山东省腹泻病人携带耶尔森菌HPI毒力岛大肠杆菌的调查

目的 了解携带耶尔森菌HPI毒力岛的大肠杆菌的易感人群、感染率、临床症状、分离率。方法 对4个医院1997年6～11月就诊泻患者，进行流行病学调查并收集大便标本，进行细菌分离和鉴定。结果 在671例腹泻病人中，共检出20个属种449株致病毒，志贺菌检出率为25.48%，致泻性大肠杆菌为15.05%,对于176株疑似产志贺样毒素且具侵袭大肠杆菌(ESIEC)菌株采用irp-2、irp-B基因探针进行菌落原位杂交，检出42株携带HPI毒力岛的大肠杆菌。与42株携带HPI毒力岛的大肠杆菌相关的腹泻病人所表现的临床症状为食欲不振、腹痛、腹泻、寒战、乏力、体温正常或低热，粪例多为粘液便或水样便，日腹泻次数超过6次以上者为33例，占78.57%。各年龄组均有感染，10岁以下儿童为主，占33.33%.结论 自671例腹泻病人的粪便标本中,分离到的志贺菌占首位,致泻性大肠杆菌次之;在致泻性大肠杆菌以携带耶尔森菌HPI毒力岛的大肠杆菌为主(6.26%)。

Study on diarrhea disease and Escherichia coli strains harboring HPI pathogenicity island of Yersinia enterolitica in Shandong province

OBJECTIVE: It was found that some E. coli strains previously identified as entero SLTs-producing and invasive E. coli (ESIEC), harboring HPI pathogenicity island of Yersinia enterolitica. This research was designed to reveal prevalence, susceptible group and clinical features it caused. METHODS: All of the diarrhea patients were from the out-patient units of four hospitals in Shandong province from June to November of 1997. Stool specimen were collected before administration of antibiotics for isolation of enteric bacterial pathogen. Clinical symptoms were recorded at the same time. RESULTS: A total number of 449 enteric pathogenic bacteria strains were detected among stool samples from 671 patients, with isolation rates of Shigella species and diarrheagenic E. coli 25.48% and 15.05% respectively. When irp-2 and ipaB gene fragments were used as DNA probes, 42 of 176 un-identifiable strains were found irp-2(+) and ipaB(-), which were identified as HPI-harboring E. coli. Typical symptoms of the diarrhea caused by HPI-harboring E. coli were described as mild, including abdominal pain, shiver and vapidity. Temperature of the patients was usually normal. Over 6 times of bowel movements per day was frequently observed, of which most were unformed stools with mucous. CONCLUSION: HIP-harboring E. coli was an important diarrheagenic pathogen identified from 671 patients with diarrhea. Shigella was found to be the majority strain.