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散发性溶血性尿毒症综合征及出血性结肠炎病例与抗肠出血性大肠杆菌O157脂多糖的血清IgM抗体

[Sporadic cases of hemolytic uremic syndrome and hemorrhagic colitis with serum IgM antibodies to lipopolysaccharides of enterohemorrhagic Escherichia coli O157].

作者信息

Shiomi M, Togawa M

机构信息

Department of Pediatrics and Infectious Diseases, Osaka City General Hospital.

出版信息

Nihon Rinsho. 1997 Mar;55(3):686-92.

PMID:9086782
Abstract

In 1994-1996 summer, eight patients with hemolytic uremic syndrome(HUS) and 3 patients with hemorrhagic colitis, whose fecal specimens yielded no Enterohemorrhagic Escherichia coli(EHEC) because of the antibiotic therapies before presentation, showed serum IgM antibody responses to lipopolysaccharide(LPS) of O157. Although early bacteriological examination is essential for diagnosis, serological testing of patients with HUS or HC for antibodies to the LPS of EHEC provides evidence of infection with EHEC. We also presented successful fluoroquinolones(SPFX and NFLX) therapies of another 15 HC inpatient cases from Sakai outbreak of O157 infections due to school lunch in summer 1996. In these 15 HC patients, 12 EHECs of serotype O157:H7 with VT1 and VT2 and phage type 32 were obtained, but no growths of EHECs after fluoroquinolones therapy and no progressions to HUS resulted. The MICs of SPFX is 0.025 microgram/dl, NFLX 0.1, NA 3.13, FOM 12.5, ST 0.39, KM 3.13, ABPC 1.56-3.13.

摘要

在1994 - 1996年夏季,8例溶血性尿毒症综合征(HUS)患者和3例出血性结肠炎患者,其粪便标本因在就诊前接受抗生素治疗而未检出肠出血性大肠杆菌(EHEC),但显示出对O157脂多糖(LPS)的血清IgM抗体反应。尽管早期细菌学检查对诊断至关重要,但对HUS或HC患者进行EHEC LPS抗体的血清学检测可提供EHEC感染的证据。我们还介绍了1996年夏季因学校午餐导致坂井O157感染爆发的另外15例HC住院患者接受氟喹诺酮类药物(司帕沙星和诺氟沙星)治疗的成功案例。在这15例HC患者中,获得了12株血清型为O157:H7、带有VT1和VT2且噬菌体类型为32的EHEC,但氟喹诺酮类药物治疗后未检测到EHEC生长,也未进展为HUS。司帕沙星的最低抑菌浓度为0.025微克/分升,诺氟沙星为0.1,奈替米星为3.13,氟氧头孢为12.5,链霉素为0.39,庆大霉素为3.13,氨苄青霉素为1.56 - 3.13。

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