1887

Abstract

The implementation of direct testing of clinical faecal specimens for gastrointestinal (GI) pathogens by PCR offers a sensitive and comprehensive approach for the detection of Shiga toxin-producing (STEC). The introduction of a commercial PCR assay, known as GI PCR, for the detection of GI pathogens at three frontline hospital laboratories in England between December 2012 and December 2013 led to a significant increase in detection of STEC other than serogroup O157 (non-O157 STEC). In 2013, 47 isolates were detected in England, compared with 57 in the preceding 4 years (2009–2012). The most common non-O157 STEC serogroup detected was O26 (23.2 %). A total of 47 (47.5 %) STEC isolates had only, 28 (28.3 %) carried and , and the remaining 24 (24.2 %) had only. Stx2a (64.0 %) was the most frequently detected Stx2 subtype. The (intimin) gene was detected in 52 (52.5 %) non-O157 STEC isolates. Six strains of STEC O104 had , but this gene was not detected in any other STEC serogroups in this study. Haemolytic ureamic syndrome was significantly associated with STEC strains possessing [odds ratio (OR) 5.845,  = 0.0235] and/or (OR 9.56,  = 0.0034) subtypes. A matched case–control analysis indicated an association between non-O157 STEC cases and contact with farm animals. Widespread implementation of the PCR approach in England will determine the true incidence of non-O157 STEC infection, highlight the burden in terms of morbidity and mortality, and facilitate the examination of risk factors to indicate whether there are niche risk exposures for particular strains.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.075895-0
2014-09-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/63/9/1181.html?itemId=/content/journal/jmm/10.1099/jmm.0.075895-0&mimeType=html&fmt=ahah

