产志贺毒素大肠埃希菌的鉴定及分布特征

目的 探讨吉林地区产志贺毒素大肠埃希菌（STEC）分离株的分布和特征。方法 采集牛羊粪便及其肉类食品、蔬菜，分离大肠埃希菌，PCR鉴定毒力因子及血清学分型。结果 380份标本中鉴定出12株STEC,3株为产志贺毒素O157：H7型，9株为产志贺毒素非O157：H17型。结论 STEC存在于不同来源的标本中，菌株血清型与毒力因子存在一定差异。     

espP基因在O157∶H7大肠埃希菌分离株中的分布

目的了解espP基因在中国部分地区产志贺毒素O157大肠埃希菌分离株中的分布情况及特点。方法根据O157∶H7的溶血素基因hlyA和细胞外分泌蛋白基因espP设计特异性引物,对113株O157大肠埃希菌分离株进行PCR检测。结果 hlyA的阳性率为99.1%,espP的阳性率为72.5%,且只在有大质粒pO157的菌株中检测到espP。结论 espP存在于携带pO157大质粒的O157∶H7大肠埃希菌中,其分布与菌株来源、志贺毒素携带情况等没有相关性。     

某院耐甲氧西林金黄色葡萄球菌MLVA基因分型及流行状况研究

目的通过构建适合临床实验室常规应用的耐甲氧西林金黄色葡萄球菌(MRSA)菌株同源性多位点可变数目串联重复序列分析(MLVA)分型方法,建立昆明地区临床分离MRSA菌株的MLVA基因分型基础数据库,分析医院MRSA感染流行情况。方法收集昆明市第一人民医院临床微生物室2010年10月至2013年12月分离的111株MRSA菌株,对7个可变数目串联重复序列(VNTR)位点进行聚合酶链式反应(PCR)扩增和产物电泳分析,归类各菌株的基因型别。结果 VNTR09-01位点测序结果显示9bp的重复子,重复规律性不强、易突变;111株分离株被分为25个基因型别(A~Y),其中G、A、B为主要型别,分别占47.7%、13.5%、8.1%;呼吸内科、神经外科、重症监护室(ICU)和乳腺科存在MRSA集中流行趋势。结论 MLVA分型方法可推广应用于本研究中7个VNTR位点多态性检测,部分科室存在MRSA同源菌集中流行情况,值得高度关注。     

深圳地区致泻性大肠埃希菌多位点可变数目串联重复序列分析分型方法的研究

目的通过比较多位点可变数目串联重复序列分析（MLVA）和脉冲场凝胶电泳（PFGE）分型方法,探索更优的致泻性大肠埃希菌（DEC）的快速溯源方法。方法本研究采用筛选的可变数目串联重复序列（VNTR）位点,对DEC菌株进行MLVA分型,并将该方法与金标准PFGE进行比较评估。结果PFGE分型方法将58株DEC分为43种带型,其中3种带型成簇,多样性指数（DI）值为0.965。 MLVA分型方法将58株菌分为42种带型,4种型别成簇,DI值为0.955。 此外,2种方法对2起暴发菌株的分型结果一致。结论MLVA方法与PFGE方法对深圳地区的58株DEC菌株的分型能力差异无统计学意义,但MLVA具有快速、简便、通量高的特点,使得MLVA优于PFGE分型方法,在疾病监测、疾病暴发调查中将会发挥重要的应用价值。     

某院产ESBLs大肠埃希菌多位点序列分型研究

目的了解郑州大学附属肿瘤医院临床和环境中产超广谱β-内酰胺酶(ESBLs)大肠埃希菌多位点序列分型(MLST)及其遗传进化关系,为监测产ESBLs菌株的流行和医院感染控制提供依据。方法采用基因扩增和测序的方法对26株产ESBLs大肠埃希菌7个管家基因进行序列分析,并与MLST数据库比对,得到每个菌株相应的等位基因号。结果 26株产ESBLs大肠埃希菌获得16种序列分型(ST),其中3株为ST69型、3株为ST131型。结论产ESBLs大肠埃希菌遗传背景多样化,ST131型和ST69型为本研究主要型别,其它型别散在分布。     

