肠出血性大肠埃希菌O157：H7引起的溶血性尿毒综合征患者血清抗体调查

徐建国; 程伯鲲; 冯丽萍; 景怀琦; 杨晋川; 赵广法; 汪华; 李洪卫

Abstract

徐建国,程伯鲲,冯丽萍,景怀琦,杨晋川,赵广法,汪华,李洪卫.肠出血性大肠埃希菌O157：H7引起的溶血性尿毒综合征患者血清抗体调查[J].Chinese journal of Epidemiology,2002,23(2):114-118

肠出血性大肠埃希菌O157：H7引起的溶血性尿毒综合征患者血清抗体调查

Serological investigations on patients with hemolytic uremic syndromes due to enterohemorrhagic Escherichia coliO157：H7 infection

Received:November 10, 2001 Revised:May 28, 2012

DOI：

KeyWord: 大肠杆菌O157：H7 溶血性尿毒综合征溶血素脂多糖

English Key Word: Escherichia coli O157：H7 Hemolytic uremic syndrome Hemolysin Lipo poly polysaccharide

FundProject:国家自然科学基金资助项目(39770043)

Author Name	Affiliation
XU Jianguo	Institute for Infectious Disease Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
CHENG Bokun	Institute for Infectious Disease Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
FENG Liping	Institute for Infectious Disease Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
JING Huaiqi	Institute for Infectious Disease Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China
YANG Jinchuan	徐州市疾病预防控制中心
ZHAO Guangfa	徐州市疾病预防控制中心
WANG Hua	江苏省疾病预防控制中心
LI Hongwei	徐州市疾病预防控制中心

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Abstract:

目的对 1999年某地出现的一批先有腹泻病症状后继发急性肾功能衰竭 (肾衰)的患者进行血清学调查和诊断。方法使用基因克隆表达纯化的肠出血性大肠埃希菌 (EHEC) -溶血素(Hly)和EHECO15 7脂多糖 (LPS)为抗原,对采集自 4 2例肾衰患者的血清标本进行蛋白印记试验。结果 EHEC Hly的检测发现,IgG抗体阳性 2 1份,阳性率5 0.0 % ;IgM抗体阳性 16份,阳性率38.1% ;在 11份标本中同时检测到IgG和IgM抗体,阳性率2 6.2 % ;检测到IgG或IgM抗体阳性的标本 2 6份,阳性率 6 1.9%。EHECO15 7LPS的检测发现,2 4份标本分别检测到IgG和IgM抗体,阳性率各为 5 7.1% ;在 2 9份标本中检测到IgG或IgM抗体,阳性率6 9.0 % ;在 2 0份标本中检测到IgG和IgM抗体,阳性率4 7.6 %。在 4 2份血清标本中同时检测到EHEC Hly和O15 7LPS的特异性抗体的标本 2 2份,阳性率 5 2.4 % ;检测到EHEC Hly或O15 7LPS的特异性抗体的标本 34份,阳性率81.0 %。结论结合细菌学和血清学诊断结果、临床症状和流行病学分析,可以认为这些患者感染了EHECO15 7：H7。在分离不到病原菌的情况下,检测患者血清标本的EHEC Hly和 /或EHECO15 7LPS的特异性抗体,不失为一种可以考虑的诊断方法.

English Abstract:

Objective To investigate the etiological agent of patients with diarrhea followed by acute kidney failure symptoms in China, 1999. Methods Western blot was used to detect serum specific antibodies of patients against entero haemorrhagic Escherichia coli hemolysin (EHEC Hly) and lipo polysaccharide of E.coli O157. Results Twenty one and 16 of 42 patients showed positive reaction of specific IgG or IgM antibodies against EHEC Hly respectively. Eleven of 42 serum samples were positive for having both IgG and IgM antibodies while 26 of 42 samples were positive for IgG or IgM. For E.coli O157 LPS test, 24 and 24 of 42 samples showed positive for IgG or IgM antibodies respectively. In 42 samples, 20 were positive for IgG and IgM while 29 were positive for IgG or IgM. Conclusion s Twenty two of 42 samples were reacted with EHEC Hly and E.coli O157 LPS, but 34 of 42 samples were positive for EHEC Hly or E.coli O157. In combination of western blot results, bacterial isolation clinical symptoms and epidemiological investigation findings, it was reasonable to conclude that this cluster of patients with distinguish clinical symptoms was caused by E. coli O157：H7, which had never been reported in China. Hence serological Methods with EHEC Hly and E.coli O157 LPS are valuable for diagnosis of infections of E.coli O157：H7, when bacterial isolation is failed.

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