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Tapia-Pastrana G, Rojas-Bautista M, Hernández-Pérez P, Santiago-Martínez O, Gómez-Rodríguez LC, Terrazas-Luna VM, Montes-Yedra J, Bautista-Avendaño AA, García-López ES, Leon-Sicairos N, Angulo-Zamudio UA, Canizalez-Roman A. Virulence genes, antimicrobial resistance profile, phylotyping and pathotyping of diarrheagenic Escherichia coli isolated from children in Southwest Mexico. PLoS One 2024; 19:e0300304. [PMID: 38470897 DOI: 10.1371/journal.pone.0300304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
Diarrheagenic E. coli (DEC) strains are one of the most important etiology factors causing diarrhea in children worldwide, especially in developing countries. DEC strains have characteristic virulence factors; however, other supplemental virulence genes (SVG) may contribute to the development of diarrhea in children. Therefore, this study aimed to determine the prevalence of DEC in children with diarrhea in southwestern Mexico and to associate childhood symptoms, SVG, and pathotypes with diarrhea-causing DEC strains. DEC strains were isolated from 230 children with diarrhea aged 0-60 months from the state of Oaxaca, southwestern Mexico; clinical data were collected, and PCR was used to identify SVG and pathotypes. Antibiotic resistance profiling was performed on DEC strains. 63% of samples were DEC positive, single or combined infections (two (21%) or three strains (1.3%)) of aEPEC (51%), EAEC (10.2%), tEPEC (5.4%), DAEC (4.8%), ETEC (4.1%), EIEC (1.4%), or EHEC (0.7%) were found. Children aged ≤ 12 and 49-60 months and symptoms (e.g., fever and blood) were associated with DEC strains. SVG related to colonization (nleB-EHEC), cytotoxicity (sat-DAEC and espC-tEPEC), and proteolysis (pic-aEPEC) were associated with DECs strains. E. coli phylogroup A was the most frequent, and some pathotypes (aEPEC-A, DAEC-B), and SVG (espC-B2, and sat-D) were associated with the phylogroups. Over 79% of the DEC strains were resistant to antibiotics, and 40% were MDR and XDR, respectively. In conclusion aEPEC was the most prevalent pathotype in children with diarrhea in this region. SVG related to colonization, cytotoxicity, and proteolysis were associated with diarrhea-producing DEC strains, which may play an essential role in the development of diarrhea in children in southwestern Mexico.
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Affiliation(s)
- Gabriela Tapia-Pastrana
- Laboratorio de Investigación Biomédica, Hospital Regional de Alta Especialidad de Oaxaca, Servicios de Salud, IMSS-Bienestar, Oaxaca, Mexico
| | - Metztli Rojas-Bautista
- Facultad de Ciencias Químicas de la Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca de Juarez, Oaxaca, Mexico
| | - Pilar Hernández-Pérez
- Facultad de Ciencias Químicas de la Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca de Juarez, Oaxaca, Mexico
| | - Olegario Santiago-Martínez
- Facultad de Ciencias Químicas de la Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca de Juarez, Oaxaca, Mexico
| | - Lucía C Gómez-Rodríguez
- Facultad de Ciencias Químicas de la Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca de Juarez, Oaxaca, Mexico
| | - Víctor M Terrazas-Luna
- Laboratorio de Investigación Biomédica, Hospital Regional de Alta Especialidad de Oaxaca, Servicios de Salud, IMSS-Bienestar, Oaxaca, Mexico
| | - Jacobo Montes-Yedra
- Departamento de Ciencias Básicas del Instituto Tecnológico del Valle de Oaxaca, Santa Cruz Xoxocotlán, Oaxaca, Mexico
| | - Alfonso A Bautista-Avendaño
- Departamento de Ciencias Básicas del Instituto Tecnológico del Valle de Oaxaca, Santa Cruz Xoxocotlán, Oaxaca, Mexico
| | | | - Nidia Leon-Sicairos
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Sinaloa, Mexico
- Pediatric Hospital of Sinaloa, Culiacan, Sinaloa, Mexico
| | | | - Adrian Canizalez-Roman
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Sinaloa, Mexico
- The Women's Hospital, Secretariat of Health, Culiacan, Sinaloa, Mexico
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Fernandez-Ciruelos B, Potmis T, Solomin V, Wells JM. Cross-talk between QseBC and PmrAB two-component systems is crucial for regulation of motility and colistin resistance in Enteropathogenic Escherichia coli. PLoS Pathog 2023; 19:e1011345. [PMID: 38060591 PMCID: PMC10729948 DOI: 10.1371/journal.ppat.1011345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 12/19/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
The quorum sensing two-component system (TCS) QseBC has been linked to virulence, motility and metabolism regulation in multiple Gram-negative pathogens, including Enterohaemorrhagic Escherichia coli (EHEC), Uropathogenic E. coli (UPEC) and Salmonella enterica. In EHEC, the sensor histidine kinase (HK) QseC detects the quorum sensing signalling molecule AI-3 and also acts as an adrenergic sensor binding host epinephrine and norepinephrine. Downstream changes in gene expression are mediated by phosphorylation of its cognate response regulator (RR) QseB, and 'cross-talks' with non-cognate regulators KdpE and QseF to activate motility and virulence. In UPEC, cross-talk between QseBC and TCS PmrAB is crucial in the regulation and phosphorylation of QseB RR that acts as a repressor of multiple pathways, including motility. Here, we investigated QseBC regulation of motility in the atypical Enteropathogenic E. coli (EPEC) strain O125ac:H6, causative agent of persistent diarrhoea in children, and its possible cross-talk with the KdpDE and PmrAB TCS. We showed that in EPEC QseB acts as a repressor of genes involved in motility, virulence and stress response, and in absence of QseC HK, QseB is likely activated by the non-cognate PmrB HK, similarly to UPEC. We show that in absence of QseC, phosphorylated QseB activates its own expression, and is responsible for the low motility phenotypes seen in a QseC deletion mutant. Furthermore, we showed that KdpD HK regulates motility in an independent manner to QseBC and through a third unidentified party different to its own response regulator KdpE. We showed that PmrAB has a role in iron adaptation independent to QseBC. Finally, we showed that QseB is the responsible for activation of colistin and polymyxin B resistance genes while PmrA RR acts by preventing QseB activation of these resistance genes.