不同来源STECO157:H7生物学特性研究

目的 探讨浙江省产志贺毒素大肠埃希菌O157:H7菌株PFGE分型及携带毒力基因以及耐药情况.方法 菌株生化、血清鉴定按API 20E鉴定系统;大肠杆菌O157:H7诊断血清凝集试验;采用聚合酶链反应(PCR)法检测O、H抗原及毒力基因SLT1、SLT2、Hly、eaeA;STEC O157:H7分型用脉冲场凝胶电泳(pulse field gel electrophoresis,PFGE)方法进行;14种抗生素进行药敏试验采用K-B法.结果 5株可疑菌株经生化和血清鉴定符合O157:H7特性;毒力基因检测所有分离株SLT2、Hly、eaeA三种毒力基因均阳性而SLT1均阴性;脉冲场凝胶电泳分型结果显示,有2株菌PFGE电泳条带完全相同,其余3株菌电泳条带不同,5株菌共分为4个带型;经耐药性分析,菌株对头孢噻吩、头孢噻肟、庆大霉素、环丙沙星100%敏感;对复方新诺明、氨苄西林100%耐药.结论 STEC O157:H7菌株在浙江省一些地区存在,并且携带SLT2毒力基因,PFGE型别较多,同时也有人间感染病例的出现,提示应加强O157:H7监测力度,防止该菌在人间的感染和流行.     

江苏省建湖地区大肠埃希菌O157:H7毒力基因分析

目的对检测出的17份肠出血性大肠埃希菌0157：H7阳性菌株进行毒力基因分析。方法收集江苏省建湖地区2008年5月～9月监测出的17株肠出血性大肠埃希菌0157：H7阳性菌株,利用单一和多重PCR法检测不同来源菌株0157抗原编码（rfbE）、H7鞭毛抗原编码（fliC）、志贺样毒素（stx1和stx2）、溶血素（hly）和黏附抹平因子（eaeA）。结果通过血清学方法确定的17株肠出血性大肠埃希菌0157：H7阳性菌株,再通过PCR法检测,其中15株大肠埃希菌rfbE和fliC基因检测为阳性,确认为EHEC O157：H7,其中9株菌株扩增出全部毒力基因,5株菌株扩增出除stxl外其它全部毒力基因,1株仅检出stx2,hly毒力基因;2株大肠埃希菌rfbE基因检测阳性、fliC基因检测为阴性,确认为O157：H7-大肠埃希菌,无毒力基因检出。结论该地区存在O157：H7大肠埃希菌强毒株污染,从流行病学角度看具潜在的流行性危险,当地疾控部门应加强O157：H7的综合监测。     

一起产志贺毒素大肠埃希菌O146∶H10引起的食物中毒的溯源分析

  目的  对2019年广西壮族自治区桂林市发生的一起校内食物中毒进行病原检测及溯源分析。  方法  对该起食物中毒事件开展流行病学调查,采集腹泻患者粪便、餐厨工作人员肛拭子、留样食品、厨房环境及餐厨用具涂抹样本,按常规方法进行病原分离和鉴定,对分离的病原菌进行毒力基因检测及脉冲场凝胶电泳（PFGE）分子分型分析。  结果  本次食物中毒事件共造成87人出现腹泻或其他症状。从1例腹泻患者粪便及1位餐厨工作人员肛拭子标本中分离到产志贺毒素大肠埃希菌,血清型均为O146∶H10,志贺毒素基因均为stx_1c亚型,且2株分离株具有相同的PFGE带型。  结论  这起食物中毒是由产志贺毒素大肠埃希菌O146∶H10引起,为国内首次报道由非O157产志贺毒素大肠埃希菌引起的食物中毒事件。     

脉冲场凝胶电泳和多位点串联重复序列分析 应用于中国鼠伤寒沙门菌分型能力的评价

目的 比较脉冲场凝胶电泳(PFGE)和两种国际多位点串联重复序列分析(MLVA)分型方法用于我国鼠伤寒沙门菌分子分型的能力,并初步确定适用于我国鼠伤寒沙门菌MLVA分型中的VNTR位点。 方法 根据国际PulseNet公布的沙门菌PFGE分型方案、MLVA分型方案(包含7个VNTR位点,简称MLVA_PN)及欧洲食源性疾病监测网公布的鼠伤寒沙门菌MLVA分型方案(包含5个VNTR位点, 简称MLVA_EU),对来自我国5个省(直辖市)的175株鼠伤寒沙门菌进行分子分型分析,并结合流行病学资料,评价这三种分型方法对我国分离的鼠伤寒沙门菌的分型能力。 结果 175株鼠伤寒沙门菌经XbaⅠ酶切,PFGE后,获得56种带型,其分辨能力(D值)为0.8823。对其中的主优势带型JPXX01.CN0001菌株55株进一步用第二种内切酶BlnⅠ酶切后,获得6种带型。用MLVA_EU分型,获得96种型别,D值为0.9758。应用MLVA_PN分析,获得98种型别, D值为0.9763。 两种MLVA分型方法对菌株的分辨能力几乎相同,且分型结果具有较高的一致性。对流行病学调查显示为鼠伤寒沙门菌暴发患者和食物来源的菌株进行PFGE双酶切及MLVA分型,三种分型方法获得一致性结果,均显示这些菌株具有明显的聚集性。 结论 两种MLVA分型方法的分辨能力均高于PFGE,在确认鼠伤寒沙门菌引起的暴发事件时,采用需时较短,操作更方便的5个VNTR位点的MLVA分型方法可满足菌株聚集性分析。     

