浙江省首株产志贺毒素大肠埃希菌0157：H7的分子生物学特性研究

目的：了解自浙江省杭州市腹泻婴儿中分离的1株大肠埃希菌O157：H7（HZI-11株）的分子生物学特性。方法：应用ATB1525细菌半动化生化鉴定系统鉴定菌种。应用0157特异性抗血清玻片凝集试验、H7特异性抗血清试管凝集试验、以及PCR检测O抗原特异性rfbE基因和H7特异性fliC基因，进行菌株血清型的鉴定。应用多重Real-time PCR和常规PCR检测stx1、stx2、hly和eae毒力基因。对菌株进行脉冲场凝胶电泳（PFGE）分型，并与国内代表菌株进行比较。ATB1525药敏检测仪和纸片法检测菌株的抗药性。结果：细菌生化鉴定为大肠埃希菌，山梨醇阴性。血清型为O157：H7。毒力基因stx2、hly和eae均阳性，stx1阴性。PFGE谱带同江苏分离O157：H7菌株几乎完全相同，带型的相似度为97％。结论：该菌株为浙江省首株产志贺毒素大肠埃希菌（STEC）O157：H7。与国内近年在江苏等地流行的STEC O157：H7菌株密切相关。STEC O157：H7已开始对浙江地区的人民健康构成了威胁。     

大肠埃希菌O157∶H7携带stx2::IS1203v基因研究

目的了解中国部分地区大肠埃希菌O157：H7菌株携带志贺毒素基因变异状况。方法采用聚合酶链反应扩增志贺毒素基因，使用核苷酸序列测定判断是否存在志贺毒素的新变种，用HeLa细胞毒性实验研究其细胞毒性的变化。结果1992—2002年中国部分地区分离到的289株产志贺毒素的大肠埃希菌O157：H7中有3株菌携带的志贺毒素2（stx2）基因有1．3kb的插入序列（IS）插入，且这段IS和IS1203变种（IS1203 variant，IS1203v）有100％的核苷酸序列同源性。IS1203v插入到3株大肠埃希菌O157：H7 stx2基因的位置及开放性读码框（ORF）方向有所不同。除此之外，3株菌原有的stx2基因序列完全一致且为Stx2原型毒素。和Stx2原型毒素相比，这3株携带stx2：：IS1203v基因的菌株对HeLa细胞的毒性明显降低。结论分离到IS1203v插入stx2基因的大肠埃希菌O157：H7菌株；IS1203v的插入可导致对HeLa细胞的细胞毒性降低。     

大肠埃希菌O157:H7嵌合荧光RAM检测分析

目的建立大肠埃希菌O157：H7的嵌合荧光法（SYBR Green I）实时网状分枝扩增（RAM）检测技术.方法将产志贺样毒素大肠埃希菌O157：H7靶基因递比稀释确定SYBR Green I实时RAM的灵敏度,并进一步检测临床分离的菌株.结果SYBR Green I实时网状分枝扩增技术最低能检测10个产志贺样毒素大肠埃希菌O157：H7,检测信号出现的时间与靶基因的浓度成正比,临床分离3株产志贺样毒素大肠埃希菌O157为阳性,而非致病性大肠埃希菌为阴性.结论SYBR Green I实时RAM是一种快速、灵敏、准确、实时、环保的检测大肠埃希菌O157：H7的新核酸扩增技术.     

大肠埃希菌O157血清型分离株的脉冲场凝胶电泳分型

目的了解杭州地区分离的产志贺毒素和不产志贺毒素大肠埃希菌O157菌株的分子流行病学特征。方法对杭州地区于1997～2005年间自散发腹泻患者和动物中分离的10株大肠埃希菌O157血清型菌株,PCR检测毒力基因stx1、stx2、eae和ehxA,eae阳性者进行eae基因分型;按标准化的脉冲场凝胶电泳法(pulsefieldgelelectrophoresis,PFGE)进行分子分型,并与国内其他省份分离的产志贺毒素大肠埃希菌(Shigatoxin_producingEscherichiacoli,STEC)O157∶H7菌株进行比较。结果杭州分离菌株HZ1_11携带毒力基因stx2、γ型eae和ehxA,为浙江省检获的首株STECO157∶H7;3株杭州O157∶NM分离菌株(2_1、26_1和SR05株)仅携带β型eae基因;其他6株杭州O157∶H?分离菌株中,均未检出毒力基因。PFGE揭示,在杭州人源O157菌株中,STECO157∶H7HZ1_11株与近年江苏和安徽分离STECO157∶H7菌株密切近缘,且其图谱与江苏菌株几乎完全相同;3株eae阳性的O157∶NM分离菌株聚类成与STECO157∶H7菌株较远的一簇,杭州1株stx阴性的O157∶H?(1_68株)则处于另一独立的一簇。5株杭州O157∶H?动物分离菌株与其他人源菌株图谱差异极大。结论浙江省首株STECO157∶H7可能是源自近年在江苏流行的STECO157∶H7菌株。β型eae阳性的大肠埃希菌O157∶NM菌株可能具有引起散发腹泻的能力。     

