scholarly journals An outbreak of diarrhoea due to multiple antimicrobial-resistant Shiga toxin-producing Escherichia coli O26[ratio ]H11 in a nursery

2001 ◽  
Vol 127 (2) ◽  
pp. 221-227 ◽  
Author(s):  
N. HIRUTA ◽  
T. MURASE ◽  
N. OKAMURA
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Food Samples ◽  
The Other ◽  
Haemolytic Uremic Syndrome ◽  
Pulsed Field ◽  
Electrophoretic Patterns ◽  
Transmissible Plasmid ◽  
Contaminated Food ◽  
Uremic Syndrome

An outbreak due to Shiga toxin-producing Escherichia coli O26[ratio ]H11 (STEC) occurred at a nursery in southeastern Japan in 1997. Thirty-two children had watery or bloody diarrhoea but none of them suffered from haemolytic-uremic syndrome. All of the STEC O26 were isolated during the period from 23 July to 22 August from 24 children, 3 nurses, and 2 food samples. These organisms had stx1 and eae genes but none of the other genes for which we tested (stx2, bfp, and EAF plasmid). They also possessed multiple antimicrobial resistances, which were encoded by a transmissible plasmid, and showed mostly identical genomic pulsed-field gel electrophoretic patterns. The results of this investigation suggested that contaminated food was the main contributing factor to this multiple antimicrobial-resistant STEC O26 infection, and person-to-person transmission also contributed to the spread of this outbreak.

scholarly journals Effects of Antibiotics on Shiga Toxin 2 Production and Bacteriophage Induction by Epidemic Escherichia coli O104:H4 Strain

2012 ◽  
Vol 56 (6) ◽  
pp. 3277-3282 ◽  
Author(s):  
Martina Bielaszewska ◽  
Evgeny A. Idelevich ◽  
Wenlan Zhang ◽  
Andreas Bauwens ◽  
Frieder Schaumburg ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Therapy ◽  
Shiga Toxin ◽  
The Other ◽  
Emerging Pathogen ◽  
Outbreak Strain ◽  
Content Type ◽  
Shiga Toxin 2 ◽  
Uremic Syndrome

ABSTRACTThe role of antibiotics in treatment of enterohemorrhagicEscherichia coli(EHEC) infections is controversial because of concerns about triggering hemolytic-uremic syndrome (HUS) by increasing Shiga toxin (Stx) production. During the recent large EHEC O104:H4 outbreak, antibiotic therapy was indicated for some patients. We tested a diverse panel of antibiotics to which the outbreak strain is susceptible to interrogate the effects of subinhibitory antibiotic concentrations on induction ofstx2-harboring bacteriophages,stx2transcription, and Stx2 production in this emerging pathogen. Ciprofloxacin significantly increasedstx2-harboring phage induction and Stx2 production in outbreak isolates (Pvalues of <0.001 to <0.05), while fosfomycin, gentamicin, and kanamycin insignificantly influenced them (P> 0.1) and chloramphenicol, meropenem, azithromycin, rifaximin, and tigecycline significantly decreased them (P≤ 0.05). Ciprofloxacin and chloramphenicol significantly upregulated and downregulatedstx2transcription, respectively (P< 0.01); the other antibiotics had insignificant effects (P> 0.1). Meropenem, azithromycin, and rifaximin, which were used for necessary therapeutic or prophylactic interventions during the EHEC O104:H4 outbreak, as well as tigecycline, neither inducedstx2-harboring phages nor increasedstx2transcription or Stx2 production in the outbreak strain. These antibiotics might represent therapeutic options for patients with EHEC O104:H4 infection if antibiotic treatment is inevitable. We await further analysis of the epidemic to determine if usage of these agents was associated with an altered risk of developing HUS.

scholarly journals DiarrhoeagenicEscherichia coliandEscherichia albertiiin Brazil: pathotypes and serotypes over a 6-year period of surveillance

2018 ◽  
Vol 147 ◽  
Author(s):  
E. L. Ori ◽  
E. H. Takagi ◽  
T. S. Andrade ◽  
B. T. Miguel ◽  
M. C. Cergole-Novella ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Active Surveillance ◽  
Shiga Toxin ◽  
Control Strategies ◽  
Clinical Samples ◽  
Haemolytic Uremic Syndrome ◽  
E Coli ◽  
Enteric Diseases ◽  
Uremic Syndrome ◽  
And Control