产志贺毒素大肠埃希菌的特殊类型

产志贺毒素大肠埃希菌（STEC）的菌种以O157：H7为代表，但现在已扩展至近70个血清型。STEC的重要生化反应特征是不发酵山梨醇，现已在德国，捷克发现能在24h内发酵山梨醇的菌株，且其H抗原缺失。少数不产生志贺毒素，stx基因为阴性的发酵山梨醇的O157：H菌株也有欧洲发现。以上新情况及STEC的检出更具挑战性。     

A multiple protocol to improve diagnosis and isolation of Shiga toxin-producing Escherichia coli from human stool specimens

Many infections caused by Shiga toxin-producing Escherichia coli (STEC) are undiagnosed, particularly non-O157 STEC. We evaluated the use of a multiple protocol approach to improve diagnosis, isolation, and characterization of STEC strains. Among 18 presumptive STEC-positive stool samples received by the INOVA Fairfax Hospital, Falls Church, VA, in 2006, 16 were Shiga toxin positive. From these 16 stool samples, 8 O157:H7 and 5 non-O157 STEC were isolated by plating onto sorbitol MacConkey (SMAC) agar. The remaining 5 stool samples that did not yield colonies on SMAC agar plates were enriched. All enriched samples were Shiga toxin positive, and 2 O157:H7 and 1 non-O157 STEC were subsequently isolated. The 2 remaining enriched samples did not yield isolates; however, based on polymerase chain reaction (PCR) analysis, both samples contained STEC genes. Based on PCR analysis of non-O157 strains, 3 strain types were identified. Samples from 3 patients, received within 2 days of one another, had a similar gene profile-eae and stx(1) negative and stx(2) positive-suggesting that these patients were likely infected with the same strain. Our results indicate that a multiple protocol approach is necessary to reliably diagnose and isolate STEC strains, and that PCR profiling of strains could allow for more rapid identification of outbreaks.     

Shiga toxin- and enterotoxin-producing Escherichia coli isolated from subjects with bloody and nonbloody diarrhea in Bangkok,Thailand

A total of 314 stool samples collected from 92 subjects with bloody diarrhea, 119 subjects with non-bloody diarrhea and 103 normal subjects in Bangkok, Thailand, were investigated for the presence of Shiga toxin-producing Escherichia coli (STEC) and enterotoxin-producing E. coli (ETEC) by multiplex PCR assay. Virulence genes and cytotoxic effect to Vero cells of STEC were also determined. STEC (5 isolates) and ETEC (18 isolates) were detected in 3 and 14 subjects, respectively. Among subjects containing ETEC, only one person belonged to normal control group. The detected STEC included two isolates (serotypes O26:H(-) and O111:H(-)) of Shiga toxin type 1 (Stx1-only) STEC from a child with non-bloody diarrhea, two isolates (Stx1-Stx2 STEC and Stx1-only STEC) from an adult with bloody diarrhea, and one isolate of Stx1-Stx2v STEC (O157:H7) from normal child. Only Stx1-Stx2 STEC isolate was found to exhibit toxicity to Vero cells and carry hlyA gene. The intimin encoding gene locus eaeA was not detected in any isolate. These results indicate that most of STEC isolates in Thailand were low virulent.     

