An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

In the summer of 2001 an outbreak of Escherichia coli O157 gastroenteritis affected staff and residents of a care home for the elderly in the West Midlands, UK. E. coli O157 phage type 2 was isolated from faeces in eight patients and 12 staff members. Thirty-five staff and 40 residents met the case definition for clinical gastrointestinal infection. Serological testing identified a further 14 possible cases of infection amongst asymptomatic staff and residents. The outbreak was atypical, as the disease seemed to be milder than has been observed in past outbreaks in similar settings. The index case, a member of staff, developed bloody diarrhoea and haemolytic-uraemic syndrome (HUS), but only one resident developed bloody diarrhoea and required hospitalization. No deaths occurred, despite the high-risk nature of the affected population. The source of the outbreak could not be identified. The prolonged nature of the outbreak and observed lapses in infection control practices indicated that person-to-person spread was the likely route of transmission. This outbreak illustrates the importance of observing appropriate infection control measures in the institutions providing residential and nursing care to the elderly.

Chromosomal dynamism in progeny of outbreak-related sorbitol-fermenting enterohemorrhagic Escherichia coli O157:NM

Sorbitol-fermenting (SF) enterohemorrhagic Escherichia coli (EHEC) O157:NM (nonmotile) is a unique clone that causes outbreaks of hemorrhagic colitis and hemolytic-uremic syndrome. In well-defined clusters of cases, we have observed significant variability in pulsed-field gel electrophoresis (PFGE) patterns which could indicate coinfection by different strains. An analysis of randomly selected progeny colonies of an outbreak strain after subcultivation demonstrated that they displayed either the cognate PFGE outbreak pattern or one of four additional patterns and were <89% similar. These profound alterations were associated with changes in the genomic position of one of two Shiga toxin 2-encoding genes (stx2) in the outbreak strain or with the loss of this gene. The two stx2 alleles in the outbreak strain were identical but were flanked with phage-related sequences with only 77% sequence identity. Neither of these phages produced plaques, but one lysogenized E. coli K-12 and integrated in yecE in the lysogens and the wild-type strain. The presence of two stx2 genes which correlated with increased production of Stx2 in vitro but not with the clinical outcome of infection was also found in 14 (21%) of 67 SF EHEC O157:NM isolates from sporadic cases of human disease. The variability of PFGE patterns for the progeny of a single colony must be considered when interpreting PFGE patterns in SF EHEC O157-associated outbreaks.

Analysis of feces samples collected from a wild-bird garden feeding station in Scotland for the presence of verocytotoxin-producing Escherichia coli O157

Composite wild bird feces collected at regular intervals from a garden feeding station in southwest Scotland over a 3-year period were examined for verocytotoxin-producing Escherichia coli O157. One sample was positive for Escherichia coli O157. The isolate belonged to phage type 21/28 and possessed vtx2, eaeA, and enterohemorrhagic E. coli hlyA genes.

Intraserotype diversity among Argentinian verocytotoxigenic Escherichia coli detected by random amplified polymorphic DNA analysis

Most cases of diarrhoea-associated haemolytic uraemic syndrome (HUS) are caused by verocytotoxin-producing Escherichia coli (VTEC). Argentina has the highest worldwide incidence of HUS, but with a lower incidence of VTEC O157 : H7 serotype than non-Latin American countries. A large number of VTEC serotypes have been isolated from cattle and cattle-derived food products in Argentina. The aim of this work was to study intraserotype genetic diversity among these VTEC strains by random amplification of polymorphic DNA (RAPD). Strains were selected that belonged to the same serotype, but had been isolated from different sources (cattle and meat). Intraserotype genetic diversity was detected among strains belonging to O20 : H19, O113 : H21, O117 : H7, O157 : H7, O171 : H2 and O174 : H21, but only one RAPD profile corresponded to strains belonging to O91 : H21, although these isolates were from different sources.