AbstractDiarrhoeagenicEscherichia coli(DEC) is a leading cause of infectious diarrhoea worldwide. In recent years,Escherichia albertiihas also been implicated as a cause of human enteric diseases. This study describes the occurrence ofE. colipathotypes and serotypes associated with enteric illness and haemolytic uremic syndrome (HUS) isolated in Brazil from 2011 to 2016. Pathotypes isolated included enteropathogenicE. coli(EPEC), enteroaggregativeE. coli(EAEC), enterotoxigenicE. coli(ETEC), enteroinvasiveE. coli(EIEC) and Shiga toxin-producingE. coli(STEC). PCR of stool enrichments for DEC pathotypes was employed, andE. albertiiwas also sought. O:H serotyping was performed on all DEC isolates. A total of 683 DEC and 10E. albertiistrains were isolated from 5047 clinical samples. The frequencies of DEC pathotypes were 52.6% (359/683) for EPEC, 32.5% for EAEC, 6.3% for ETEC, 4.4% for EIEC and 4.2% for STEC. DEC strains occurred in patients from 3 months to 96 years old, but EPEC, EAEC and STEC were most prevalent among children. Both typical and atypical isolates of EPEC and EAEC were recovered and presented great serotype heterogeneity. HUS cases were only associated with STEC serotype O157:H7. TwoE. albertiiisolates belonged to serogroup O113 and one had thestx2f gene. The higher prevalence of atypical EPEC in relation to EAEC in community-acquired diarrhoea in Brazil suggests a shift in the trend of DEC pathotypes circulation as previously EAEC predominated. This is the first report ofE. albertiiisolation from active surveillance. These results highlight the need of continuing DEC andE. albertiisurveillance, as a mean to detect changes in the pattern of pathotypes and serotypes circulation and provide useful information for intervention and control strategies.

scholarly journals Risk determinants for the development of typical haemolytic uremic syndrome in Belgium and proposition of a new virulence typing algorithm for Shiga toxin-producing Escherichia coli

2018 ◽  
Vol 147 ◽  
Author(s):  
K. De Rauw ◽  
R. Buyl ◽  
S. Jacquinet ◽  
D. Piérard
Keyword(s):  
Escherichia Coli ◽  
Infection Control ◽  
Shiga Toxin ◽  
Lower Risk ◽  
Control Measures ◽  
Haemolytic Uremic Syndrome ◽  
Health Inspection ◽  
Uremic Syndrome ◽  
Virulence Typing ◽  
Risk Determinants

Abstract In Belgium, it is mandatory to report Shiga toxin-producing Escherichia coli (STEC) infections to the health inspection authorities. To facilitate the decision making regarding infection control measures, information about the risk factors for the development of the haemolytic uremic syndrome (HUS) can be helpful. We performed statistical analyses on a dataset of 411 Belgian STEC strains. Demographic and clinical patient characteristics as well as phenotypical and genotypical STEC strain characteristics were taken into account. Multivariate logistic regression models indicated that age categories ⩽5, 6–12 and ⩾75; the stx2 gene; and the eae gene were significant HUS development risk determinants. The stx2a subtype had the highest risk (OR 29.6, 95% CI 7.0–125.1), while all stx1 subtypes encompassed a significant lower risk (OR 0.3, 95% CI 0.1–0.5). Presence of the stx1 gene without stx2 encompassed a lower risk than the combined presence of stx1 and stx2, or stx2 solely. Based on these results, we propose a new virulence typing algorithm that will enable the National Reference Centre to provide the physicians and health inspection authorities with a risk classification for the development of HUS. We believe this will contribute to a more efficient STEC infection control management in Belgium.

scholarly journals Heterogeneity of Shiga Toxin-Producing Escherichia coli Strains Isolated from Hemolytic-Uremic Syndrome Patients, Cattle, and Food Samples in Central France

2001 ◽  
Vol 67 (6) ◽  
pp. 2460-2468 ◽  
Author(s):  
Nathalie Pradel ◽  
Karima Boukhors ◽  
Yolande Bertin ◽  
Christiane Forestier ◽  
Christine Martin ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Geographical Area ◽  
Plasmid Profile ◽  
Food Samples ◽  
Plasmid Analysis ◽  
Short Period ◽  
Close Relationship ◽  
Uremic Syndrome

