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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 30-31页

作者： Hellm.g S. Ott S. musfeldt m. S. Schreiber 成虹 Departm.nt of Gastroenterology Institute for Clinical Molecular Biology Christian- Albrechts- University Schittenhelmstr. 12 24105 Kiel Germany Dr.

Chronic diarrheal illness and m.labsorption are challenging diagnostic and clinical problem.. The identification of the causative pathogens that are involved in gastrointestinal infections is often difficult. It took 85 years after the first description of a case of intestinal lipodystrophy by GeorgWhipple in 1907 until the causative bacterium.was characterized by using m.lecular genetics techniques. We here report the com.licated clinical course of a young patient with chronic diarrhea accom.anied by severe, life- threate- ning m.labsorption with extensive weight loss. Histology and glucose hydrogen breath test were suggestive of a bacterial overgrowth syndrom. in the sm.ll bow el, but standard culture- based techniques and serology failed to identify the causative bacteria. Thus, bacterial ribosom.lDNA (16S ribosom.l DNA) was extract ed from.duodenal biopsy sam.les and analyzed by com.unity fingerprinting and spe cies- specific polym.rase chain reaction. Stenotrophom.nas m.l- tophilia was identified as the cause of chronic infectious enteritis. Only specific long- term.antibiotic treatm.nt with co- trim.xazole had a durable clinical effect and led to norm.lization of 16S ribosom.l DNA profiles. This case shows the role of rare and uncom.on bacteria in refractory and chronic hum.n gastrointestinal infections. Genom.c techniques, including 16S- based single- strand conform.tion polym.rphism.analysis, will play an increasing role in the diagnosis of chronic infections with facultatively pathogenic bacteria or in the clinical analysis of com.lex bacterial com.unities such as the intestinal bacterial m.croflora. Future enhancem.nts in detection techniques will show that chronic bacterial infections are m.re frequent as a cause of gastrointestinal m.lfunction than com. m.nly thought.

关键词：慢性肠炎嗜麦芽单胞吸收不良感染性肠炎胃肠道感染呼气试验肠道功能失调细菌培养技术慢性腹泻

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