Locus-specific mutational events in a multilocus variable-number tandem repeat analysis of Escherichia coli O157:H7

Multilocus variable-number tandem repeat analysis (MLVA) is a validated molecular subtyping method for detecting and evaluating Escherichia coli O157:H7 outbreaks. In a previous study, five outbreaks with a total of 21 isolates were examined by MLVA. Nearly 20% of the epidemiologically linked strains were single-locus variants (SLV) of their respective predominant outbreak clone. This result prompted an investigation into the mutation rates of the seven MLVA loci (TR1 to TR7). With an outbreak strain that was an SLV at the TR1 locus of the predominant clone, parallel and serial batch culture experiments were performed. In a parallel experiment, none (0/384) of the strains analyzed had mutations at the seven MLVA loci. In contrast, in the two 5-day serial experiments, 4.3% (41/960) of the strains analyzed had a significant variation in at least one of these loci (P < 0.001). The TR2 locus accounted for 85.3% (35/41) of the mutations, with an average mutation rate of 3.5 x 10(-3); the mutations rates for TR1 and TR5 were 10-fold lower. Single additions accounted for 77.1% (27/35) of the mutation events in TR2 and all (6/6) of the additions in TR1 and TR5. The remaining four loci had no slippage events detected. The mutation rates were locus specific and may impact the interpretation of MLVA data for epidemiologic investigations.

Probing genomic diversity and evolution of Escherichia coli O157 by single nucleotide polymorphisms

Infections by Shiga toxin-producing Escherichia coli O157:H7 (STEC O157) are the predominant cause of bloody diarrhea and hemolytic uremic syndrome in the United States. In silico comparison of the two complete STEC O157 genomes (Sakai and EDL933) revealed a strikingly high level of sequence identity in orthologous protein-coding genes, limiting the use of nucleotide sequences to study the evolution and epidemiology of this bacterial pathogen. To systematically examine single nucleotide polymorphisms (SNPs) at a genome scale, we designed comparative genome sequencing microarrays and analyzed 1199 chromosomal genes (a total of 1,167,948 bp) and 92,721 bp of the large virulence plasmid (pO157) of eleven outbreak-associated STEC O157 strains. We discovered 906 SNPs in 523 chromosomal genes and observed a high level of DNA polymorphisms among the pO157 plasmids. Based on a uniform rate of synonymous substitution for Escherichia coli and Salmonella enterica (4.7x10(-9) per site per year), we estimate that the most recent common ancestor of the contemporary beta-glucuronidase-negative, non-sorbitolfermenting STEC O157 strains existed ca. 40 thousand years ago. The phylogeny of the STEC O157 strains based on the informative synonymous SNPs was compared to the maximum parsimony trees inferred from pulsed-field gel electrophoresis and multilocus variable numbers of tandem repeats analysis. The topological discrepancies indicate that, in contrast to the synonymous mutations, parts of STEC O157 genomes have evolved through different mechanisms with highly variable divergence rates. The SNP loci reported here will provide useful genetic markers for developing high-throughput methods for fine-resolution genotyping of STEC O157. Functional characterization of nucleotide polymorphisms should shed new insights on the evolution, epidemiology, and pathogenesis of STEC O157 and related pathogens.

The use of Fourier transform infrared spectroscopy to differentiate Escherichia coli O157:H7 from other bacteria inoculated into apple juice

Fourier transform infrared spectroscopy (FT-IR) can discriminate Escherichia coli O157:H7 ATCC 35150 from other bacteria: E. coli ATCC 25522, Bacillus cereus ATCC 10876, and Listeria innocua ATCC 51742 inoculated in to apple juice. Spectra of bacterial suspensions (ca. 10(9) cfu/ml in 0.9% NaCl) on Anodisc (aluminum oxide) filters were tested. Unique FT-IR vibrational combination bands from mid-IR active components of bacterial cells are present in the "fingerprint region" at wavenumbers between 1500 and 800 cm(-1). Principal component analysis (PCA) revealed clear segregations between different bacterial strains. Also, soft independent modeling of class analogy (SIMCA) correctly classified E. coli O157:H7 ATCC 35150 from E. coli ATCC 25522 at an 82% confidence level; whereas a 77% confidence level was obtained when using SIMCA to classify E. coli O157:H7 from three other bacterial strains.

