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

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EHECO157脂多糖（LPS）为抗原，对采集自42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21份，阳性率50.0%；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26.2%；检测到IgG或IgM抗体阳性的标本26份，阳性率61.9%，EHECO157LPS的检测发现，24份标本分别检测到IgG和IgM抗体，阳性率各为57.1%；在29份标本中检测到IgG或IgM抗体，阳性率69.0%;在20份标本中检测到IgG和IgM抗体，阳性率47.6%，在42份血清标本中同时检测到EHEC-Hly和O157LPS的特异性抗体的标本22份，阳性率52.4%；检测到EHEC-Hly或O157LPS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EHECO157：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EHECO157LPS的特异性抗体，不失为一种可以考虑的诊断方法。

Serological investigations on patients with hemolytic uremic syndromes due to enterohemorrhagic Escherichia coli O157:H7 infection

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. CONCLUSIONS: 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.