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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。
Objective To investigate the pathogenicity of Escherichia coli O157: N M isolated from feces of an acute diarrhea patient in Hangzhou. Methods Acute diarrhea patients with Escherichia coli O157: N M and Vibrio parahaemolyticus were inoculated to investigate their clinical manifestations and epidemiological data. Meanwhile, biochemical analysis, serological test and virulence test were performed on the isolates , And collect the quantitative agglutination test of serum and isolates from the 4th and 18th days after onset, and detect their specific antibacterial antibodies. Results The strain 26-1 was Escherichia coli O157: N M, negative to Vero toxin, carrying no 60 M Da plasmid. The negative for EH E C hemolysin was strain 26-2, which was a virulent strain of Vibrio parahaemolyticus. On the 4th and 18th days, there was no agglutination positive reaction in serum and isolates. Combined with clinical manifestations and epidemiological data, consider the diagnosis of acute Vibrio enteritis. Conclusion There may exist a group of pathogenic E. coli O157 strains in the intestinal tract of Chinese population and livestock. The identification of E H E C should pay attention to the detection of virulence factors, and it should not be ignored whether the patients have other intestinal Over-infection of pathogens.