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目的 调查大肠埃希菌O15 7∶H7感染性腹泻的分布特征、临床特点及家畜、家禽的带菌状况和外环境污染程度。方法 用现患调查方法 ,描述大肠埃希菌O15 7∶H7感染性腹泻的发病情况 ,分析引起流行的原因 ,用O15 7特异性筛查方法进行病原体分离培养 ,应用分子生物学、微生物学、细胞学技术进行病人、家畜、家禽的病原学分离、培养、毒素因子测定。结果 睢县是河南省首先发现的疫区 ,从 3月 17日至 7月 6日共发生病人 35例 ,合并急性肾功能衰竭 32例 ,死亡 2 8例 ,病死率 87.5 0 % ,6 0岁以上发病占 91% ;从家畜、家禽分离出 10 7株O15 7∶H7菌株 ,从腹泻病人中分离出4 8株 ;微生物学、分子生物学及细胞学技术鉴定 6 7株具有毒素基因 ;显示有 5个毒素因子组合型。结论 大肠埃希菌O15 7∶H7感染性腹泻并发急性肾功能衰竭是病人死亡的主要原因 ,家畜、家禽的高带菌率可通过污染水、食物传染给人 ,亦可通过蝇和日常生活接触感染。睢县疫情是一起大肠埃希菌O15 7∶H7感染引起的溶血性尿毒综合征的爆发
Objective To investigate the distribution and clinical characteristics of Escherichia coli O15 7:H7 infectious diarrhea and the infection status of domestic animals and poultry and the external pollution. Methods The prevalence of Escherichia coli O15 7:H7 infectious diarrhea was described by the prevalence survey method. The cause of epidemic was analyzed. The pathogen was isolated and cultured by O15 7 specific screening method. The molecular biology, microbiology, Cytology of patients, livestock, poultry etiology separation, culture, toxin factor determination. Results Shexian County was the first endemic area found in Henan Province. From March 17 to July 6, 35 patients were enrolled. Among 32 patients with acute renal failure, 28 were fatal, with a mortality rate of 87.5% and 60 years The above pathogens accounted for 91%. 107 strains of O15 7:H7 were isolated from livestock and poultry and 48 strains were isolated from diarrhea patients. Sixty-seven strains of toxins were identified by microbiology, molecular biology and cytology. There are 5 combinations of toxin factors. Conclusions Escherichia coli O15 7:H7 infectious diarrhea complicated with acute renal failure is the main cause of death of the patients. The high carrier rate of domestic animals and poultry can be transmitted to humans through contaminated water and food, and can also be infected through flies and daily life . Yudai outbreak is an outbreak of hemolytic uremic syndrome caused by Escherichia coli O15 7:H7 infection