Detection of Shiga toxin genes stx1, stx2, and the +93 uidA mutation of E. coli O157:H7/H-using SYBR Green I in a real-time multiplex PCR

Enterohemorrhagic Escherichia coli (EHEC) is a major foodborne pathogen capable of causing diarrhea and vomiting, but more serious complications such as hemorrhagic colitis and hemolytic-uremic syndrome (HUS) can result. A real-time PCR method to detect the presence of Shiga toxin producing E. coli (STEC) and E. coli O157:H7 was investigated using SYBR Green I (SG). Primers were designed to target the Shiga toxin genes (stx1 and stx2) and a highly conserved base substitution at +93 of the beta-glucuronidase gene (uidA) unique to E. coli O157:H7. An initial test panel of five E. coli and non-E. coli isolates was tested with individual primer sets (simplex assay) and all primer sets including stx1, stx2, and uidA (multiplex assay). All strains were correctly identified in both assays. Average melt temperatures (Tm's, degrees C) for PCR products were 85.42--stx1, 81.93--stx2, and 88.25--uidA in simplex assays and 85.20--stx1, 81.20--stx2, and 88.16--uidA when multiplexed. Each of the three gene targets in one multiplex reaction could be distinguished by melt curve data with significantly different Tm's. The assay was expanded to a panel of 138 isolates consisting of STEC, E. coli O157:H7, non-toxigenic E. coli, and non-E. coli isolates with melt peaks consistent with those stated above.     

Semi-automated fluorogenic PCR assays (TaqMan) forrapid detection of Escherichia coli O157:H7 and other shiga toxigenic E. coli.

Semi-automated detection of Enterohaemorrhagic Escherichia coli (EHEC) O157:H7 and non-O157:H7 Shiga toxin-producing E. coli (STEC) was achieved using fluorogenic polymerase chain reaction (PCR). These PCR assays were designed to amplify 80, 120 and 150 bp regions of virulence genes stx1, stx2 and eaeA, respectively, using specific primers. The fluorogenic probes were used for specific detection of amplified products of the stx1 and stx2 genes of STEC, and the eaeA gene of EHEC O157:H7. For multiplex PCR assay, the three sets of primers and fluorogenic probes were included in one reaction to simultaneously amplify and detect any of the three targeted virulence genes. In non-multiplex PCR assay, each of the three virulence genes was amplified and detected in independent reactions. The specificity of these assays was evaluated using suspensions of STEC and other bacterial species lacking stx1, stx2 and eaeA. The multiplex assay detected all STEC harbouring any combination of three virulence genes. Three non-multiplex PCR reactions identified types of Shiga toxin genes carried by a STEC and identified STEC as either EHEC O157:H7 or non-O157:H7 STEC. Sensitivity limits of these assays in beef and faeces inoculated with EHEC O157:H7 were 5.8 to 580 cfu and 1.2 to 1200 cfu, respectively. These assays can be completed within 8-10 h when performed simultaneously or within 13 h if the multiplex assay is used as an initial screen for detecting STEC and the non-multiplex assay is used for subsequent detection of stx1 and stx2 of STEC and eaeA of EHEC O157:H7 Copyright 1999 Academic Press.     

Preliminary evaluation of a procedure for improved detection of Shiga toxin-producing Escherichia coli in fecal specimens

Culture confirmation of Shiga toxin-producing Escherichia coli (STEC) is very important for epidemiologic analysis. However, isolation of non-O157 STEC on conventional selective media such as sorbitol–MacConkey agar (SMAC) can be difficult because of heavy growth of competing bacteria and its phenotypical similarity to commensal nonpathogenic E. coli. An acid enrichment procedure was introduced in this study to facilitate detection of STEC from patients who were symptomatic. Forty-seven clinical fecal broths, which tested positive for Shiga toxin by commercial immunoassay, were processed for the isolation of STEC by both conventional and the acid enrichment methods. The acid enrichment method and conventional culture recovered STEC from 91% (43/47) and 70% (33/47) of the fecal broths, respectively. Neither method retrieved STEC in 3 specimens. Thirty-six STEC were successfully serogrouped, which included O26 (n = 11), O157 (n = 9), O103 (n = 7), O121 (n = 3), O111 (n = 2 each), O28AC, O146, O76, and O undetermined (n = 1 each). The analysis of STEC isolates by real-time PCR indicated that all 9 E. coli O157 contained stx2 gene alone or in combination with stx1. Non-O157 STEC more frequently contained stx1 only, and about one-third possessed stx2. The novel acid enrichment protocol greatly reduced the growth of competitor colonies on RTN and TCSMAC. The study demonstrated that incorporation of an acid enrichment procedure in clinical testing improved the isolation of STEC in fecal specimens.     