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Affiliation(s)
- Blanca Fernandez-Ciruelos
- Host-Microbe Interactomics Group, Wageningen University & Research (WUR), Wageningen, The Netherlands
| | - Tasneemah Potmis
- Host-Microbe Interactomics Group, Wageningen University & Research (WUR), Wageningen, The Netherlands
| | - Vitalii Solomin
- Organic Synthesis Methodology Group, Latvian Institute of Organic Synthesis (LIOS), Riga, Latvia
| | - Jerry M. Wells
- Host-Microbe Interactomics Group, Wageningen University & Research (WUR), Wageningen, The Netherlands
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McDougall F, Gordon D, Robins-Browne R, Bennett-Wood V, Boardman WSJ, Graham PL, Power M. Characterisation of typical enteropathogenic Escherichia coli (tEPEC) lineages and novel bfpA variants detected in Australian fruit bats (Pteropus poliocephalus). THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 902:166336. [PMID: 37591385 DOI: 10.1016/j.scitotenv.2023.166336] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
Enteropathogenic Escherichia coli (EPEC) is an important cause of diarrhoeal disease in human infants. EPEC strains are defined by the presence of specific virulence factors including intimin (encoded by the eae gene) and bundle forming pili (Bfp). Bfp is encoded by the bfp operon and includes the bfpA gene for the major pilus subunit. By definition, Bfp are only present in typical EPEC (tEPEC), for which, humans are considered to be the only known natural host. This study detected tEPEC in faecal samples from a wild Australian fruit bat species, the grey-headed flying-fox (Pteropus poliocephalus). Whole genome sequencing of 61 E. coli isolates from flying-foxes revealed that 21.3 % (95%CI: 13 %-33 %) were tEPEC. Phylogenetic analyses showed flying-fox tEPEC shared evolutionary lineages with human EPEC, but were predominantly novel sequence types (9 of 13) and typically harboured novel bfpA variants (11 of 13). HEp-2 cell adhesion assays showed adherence to human-derived epithelial cells by all 13 flying-fox tEPEC, indicating that they all carried functional Bfp. Using an EPEC-specific duplex PCR, it was determined that tEPEC comprised 17.4 % (95%CI: 13 %-22 %) of 270 flying-fox E. coli isolates. Furthermore, a tEPEC-specific multiplex PCR detected the eae and bfpA virulence genes in 18.0 % (95%CI: 8.0 %-33.7 %) of 506 flying-fox faecal DNA samples, with occurrences ranging from 1.3 % to 87.0 % across five geographic areas sampled over a four-year period. The identification of six novel tEPEC sequence types and five novel bfpA variants suggests flying-foxes carry bat-specific tEPEC lineages. However, their close relationship with human EPEC and functional Bfp, indicates that flying-fox tEPEC have zoonotic potential and that dissemination of flying-fox tEPEC into urban environments may pose a public health risk. The consistent detection of tEPEC in flying-foxes over extensive geographical and temporal scales indicates that both wild grey-headed flying-foxes and humans should be regarded as natural tEPEC hosts.
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Affiliation(s)
- Fiona McDougall
- School of Natural Sciences, Faculty of Science and Engineering, Macquarie University, NSW 2109, Australia.
| | - David Gordon
- Research School of Biology, Australian National University, ACT 2601, Australia.
| | - Roy Robins-Browne
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, VIC 3010, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, VIC 3052, Australia.
| | - Vicki Bennett-Wood
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, VIC 3010, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, VIC 3052, Australia.
| | - Wayne S J Boardman
- School of Animal and Veterinary Sciences, University of Adelaide, SA 5371, Australia.
| | - Petra L Graham
- School of Mathematical and Physical Sciences, Faculty of Science and Engineering, Macquarie University, NSW 2109, Australia.
| | - Michelle Power
- School of Natural Sciences, Faculty of Science and Engineering, Macquarie University, NSW 2109, Australia.
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Burke LP, Chique C, Fitzhenry K, Chueiri A, O'Connor L, Hooban B, Cahill N, Brosnan E, Olaore L, Sullivan E, Reilly L, Morris D, Hynds P, O'Dwyer J. Characterization of Shiga toxin-producing Escherichia coli presence, serogroups and risk factors from private groundwater sources in western Ireland. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 866:161302. [PMID: 36592918 DOI: 10.1016/j.scitotenv.2022.161302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/14/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Over recent years, Ireland has reported the highest crude incidence rates of Shiga toxin-producing Escherichia coli (STEC) enteritis in Europe. Unregulated private groundwater sources have emerged as an important potential transmission route for STEC, with up to 750,000 Irish residents reliant on these sources for domestic waters. This study aimed to investigate the prevalence and serogroup profile of STEC contamination from domestic private wells in western Ireland. Fifty-two groundwater sources were analysed during two sampling campaigns in the autumn (September/October) of 2019 (n = 21) and 2021 (n = 31). Untreated groundwater samples (30 L) were collected and analysed using the "CapE" (capture, amplify, extract) method. Extracted DNA was tested using multiplex real-time PCR for Shiga toxin stx1 and/or stx2 and eae genes. STEC positive DNA samples were tested for clinically relevant serogroups by real-time PCR. Data relating to 27 potential groundwater contamination risk factors were geospatially linked to each well and assessed for association with E. coli, stx1 and/or stx2 and eae presence/absence. Overall, 20/52 wells (38.4 %) were positive for E. coli (median concentration 8.5 MPN/100 mL as assessed by Colilert-18 method). Stx1 and/or stx2 was detected in 10/52 (19.2 %) wells overall and 8/20 E. coli positive wells, equating to a STEC to "generic" E. coli detection ratio of 40 %. Six of these wells (30 %) were also positive for eae. One or more serogroup-specific gene targets were identified in all but one stx1 and/or stx2 positive sample, with O145 (n = 6), O157 (n = 5) and O103 (n = 4) most prevalent. STEC presence was significantly associated with decreasing well depth (U = -2.243; p = 0.024) and increasing 30-day mean antecedent rainfall (U = 2.126; p = 0.034). Serogroup O104 was associated with increased sheep density (U = 2.089; p = 0.044) and detection of stx1 and/or stx2 + eae with increased septic tank density (U = 2.246 p = 0.023). Findings indicate high detection rates of clinically relevant STEC in E. coli contaminated groundwater sources in Ireland.
