徐州市2000年肠出血性大肠埃希菌O157：H7感染性腹泻的调查

李洪卫; 景怀琦; 逄波; 赵广法; 杨晋川; 徐建国

Abstract

李洪卫,景怀琦,逄波,赵广法,杨晋川,徐建国.徐州市2000年肠出血性大肠埃希菌O157：H7感染性腹泻的调查[J].Chinese journal of Epidemiology,2002,23(2):119-122

徐州市2000年肠出血性大肠埃希菌O157：H7感染性腹泻的调查

Study on diarrhea disease caused by enterohemorrhagic Escherichia coli O157：H7 in Xuzhou city, Jiangsu province in 2000

Received:November 08, 2001 Revised:June 05, 2012

DOI：

KeyWord: 大肠杆菌O157：H7 志贺毒素腹泻病

English Key Word: Escherichia coli O157：H7 Shiga toxin Diarrhea disease

FundProject:国家科技部社会公益性基金资助项目

Author Name	Affiliation
LI Hongwei	Center for Disease Prevention and Control, Xuzhou City, Jiangsu Province, Xuzhou 221103, China
JING Huaiqi	中国疾病预防控制中心传染病预防控制所卫生部医学分子细菌学重点实验室
PANG Bo	中国疾病预防控制中心传染病预防控制所卫生部医学分子细菌学重点实验室
ZHAO Guangfa	Center for Disease Prevention and Control, Xuzhou City, Jiangsu Province, Xuzhou 221103, China
YANG Jinchuan	Center for Disease Prevention and Control, Xuzhou City, Jiangsu Province, Xuzhou 221103, China
XU Jianguo	中国疾病预防控制中心传染病预防控制所卫生部医学分子细菌学重点实验室

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Abstract:

目的了解徐州市丰县和铜山县肠出血性大肠埃希菌 (EHEC)O15 7：H7引起的出血性结肠炎 (HC)在腹泻病患者中所占的比例,以及临床症状和肾功能变化的情况。方法使用EHECO15 7胶体金快速检测试剂筛选粪便标本,阳性者使用免疫磁珠方法分离病原菌。对经过细菌学证实的EHECO15 7：H7引起的HC患者,进行临床症状的观察和生化检验指标分析。结果 2 0 0 0年 5月份,丰县由EHECO15 7：H7引起的HC占腹泻病患者 0.98%,6月份铜山县的HC患者占腹泻病患者5.89%。在出现腹泻病症状的同时,18.5 %患者的肾功能已经出现异常,表现为尿蛋白、血清肌苷或血尿素氮等指标的升高。在 2 7例HC患者中,有 14和 13例分别分离到不产生志贺毒素和产生志贺毒素的EHECO15 7：H7菌株。根据分离菌株是否产生志贺毒素将患者分为两组进行比较,尿蛋白阳性患者的比例分别为 4 / 13和 1/ 14,血小板减少患者的比例分别为 6 / 13和 3/ 14。统计学分析有显著意义。提示分离到产生志贺毒素的EHECO15 7：H7菌株的患者,发生肾功能异常的可能性较大。结论此次调查证实了EHECO15 7：H7感染所引起的HC在整个腹泻病患者中所占的比例随季节的变化而不同,感染产生志贺毒素EHECO15 7：H7菌株的患者,发生肾功能异常的可能性要比不产生志贺?

English Abstract:

Objective To investigate the proportion of hemorrhagic colitis(HC) caused by Escherichia coli O157：H7 in bacterial diarrhea in Xuzhou city, Jiangsu province. Methods All stool samples from patients with diarrhea were screened for O157 antigen, using Immuno gold kits.Positive samples were cultured to detect the existence of pathogens. All of the HC patients confirmed by bacterial isolation and identification were investigated for clinical symptoms and laboratory tests. Results Of the diarrhea patients identified in Feng county in May, and in Tongshan county of Xuzhou city in June 2000, Jiangsu province 0.98 % and 5.89 % were caused by Escherichia coli O157：H7 respectively, confirmed by bacteriological isolation and identification of stool samples. At the early phase of hemorrhagic colitis, 18.5 % patients had at least one abnormal clinical laboratory test Results including protein in urea and increased BUN or creatinine that indicating the possibilily of kidney damage. In 27 strains of E.coli O157： H7 isolated from those patients, 13 and 14 were identified as Shiga toxin producing and Shiga toxin negative E.coli O157：H7 (Stx positive or Stx negative) respectively. By analysis of the two groups of patients divided by according to the nature of Shiga toxin, four of 13 patients of Stx positive group showed positive urea protein. However only 1 of the 13 patients of Stx negative group was urea protein positive. The decreased Platelets counts were observed in 6 of 13 patients with Stx positive group, but only in 1 of 14 patients with stx negative group. These differences were statistically significant. Conclusion HC patients caused by E.coli O157：H7 were commonly seen (up to 5.89%) in Xuzhou city, Jiangsu province.Early laboratory tests should be conducted for HC patients as early as possible in order to find early indictor of kidney failure which was critical for prevention of hemolytic uremic syndrome.

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