浙江省首株产志贺毒素大肠埃希菌O157:H7的分子生物学特性研究

目的:了解自浙江省杭州市腹泻婴儿中分离的1株大肠埃希菌O157:H7(HZ1-11株)的分子生物学特性.方法:应用ATB1525细菌半动化生化鉴定系统鉴定菌种.应用O157特异性抗血清玻片凝集试验、H7特异性抗血清试管凝集试验、以及PCR检测O抗原特异性rfbE基因和H7特异性fliC基因,进行菌株血清型的鉴定.应用多重Real-timePCR和常规PCR检测stx1、stx2、hly和eae毒力基因.对菌株进行脉冲场凝胶电泳(PFGE)分型,并与国内代表菌株进行比较.ATB1525药敏检测仪和纸片法检测菌株的抗药性.结果:细菌生化鉴定为大肠埃希菌,山梨醇阴性.血清型为O157:H7.毒力基因stx2、hly和eae均阳性,stx1阴性.PFGE谱带同江苏分离O157:H7菌株几乎完全相同,带型的相似度为97%.结论:该菌株为浙江省首株产志贺毒素大肠埃希菌(STEC)O157:H7,与国内近年在江苏等地流行的STECO157:H7菌株密切相关.STEC O157:H7已开始对浙江地区的人民健康构成了威胁.     

产志贺毒素大肠杆菌毒力基因检测

目的 分析河南省2000～2002年分离的351株与产志贺毒素大肠菌(STEC)感染有关的菌株，了解不同来源标本各种毒素基因携带模式。方法 应用多重PCR技术，检测所有菌株志贺毒素(stx1和stx2、hlyA、eaeA、rfbO111和rfbO157基因。结果 351株待检菌株分为枸橼酸杆菌、O157：H7大肠杆菌、rfbO157基因阳性不携带志贺毒素基因的大肠杆菌和rfbO157基因阴性携带志贺毒素基因的大肠杆菌4种不同类型。4种类型菌株具有6种rebO157、stx2、stx1基因模式。携带志贺毒素基因的菌株主要源自波尔山羊、普通本地羊和病人，其它家畜家禽中有不同程度感染STEC。结论 河南省存在STEC的感染．主要以O157：H7大肠杆菌为主，但也存在其它非O157的STEC。     

中国部分地区大肠埃希菌O157的分子分型及变异研究

目的了解出血性大肠埃希菌（EHEC）O157的分子流行特征和遗传变异关系并完善EHECO157：H7感染性腹泻监测制度。方法采用聚合酶链反应分析毒力基因的分布情况；用脉冲场凝胶电泳技术对1988-2005年部分地区分离到的249株EHECO157：H7（其中产志贺毒素的245株，不产志贺毒素的4株）和51株O157非H7进行分子流行病学分析。结果stx2基因在我国的EHECO157：H7菌株中有着很高的分布率，部分菌株携带stx2基因变种。300株O157共分为161种带型，其中51株O157非H7菌株共有42种带型，4株O157：H7非产毒株分别为4种带型，245株EHECO157：H7共有115种带型。结论EHECO157间的基因变异较大；产stx2原毒素的菌株和5衄2毒素发生变异的菌株带型相差较大。部分菌株之间存在着一定的交叉，说明虽然这两大类菌株有其特有的流行克隆系，但是它们的克隆系之间亲缘关系较近。     