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Affiliation(s)
- Liam Patrick Burke
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland.
| | - Carlos Chique
- School of Biological, Earth and Environmental Science (BEES), University College Cork, Cork, Ireland; Environmental Research Institute, University College Cork, Cork, Ireland
| | - Kelly Fitzhenry
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Alexandra Chueiri
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Louise O'Connor
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Brigid Hooban
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Niamh Cahill
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Ellen Brosnan
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Lateefat Olaore
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Emma Sullivan
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Louise Reilly
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Dearbháile Morris
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland
| | - Paul Hynds
- Irish Centre for Research in Applied Geosciences, University College Dublin, Dublin, Ireland; Environmental Sustainability and Health Institute (ESHI), Technological University Dublin, Ireland
| | - Jean O'Dwyer
- School of Biological, Earth and Environmental Science (BEES), University College Cork, Cork, Ireland; Environmental Research Institute, University College Cork, Cork, Ireland; Irish Centre for Research in Applied Geosciences, University College Dublin, Dublin, Ireland
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High Burden of Co-Infection with Multiple Enteric Pathogens in Children Suffering with Diarrhoea from Rural and Peri-Urban Communities in South Africa. Pathogens 2023; 12:pathogens12020315. [PMID: 36839587 PMCID: PMC9959912 DOI: 10.3390/pathogens12020315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Infectious diarrhoea contributes to high morbidity and mortality in young children from sub-Saharan Africa. The aim of this study was to assess the prevalence of single and multiple diarrhoeal-causing pathogen combinations in children suffering from diarrhoea from rural and peri-urban communities in South Africa. A total of 275 diarrhoea stool specimens were collected between 2014 and 2016 from Hospitals and Primary Health Care clinics. The BioFire® FilmArray® Gastrointestinal panel was used to simultaneously detect 22 diarrhoea pathogens (viruses, bacteria, parasites) known to cause diarrhoea. A total of 82% (226/275) enteric pathogens were detected in the stool specimens. The two most detected bacterial, viral and parasitic pathogens each included: EAEC (42%), EPEC (32%), Adenovirus F40/41 (19%), Norovirus (15%), Giardia (8%) and Cryptosporidium (6%), respectively. Single enteric pathogen infections were recorded in 24% (65/275) specimens with EAEC, and Norovirus was found in 26% (17/65) and 14% (9/65) of the specimens, respectively. Multiple enteric pathogen combinations were recorded in 59% (161/275) of the stool specimens with 53% (85/161) containing two pathogens, 22% (35/161) containing three pathogens and 25% (41/161) containing four or more pathogens. The results from this study demonstrated the complex nature of pathogen co-infections in diarrhoeal episodes which could have an impact on treatment effectiveness.
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Baumgartner M, Zirnbauer R, Schlager S, Mertens D, Gasche N, Sladek B, Herbold C, Bochkareva O, Emelianenko V, Vogelsang H, Lang M, Klotz A, Moik B, Makristathis A, Berry D, Dabsch S, Khare V, Gasche C. Atypical enteropathogenic E. coli are associated with disease activity in ulcerative colitis. Gut Microbes 2022; 14:2143218. [PMID: 36415023 PMCID: PMC9704410 DOI: 10.1080/19490976.2022.2143218] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
With increasing urbanization and industrialization, the prevalence of inflammatory bowel diseases (IBDs) has steadily been rising over the past two decades. IBD involves flares of gastrointestinal (GI) inflammation accompanied by microbiota perturbations. However, microbial mechanisms that trigger such flares remain elusive. Here, we analyzed the association of the emerging pathogen atypical enteropathogenic E. coli (aEPEC) with IBD disease activity. The presence of diarrheagenic E. coli was assessed in stool samples from 630 IBD patients and 234 age- and sex-matched controls without GI symptoms. Microbiota was analyzed with 16S ribosomal RNA gene amplicon sequencing, and 57 clinical aEPEC isolates were subjected to whole-genome sequencing and in vitro pathogenicity experiments including biofilm formation, epithelial barrier function and the ability to induce pro-inflammatory signaling. The presence of aEPEC correlated with laboratory, clinical and endoscopic disease activity in ulcerative colitis (UC), as well as microbiota dysbiosis. In vitro, aEPEC strains induce epithelial p21-activated kinases, disrupt the epithelial barrier and display potent biofilm formation. The effector proteins espV and espG2 distinguish aEPEC cultured from UC and Crohn's disease patients, respectively. EspV-positive aEPEC harbor more virulence factors and have a higher pro-inflammatory potential, which is counteracted by 5-ASA. aEPEC may tip a fragile immune-microbiota homeostasis and thereby contribute to flares in UC. aEPEC isolates from UC patients display properties to disrupt the epithelial barrier and to induce pro-inflammatory signaling in vitro.
