10%]). Fecal isolates from the patients with IA resembled their corresponding appendiceal isolates rather than fecal isolates from patients with NA; this finding suggests that colonization of the gut by virulent E. coli--such as a hemolysin-producing, type 1C-fimbriated, P-fimbriated O25:K5:H1 serotype--may be a prerequisite for the development of appendicitis.
对来自146例患有炎症性阑尾（IA）（110例患者）或非炎症性阑尾（NA）（36例患者）的患者的204株大肠杆菌阑尾分离株进行了特征分析。在27%的IA患者和31%的NA患者中检测到带有P菌毛的菌株，而仅在IA患者中发现了1C型菌毛菌株（13%）。四种血清型，三种带有K5抗原（O18:K5、O25:K5:H1和O75:K5:H-），一种带有K1抗原（O75:K1:H7），仅从IA患者中分离得到（110例中的20株[18%]）；O25:K5:H1是最常见的血清型（从11例IA患者中分离得到[10%]）。IA患者的粪便分离株与其相应的阑尾分离株相似，而不是与NA患者的粪便分离株相似；这一发现表明，肠道被致病性大肠杆菌（如产生溶血素的、1C型菌毛的、P菌毛的O25:K5:H1血清型）定植可能是阑尾炎发生的先决条件。