产志贺样毒素大肠埃希菌Ⅰ类整合子的鉴定和分析

目的阐明各种来源的产志贺样毒素大肠埃希菌(Shiga toxin-producing E. coli,STEC)中I类耐药整合子的分布、特征、所含基因盒的状况以及所表达的耐药信息.方法常规分离出大肠埃希菌、血清学分型,PCR法鉴定产stx1-2毒素性菌株;纸片扩散法对17种抗菌药物进行耐药性监测和分析;PCR法鉴定I类整合子阳性株;PCR产物测序并对结果进行分析.结果各种标本中共鉴定出46株产志贺样毒素大肠埃希菌,其中23株为O157:H7;全部STEC对复方新诺明耐药,对链霉素耐药率为28.3%,氨苄西林为30.4%,而且有5株对至少＞4种抗菌药物多重耐药,耐药谱为复方新诺明-链霉素-氨苄西林-庆大霉素;46株分离株中有11株(23.9%)鉴定出I类整合子,PCR产物测序得知9株携带aadA1基因盒,2株携带aadA2基因盒,均来自氨基糖苷类抗菌药物耐药菌株(39.3%),传递对氨基糖苷类抗菌药物的耐药性.结论I类整合子存在于各种来源的产志贺样毒素大肠埃希菌中,并携带相应的基因盒,决定着对氨基糖苷类抗菌药物的耐药性.     

2007年浙江省衢州地区动物中产志贺毒素大肠埃希菌O157:H7感染状况

目的:了解2007年浙江省衢州地区产志贺毒素大肠埃希菌O157:H7在动物中的分布情况及其耐药性、PFGE分型及毒力基因携带状况。方法:按全国O157:H7监测方案于5~10月份肠道传染病高发季节,在衢州地区采集各种动物粪便/肛拭,用免疫磁珠富集后进行O157:H7分离培养、鉴定,可疑菌株以PCR法检测O、H抗原及志贺样毒素(SLT1和SLT2)、粘附抹平因子(eaeA)及溶血素(hly)4种毒力基因。用脉冲场凝胶电泳(pulse field gel electrophoresis,PFGE)方法进行同源性分析,同时选择14种抗生素进行药敏试验,分析分离所得菌株的耐药状况。结果:共监测动物粪便标本300份,分离得产志贺毒素大肠埃希菌O157:H7菌株16株,分离率为5.33%。16株O157:H7菌株,毒力基因Hly、eaeA、SLT2均阳性,SLT1均阴性。脉冲场凝胶电泳分型显示,16株O157:H7菌株可分2个PFGE基因型,型间差异较小。耐药性分析显示这些菌株对红霉素、利福平的耐药率最高,达100.0%,对其他受试抗生素均敏感。结论:该地区动物中产志贺毒素大肠埃希菌O157:H7带菌率较高,所分离菌株主要携带SLT2基因,因此推测该地区存在发生产志贺毒素大肠埃希菌O157:H7感染暴发或流行的潜在危险,需增加对动物源性O157:H7的监测力度。     

2000～2005年海盐县肠出血性O157:H7大肠埃希菌监测

目的：了解海盐县肠出血性O157：H7大肠埃希菌的分布及流行情况。方法：采取肠道门诊病人肛拭样和动物宿主粪便，采用免疫磁珠分离和大肠杆菌O157特异性单克隆抗体胶体金快速诊断技术以及特定培养基分离鉴定技术检测O157：H7大肠埃希菌。结果：从1例腹泻患者的大便中检了了1株O157：H7大肠埃希菌，不产生类志贺毒素；从动物粪便中检出7株O157大肠埃希菌。结论：海盐地区人群中感染率较低，且为非产毒株；猪、鸡是我地区O157：H7大肠埃希菌的主要贮存宿主动物。     

Clonal diversity of Shiga toxin-producing Escherichia coli O103:H2/H(-) in Germany.

Shiga toxin producing Escherichia coli O103:H2/H(-) belong to the third most frequently isolated EHEC serotypes in Germany following isolates of O157:H7/H(-) and O26:H11/H(-). A total of 145 respective E. coli 103 isolates from single cases of diarrhoea and haemolytic uremic syndrome (HUS) in 1997-2000 were characterised by a range of molecular subtyping methods (PFGE, P-gene profiling, ribotyping, electrotyping) and phage typing in order to analyse their genetic relatedness and the practicability for new epidemiological tracing back. All isolates cluster into a distinct EHEC subgroup and reveal a high clonal diversity together with a considerable stability. Since strains of this serotype rank up to the third most frequently isolated EHEC in Germany a large population of this serotype, and therefore, a great supply of such strains may exist in this country.     