Laboratory-based surveillance of human verocytotoxigenic Escherichia coli infection in the Republic of Ireland, 2002-2004

The aim of this study was to examine the frequency and distribution of human verocytotoxigenic Escherichia coli (VTEC) O157 and non-O157 in the Republic of Ireland, and also to examine the presence of virulence genes in these isolates. This genetic information combined with phenotypic tests was used to produce a complete laboratory-based surveillance of human clinical VTEC infection in the Republic of Ireland between 2002 and 2004. Between January 2002 and December 2004 a total of 207 VTEC isolates were studied (one isolate per patient), 185 (89 %) of these were E. coli O157. The remaining 22 (11 %) were non-O157 E. coli, made up of 15 (7.2 %) E. coli O26, one (0.5 %) E. coli O103, one (0.5 %) E. coli O146, one (0.5 %) E. coli O145, two (1 %) E. coli O111 and two (1 %) ungroupable VTEC. These isolates originated from the eight health boards in the Republic of Ireland and represented over 90 % of the clinical cases of VTEC in the Republic of Ireland during this period. The results showed that VTEC O157 was the predominant serogroup and had a predominant toxin genotype of VT2 alone. Phage type 32 was the most common phage type of E. coli O157 identified. Non-O157 VTEC was a small proportion of all VTEC (10 % in 2002, 8 % in 2003, 15.5 % in 2004). In 2004 it was noted that there was an increase in the number and variety of non-O157 VTEC strains; however, this requires further monitoring in the future to see if this trend is sustained. It was also noted throughout the study period that the incidence of VTEC was higher in rural areas. Implementation of real-time PCR for the detection and subtyping of VTEC has aided outbreak investigations and is important for enhanced surveillance of VTEC in the Republic of Ireland.

Microarray based comparison of two Escherichia coli O157:H7 lineages

BACKGROUND

Previous research has identified the potential for the existence of two separate lineages of Escherichia coli O157:H7. Clinical isolates tended to cluster primarily within one of these two lineages. To determine if there are virulence related genes differentially expressed between the two lineages we chose to utilize microarray technology to perform an initial screening.

RESULTS

Using a 610 gene microarray, designed against the E. coli O157 EDL 933 transcriptome, targeting primarily virulence systems, we chose 3 representative Lineage I isolates (LI groups mostly clinical isolates) and 3 representative Lineage II isolates (LII groups mostly bovine isolates). Using standard dye swap experimental designs, statistically different expression (P < 0.05) of 73 genes between the two lineages was revealed. Result highlights indicate that under in vitro anaerobic growth conditions, there is up-regulation of stx2b, ureD, curli (csgAFEG), and stress related genes (hslJ, cspG, ibpB, ibpA) in Lineage I, which may contribute to enhanced virulence or transmission potential. Lineage II exhibits significant up-regulation of type III secretion apparatus, LPS, and flagella related transcripts.

CONCLUSION

These results give insight into comparative regulation of virulence genes as well as providing directions for future research. Ultimately, evaluating the expression of key virulence factors among different E. coli O157 isolates has inherent value and the interpretation of such expression data will continue to evolve as our understanding of virulence, pathogenesis and transmission improves.

Escherichia coli O antigen typing using DNA microarrays

DNA microarrays were developed for rapid identification of different serogroups of Escherichia coli in a single platform. Oligonucleotides, as well as PCR products from genes in the O antigen gene clusters of E. coli serogroups O7, O104, O111, and O157 were spotted onto glass slides. This was followed by hybridization with labeled long PCR products of the entire O antigen gene clusters of these serogroups. Results demonstrated that microarrays consisting of either oligonucleotides or PCR products generated specific signals for each serogroup. This is the first report describing the development of model DNA microarrays for determining the serogroup of E. coli strains.

Continuous Surveillance of Shiga Toxin–ProducingEscherichia coliInfections by Pulsed-Field Gel Electrophoresis Shows That Most Infections Are Sporadic

The purpose of this study was to evaluate the value of real-time molecular typing of Shiga toxin (Verocytotoxin)-producing Escherichia coli (STEC) infections in order to detect possible outbreaks of infections. All laboratory confirmed STEC infections in Denmark from 2003 to mid 2005 were routinely characterized by serotyping, virulence genes characterization, and subtyping by pulsed-field gel electrophoresis (PFGE) using the PulseNet protocol for STEC O157. The study included 312 STEC isolates representing 50 different O groups and 75 O:H-serotypes, and 68% of the isolates belonged to the eight most common O-groups: O157 (26%), O103 (13%), O146 (8%), O26 (8%), O117 (4%), O145 (3%), O128 (3%), and O111 (2%). The remaining O-groups constituted less than 2% each, and 8.1% of the isolates were O-rough. The eae gene was found in 60% of all isolates, and detection of the two main Shiga toxin genes showed that 40% had stx1 only, 31% had stx2 only, and 29% had both stx1 and stx2. A high diversity was seen within all O groups, and for most of the rare O groups, the number of PFGE profiles equaled the number of isolates. However, one outbreak of E. coli O157 was detected by the routine PFGE typing. The value of "real-time' PFGE typing of the infrequent serotypes is limited if the full scheme for O-grouping or O:H-serotyping is used routinely for all STEC isolates. Possible outbreaks can then be detected by the increased number of isolates within a particular serotype. PFGE typing would then be valuable in subsequent steps of the outbreak investigation. However, routine PFGE typing of the three to five most common O groups will enable early recognition of possible outbreaks.