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Affiliation(s)
- Maximilian Baumgartner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Rebecca Zirnbauer
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Sabine Schlager
- National Reference Laboratory for Escherichia coli, Austrian Agency for Health and Food Safety, Graz, Austria
| | - Daniel Mertens
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | | | | | - Craig Herbold
- Joint Microbiome Facility of the Medical University of Vienna and the University of Vienna, Vienna, Austria
| | - Olga Bochkareva
- Institute of Science and Technology Austria, Klosterneuburg, Austria
| | - Vera Emelianenko
- Institute of Science and Technology Austria, Klosterneuburg, Austria
| | - Harald Vogelsang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Michaela Lang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria,Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, Division of Microbial Ecology, University of Vienna, Vienna, Austria
| | - Anton Klotz
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Birgit Moik
- National Reference Laboratory for Escherichia coli, Austrian Agency for Health and Food Safety, Graz, Austria
| | - Athanasios Makristathis
- Joint Microbiome Facility of the Medical University of Vienna and the University of Vienna, Vienna, Austria,Division of Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - David Berry
- Joint Microbiome Facility of the Medical University of Vienna and the University of Vienna, Vienna, Austria,Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, Division of Microbial Ecology, University of Vienna, Vienna, Austria
| | - Stefanie Dabsch
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Vineeta Khare
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Christoph Gasche
- Division of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria,CONTACT Christoph Gasche Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, A-1090Austria
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Kralicek SE, Sitaraman LM, Kuprys PV, Harrington AT, Ramakrishna B, Osman M, Hecht GA. Clinical Manifestations and Stool Load of Atypical Enteropathogenic Escherichia coli Infections in United States Children and Adults. Gastroenterology 2022; 163:1321-1333. [PMID: 35948108 PMCID: PMC9613550 DOI: 10.1053/j.gastro.2022.07.064] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS There is debate whether atypical enteropathogenic Escherichia coli (aEPEC) causes disease in adults. aEPEC is commonly detected in symptomatic and asymptomatic individuals. aEPEC, in contrast to typical EPEC, lacks bundle-forming pili, altering its pathogenicity. Here, we define for the first time the clinical manifestations of sporadic aEPEC infection in United States children and adults and determine whether EPEC load correlates with disease. METHODS This is a retrospective case-control study of 380 inpatients/outpatients of all ages. EPEC load in stools was determined by quantitative polymerase chain reaction. RESULTS Diarrhea, vomiting, abdominal pain, and fever were more prevalent in EPEC-positive cases than in EPEC-negative controls. aEPEC infection caused mostly acute, mild diarrhea lasting for 6 to 13 days. However, some had severe diarrhea with 10 to 40 bowel movements per day or had persistent/chronic diarrhea. Fever, vomiting, and abnormal serum sodium levels were more common in children. Adults more often reported abdominal pain and longer duration of diarrhea. Symptomatic aEPEC infection was associated with leukocytosis in 24% of patients. EPEC load >0.1% was associated with symptomatic infection; however, loads varied greatly. Co-infecting pathogens did not alter diarrhea severity or EPEC load. Longitudinal data reveal that some are colonized for months to years or are repeatedly infected. CONCLUSIONS aEPEC is associated with a wide array of symptoms in adults, ranging from asymptomatic carriage to severe diarrhea. Higher EPEC loads are associated with presence of symptoms, but bacterial load does not predict disease or severity. Future studies are needed to understand bacterial and host factors that contribute to aEPEC pathogenicity to improve diagnostic tools and clinical care.
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Affiliation(s)
- Sarah E Kralicek
- Department of Biochemistry and Molecular Biology, Loyola University Chicago, Maywood, Illinois
| | - Lalitha M Sitaraman
- Division of Gastroenterology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Paulius V Kuprys
- Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Amanda T Harrington
- Clinical Microbiology Laboratory, Loyola University Medical Center, Maywood, Illinois; Pathology and Laboratory Medicine, Loyola University Chicago, Maywood, Illinois
| | | | | | - Gail A Hecht
- Division of Gastroenterology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois; Department of Microbiology and Immunology, Loyola University Chicago, Maywood, Illinois.
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8
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Ledwaba SE, Bolick DT, de Medeiros PHQS, Kolling GL, Traore AN, Potgieter N, Nataro JP, Guerrant RL. Enteropathogenic Escherichia coli (EPEC) expressing a non-functional bundle-forming pili (BFP) also leads to increased growth failure and intestinal inflammation in C57BL/6 mice. Braz J Microbiol 2022; 53:1781-1787. [PMID: 35882715 PMCID: PMC9679052 DOI: 10.1007/s42770-022-00802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/17/2022] [Indexed: 01/13/2023] Open
Abstract
Bundle-forming pili (BFP) are implicated in the virulence of typical enteropathogenic E. coli (EPEC), resulting in enhanced colonization and mild to severe disease outcomes; hence, non-functional BFP may have a major influence on disease outcomes in vivo. Weaned antibiotic pre-treated C57BL/6 mice were orally infected with EPEC strain UMD901 (E2348/69 bfpA C129S); mice were monitored daily for body weight; stool specimens were collected daily; and intestinal tissues were collected at the termination of the experiment on day 3 post-infection. Real-time PCR was used to quantify fecal shedding and tissue burden. Intestinal inflammatory biomarkers lipocalin-2 (LCN-2) and myeloperoxidase (MPO) were also assessed. Infection caused substantial body weight loss, bloody diarrhea, and intestinal colonization with fecal and intestinal tissue inflammatory biomarkers that were comparable to those previously published with the wild-type typical EPEC strain. Here we further report on the evaluation of an EPEC infection model, showing how disruption of bfp function does not impair, and may even worsen diarrhea, colonization, and intestinal disruption and inflammation. More research is needed to understand the role of bfp in pathogenicity of EPEC infections in vivo.
