本文選題：大腸桿菌　切入點(diǎn)：血清型　出處：《重慶醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 目的:分析腸道致病大腸桿菌導(dǎo)致腸外感染的細(xì)菌學(xué)特征以及臨床表現(xiàn)。 方法:以我院2006—2009年臨床分離的227株腸外致病大腸桿菌(Extraintestinal Pathogenic E.coli,ExPEC)為研究對(duì)象。用常見腸內(nèi)致病的腸產(chǎn)毒性大腸桿菌(ETEC)、腸侵襲性大腸桿菌(EIEC)、腸致病性大腸桿菌(EPEC)、腸出血性大腸桿菌(EHEC)的“OK”診斷血清,對(duì)上述227株臨床分離的ExPEC進(jìn)行鑒定,發(fā)現(xiàn)腸道致病大腸桿菌。然后用PCR進(jìn)行基因分型和檢測(cè)腸道致病大腸桿菌的毒力基因,同時(shí)用PFGE比較部分患者ExPEC與該患者腸內(nèi)大腸桿菌的同源性,并結(jié)合臨床資料分析臨床特征。 結(jié)果:在227株ExPEC中,有34株(20株ETEC, 14株EPEC)腸道致病大腸桿菌。PCR基因分型:A型30株,B1型3株,B2型1株。34株腸道致病大腸桿菌的株毒力基因攜帶率:ETEC的毒力基因陽(yáng)性率各為lt 25%、st50%、st/lt20%;EPEC的毒力基因bfpA 71.42%,eaeA 61.42%,eaeA/bfpA 28.57%。PFGE分型:兩例敗血癥患者血培養(yǎng)的大腸桿菌與該患者糞便中分離出的大腸桿菌PFGE分型一致,兩患者均有發(fā)熱、腹瀉,血WBC和中性粒細(xì)胞異常升高。 結(jié)論:腸內(nèi)致病大腸桿菌血清型能夠引起臨床腸外感染,但所占比例相對(duì)較少,且主要為ETEC和EPEC血清型,高齡伴有多基礎(chǔ)疾病的住院患者是其感染的高危人群。ETEC感染的敗血癥患者,其來(lái)源可能是患者腸道致病大腸桿菌的移位所致。
[Abstract]:Objective: to analyze the bacteriological characteristics and clinical manifestations of intestinal pathogenic Escherichia coli. Methods: 227 strains of Escherichia coli isolated from 2006 to 2009 in our hospital were studied. The enterotoxigenic Escherichia coli (ETEC), enteroinvasive Escherichia coli (EIEC), enteropathogenic Escherichia coli (E.coli) and enteroectasis were used. The "OK" diagnostic serum of EHEC, Two hundred and two hundred and twenty-two strains of clinical ExPEC were identified and the pathogenic Escherichia coli was found. Then the genotyping and virulence genes of enteric pathogenic Escherichia coli were detected by PCR. At the same time, PFGE was used to compare the homology between ExPEC and Escherichia coli in some patients, and to analyze the clinical characteristics with clinical data. Results: among 227 ExPEC strains, Enteric pathogenic Escherichia coli. PCR genotyping: 30 strains of type A, 30 strains of B 1 strain, 3 strains of B 2 strain. 34 strains of intestinal pathogenic Escherichia coli have virulence gene carrying rate. The virulence gene positive rate of 10% ETEC is the virulence base of EPEC. Because of the typing of bfpA 71.42 and A61.42, the blood culture Escherichia coli of two patients with septicemia was the same as the Escherichia coli PFGE isolated from the feces of the patients. Both patients had fever, diarrhea, abnormal elevation of WBC and neutrophil. Conclusion: the serotype of enteropathogenic Escherichia coli can cause clinical extraintestinal infection, but the proportion is relatively small, and the main serotypes are ETEC and EPEC. Elderly inpatients with multiple underlying diseases are septicemia patients with high risk of infection. ETEC infection may be caused by the translocation of pathogenic Escherichia coli in the intestinal tract of the patients.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R378;R515

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