Evaluation of a surface plasmon resonance imaging-based multiplex O-antigen serogrouping for Escherichia coli using eleven major serotypes of Shiga -toxin-producing E. coli

The early detection of Shiga toxin-producing Escherichia coli (STEC) is important for early diagnosis and preventing the spread of STEC. Although the confirmatory test for STEC should be based on the detection of Shiga toxin using molecular analysis, isolation permits additional characterization of STEC using a variety of methods, including O:H serotyping. The conventional slide agglutination O-antigen serogrouping used in many clinical laboratories is laborious and time-consuming. Surface plasmon resonance (SPR)-based immunosensors are commonly used to investigate a large variety of bio-interactions such as antibody/antigen, peptide/antibody, DNA/DNA, and antibody/bacteria interactions. SPR imaging (SPRi) is characterized by multiplexing capabilities for rapidly screening (approximately 100 to several hundred sensorgrams in parallel) molecules. SPRi-based O-antigen serogrouping method for STEC was recently developed by detecting the interactions between O-antigen-specific antibodies and bacterial cells themselves. The aim of this study was to evaluate its performance for E. coli serogrouping using clinical STEC isolates by comparing the results of slide agglutination tests. We tested a total of 188 isolates, including O26, O45, O91, O103, O111, O115, O121, O128, O145, O157, and O159. The overall sensitivity of SPRi-based O-antigen serogrouping was 98.9%. Only two O157 isolates were misidentified as nontypeable and O121. The detection limits of all serotypes were distributed between 1.1 × 10⁶ and 17.6 × 10⁶ CFU/ml. Pulsed-field gel electrophoresis (PFGE) revealed the heterogeneity of the examined isolates. In conclusion, SPRi is a useful method for the O-antigen serogrouping of STEC isolates, but the further evaluation of non-O157 minor serogroups is needed.     

An In Vitro Combined Antibiotic-Antibody Treatment Eliminates Toxicity from Shiga Toxin-Producing Escherichia coli

Treating Shiga toxin-producing Escherichia coli (STEC) gastrointestinal infections is difficult. The utility of antibiotics for STEC treatment is controversial, since antibiotic resistance among STEC isolates is widespread and certain antibiotics dramatically increase the expression of Shiga toxins (Stxs), which are some of the most important virulence factors in STEC. Stxs contribute to life-threatening hemolytic uremic syndrome (HUS), which develops in considerable proportions of patients with STEC infections. Understanding the antibiotic resistance profiles of STEC isolates and the Stx induction potential of promising antibiotics is essential for evaluating any antibiotic treatment of STEC. In this study, 42 O157:H7 or non-O157 STEC isolates (including the “big six” serotypes) were evaluated for their resistance against 22 antibiotics by using an antibiotic array. Tigecycline inhibited the growth of all of the tested STEC isolates and also inhibited the production of Stxs (Stx2 in particular). In combination with neutralizing antibodies to Stx1 and Stx2, the tigecycline-antibody treatment fully protected Vero cells from Stx toxicity, even when the STEC bacteria and the Vero cells were cultured together. The combination of an antibiotic such as tigecycline with neutralizing antibodies presents a promising strategy for future STEC treatments.     

Characteristics and association with disease of two major subclones of Shiga toxin (Verocytotoxin)-producing strains of Escherichia coli (STEC) O157 that are present among isolates from patients in Germany

Shiga toxin (Verocytotoxin) producing E. coli (STEC) O157 were isolated from 168 patients living in different parts of Germany. Most isolates were from sporadic cases and seven small outbreaks with STEC O157 were identified. The 168 strains were examined for phenotypic and genotypical traits in order to identify major types of STEC O157 occurring in Germany. Phage typing (PT) revealed PT8 (n = 54) and PT2 (n = 48) strains as most frequent (60.7%) among the isolates. Carriage of the stx(2) gene by STEC O157 was closely associated with hemolytic uremic syndrome (100%) and with bloody diarrhea (61.7%). The stx(2) gene was frequent in PT88, PT47 (both 100%), PT2 (91.5%) and PT4 (87.5%) strains and more rarely (33.3%) found in strains belonging to the other PTs. PT8 and PT2 strains formed two groups which differed from each other in their motility, stx-genotypes and the severity of the illness they caused. Pulsed-field gel electrophoresis of PT2 and PT8 strains and hybridization of XbaI digested DNA with stx(1) and stx(2) specific gene probes revealed similarities among epidemiologically unrelated strains belonging to the same PT. The results indicate that STEC O157 PT2 and PT8 strains form two distinct subclones which are dominating in Germany and other European countries.