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Affiliation(s)
- Solanka Ellen Ledwaba
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou, Limpopo Province South Africa
| | - David Thomas Bolick
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA USA
| | | | - Glynis Luanne Kolling
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA USA ,Department of Biomedical Engineering, University of Virgina, Charlottesville, VA USA
| | - Afsatou Ndama Traore
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou, Limpopo Province South Africa
| | - Natasha Potgieter
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou, Limpopo Province South Africa
| | - James Paul Nataro
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA USA
| | - Richard Littleton Guerrant
- Division of Infectious Disease and International Health, School of Medicine, University of Virginia, Charlottesville, VA USA
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9
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Molecular Characterization and Antimicrobial Resistance of Pathogenic Escherichia coli Strains in Children from Wolaita Sodo, Southern Ethiopia. J Trop Med 2022; 2022:9166209. [PMID: 35846070 PMCID: PMC9279085 DOI: 10.1155/2022/9166209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Pathogenic Escherichia coli strains cause diarrheal infection in children due to their virulence factors. A nonanalytical observational study followed by a purposive sampling technique was conducted from October 2017 to June 2018, to determine the antimicrobial susceptibility patterns and molecularly detect pathogenic Escherichia coli strains in under-five children at Wolaita Sodo town using molecular and the Kirby-Bauer disc diffusion method. Result In the current investigation, out of 110 stool samples, Escherichia coli was isolated in 68 (61.8%) (95% CI: 52.1–70.9%). Out of 68 Escherichia coli isolates, 61.9% of Escherichia coli isolates were resistant, 9.4% were intermediately resistant, and 28.7% were susceptible. Among the antimicrobial agents, 91.2% of Escherichia coli isolates were highly sensitive to ciprofloxacin followed by norfloxacin (86.8%). Virulence genes were detected in 55.9% (38/68) (95% CI 52.1%–70.9%) of isolates. The following genes were detected: stx1 (6 (8.8%)), stx2 (4 (5.9%)), eaeA (5 (7.4%)), eaat (14 (20.5%)), and St (4 (5.9%)). Out of 68 Escherichia coli isolates, 43 (63.2%) isolates had shown multidrug resistance patterns. Furthermore, 11.8% of Escherichia coli isolates had shown resistance to eight different drugs. The multidrug resistance index value of Diarrheagenic Escherichia coli pathotypes was greater than or equal to 0.4, which indicates the high risk of resistance. Conclusion This study demonstrated important pathogenic Escherichia coli strains and multidrug resistance in isolates containing virulence genes. Wise use of antimicrobials and improving the hygienic practices amongst parents of children reduce its occurrence. Therefore, appropriate usage of antimicrobial agents should also be highly practiced in hospitals.
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10
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Site specific incidence rate of genomic subtypes of enteropathogenic Escherichia coli and association with enteric inflammation and child growth. Sci Rep 2022; 12:5724. [PMID: 35388098 PMCID: PMC8986875 DOI: 10.1038/s41598-022-09730-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/16/2022] [Indexed: 02/01/2023] Open
Abstract
There is a lack of information highlighting the possible association between the genomic subtypes of enteropathogenic Escherichia coli (EPEC) on environmental enteric dysfunction (EED) and on linear growth during childhood. Genomic subtypes of EPEC from stool samples collected from 1705 children enrolled in the MAL-ED birth cohort were detected by TaqMan Array Cards. We measured site-specific incidence rate by using Poisson regression models, identified the risk factors and estimated the association of genomic subtypes of EPEC with the composite EED score and linear growth at 24 months of age. In general, the highest incidence rate (39%) was found among children having aEPEC infection, which was the greatest in Tanzania (54%). Exclusive breastfeeding and having an improved sanitation facility were found to be protective factors against EPEC infection. In the multivariate models, in overall effect after adjusting for the potential covariates aEPEC showed strong positive associations with the EED scores and tEPEC showed a positive association with poor linear growth at 24 months of age. Our analyses may lay the cornerstone for a prospective epidemiologic investigation for a potential vaccine development aimed at reducing the burden of EPEC infections and combat childhood malnutrition.