References

  1. Beutin L., Krause G., Zimmermann S., Kaulfuss S., Gleier K. 2004; Characterization of Shiga toxin-producing Escherichia coli strains isolated from human patients in Germany over a 3-year period. J Clin Microbiol 42:1099–1108 [View Article][PubMed]
    [Google Scholar]
  2. Bielaszewska M., Mellmann A., Bletz S., Zhang W., Köck R., Kossow A., Prager R., Fruth A., Orth-Höller D.& other authors ( 2013; Enterohemorrhagic Escherichia coli O26:H11/H-: a new virulent clone emerges in Europe. Clin Infect Dis 56:1373–1381 [View Article][PubMed]
    [Google Scholar]
  3. Brooks J. T., Sowers E. G., Wells J. G., Greene K. D., Griffin P. M., Hoekstra R. M., Strockbine N. A. 2005; Non-O157 Shiga toxin-producing Escherichia coli infections in the United States, 1983-2002. J Infect Dis 192:1422–1429 [View Article][PubMed]
    [Google Scholar]
  4. Carroll A. M., Gibson A., McNamara E. B. 2005; Laboratory-based surveillance of human verocytotoxigenic Escherichia coli infection in the Republic of Ireland, 2002-2004. J Med Microbiol 54:1163–1169 [View Article][PubMed]
    [Google Scholar]
  5. Chase-Topping M. E., Rosser T., Allison L. J., Courcier E., Evans J., McKendrick I. J., Pearce M. C., Handel I., Caprioli A.& other authors ( 2012; Pathogenic potential to humans of bovine Escherichia coli O26, Scotland. Emerg Infect Dis 18:439–448 [View Article][PubMed]
    [Google Scholar]
  6. Dallman T., Smith G. P., O’Brien B., Chattaway M. A., Finlay D., Grant K. A., Jenkins C. 2012; Characterization of a verocytotoxin-producing enteroaggregative Escherichia coli serogroup O111:H21 strain associated with a household outbreak in Northern Ireland. J Clin Microbiol 50:4116–4119 [View Article][PubMed]
    [Google Scholar]
  7. Dallman T., Cross L., Bishop C., Perry N., Olesen B., Grant K. A., Jenkins C. 2013; Whole genome sequencing of an unusual serotype of Shiga toxin-producing Escherichia coli.. Emerg Infect Dis 19:1302–1304 [View Article][PubMed]
    [Google Scholar]
  8. Ethelberg S., Olsen K. E. P., Scheutz F., Jensen C., Schiellerup P., Engberg J., Petersen A. M., Olesen B., Gerner-Smidt P., Mølbak K. 2004; Virulence factors for hemolytic uremic syndrome, Denmark. Emerg Infect Dis 10:842–847 [View Article][PubMed]
    [Google Scholar]
  9. Frank C., Werber D., Cramer J. P., Askar M., Faber M., an der Heiden M., Bernard H., Fruth A., Prager R.& other authors ( 2011; Epidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany. N Engl J Med 365:1771–1780 [View Article][PubMed]
    [Google Scholar]
  10. Frankel G., Phillips A. D., Trabulsi L. R., Knutton S., Dougan G., Matthews S. 2001; Intimin and the host cell–is it bound to end in Tir(s)?. Trends Microbiol 9:214–218 [View Article][PubMed]
    [Google Scholar]
  11. Gerber A., Karch H., Allerberger F., Verweyen H. M., Zimmerhackl L. B. 2002; Clinical course and the role of Shiga toxin-producing Escherichia coli infection in the hemolytic-uremic syndrome in pediatric patients, 1997-2000, in Germany and Austria: a prospective study. J Infect Dis 186:493–500 [View Article][PubMed]
    [Google Scholar]
  12. Gould L. H., Mody R. K., Ong K. L., Clogher P., Cronquist A. B., Garman K. N., Lathrop S., Medus C., Spina N. L.& other authors ( 2013; Increased recognition of non-O157 Shiga toxin-producing Escherichia coli infections in the United States during 2000-2010: epidemiologic features and comparison with E. coli O157 infections. Foodborne Pathog Dis 10:453–460 [View Article][PubMed]
    [Google Scholar]
  13. Gross R. J., Rowe B. 1985; Serotyping of Escherichia coli. In The Virulence of Escherichia coli: Reviews and MethodsSpecial Publication of the Society for General Microbiology no. 13 pp 345–360 Edited by Sussman M. London: Academic Press;
    [Google Scholar]
  14. Jenkins C., Evans J., Chart H., Willshaw G. A., Frankel G. 2008; Escherichia coli serogroup O26–a new look at an old adversary. J Appl Microbiol 104:14–25[PubMed]
    [Google Scholar]
  15. Jenkins C., Lawson A. J., Cheasty T., Willshaw G. A. 2012; Assessment of a real-time PCR for the detection and characterization of verocytotoxigenic Escherichia coli.. J Med Microbiol 61:1082–1085 [View Article][PubMed]
    [Google Scholar]
  16. Luna-Gierke R. E., Griffin P. M., Gould L. H., Herman K., Bopp C. A., Strockbine N., Mody R. K. 2014; Outbreaks of non-O157 Shiga toxin-producing Escherichia coli infection: USA. Epidemiol Infect1–11 doi:10.1017/S0950268813003233 [Epub ahead of print] [View Article][PubMed]
    [Google Scholar]
  17. Lynn R. M., O’Brien S. J., Taylor C. M., Adak G. K., Chart H., Cheasty T., Coia J. E., Gillespie I. A., Locking M. E.& other authors ( 2005; Childhood hemolytic uremic syndrome, United Kingdom and Ireland. Emerg Infect Dis 11:590–596 [View Article][PubMed]
    [Google Scholar]
  18. Persson S., Olsen K. E., Ethelberg S., Scheutz F. 2007; Subtyping method for Escherichia coli Shiga toxin (verocytotoxin) 2 variants and correlations to clinical manifestations. J Clin Microbiol 45:2020–2024 [View Article][PubMed]
    [Google Scholar]
  19. Preußel K., Höhle M., Stark K., Werber D. 2013; Shiga toxin-producing Escherichia coli O157 is more likely to lead to hospitalization and death than non-O157 serogroups–except O104. PLoS ONE 8:e78180 [View Article][PubMed]
    [Google Scholar]
  20. Scheutz F., Teel L. D., Beutin L., Piérard D., Buvens G., Karch H., Mellmann A., Caprioli A., Tozzoli R.& other authors ( 2012; Multicenter evaluation of a sequence-based protocol for subtyping Shiga toxins and standardizing Stx nomenclature. J Clin Microbiol 50:2951–2963 [View Article][PubMed]
    [Google Scholar]
  21. Scheutz M., Strockbine N. A. 2005; Genus I. Escherichia Castellani and Chalmers 1919, 941TAL. In Bergey’s Manual of Systematic Bacteriology vol. 2 pp. 607–624 Edited by Garrity G. M., Brenner D. J., Krieg N. R., Staley J. T. New York: Springer;
    [Google Scholar]
  22. Tam C. C., Rodrigues L. C., Viviani L., Dodds J. P., Evans M. R., Hunter P. R., Gray J. J., Letley L. H., Rait G.& other authors ( 2012; Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice. Gut 61:69–77 [View Article][PubMed]
    [Google Scholar]
  23. Tozzi A. E., Caprioli A., Minelli F., Gianviti A., De Petris L., Edefonti A., Montini G., Ferretti A., De Palo T.& other authors ( 2003; Shiga toxin-producing Escherichia coli infections associated with hemolytic uremic syndrome, Italy, 1988-2000. Emerg Infect Dis 9:106–108 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.075895-0
Loading
/content/journal/jmm/10.1099/jmm.0.075895-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error