大肠杆菌O157的致病性:1例大肠杆菌O157∶NM和副溶血性弧菌的重叠感染  

A CASE REPORT OF COINFECTION OF ESCHERICHIA COLI O157:NM AND VIBRIO PARAHAEMOLYTICUS

作　　者：潘劲草[1] 孟冬梅[1] 黄诚孝[1] 邓晶[1] 

机构地区：[1]杭州市卫生防疫站,杭州310006

出　　处：《中国人兽共患病杂志》1999年第5期64-66,共3页Chinese Journal of Zoonoses

摘　　要：目的　探讨从杭州一急性腹泻患者粪便中分离的大肠杆菌 Ｏ１５７∶ Ｎ Ｍ 的致病性。方法对一重叠感染大肠杆菌 Ｏ１５７∶ Ｎ Ｍ 和副溶血性弧菌的急性腹泻患者，调查其临床表现及相关流行病学资料， 同时对分离菌株进行生化特性分析、血清学鉴定、毒力试验等， 并采集发病后第４ 、１８ 天血清与分离菌株试管定量凝集试验， 检测其特异性抗菌抗体。结果　菌株２６ － １ 为大肠杆菌 Ｏ１５７∶ Ｎ Ｍ， Ｖｅｒｏ 毒素阴性， 未携６０ Ｍ Ｄａ 质粒， Ｅ Ｈ Ｅ Ｃ 溶血素基因阴性： 菌株２６ － ２ 为副溶血性弧菌， 为强毒株。患者第４ 、１８ 天血清与分离菌株未见凝集阳性反应。结合临床表现和流行病学资料， 考虑诊断该病例为急性副溶血性弧菌肠炎。结论　我国人群和家畜肠道中可能存在一类致病性不明或非致病性的大肠杆菌 Ｏ１５７ 菌株； Ｅ Ｈ Ｅ Ｃ 的鉴定应重视毒力因子的检测， 同时亦不能忽视患者是否有其它肠道病原体的重叠感染。AimTo understand the pathogenesis of a strain of Escherichia coli O157∶NM isolated from an acute diarrea patient in Hangzhou.MethdosThe clinical symptoms and epidemiology data of an acute diarrhea patient coinfected with E coli O157∶NM and Vibrio parahaemolyticus were investigated.Both strains were tested for biochemical characteristic,serotype and virulence.The patient sera,collected at the 4th and 18th days after onset of disease,were detected for specific antibodies by tube quantitative agglutination test.ResultsStrain 26-1 was identified as E coli O157:NM without Vero toxin or EHEC entero hemolysin gene;the strain 26-2 was identified as V parahaemolyticus with strong toxicity.Any agglutinating reaction was not found between the strains and the patient sera collected at the 4th and 18th days after onset of disease.According to the clinical symptoms and epidemiology data,the case was diagnosed as acute V parahaemolyticus colitis.ConclusionThere may be a group of E coli O157 in the intestines of population and domestic animals in China,whose pathogenesis has not been proved.In identification of EHEC,the detecting for virulence is necessary,and it should be also paid attention to whether there is any coinfection with other enteric pathogen.

关 键 词：大肠杆菌 O157:NM 副溶血性弧菌 重叠感染 

分 类 号：R516.02[医药卫生—内科学] R378[医药卫生—临床医学]