CAJ | 학술논문

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月就诊腹泻患者，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株致病菌，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力大肠杆菌(ESIEC)菌株采用irp-2、ipaB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，粪便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；在致泻性大肠杆菌中以携带耶尔森菌HPI毒力岛的大肠杆菌为主(6.26%)。
목적　료해휴대야이삼균HPI독력도적대장간균적역감인군、감염솔、림상증상、분리솔。방법　대4개의원1997년6～11월취진복사환자，진행류행병학조사병수집대편표본，진행세균분리화감정。결과　재671례복사병인중，공검출20개속충449주치병균，지하균검출솔위25.48%，치사성대장간균위15.05%，대우176주의사산지하양독소차구침습력대장간균(ESIEC)균주채용irp-2、ipaB기인탐침진행균락원위잡교，검출42주휴대HPI독력도적대장간균。여42주휴대HPI독력도적대장간균상관적복사병인소표현적림상증상위식욕불진、복통、복사、한전、핍력，체온정상혹저열，분편다위점액편혹수양편，일복사차수초과6차이상자위33례，점78.57%。각년령조균유감염，10세이하인동위주，점33.33%。결론　자671례복사병인적분편표본중，분리도적지하균점수위，치사성대장간균차지；재치사성대장간균중이휴대야이삼균HPI독력도적대장간균위주(6.26%)。
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 identifed from 671 patients with diarrhea. Shigella was found to be the majority strain.