ABSTRACT A detailed analysis of the molecular epidemiology of non-O157:H7 Shiga toxin-producing Escherichia coli (STEC) was performed by using isolates from sporadic cases of hemolytic-uremic syndrome (HUS), animal reservoirs, and food products. The isolates belonged to the O91 and OX3 serogroups and were collected in the same geographical area over a short period of time. Five typing methods were used; some of these were used to explore potentially mobile elements like thestx genes or the plasmids (stx 2-restriction fragment length polymorphism [RFLP], stx 2 gene variant, and plasmid analyses), and others were used to study the whole genome (ribotyping and pulsed-field gel electrophoresis [PFGE]). The techniques revealed that there was great diversity among the O91 and OX3 STEC strains isolated in central France. A close relationship between strains of the same serotype having the same virulence factor pattern was first suggested by ribotyping. However, stx 2-RFLP andstx 2 variant analyses differentiated all but 5 of 21 isolates, and plasmid analysis revealed further heterogeneity; a unique combination of characteristics was obtained for all strains except two O91:H21 isolates from beef. The latter strains were shown by PFGE to be the most closely related isolates, with >96% homology, and hence may be subtypes of the same strain. Overall, our results indicate that the combination of stx 2-RFLP,stx 2 variant, and plasmid profile analyses is as powerful as PFGE for molecular investigation of STEC diversity. Finally, the non-O157:H7 STEC strains isolated from HUS patients were related to but not identical to those isolated from cattle and food samples in the same geographical area. The possibility that there are distinct lineages of non-O157:H7 STEC, some of which are more virulent for humans, should be investigated further.

scholarly journals Highlights from the clinical symposium on Shiga toxin-producing Escherichia coli / haemolytic uremic syndrome, Berlin, September 2011

2011 ◽  
Vol 16 (39) ◽  
Author(s):  
A Jansen
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Basic Science ◽  
Antibody Therapy ◽  
German Society ◽  
Haemolytic Uremic Syndrome ◽  
Convention Center ◽  
Uremic Syndrome

On 9 September 2011, the Estrel Convention Center in Berlin was the venue for a first clinical symposium on Shiga toxin-producing Escherichia coli / haemolytic uremic syndrome (STEC/HUS) reflecting on the large STEC outbreak in Germany earlier this year. The German Society of Nephrology (DGfN) invited internationally renowned clinical experts and microbiologists to discuss the basic science and diagnostics of STEC infections and the different options for treating an EHEC-associated HUS, including plasmapheresis, antibody therapy with Eculizumab, and extracorporeal immune adsorption.

The Czech Experience with Eculizumab in Severe Paediatric Shiga Toxin-Producing Escherichia coli-Associated Haemolytic Uremic Syndrome Patients

2020 ◽  
Author(s):  
Patrik Konopasek ◽  
Jan David ◽  
Monika Marejkova ◽  
Nadezda Simankova ◽  
Karel Vondrak ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Haemolytic Uremic Syndrome ◽  
Uremic Syndrome

scholarly journals Molecular characterisation of human Shiga toxin-producing Escherichia coli O26 strains: results of an outbreak investigation, Romania, February to August 2016

2017 ◽  
Vol 22 (47) ◽  
Author(s):  
Codruţa-Romaniţa Usein ◽  
Adriana Simona Ciontea ◽  
Cornelia Mãdãlina Militaru ◽  
Maria Condei ◽  
Sorin Dinu ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Genetic Relatedness ◽  
Diverse Population ◽  
National Surveillance ◽  
Severe Diarrhoea ◽  
Surveillance Strategy ◽  
Haemolytic Uremic Syndrome ◽  
Virulence Markers ◽  
Uremic Syndrome

Introduction At the beginning of 2016, an increase in paediatric haemolytic uremic syndrome (HUS) cases was observed in Romania. The microbiological investigations allowed isolation of Shiga toxin-producing Escherichia coli (STEC) O26 as the causative agent from most cases. Methods: An enhanced national surveillance of HUS and severe diarrhoea was established across the country following the identification of the first cases and was carried out until August 2016. A total of 15 strains were isolated from 10 HUS and five diarrhoea cases. Strains were characterised by virulence markers (i.e. stx type/subtype, eae, ehxA genes), phylogroup, genetic relatedness and clonality using PCR-based assays, PFGE and multilocus sequence typing (MLST). The first six strains were further characterised by whole genome sequencing (WGS). Results: Five PCR-defined genotypes were distinguished. All strains from HUS cases harboured stx2a and eae, with or without stx1a, while strains from diarrhoea cases carried exclusively stx1a and eae genes. PFGE resolved strains into multiple pulsotypes, compatible with a certain geographic segregation of the cases, and strains were assigned to phylogroup B1 and sequence type (ST) 21. WGS confirmed the results of conventional molecular methods, brought evidence of O26:H11 serotype, and complemented the virulence profiles. Discussion/conclusion: This first description of STEC O26 strains from cases in Romania showed that the isolates belonged to a diverse population. The virulence content of most strains highlighted a high risk for severe outcome in infected patients. Improving the national surveillance strategy for STEC infections in Romania needs to be further considered.

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