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11
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Jarquin C, Morales O, McCracken JP, Lopez MR, Lopez B, Reyes L, Gómez GA, Bryan JP, Peruski LF, Pattabiraman V, Parsons MB. Burden of Diarrheagenic
Escherichia coli
in Santa Rosa, Guatemala in active health‐services surveillance during 2008‐2009 and 2014‐2015. Trop Med Int Health 2022; 27:408-417. [DOI: 10.1111/tmi.13735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Claudia Jarquin
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - Oneida Morales
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - John P. McCracken
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - Maria R. Lopez
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - Beatriz Lopez
- US Centers for Disease Control and Prevention Central America Regional Office Center for Global Health Guatemala
| | - Lisette Reyes
- Guatemalan Ministry of Public Health and Social Welfare Guatemala
| | - Gerardo A. Gómez
- National Center for Emerging and Zoonotic Infectious Diseases US Centers for Disease Control and Prevention Atlanta USA
| | - Joe P. Bryan
- US Centers for Disease Control and Prevention Central America Regional Office Center for Global Health Guatemala
| | - Leonard F. Peruski
- US Centers for Disease Control and Prevention Central America Regional Office Center for Global Health Guatemala
| | - Vaishnavi Pattabiraman
- National Center for Emerging and Zoonotic Infectious Diseases US Centers for Disease Control and Prevention Atlanta USA
| | - Michele B. Parsons
- National Center for Emerging and Zoonotic Infectious Diseases US Centers for Disease Control and Prevention Atlanta USA
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12
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Wolde A, Deneke Y, Sisay T, Mathewos M, Fesseha H. Isolation of Escherichia coli and Its Associated Risk Factor from Diarrheic Children in Wolaita Sodo Town, Southern Ethiopia. Res Rep Trop Med 2021; 12:227-234. [PMID: 34675750 PMCID: PMC8518477 DOI: 10.2147/rrtm.s327129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/26/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Escherichia coli are among the major causes of mortality and morbidity in under-five children in developing nations including Ethiopia. METHODS A non-analytical observational study design followed by a purposive sampling technique was conducted from October 2017 to June 2018, to isolate Escherichia coli and determine its associated risk factors from diarrheic children that were admitted to Christian hospital, Wolaita Sodo town. E. coli was confirmed using standard culture and biochemical analyses of the bacterium. In addition, a semi-structured questionnaire was provided to evaluate the potential risk factors that contribute to diarrhea in children. RESULTS The overall isolation rate of E. coli in diarrheic children was 61.8% (68/110) (95% CI: 52.1-70.9%). Factors such as age, contact with either animals or manure, negligence to handwashing before a meal with soap, and exclusive breastfeeding at six months (p<0.05) has significant contribution to the prevalence of the E. coli in diarrheic children. The odds of being infected were highest in children whose caretakers had a habit of the negligence of handwashing before the meal (AOR = 6; 95% CI 30.8-49.8%; p = 0.01). CONCLUSION Improving the hygienic practices amongst parents of children reduces its Escherichia coli occurrence. Furthermore, awareness of the importance of exclusive breastfeeding to parents of children should be maximized.
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Affiliation(s)
- Amanuel Wolde
- College of Agriculture, Department of Veterinary Science, Jinka University, Jinka, Ethiopia
| | - Yosef Deneke
- School of Agriculture and Veterinary Medicine, Jimma University, Jimma, Ethiopia
| | - Tesfaye Sisay
- Institute of Biotechnology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mesfin Mathewos
- School of Veterinary Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Haben Fesseha
- School of Veterinary Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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13
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Olvera A, Carter H, Rajan A, Carlin LG, Yu X, Zeng XL, Shelburne S, Bhatti M, Blutt SE, Shroyer NF, Jenq R, Estes MK, Maresso A, Okhuysen PC. Enteropathogenic Escherichia coli Infection in Cancer and Immunosuppressed Patients. Clin Infect Dis 2021; 72:e620-e629. [PMID: 32930708 DOI: 10.1093/cid/ciaa1394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The role of enteropathogenic Escherichia coli (EPEC) as a cause of diarrhea in cancer and immunocompromised patients is controversial. Quantitation of fecal bacterial loads has been proposed as a method to differentiate colonized from truly infected patients. METHODS We studied 77 adult cancer and immunosuppressed patients with diarrhea and EPEC identified in stools by FilmArray, 25 patients with pathogen-negative diarrhea, and 21 healthy adults without diarrhea. Stools were studied by quantitative polymerase chain reaction (qRT-PCR) for EPEC genes eaeA and lifA/efa-1 and strains characterized for virulence factors and adherence to human intestinal enteroids (HIEs). RESULTS Patients with EPEC were more likely to have community-acquired diarrhea (odds ratio, 3.82 [95% confidence interval, 1.5-10.0]; P = .008) compared with pathogen-negative cases. Although EPEC was identified in 3 of 21 (14%) healthy subjects by qPCR, the bacterial burden was low compared to patients with diarrhea (≤55 vs median, 6 × 104 bacteria/mg stool; P < .001). Among EPEC patients, the bacterial burden was higher in those who were immunosuppressed (median, 6.7 × 103 vs 55 bacteria/mg; P < .001) and those with fecal lifA/ifa-1 (median, 5 × 104 vs 120 bacteria/mg; P = .015). Response to antimicrobial therapy was seen in 44 of 48 (92%) patients with EPEC as the sole pathogen. Antimicrobial resistance was common and strains exhibited distinct patterns of adherence with variable cytotoxicity when studied in HIEs. Cancer care was delayed in 13% of patients. CONCLUSIONS Immunosuppressed cancer patients with EPEC-associated diarrhea carry high burden of EPEC with strains that are resistant to antibiotics, exhibit novel patterns of adherence when studied in HIEs, and interfere with cancer care.
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Affiliation(s)
- Adilene Olvera
- Department of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hannah Carter
- Department of Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Anubama Rajan
- Department of Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Lily G Carlin
- Department of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xiaomin Yu
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Xi-Lei Zeng
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Samuel Shelburne
- Department of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Micah Bhatti
- Department of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sarah E Blutt
- Department of Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Noah F Shroyer
- Department of Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Robert Jenq
- Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mary K Estes
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Anthony Maresso
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Pablo C Okhuysen
- Department of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
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14
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Abstract
PURPOSE OF REVIEW Several types of Escherichia coli cause acute diarrhea in humans and are responsible for a large burden of disease globally. The purpose of this review is to summarize diarrheagenic Escherichia coli (DEC) pathotype definitions and discuss existing and emerging molecular, genomic, and gut microbiome methods to detect, define, and study DEC pathotypes. RECENT FINDINGS DEC pathotypes are currently diagnosed by molecular detection of unique virulence genes. However, some pathotypes have defied coherent molecular definitions because of imperfect gene targets, and pathotype categories are complicated by hybrid strains and isolation of pathotypes from asymptomatic individuals. Recent progress toward more efficient, sensitive, and multiplex DEC pathotype detection has been made using emerging PCR-based technologies. Genomics and gut microbiome detection methods continue to advance rapidly and are contributing to a better understanding of DEC pathotype diversity and functional potential. SUMMARY DEC pathotype categorizations and detection methods are useful but imperfect. The implementation of molecular and sequence-based methods and well designed epidemiological studies will continue to advance understanding of DEC pathotypes. Additional emphasis is needed on sequencing DEC genomes from regions of the world where they cause the most disease and from the pathotypes that cause the greatest burden of disease globally.