[Serum anti-lPS antibody production in an outbreak of enterohemorrhagic Escherichia coli O157 infection among schoolchildren]

Although there have been many reports of the usefulness of serodiagnosis of enterohemorrhagic Escherichia coli (EHEC) O157, the serotype of the bacteria detected and the increase in anti-LPS antibody have not always been consistent. In this study we investigated the diagnostic significance of measurements of anti-LPS antibody by ELISA in an outbreak of O157 infection among schoolchildren in whom the bacteriological test findings were clarified and the age groups were uniform. The anti-LPS antibody titer was measured in 31 patients (77 serum samples) in an outbreak of EHEC O157 : H7 infection (220 children infected) that occurred in a primary school in Morioka in 1996. The anti-O157 LPS antibody positivity rates of IgM, IgG, and IgA were 98.7%, 85.7%, and 98.7%, respectively. Between the time the meal that caused the outbreak and 19 days later, anti-O157 LPS IgM antibody and IgA antibody were detected in all patients. The specificity was investigated using control serum, and the specificity of IgM, IgG, and IgA was 93.5%, 93.5%, and 97.2%, respectively. Some samples contained antibodies against O111 and O26 LPS, but the titers were lower than the anti-O157 antibody titer. The anti-O111 antibody titer and anti-O26 antibody titer were highly correlated, suggesting that they were crossreactive antibodies for O157 LPS. No significant correlation was found between differences in clinical manifestations and the anti-O157 LPS antibody titer in this O157 outbreak in schoolchildren. It was clarified that an increase in anti-LPS antibody was found to support the diagnosis of mild cases of 0157 infection infection as well as severe cases.

Second Generation Subtyping: A Proposed PulseNet Protocol for Multiple-Locus Variable-Number Tandem Repeat Analysis of Shiga Toxin–ProducingEscherichia coliO157 (STEC O157)

Most bacterial genomes contain tandem duplications of short DNA sequences, termed "variable-number tandem repeats" (VNTR). A subtyping method targeting these repeats, multiple-locus VNTR analysis (MLVA), has emerged as a powerful tool for characterization of clonal organisms such as Shiga toxin-producing Escherichia coli O157 (STEC O157). We modified and optimized a recently published MLVA scheme targeting 29 polymorphic VNTR regions of STEC O157 to render it suitable for routine use by public health laboratories that participate in PulseNet, the national and international molecular subtyping network for foodborne disease surveillance. Nine VNTR loci were included in the final protocol. They were amplified in three PCR reactions, after which the PCR products were sized using capillary electrophoresis. Two hundred geographically diverse, sporadic and outbreak- related STEC O157 isolates were characterized by MLVA and the results were compared with data obtained by pulsed-field gel electrophoresis (PFGE) using XbaI macrorestriction of genomic DNA. A total of 139 unique XbaI PFGE patterns and 162 MLVA types were identified. A subset of 100 isolates characterized by both XbaI and BlnI macrorestriction had 62 unique PFGE and MLVA types. Although the clustering of isolates by the two subtyping systems was generally in agreement, some discrepancies were observed. Importantly, MLVA was able to discriminate among some epidemiologically unrelated isolates which were indistinguishable by PFGE. However, among strains from three of the eight outbreaks included in the study, two single locus MLVA variants and one double locus variant were detected among epidemiologically implicated isolates that were indistinguishable by PFGE. Conversely, in three other outbreaks, isolates that were indistinguishable by MLVA displayed multiple PFGE types. An additional more extensive multi-laboratory validation of the MLVA protocol is in progress in order to address critical issues such as establishing epidemiologically relevant interpretation guidelines for the MLVA data.

