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Escherichia coli diyarelerinin patogenezindeki son gelişmeler

Recent advances in the field of pathogenesis of diarrhoea caused by Escherichia coli

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 1995

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
I)iarrhogenic Escherichia coli has been shown that at least Jive di fferent pathogenic mechanisms are used to cause disease. Enterotoxigenic li.coli (ETEC) and enleropalhogenic li.coli (EJ'EC) produce a non-m/lammatory diarrhoea, whereas enteroinvasive li.coli (EIEC). enlerohaemorrhagic li.coli (IİIIIİC) and enteroaggregative li.coli (EAggliC) produce an inflammatory diarrhoea. EIEC causes an acute cholera-like diarrhoea in infants and travellers. EI'EC is a major cause of summer diarrhoea in infants and neonatal diarrhoea. EIEC produce diarrhoea hy attaching to the proximal small intestinal mucosa and elaborate one or both at heal labile and heat stable toxins. EI'EC is capable of attaching intimately to the proximal intestinal epithelial cells and effacing their microvilli (attaching-effacement fenomen). EIEC attach to colonic enlerocyles. penetrate by an endocylotic mechanism and replicate therein. This results in necrosis and stripping of large areas o/ colonic mucosa and a d\ seııler\ similar to but usual/)1 less severe than Shigella dysenten: El I EC produce attaching-ef/acement to the terminal ileal and colonic mucosa and release the Shıga-lıke toxins (SITs). li.coli ()I5~:H~ . the predominant serotype of EI/EC. is a cause of hol h outbreaks and sporadic cases of haemorrhagic colitis. In addition. SI.T can damage vascular endothelial cells, leading to haemolytic uraemic syndrome. EAggliC is a new pathogen causing acule and /lersislenl diarrhea in children. 'They damage and blunt colonic villi hy haemorrhagic necrosis, although the precise pathogenic mechanisms are unclear. Specific diagnosis depends upon demonstration of the pathogenicity trail, and the pathogenicity genes or their gene products. At present, to undertake such testing is not recommended for routine diagnosis hut is most useful when surveys- of the aetiolog)- of acute and chronic diarrhoea are undertaken. /Journal of Turgut Özal Medical Center 2( I ):S6-102. /Wj/
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Abstract (Original Language): 
Divare yapan li.coli 'terin en az heş /arktı patogenetik mekanizma ile hastalıklımı neden olduğu gösterilmiştir, linterotoksijenik li.coli (ETEC) ve enieropatogenik li.coli (EI'IİC) mm-inflamatuvar di)-ürelere neden olurken enteroinvazıf li.coli (HI EC), enterohemorajik li.coli (EI I EC) ve enteroagregatif li.coli (EAggliC) ın/lamatııvar dıyerelere neden olmaktadır. ET EC in/antlarda ve turistlerde koleraya benzer divarelere neden olur. EI'IİC infant ve yenidoğanlarıla yaz ishal/erinin önemli hır nedenidir. ETEC proksımal ince bağırsak mukozasına bağlanır. Isıya lahil ve ısıya slahil (I.T ve ST) toksinlerden hırı veya ikisini salgılayarak diyareye neden olur. EI'IİC proksımal ince bağırsak epıtelyal hücrelerine saldırarak haradaki mikrovillusları yokedehilir (saldırma ve yoketme fenomeni). EIEC kolondaki enterosıtlere bağlanır, endositoz/a hücre içine girer ve burada çoğalır. Kolon mukozasında nekroz ve soyulmalar meydana gelir. Shigella dizanterisine benze) en fakat genellikle daha hafif tipte dizanteriye neden olur. El IHA '. terminal ileum ve kolon mukozasında saldırma-yoketme fenomeni oluşturur ve Shiga-like toksinleri üretir. EllliC'ın predomınat hır serolıpi olan li.coli ()I5~:II~. epıdemık veya eıulemik hemorajik kolitlere neden olur. Ayrıca. SI.'T vasküler endotel hücrelerinde hasara yol açar ve hemolıtık üremik sendroma neden olabilir. HAggliC akut ve persistan divarelere neden olan yeni hır patojendir. Hemorajik nekroz nedeniyle kolondaki vıllusların küntleşmesı veya yokedilmesine rağmen kesin patogenetık mekanizması bilinmemektedir. Spesifik tanı patogenetık özelliklerin, patogenetik genlerinin veya gen ürünlerinin gösterilmesine bağlıdır, dünümüzde, hu testlerin rutin diyağnostık amaçlarla kullanılması tavsiye edilmez fakat akut ve kronik dıyare etyolojısinın izlenmesinde çok yararlı olmaktadır. /Turgut Ozal Tıp Merkezi Dergisi 2( I ):S6-102. ll)')5j
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