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15
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Comparative Genomics of Atypical Enteropathogenic Escherichia coli from Kittens and Children Identifies Bacterial Factors Associated with Virulence in Kittens. Infect Immun 2021; 89:IAI.00619-20. [PMID: 33257534 DOI: 10.1128/iai.00619-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
Typical enteropathogenic Escherichia coli (tEPEC) is a leading cause of diarrhea and associated death in children worldwide. Atypical EPEC (aEPEC) lacks the plasmid encoding bundle-forming pili and is considered less virulent, but the molecular mechanism of virulence is poorly understood. We recently identified kittens as a host for aEPEC where intestinal epithelial colonization was associated with diarrheal disease and death. The purposes of this study were to (i) determine the genomic similarity between kitten aEPEC and human aEPEC isolates and (ii) identify genotypic or phenotypic traits associated with virulence in kitten aEPEC. We observed no differences between kitten and human aEPEC in core genome content or gene cluster sequence identities, and no distinguishing genomic content was observed between aEPEC isolates from kittens with nonclinical colonization (NC) versus those with lethal infection (LI). Variation in adherence patterns and ability to aggregate actin in cultured cells mirrored descriptions of human aEPEC. The aEPEC isolated from kittens with LI were significantly more motile than isolates from kittens with NC. Kittens may serve as a reservoir for aEPEC that is indistinguishable from human aEPEC isolates and may provide a needed comparative animal model for the study of aEPEC pathogenesis. Motility seems to be an important factor in pathogenesis of LI associated with aEPEC in kittens.
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16
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García A, Fox JG. A One Health Perspective for Defining and Deciphering Escherichia coli Pathogenic Potential in Multiple Hosts. Comp Med 2021; 71:3-45. [PMID: 33419487 PMCID: PMC7898170 DOI: 10.30802/aalas-cm-20-000054] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/17/2020] [Accepted: 09/19/2020] [Indexed: 11/05/2022]
Abstract
E. coli is one of the most common species of bacteria colonizing humans and animals. The singularity of E. coli 's genus and species underestimates its multifaceted nature, which is represented by different strains, each with different combinations of distinct virulence factors. In fact, several E. coli pathotypes, or hybrid strains, may be associated with both subclinical infection and a range of clinical conditions, including enteric, urinary, and systemic infections. E. coli may also express DNA-damaging toxins that could impact cancer development. This review summarizes the different E. coli pathotypes in the context of their history, hosts, clinical signs, epidemiology, and control. The pathotypic characterization of E. coli in the context of disease in different animals, including humans, provides comparative and One Health perspectives that will guide future clinical and research investigations of E. coli infections.
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Key Words
- aa, aggregative adherence
- a/e, attaching and effacing
- aepec, atypical epec
- afa, afimbrial adhesin
- aida-i, adhesin involved in diffuse adherence
- aiec, adherent invasive e. coli
- apec, avian pathogenic e. coli
- atcc, american type culture collection
- bfp, bundle-forming pilus
- cd, crohn disease
- cdt, cytolethal distending toxin gene
- clb, colibactin
- cnf, cytotoxic necrotizing factor
- cs, coli surface (antigens)
- daec, diffusely adhering e. coli
- db, dutch belted
- eae, e. coli attaching and effacing gene
- eaec, enteroaggregative e. coli
- eaf, epec adherence factor (plasmid)
- eahec, entero-aggregative-hemorrhagic e. coli
- east-1, enteroaggregative e. coli heat-stable enterotoxin
- e. coli, escherichia coli
- ed, edema disease
- ehec, enterohemorrhagic e. coli
- eiec, enteroinvasive e. coli
- epec, enteropathogenic e. coli
- esbl, extended-spectrum β-lactamase
- esp, e. coli secreted protein
- etec, enterotoxigenic e. coli
- expec, extraintestinal pathogenic e. coli
- fyua, yersiniabactin receptor gene
- gi, gastrointestinal
- hly, hemolysin
- hus, hemolytic uremic syndrome
- ibd, inflammatory bowel disease
- la, localized adherence
- lee, locus of enterocyte effacement
- lpf, long polar fimbriae
- lt, heat-labile (enterotoxin)
- mlst, multilocus sequence typing
- ndm, new delhi metallo-β-lactamase
- nzw, new zealand white
- pap, pyelonephritis-associated pilus
- pks, polyketide synthase
- sfa, s fimbrial adhesin
- slt, shiga-like toxin
- st, heat-stable (enterotoxin)
- stec, stx-producing e. coli
- stx, shiga toxin
- tepec, typical epec
- upec, uropathogenic e. coli
- uti, urinary tract infection
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Affiliation(s)
- Alexis García
- Molecular Sciences Research Center, University of Puerto Rico, San Juan, Puerto Rico; Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts; Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts;,
| | - James G Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts
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17
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Abstract
Diarrheal disease is still a major public health concern, as it is still considered an important cause of death in children under five years of age. A few decades ago, the detection of enteropathogenic E. coli was made by detecting the O, H, and K antigens, mostly by agglutination. The recent protocols recommend the molecular methods for diagnosing EPEC, as they can distinguish between typical and atypical EPEC by identifying the presence/absence of specific virulence factors. EPEC are defined as diarrheagenic strains of E. coli that can produce attaching and effacing lesions on the intestinal epithelium while being incapable of producing Shiga toxins and heat-labile or heat-stable enterotoxins. The ability of these strains to produce attaching and effacing lesions enable them to cause localized lesions by attaching tightly to the surface of the intestinal epithelial cells, disrupting the surfaces of the cells, thus leading to the effacement of the microvilli. EPEC are classified on typical and atypical isolates, based on the presence or absence of E. coli adherence factor plasmids. All the EPEC strains are eae positive; typical EPEC strains are eae+, bfpA+, while atypical strains are eae+, bfpA−. No vaccines are currently available to prevent EPEC infections.