[Application of pulse field gel electrophoresis in molecular typing method on dealing with the outbreak of intestinal pathogen]

OBJECTIVE

To explore and establish fast and sensitive typing diagnostic methods on intestinal pathogen.

METHODS

All 29 isolates of Shigella. sonnei and 12 strains of Escherichia coli O157:H7 (EHEC O157:H7) isolated in 1999 were carried out for typing by using pulse-field gel electrophoresis (PFGE) and phage typing.

RESULTS

PFGE results of 4 outbreak incidents caused by Shigella. sonnei showed that the PFGE patterns of the strains isolated from the same incident were almost the same. It was also the same during analysing the 2 outbreak incidents caused by EHEC O157:H7, however, the PFGE patterns of the 3 individual strains of EHEC O157:H7 were different. Moreover, the phage typing method showed its fine typing ability while its being used in the analysing 12 strains of EHEC O157:H7.

CONCLUSION

The fine typing ability and reliability of PFGE was helpful for finding out the heredity background of intestinal pathogen and the infectious resource of the outbreak. And the epidemic situation might thus be effectively prevented from spreading.

Prevalence, serotypes and virulence genes of Shiga toxin-producing Escherichia coli isolated from ovine and caprine milk and other dairy products in Spain

The aim of this study was to determinate the prevalence, serotypes and virulence genes of Shiga toxin-producing Escherichia coli (STEC) strains isolated from different dairy products (DP) in Spain with the purpose of determining whether DP represent a potential source of STEC pathogenic for humans. A total of 502 DP were examined from 64 different ovine and caprine flocks and 6 dairy plants in Extremadura (Western Spain). Samples were collected monthly between March 2003 and June 2004 and included 360 unpasteurised milk obtained from the bulk tank, 103 fresh cheese curds and 39 cheeses. Samples obtained were examined for STEC using genotypic (PCR) methods. STEC strains were detected from 39 (10.8%) bulk tank, 4 (3.9%) fresh cheese curds and 2 (5%) cheese, whereas O157:H7 serotype were isolated from one (0.3%) bulk tank. A total of 9 STEC strains (O27:H18, O45:H38, O76:H19, O91:H28, O157:H7, ONT:H7, ONT:H9 and ONT:H21) were identified in this study. One of them, the serotype O27:H18, has not been reported previously as STEC. PCR showed that 3 strains carried stx1 genes, 5 possessed stx2 genes and 1 both stx1 and stx2. Whereas all STEC caprine isolates showed ehxA genes, only O157:H7 serotype showed eae virulence genes. The strain O157:H7 isolated possessed intimin type gamma1 and belonged to phage type 31. This study confirms that dairy product is an important reservoir of STEC pathogenic for humans.

Standardized Pulsed-Field Gel Electrophoresis of Shiga Toxin–Producing Escherichia coli: The PulseNet Europe Feasibility Study

PulseNet USA, the American molecular subtyping network for foodborne infections, has since 1996 been highly successful combating infections caused by Shiga toxin-producing Escherichia coli (STEC) O157, Salmonella, Listeria, and Shigella spp. The PulseNet Europe feasibility study was initiated to ascertain the interest of public health and veterinary reference laboratories to establish a similar network, and to determine if it was possible to perform standardized pulsed-field gel electrophoresis (PFGE) typing of Salmonella, Listeria, and STEC on a large scale in Europe. The results of the STEC part of that study are presented here. Twenty-seven veterinary and public health laboratories participated in the study. The participants subtyped eight E. coli strains by PFGE using the restriction enzyme XbaI according to the PulseNet or a similar protocol, with strict adherence to the electrophoretic conditions stated in the former and submitted an image of their gel for centralized anonymous analysis. The quality of the gels was first graded visually as "good," "intermediate," and "unsatisfactory." The number of gels graded this way was 11, 14, and 2, respectively. All "good" and "intermediate" gels were also analysed and compared by computerized analysis to a reference gel. For gels graded "good," on average 5.6, 7.4, and 8 patterns out of 8 per gel were identified with a similarity of 100%, >95%, and >90%, respectively. The corresponding numbers for gels graded "intermediate" were 1.7, 4.9, and 7.4, respectively. The problems causing the grading to be "intermediate" was overloaded lanes, overexposed images, not optimally focused images and incomplete digestion, all problems that led to misinterpretation of the number of restriction fragments in the gel. These problems may be corrected by simple adjustments to the subtyping procedure. Thus, there seems to be little need for training of the participants in PulseNet Europe.