Importance of culture confirmation of shiga toxin-producing Escherichia coli infection as illustrated by outbreaks of gastroenteritis--New York and North Carolina, 2005

Escherichia coli O157:H7 and other strains of E. coli that produce Shiga toxin are collectively known as Shiga toxin-producing E. coli (STEC). The current outbreak of STEC O157 infections associated with eating fresh spinach illustrates the importance of obtaining isolates to identify the source of the infections. Laboratory methods that do not require bacterial culture of stool specimens to identify STEC are being used increasingly by clinical diagnostic laboratories, sometimes without subsequent confirmation of a strain by isolating it in culture. This report describes findings from outbreaks of gastroenteritis in 2005 in New York and North Carolina in which clinical diagnostic laboratories initially used only non-culture methods to detect Shiga toxin (Stx). The findings highlight the importance of confirmation of Stx-positive stool specimens by bacterial culture for timely and reliable identification of STEC infections, including E. coli O157 and non-O157 STEC, to enable implementation of appropriate public health actions. An important part of that identification is determining the serotype of all STEC isolates and the subtype of STEC O157 strains so that outbreaks can be detected and traced back to sources.     

徐州市2000年肠出血性大肠埃希菌O157：H7感染性腹泻的调查

目的 了解徐州市丰县和铜山县肠出血性大肠埃希菌（EHEC）O157：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EHECO157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EHECO157：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 2000年5月份，丰县由EHECO157：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27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EHECO157：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EHECO157：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EHECO157：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EHECO157：H7菌株的患者，发生肾功能异常的可能性要比不产生志贺毒素的大，还证实了在该菌感染的初期，患者的肾功能就已经出现了异常。     

Comparison of Escherichia coli Isolates from humans, food, and farm and companion animals for presence of Shiga toxin-producing E. coli virulence markers

The objective of this study was to characterize Escherichia coli isolates from dairy cows/feedlots, calves, mastitis, pigs, dogs, parrot, iguana, human disease, and food products for prevalence of Shiga toxin-producing E. coli (STEC) virulence markers. The rationale of the study was that, isolates of the same serotypes that were obtained from different sources and possessed the same marker profiles, could be cross-species transmissible. Multiplex polymerase chain reaction (PCR) was used to detect presence of genes encoding Shiga toxin 1 and 2 (stx1 and stx2), H7 flagella (flicC), enterohemolysin (hly) and intimin (eaeA) in E. coli isolates (n = 400). Shiga toxin-producing isolates were tested for production of Shiga toxins (Stx1 and Stx2 and enterohemolysin. Of the E. coli O157:H7/H- strains, 150 of 164 (mostly human, cattle, and food) isolates were stx+. Sixty-five percent of O157 STEC produced both Stx1 and Stx2; 32% and 0.7% produced Stx2 or Stx1, respectively. Ninety-eight percent of O157 STEC had sequences for genes encoding intimin and enterohemolysin. Five of 20 E. coli O111, 4 of 14 O128 and 4 of 10 O26 were stx+ . Five of 6 stx+ O26 and O111 produced Stx1, however, stx+ O128 were Stx-negative. Acid resistance (93.3%) and tellurite resistance (87.3%) were common attributes of O157 STEC, whereas, non-O157 stx+ strains exhibited 38.5% and 30.8% of the respective resistances. stx-positive isolates were mostly associated with humans and cattle, whereas, all isolates from mastitis (n = 105), and pigs, dogs, parrot and iguanas (n = 48) were stx-negative. Multiplex PCR was an effective tool for characterizing STEC pathogenic profiles and distinguished STEC O157:H7 from other STEC. Isolates from cattle and human disease shared similar toxigenic profiles, whereas isolates from other disease sources had few characteristics in common with the former isolates. These data suggest interspecies transmissibility of certain serotypes, in particular, STEC O157:H7, between humans and cattle.     

Prevalence of non-O157:H7 shiga toxin-producing Escherichia coli in diarrheal stool samples from Nebraska

We determined the prevalence of Shiga toxin-producing Escherichia coli (STEC) in diarrheal stool samples from Nebraska by three methods: cefixime-tellurite sorbitol MacConkey (CT- SMAC) culture, enterohemorrhagic E. coli (EHEC) enzyme immunoassay, and stx1,2 polymerase chain reaction (PCR). Fourteen (4.2%) of 335 specimens were positive by at least one method (CT-SMAC culture [6 of 14], EHEC enzyme immunoassay [13 of 14], stx1,2 PCR [14 of 14]). Six contained serogroup O157, while non-O157 were as prevalent as O157 serogroups.     

