肠出血性大肠杆菌与国境卫生检疫

德国近期的溶血性尿毒症(HUS)疫情引发关注,报告的有肠出血性大肠杆菌O104:H4感染的确诊或疑似病例2000余例,除德国外,奥地利、捷克、丹麦、法国、荷兰、挪威、西班牙、瑞典、瑞士、英国、美国等13个国家也报到了输入性肠出血性大肠杆菌感染病例或其严重并发症——溶血性尿毒综合征病例,全球数以百计的患者确诊感染,多名病例死亡。研究者发现,造成此次肠出血性大肠杆菌疫情的病菌"是常见的肠出血性大肠杆菌的一个非常远的远亲"。它大约80%的基因来自血清型为O104型的大肠杆菌,其余20%的基因来自另外一种大肠杆菌。这一新组合有利于病菌在肠细胞上附着,从而使其能在肠道内宿居更长时间,造成更大的破坏。此外,这种病菌还对抗生素具有很强的抗药性,研究人员已经发现该菌株携带氨基糖甙类、大环内酯类及磺胺类抗生素的耐药基因,对目前已知的绝大多数抗生素药物耐药,导致感染者几乎无药可医。肠出血性大肠杆菌感染疫情大规模蔓延的潜在危险给全球公共卫生事业和我国国境卫生检疫工作带来了巨大的威胁和挑战。如何正确的看待此次肠出血性大肠杆菌感染疫情带来的挑战,加强预警,防范于未然,进一步完善国境卫生检疫工作的手段,提高科技含量,满足《国际卫生条例(2005)》对卫生检疫核心能力建设提出的要求,力争做到对输入性病例包括肠出血性大肠杆菌在内的新发传染病早发现、早处置、早治疗、早隔离,保障国内人民身体健康,是值得每一个检疫工作者思考的问题。

Enterohemorrhagic Escherichia Coli (EHEC) and frontier health quarantine

The outbreak of hemolytic- uremic syndrome （HUS） in Germany has come to people＇s attention. The confirmed and suspected cases of EHEC O104：H4 infections are reported over 2,000. Except Germany, another 13 countries, including Austria, Czech, Denmark, French, Holland, Norway, Spain, Sweden, Switzerland, the UK, the US, etc, have also reported some imported cases of EHEC infection or serious complications of hemolytic uremic syndrome. Globally, hundreds of people have been confirmed infected, and many sufferers have dead. Re- searchers have found that, the pathogen which caused the outbreak of EHEC is ＂a very distant relative of common EHEC＂. Eighty percent of its gene is from Serotype O104 of EHEC, the left twenty percent is from another EHEC. This new combination will help the pathogen latch onto the enterocyte, thus wreak more havoc by longer remaining in the intestines. Moreover, this kind of pathogen has a strong drug resistance to antibiotics. Researchers have found that this strain is genetically drug -resistant to aminoglycosides antibiotics, macrolides antibiotics and sulfon- amides antibiotics. Roughly, it＇s drug- resistant to most antibiotics currently known, so there are few drugs that can be used on the sufferers. The outbreaks of EHEC infection may spread widely. This kind of potential danger has become a big challenge and threat to global public health and the frontier health and quarantine work of our country. How to correctly face the challenge of this outbreak？ How to strengthen early warning and nip the outbreak the core capacity building of the health and quarantine work？ How to ensure sufferers of emerging infectious disea- ses, including imported cases, like EHEC, get early detection, early disposal, early treatment and early isolation？ All these questions are worthy of every quarantine participator＇s consideration.