Slugs: potential novel vectors of Escherichia coli O157

Field and laboratory studies were performed to determine whether slugs could act as novel vectors for pathogen (e.g., Escherichia coli O157) transfer from animal feces to salad vegetables. Escherichia coli O157 was isolated from 0.21% of field slugs from an Aberdeenshire sheep farm. These isolates carried the verocytotoxin genes (vt1 and vt2) and the attaching and effacing gene (eae), suggesting that they are potentially pathogenic to humans. Strain typing using multilocus variable number tandem repeats analysis showed that slug and sheep isolates were indistinguishable. Laboratory experiments using an E. coli mutant resistant to nalidixic acid showed that the ubiquitous slug species Deroceras reticulatum could carry viable E. coli on its external surface for up to 14 days. Slugs that had been fed E. coli shed viable bacteria in their feces with numbers showing a short but statistically significant linear log decline. Further, it was found that E. coli persisted for up to 3 weeks in excreted slug feces, and hence, we conclude that slugs have the potential to act as novel vectors of E. coli O157.

Standardization of Pulsed-Field Gel Electrophoresis Protocols for the Subtyping ofEscherichia coliO157:H7,Salmonella, andShigellafor PulseNet

Standardized rapid pulsed-field gel electrophoresis (PFGE) protocols for the subtyping of Escherichia coli O157:H7, Salmonella serotypes, and Shigella species are described. These protocols are used by laboratories in PulseNet, a network of state and local health departments, and other public health laboratories that perform real-time PFGE subtyping of these bacterial foodborne pathogens for surveillance and outbreak investigations. Development and standardization of these protocols consisted of a thorough optimization of reagents and reaction conditions to ensure that the protocols yielded consistent results and high-quality PFGE pattern data in all the PulseNet participating laboratories. These rapid PFGE protocols are based on the original 3-4-day standardized procedure developed at Centers for Disease Control and Prevention that was validated in 1996 and 1997 by eight independent laboratories. By using these rapid standardized PFGE protocols, PulseNet laboratories are able to subtype foodborne pathogens in approximately 24 h, allowing for the early detection of foodborne disease case clusters and often aiding in the identification of the source responsible for the infections.

Detection of water-borne E. coli O157 using the integrating waveguide biosensor

Escherichia coli O157:H7, the most common serotype of enterohemorrhagic E. coli (EHEC), is responsible for numerous food-borne and water-borne infections worldwide. An integrating waveguide biosensor is described for the detection of water-borne E. coli O157, based on a fluorescent sandwich immunoassay performed inside a glass capillary waveguide. The genomic DNA of captured E. coli O157 cells was extracted and quantitative real-time PCR subsequently performed to assess biosensor-capture efficiency. In vitro microbial growth in capillary waveguide is also documented. The biosensor allows for quantitative detection of as few as 10 cells per capillary (0.075 ml volume) and can be used in conjunction with cell amplification, PCR and microarray technologies to positively identify a pathogen.

[Risk factors for abundance of shiga toxin producing Escherichia coli in sewage water]

Shiga toxin producing Escherichia coli (STEC) in sewage influent into surface water are a potential source of human infections with STEC. Eight sewage treatment plants in Bavaria, Germany, were sampled at regular intervals from 2003 to 2004 in order to estimate STEC load and quantify risk factors. 95 of 378 samples (25 %) were tested positive for stx1and/or stx2 with PCR after enrichment culture. STEC elimination after treatment was 44 %. The following risk factors were analysed with logistic regression: location of sewage plant (rural vs. urban), treatment plant technology (two stage vs. three stage treatment) and sampling location (sewage input vs. sewage output). Rural plants had odds-ratios of 1,7 (95 % CI 1.03 - 2.69; p = 0.038) for a positive stx1 and/ or stx2 PCR result, sampling at sewage input of 2.1 (95 %CI 1.28 - 3.36; p = 0.003) and three stage plants of 1.51 (95 % CI 0.94 - 2.44; p = 0.087, not significant). Sampling after rain and after dry spells had no impact on STEC abundance (univariate Chi-square test = 0.01; df1; p = 0.920). Rural sewage plants had higher odds of STEC content. The influence of the sewage plant technology on the STEC load requires further clarification.

