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目的 探讨携带毒力岛大肠杆菌 (HPIEC)在小儿腹泻中的病原学地位。方法 采用PCR扩增和菌落原位杂交检测HPIEC irp2毒力岛基因 ,并用血清学分型和聚合酶链反应 (PCR)法检测各类致泻大肠杆菌。结果 从 10 32例腹泻患儿粪便中分离出 6 5 2株大肠杆菌 ,经血清学和PCR毒力基因分型 ,检出各类致泻大肠杆菌 2 2 5株 ,其中肠致病性大肠杆菌 (EPEC) 2 0株 ,ETEC 81株 ,产志贺样毒素大肠杆菌 (SLTEC) 4 7株 ,产志贺样毒素侵袭性大肠杆菌 (ESIEC) 74株 ,产毒素大肠杆菌 (EIEC)3株。所有致泻大肠杆菌和未能分型的普通大肠杆菌株 ,再用HPIEC irp2探针作菌落原位杂交 ,共检出携带毒力岛大肠杆菌 (HPIEC irp2 ) 112株 ,总阳性率为 17 2 %。其中 41株是从致泻大肠杆菌ESIEC(2 4/ 74)和SLTEC(17/ 47)中检出。携带毒力岛大肠杆菌性小儿腹泻的主要临床表现为食欲不振(87 5 % )、腹痛 (5 8 0 % )、腹泻 (>6次 /d ,75 9% )、发热 (5 0 9% )、以粘液便为主 (6 9 6 % )。结论 携带毒力岛大肠杆菌是引起小儿腹泻的重要病原菌之一。
Objective To investigate the etiological status of HPIEC carrying children in children with diarrhea. Methods PCR amplification and colony in situ hybridization were used to detect the virulence island genes of HPIEC irp2, and various types of diarrheal Escherichia coli were detected by serological typing and polymerase chain reaction (PCR). Results A total of 652 strains of Escherichia coli were isolated from the faeces of 10 32 children with diarrhea. Serological and PCR virulence genotyping revealed that 225 strains of various diarrheal Escherichia coli strains were isolated. 20 strains of EPEC, 81 strains of ETEC, 47 strains of Shiga-like toxin-producing Escherichia coli (SLTEC), 74 strains of Shiga-like toxin-invasive Escherichia coli (ESEC) and 3 strains of toxin-producing Escherichia coli (EIEC) All the E.coli strains and normal E.coli strains that could not be typed, and then using HPIEC irp2 probe for colony in situ hybridization, a total of 112 harboring HPIEC irp2 were detected, the total positive rate was 17 2 %. Of these, 41 were detected from the digestive Escherichia coli ESIEC (24/74) and SLTEC (17/47). The main clinical manifestations of E. coli-borne diarrhea carrying virulent island were loss of appetite (87.5%), abdominal pain (58.0%), diarrhea (> 6 times / d, 75.9% , Mainly mucus (696%). Conclusion Escherichia coli carrying virulent island is one of the important pathogenic bacteria in children with diarrhea.