人-猪土生克雷伯菌感染综合征研究

A Study on Human Klebsiella Terrigena Infectious Syndrome Caused by Infected Pigs

目的 描述人-猪土生克雷伯菌感染综合征临床表现,探讨病原特征以及感染来源。方法 观察8例不明原因急性感染中毒休克综合征患者,用多种培养基进行病原菌分离培养,菌种鉴定,动物实验,DNAG +C %mol含量测定,药物敏感性试验等方法,确定8例患者引起感染的病原体;用流行病学方法调查感染来源。结果 人-猪土生克雷伯菌感染综合征临床表现:发热、呕吐、心慌、呼吸困难、腹痛、腹泻、昏迷、休克、皮肤呈玫瑰红瘀点、瘀斑,主要分布在四肢、头面部及胸部;从患者血液,死猪肉中分离5株细菌,其形态学、生理特征、毒力试验、细菌DNAG +C %mol含量测定、药物敏感性试验结果均为一致,证实为土生克雷伯菌肺炎亚种;动物实验表明:此菌株引起动物的症状和人的临床表现一致。结论 8例不明原因急性感染中毒休克综合征病原体是土生克雷伯菌肺炎亚种;经流行病学调查表明:此疾病感染来源是病、死猪,病牛。

Objectives To demonstrate the clininal manifestations of Klebsiella terrigena infectious syndrome and the characteristics of causative organism and its source. Methods 8 case of food poisoning were identified in the central area of Jiangyou city,China in September 2003.Biological specimens were collected from some patients,and the causative organism was isolated using a number of different culture media.Isolated organisms were identified by serum antibody tests,API biochemical tests,drug sensitivity tests,DNA G+C%tests and animal model experiments.Epidemiological methods were applied to trace the source of causative organisms. Results Five strains of klebsiella terrigena were isolated respectively from the blood and the corpse of infected pigs.Animal model experiment showed that these strains were sensitive to rats and pigs. Conclusions The aetiological agent of these patients is identigied as Klebsiella terrigena subspecies terrigena.Patiento are contaminated by direct contact with the infected pigs.