Prevalence and characterization of Escherichia coli O157 isolates from Minnesota dairy farms and county fairs

Samples were collected from 26 organic and conventional farms and 12 county fairs in Minnesota during 2001 and 2002 to identify the presence of Escherichia coli O157. Immunomagnetic separation was used for isolation of E. coli O157. Isolates were further characterized by the presence of virulence marker genes (stx1, stx2, eaeA, E-hly, katP, etpD, and espP), antimicrobial susceptibility profiles, and genotypes. During 2001, E. coli O157 was isolated from 16 (5.2%) of 305 fecal samples and from 7 (36.8%) of 19 farms. During 2002, E. coli O157 was isolated from 6 (4.5%) of 132 fecal samples from weaned calves at 4 (23.5%) of 17 farms. During 2001 and 2002, cattle manure samples were collected from 12 county fairs, and E. coli O157 was isolated from 19 (11%) of 178 samples and 9 (75%) of 12 county fairs. Among 40 E. coli O157 isolates, 17 isolates (43%) had both the stx1 and stx2 genes, and 21 strains (53%) had the stx2 gene only. Thirteen percent of O157 isolates were resistant to tetracycline, and 25% were resistant to sulfadimethoxine. Heterogeneity of E. coli O157 strains was demonstrated by the presence of 22 different pulsed-field gel electrophoresis (PFGE) patterns. Four PFGE patterns matched those of isolates previously found in humans. The presence of E. coli O157 at county fairs suggests the potential for transmission to the public, who may have contact with cattle or their environment.

Detection and frequency of VT1, VT2 and eaeA genes in Escherichia coli O157 and O157:H7 strains isolated from cattle, cattle carcasses and abattoir environment in Istanbul

The aim of this study was to detect VT1, VT2 and eaeA genes and to determine the frequency of these genes in Escherichia coli O157 and O157:H7 strains isolated from cattle, cattle carcasses and environmental samples of the 5 abattoirs located in Istanbul, Turkey. For this, the presence of VT1, VT2 and eaeA genes in 26 strains of E. coli O157:H7 and 6 strains of O157 was investigated by multiplex-PCR. The results have shown that eaeA gene was detected in all O157 and O157:H7 strains tested. Both VT2 and eaeA genes were detected in 4 (80%) of 5 strains of E. coli O157 and eaeA alone in 1 strain of O157. In 27 strains of O157:H7, 5 (18.5%) strains were found to be positive for VT1, VT2 and eaeA genes, 19 (70.3%) strains for both VT2 and eaeA and, 3 (11.1%) strains for only eaeA gene. Either VT1 alone or VT2 alone was not detected in any strains tested. eaeA gene alone in 2 strains, VT2-eaeA genes in 9 strains and VT1-VT2-eaeA genes in 2 strains were detected in 13 of E. coli O157:H7 strains isolated from cattle. eaeA alone in 1 strain, VT2-eaeA genes in 5 strains and VT1-VT2-eaeA genes in 2 strains were detected in 8 of E. coli O157:H7 strains isolated from carcasses. VT2-eaeA genes in 5 strains (isolated from hands, apron, knife and floor) and VT1-VT2-eaeA genes in 1 strain (isolated from knife) were also detected in 6 of E. coli O157:H7 strains isolated from environmental samples. This study reveals that most of the strains are found to be toxigenic and it is most likely that strains isolated from carcasses and abattoir environment originated from cattle feces. Therefore, HACCP systems are necessary from farm to table especially in the abattoirs to prevent contamination of meat and abattoir environment with intestinal content.

