Huppertz H I, Rutkowski S, Aleksic S, Karch H
Children's Hospital, University of Würzburg, Germany.
Lancet. 1997 Jun 7;349(9066):1660-2. doi: 10.1016/S0140-6736(96)12485-5.
Enteroaggregative Escherichia coli (EAggEC or EAEC) can spread and cause disease in developing countries, but it is not presently known whether it spreads disease in industrialised countries. Therefore, we did a prospective study to assess the incidence and the clinical manifestations of infections due to EAEC in children in Germany.
798 children with diarrhoea, admitted to hospital within a defined geographical area during a 24-month period, were included in the trial. EAEC were cultured from stool specimens, screened by PCR, and identified by colony hybridisation from DNA sequences found on the virulence plasmid. The findings were confirmed by aggregative adherence to HEp-2 cells. Stool samples from 580 children admitted to hospital without diarrhoea were also studied as controls.
EAEC were found in the stools of 16 (2%) of 798 children with diarrhoea, but in none of 580 children without diarrhoea. Only four of the EAEC-infected children had travelled to developing countries. Most EAEC infections were acquired in the summer months. Infection with EAEC was associated with acute, watery diarrhoea in 12 children, and with chronic diarrhoea of up to 5 months' duration in four. Five children had abdominal colic that lasted for 2-4 weeks as their main symptom. The incidence of EAEC infection was 7.7 patients admitted to hospital per 100,000 children in the general population aged younger than 16 years.
EAEC infection is associated with acute, watery diarrhoea and may be acquired in industrialised countries. Chronic diarrhoea or abdominal colic of unknown aetiology in young children may also be caused by EAEC infection.
肠集聚性大肠杆菌（EAggEC或EAEC）在发展中国家能够传播并引发疾病，但目前尚不清楚其在工业化国家是否会传播疾病。因此，我们开展了一项前瞻性研究，以评估德国儿童中EAEC感染的发病率及临床表现。
在24个月期间，纳入了在特定地理区域内住院的798名腹泻儿童进行试验。从粪便标本中培养EAEC，通过聚合酶链反应（PCR）进行筛查，并通过对毒力质粒上的DNA序列进行菌落杂交来鉴定。通过对人喉表皮样癌细胞（HEp-2细胞）的集聚性黏附来确认结果。还对580名无腹泻症状住院儿童的粪便样本进行了对照研究。
在798名腹泻儿童中，有16名（2%）粪便中检测到EAEC，而580名无腹泻儿童的粪便中均未检测到。仅有4名感染EAEC的儿童去过发展中国家。大多数EAEC感染发生在夏季。12名感染EAEC的儿童出现急性水样腹泻，4名儿童出现长达5个月的慢性腹泻。5名儿童以持续2 - 4周的腹部绞痛为主要症状。在16岁以下的普通儿童中，EAEC感染的发病率为每10万名儿童中有7.7名住院患者。
EAEC感染与急性水样腹泻有关且可能在工业化国家获得。幼儿不明病因的慢性腹泻或腹部绞痛也可能由EAEC感染引起。
