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首页> 外文期刊>Gut: Journal of the British Society of Gastroenterology >Shanghai fever: A distinct Pseudomonas aeruginosa enteric disease
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Shanghai fever: A distinct Pseudomonas aeruginosa enteric disease

机译：上海热：一种独特的铜绿假单胞菌肠病

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Background: Shanghai fever, a community-acquired enteric illness associated with sepsis caused by Pseudomonas aeruginosa, was first described in 1918. The understanding of Shanghai fever is incomplete. Objective: To delineate the clinical features and to examine the host and microbial factors associated with Shanghai fever. Methods: We prospectively enrolled 27 consecutive previously healthy children with community-acquired P aeruginosa enteritis and sepsis between July 2003 and June 2012. An immunological investigation, including measurement of serum immunoglobulin levels and lymphocyte subpopulations, was performed. The clonal relationship of bacterial isolates was determined by multilocus sequence typing (MLST) and the virulence of isolates was measured using cellular and animal models. Results: The median age of the patients was 7 months; 24 (89%) were aged <1 year. The most common clinical manifestations were fever (100%), diarrhoea (96%) and shock (81%). Leucopenia, thrombocytopenia, high C-reactive protein levels, coagulopathy and hypoalbuminaemia were the key laboratory findings. Necrotising enteritis with or without bowel perforation, ecthyma gangrenosum and seizures were main complications. The death rate was 15%. No common primary immune deficiency was identified. MLST genotypes indicated that isolates from Shanghai fever were non-clonal, but they shared similar phenotypes which were invariably cytotoxic, invasive and adhesive in cellular experiments and caused prolonged gut colonisation and more death than respiratory and laboratory control strains in mice. Conclusions: Shanghai fever is a sporadic community-acquired disease of previously healthy infants that manifests as sepsis associated with P aeruginosa enteric disease. Both host and microbial factors play a role in pathogenesis.
机译：背景：上海热病是一种由社区获得的与铜绿假单胞菌引起的败血症相关的肠道疾病，最早于1918年被描述。对上海热病的理解还不完整。目的：描述临床特征并检查与上海发烧有关的宿主和微生物因素。方法：我们前瞻性地收集了2003年7月至2012年6月之间连续27例先前健康的社区获得性铜绿假单胞菌性肠炎和败血症的儿童的资料。通过多基因座序列分型（MLST）确定细菌分离株的克隆关系，并使用细胞和动物模型测量分离株的毒力。结果：患者的中位年龄为7个月; <1岁的年龄为24岁（89％）。最常见的临床表现是发烧（100％），腹泻（96％）和休克（81％）。白细胞减少症，血小板减少症，高C反应蛋白水平，凝血病和低白蛋白血症是实验室的主要发现。主要的并发症是伴或不伴肠穿孔的坏死性肠炎，坏疽性坏死和癫痫发作。死亡率为15％。没有发现常见的原发性免疫缺陷。 MLST基因型表明，上海热分离株是非克隆性的，但它们具有相似的表型，在细胞实验中具有细胞毒性，侵袭性和粘附性，并且比小鼠呼吸道和实验室控制株引起肠道定植时间延长和死亡更多。结论：上海发烧是先前健康婴儿的零星社区获得性疾病，表现为败血症与铜绿假单胞菌肠病相关。宿主和微生物因素均在发病机理中起作用。

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