Escherichia coli O157 and non-O157 Shiga toxin-producing Escherichia coli in fecal samples of finished pigs at slaughter in Switzerland

Fecal samples from 630 slaughtered finisher pigs were examined by PCR to assess the shedding of Escherichia coli O157 (rfbE) and Shiga toxin-producing E. coli (STEC, stx). The proportion of positive samples was 7.5% for rfbE and 22% for stx. By colony hybridization, 31 E. coli O157 and 45 STEC strains were isolated, and these strains were further characterized by phenotypic and genotypic traits. Among E. coli O157 strains, 30 were sorbitol positive, 30 had an H type other than H7, and none harbored stx genes. Intimin (eae), enterohemolysin (ehxA), EAST1 (astA), and porcine A/E-associated protein (paa) were present in 10, 3, 26, and 6% of strains. Among them, one eae-gamma1-positive O157:H7 strain testing positive for ehxA and astA and two eae-alpha1-positive O157:H45 strains were classified as enteropathogenic E. coli (EPEC). The O157:H45 EPEC harbored the EAF plasmid and the bfpA gene, factors characteristic for typical EPEC. The isolated STEC strains (43 sorbitol positive) belonged to 11 O:H serotypes, including three previously reported in human STEC causing hemolytic uremic syndrome (O9:H-, O26:H-, and O103:H2). All but one strain harbored stx2e. The eae and ehxA genes, which are strongly correlated with human disease, were present in only one O103:H2 strain positive for stx1 and paa, whereas the astA gene was found more frequently (14 strains). High prevalence of STEC was found among finisher pigs, but according to the virulence factors the majority of these strains seem to be of low virulence.

The characterisation of E. coli O157:H7 isolates from cattle faeces and feedlot environment using PFGE

The objectives of this study were to investigate the diversity of Escherichia coli O157:H7 isolates obtained over a 3-month period from a cattle feedlot in order to assess the relationship between environmental and faecal isolates and to determine the pattern of transmission of E. coli O157:H7 between groups of cattle. Faecal samples were obtained from cattle housed in four adjacent feedlot pens at monthly intervals, with environmental pen samples collected simultaneously. All E. coli O157:H7 isolates obtained were examined by pulsed field gel electrophoresis (PFGE), polymerase chain reaction (PCR) to detect eaeA, ehxA, stx1 and stx2 genes and antibiotic sensitivity profiling. Ten isolates were subjected to acid shock to imitate conditions in the acidic cattle abomasum and assess the effect on PFGE profiles. E. coli O157:H7 was isolated from 69 faecal samples and 26 environmental samples. All isolates (n=95) carried the genes for eaeA, ehxA and stx2 and were sensitive to all antibiotics tested. The PFGE profiles of all isolates differed by no more than two bands and clustered within 80% similarity following dendrogram analysis. Acid shock had no effect on the subsequent PFGE patterns. A total of 8.7% (6/69) of cattle were shedding E. coli O157:H7 in the first month with faecal shedding increasing to 52% (36/69) by the third month of the study. A single isolate of E. coli O157:H7 may be passed rapidly through cattle pens, with the environment acting as a significant reservoir for transmission. PFGE is a useful tool for tracking the direct and indirect transmission of E. coli O157:H7 isolates on the farm.

[The epidemiology of hemolytic uremic syndrome in Argentina. Diagnosis of the etiologic agent, reservoirs and routes of transmission]

Shiga toxin-producing Escherichia coli (STEC) cause sporadic cases and outbreaks of nonbloody and bloody diarrhea, and hemolytic uremic syndrome (HUS). E. coil O157:H7 is the most prevalent STEC serotype. However, other serotypes (O26:H11; O103:H2; O111:NM; O121:H19; O145:NM, among others) can cause a similar disease spectrum. Shiga toxins (Stx1, Stx2, and their variants), intimin, and enterohemolysin are the main virulence factors. Three different diagnostic criteria are used to determine the frequency of STEC infection: 1) isolation and characterization of STEC strains; 2) detection of specifically neutralizable free fecal Stx; and 3) Serological tests to detect Stx-antibodies. The surveillance of the STEC strains is performed using subtyping techniques: a) genotyping of Stx and eae by PCR-RFLP; b) phage typing of E. coil O157 strains; and c) pulsed-field gel electrophoresis. STEC O157 and non-O157 strains are recovered from clinic, animal, food and environmental samples, and E. coli O157:H7, a Stx2 and Stx2c producer, harboring eae and ehxA genes, is the most common serotype. During a prospective case-control study conducted to evaluate risk factors for sporadic STEC infection in Mendoza Province and Buenos Aires City and its surroundings during 2001-2002, exposures associated with risk included eating undercooked beef, contact with a child < 5 years with diarrhea and living in or visiting a place with farm animals. Both washing hands after handling raw beef, and eating fruits and vegetables were frequently protective. Strategies of prevention and control are necessary to decrease the incidence of STEC infections in Argentina.