Polymerase chain reaction screening for Salmonella and enterohemorrhagic Escherichia coli on beef products in processing establishments

Pathogenic Escherichia coli strains on raw or insufficiently cooked foods are of public health concern as serious disease may result from their ingestion. Therefore, many commercial producers of beef products screen for E. coli O157:H7 before shipment. While Salmonella is not considered an adulterant on raw beef products, it is used as an indication of process control. To detect these microorganisms, rapid screening methods are often used to provide results within 8-24 hours after sampling. During 2005-2008, about 971,389 samples from several commercial beef production plants were tested using a rapid screening method based on the polymerase chain reaction to determine if they were presumptively positive for bacterial cells carrying Salmonella or Shiga toxin-producing E. coli-specific genes. Of the product lots sampled (trim, ground beef, and variety meats), 15% were positive for the stx(1) and/or stx(2) (Shiga toxin genes), 9.1% for the eae gene (the attaching and effacing gene [eae] encoding intimin), 3.0% for an rfb gene region (encoding the O157-specific O side chain polysaccharide), and 1.67% for Salmonella by the polymerase chain reaction assay. In general, lots of ground beef showed the lowest frequency of contamination, and variety meats (by-products of carcass evisceration), the highest. Overall, 4.6%, 4.6%, and 0.8% samples were screen-positive for enteropathogenic E. coli, enterohemorrhagic E. coli, and E. coli O157, respectively. Of the E. coli O157-positive samples, 14% were also Salmonella positive. The frequency of screen-positive samples increases during the summer months, probably because of the prevalence of climatic conditions more conducive to microbial growth. The presence of fecal organisms in beef products suggests a failure of sanitary controls during processing and the more prevalent relatives of E. coli O157, Shiga toxin-producing Escherichia coli, enteropathogenic E. coli, and enterohemorrhagic E. coli, serve as more sensitive indicators of contamination than O157 strains alone.     

食品标本处理方法对大肠埃希菌检出限影响

目的 研究快速、敏感、低成本的食品标本处理方法。方法 在牛肉馅中接种不同浓度的大肠埃希菌O157：H7，经离心、过滤，去除PCR抑制剂。浓缩菌株，用煮沸法和酶／冻融法裂解菌株，制备模板DNA。通过PCR检测大肠埃希菌O157：H7志贺毒素基因以评价该处理方法的可行性。结果 在未增菌条件下，PCR最低能检测到103CFU／g牛肉馅，增菌6h，最低能检测1CFU／g牛肉馅，整个检测过程只需要12h。结论 所采用的标本处理方法是一种灵敏、省时、低成本的方法，能显著地提高PCR检测食品标本中的大肠埃希菌O157：H7的灵敏度。     

Antimicrobial activity of a combination of Mume fructus, Schizandrae fructus, and Coptidis rhizoma on enterohemorrhagic Escherichia coli O26, O111, and O157 and its effect on Shiga toxin releases

The antibacterial activity of an herbal combination composed of Mume Fructus, Coptidis Rhizoma, and Schizandrae Fructus extracts on enterohemorrhagic Escherichia coli (EHEC) was evaluated in the present study. The combination demonstrated antibacterial activity against all EHEC strains tested in this study, including those resistant to multiple antibiotics; minimum inhibitory concentration values ranged from 0.49 to 31.25?mg/mL. In in vivo antibacterial activity assay, the herbal combination was administered to mice after initial E. coli O157 infection and had significant effects on mouse mortality. The effects of the herbal combination on Shiga toxin release from EHEC O26, EHEC O111, and EHEC O157 strains containing the stx1 and stx2 genes were assessed by the reversed passive latex agglutination method, and there was no increased Shiga toxin release in the strain cultures containing the herbal combination. These results suggested that the herbal combination may be a safe and effective remedy for EHEC inhibition.     

Comparison between human and animal isolates of Shiga toxin-producing Escherichia coli O157 from Australia

There is very little human disease associated with enterohaemorrhagic Escherichia coli O157 in Australia even though these organisms are present in the animal population. A group of Australian isolates of E. coli O157:H7 and O157:H- from human and animal sources were tested for the presence of virulence markers and compared by XbaI DNA macrorestriction analysis using pulsed-field gel electrophoresis (PFGE). Each of 102 isolates tested contained the gene eae which encodes the E. coli attaching and effacing factor and all but one carried the enterohaemolysin gene, ehxA, found on the EHEC plasmid. The most common Shiga toxin gene carried was stx2c, either alone (16%) or in combination with stx1 (74%) or stx2 (3%). PFGE grouped the isolates based on H serotype and some clusters were source specific. Australian E. coli O157:H7 and H- isolates from human, animal and meat sources carry all the virulence markers associated with EHEC disease in humans therefore other factors must be responsible for the low rates of human infection in Australia.