Nataro J P, Kaper J B
Department of Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
Clin Microbiol Rev. 1998 Jan;11(1):142-201. doi: 10.1128/CMR.11.1.142.
Escherichia coli is the predominant nonpathogenic facultative flora of the human intestine. Some E. coli strains, however, have developed the ability to cause disease of the gastrointestinal, urinary, or central nervous system in even the most robust human hosts. Diarrheagenic strains of E. coli can be divided into at least six different categories with corresponding distinct pathogenic schemes. Taken together, these organisms probably represent the most common cause of pediatric diarrhea worldwide. Several distinct clinical syndromes accompany infection with diarrheagenic E. coli categories, including traveler's diarrhea (enterotoxigenic E. coli), hemorrhagic colitis and hemolytic-uremic syndrome (enterohemorrhagic E. coli), persistent diarrhea (enteroaggregative E. coli), and watery diarrhea of infants (entero-pathogenic E. coli). This review discusses the current level of understanding of the pathogenesis of the diarrheagenic E. coli strains and describes how their pathogenic schemes underlie the clinical manifestations, diagnostic approach, and epidemiologic investigation of these important pathogens.
大肠杆菌是人类肠道中主要的非致病性兼性菌群。然而，一些大肠杆菌菌株甚至在最健康的人类宿主中也具备了引发胃肠道、泌尿系统或中枢神经系统疾病的能力。致泻性大肠杆菌菌株可分为至少六个不同类别，各有相应独特的致病机制。总体而言，这些微生物可能是全球小儿腹泻最常见的病因。感染不同类别致泻性大肠杆菌会伴随几种不同的临床综合征，包括旅行者腹泻（产肠毒素大肠杆菌）、出血性结肠炎和溶血尿毒综合征（肠出血性大肠杆菌）、持续性腹泻（肠集聚性大肠杆菌）以及婴儿水样腹泻（肠致病性大肠杆菌）。本文综述了目前对致泻性大肠杆菌菌株发病机制的理解水平，并描述了其致病机制如何构成这些重要病原体的临床表现、诊断方法及流行病学调查的基础。
