[國考] 醫學一 45
45.有關葡萄球菌(Staphylococcus)引起的食物中毒的敘述,下列那一項錯誤?
(A)是由 heat-labile enterotoxin 引起
(B)症狀產生快,大約 4 小時內就會發生
(C)症狀消失快,大約 24 小時會消失
(D)有些 Staphylococcus aureus 菌種會導致 pseudomembranous enterocolitis
原答案為(A)
根據Medical Microbiology 4/e p.210~p.211所述：
Certain strains of S. aureus can also cause enterocolitis, which is
manifested clinical by …Enterocolitis occurs primary in patients who
have received broad-spectrum antibiotics, which suppress the normal
colonic flora and permit growth of S. aureus. The diagnosis of
staphylococal enterocolitis can be confirmed only after other,
more common causes of infection have been excluded
(e.g., Clostridium difficile colitis).
…and white plaques with ulceration are seen on the colonic mucosa.
另外根據p.349 右下角文字所述：
Systemic studies now clearly show, however, that toxin-producine
C. difficile is responsible for antibiotic-associated gstrointestinal
diseases ranging from a relatively benign, self-limited diarrhea to
severe, life-threatening pseudomembranous colitis.
本人查找全書以及上述兩段文章並未直接提到“有些 Staphylococcus aureus 菌種
會導致 pseudomembranous enterocolitis“. 後來上網查找文獻資料, 雖然有文獻
提到During the 1950s and 1960s, Staphylococcus aureus was implicated as
the etiologic agent of pseudomebranous enterocolitis.
但並無大規模的研究證實此一描述. 加上教科書也寫的曖昧不明, 容易誤導學生,
因此建議答案由(A)改為 (A)(D)
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※ 編輯: lpa 來自: 118.169.160.86 (08/03 16:33)
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