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18
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Aboelhadid SM, Hashem S, Abdel-Kafy ES, Mahrous LN, Farghly EM, Abdel-Baki AAS, Al-Quraishy S, Kamel AA. Prebiotic supplementation effect on Escherichia coli and Salmonella species associated with experimentally induced intestinal coccidiosis in rabbits. PeerJ 2021; 9:e10714. [PMID: 33552731 PMCID: PMC7831364 DOI: 10.7717/peerj.10714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/15/2020] [Indexed: 02/01/2023] Open
Abstract
Background Coccidian infection may enhance the proliferation of gut Enterobacteriaceae. Bacterial infections in rabbits can negatively affect the body condition and cause high mortality, especially at young ages. Therefore, the effect of prebiotic supplementation on the presence of Escherichia coli and Salmonella species in rabbits experimentally infected with intestinal coccidiosis was investigated. Methods Thirty male rabbits aged 35–40 days were divided into three equal groups. These groups were; prebiotic supplemented (PS), positive control (PC), and negative control (NC) groups. The prebiotic group was supplemented with 2 g/L of Bio-Mos® until the end of the experiment. At day ten post prebiotic supplementation; the PS and PC groups were inoculated orally with 5.0 × 104 sporulated oocysts of mixed species of rabbit Eimeria. The daily fecal examination was carried out from the day 4 post-infection (PI) until the day 8 PI. At day 5 and day 8 PI, 5 rabbits from each group (PS, PC, and NC) were humanely slaughtered and parts of intestinal tissue were collected for microbiological analysis. Results There was a significant decrease (P≤ 0.05) in the oocyst count in the PS group (25.12 × 104 ± 10.36) when compared with the PC group (43.43 × 104 ± 11.52) and this decrease was continued till the end of the experiment. Eleven E. coli isolates were detected in the collected samples with an overall prevalence of 24.4%. The highest prevalence of E. coli was in the PC group (13.33%) while the lowest one was in the PS group (4.44%). Meanwhile, four Salmonella serovars were isolated with an overall prevalence of 8.89%. The NC group showed one serovar (2.22%) and PC revealed three serovars (6.67%) while the prebiotic supplemented group didn’t show any salmonella isolate. Of E. coli isolates, five isolates (O78, O125, O152, O115 and O168) showed high resistance to florfenicol and neomycin (100%). Also, of salmonella serovars, thee serovars (Salmonella entrica subsp. enterica serovar Macclesfield, Salmonella entrica Subsp. enterica serovar Canada and Salmonella entrica Subsp. enterica serovar Kisangani) showed high resistance to sulphamazole, amoxicillin and flumequin (75%) while it was sensitive to levofloxacin and ciprofloxacine (75%). The bacterial colony in this study was the same results at days 5 and 8 PI. Conclusion The use of prebiotic as prophylaxis in this experiment significantly reduced the prevalence of E. coli and salmonella associated with the intestinal coccidiosis in rabbits.
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Affiliation(s)
- Shawky M Aboelhadid
- Parasitology Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Shaymaa Hashem
- Animal Production Research Institute, Agricultural Research Center, Dokki, Giza, Egypt
| | - El-Sayed Abdel-Kafy
- Animal Production Research Institute, Agricultural Research Center, Dokki, Giza, Egypt
| | - Lilian N Mahrous
- Parasitology Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Eman M Farghly
- Animal Production Research Institute, Agricultural Research Center, Dokki, Giza, Egypt
| | | | - Saleh Al-Quraishy
- Zoology Department, College of Science, King Saud University, Riadh, Saudi Arabia
| | - Asmaa A Kamel
- Parasitology Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
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19
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Orden JA, García-Meniño I, Flament-Simon SC, Blanco J, de la Fuente R, Martínez-Rodrigo A, Mas A, Carrión J, Sobrino F, Domínguez-Bernal G. Raccoons (Procyon lotor) in the Madrid region of Spain are carriers of antimicrobial-resistant Escherichia coli and enteropathogenic E. coli. Zoonoses Public Health 2020; 68:69-78. [PMID: 33225569 DOI: 10.1111/zph.12784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/23/2020] [Accepted: 10/31/2020] [Indexed: 11/30/2022]
Abstract
The role of wildlife in the epidemiology of antimicrobial resistance is unclear. Raccoons in North America can carry a variety of enteric bacteria, with associated antimicrobial resistance, that could infect humans and livestock. The potential for raccoons to carry these bacteria in Europe, where they are an invasive species, has not been explored. Our objectives were to determine the prevalence of Escherichia coli with associated antimicrobial resistance in raccoons from the Madrid region of Spain and to determine whether they are carriers of potential human pathogens, including verotoxin-producing E. coli (VTEC) and enteropathogenic E. coli (EPEC). In total, we tested 237 E. coli isolates from the faeces of 83 euthanized raccoons for susceptibility to 14 antimicrobial agents and the presence of VTEC and EPEC. Antimicrobial resistance to at least one antimicrobial was detected in the faeces of 51% (42/83; 95% CI, 40.1-61.1) of the raccoons tested. A high percentage of raccoons carried, in their faeces, E. coli isolates resistant to ampicillin (33%), streptomycin (33%), tetracycline (30%), sulphafurazole (31%) and trimethoprim-sulphamethoxazole (23%). We detected one isolate of extended-spectrum β-lactamase-producing E. coli from the faeces of one raccoon. We detected VTEC in the faeces of one raccoon, and EPEC in the faeces of 12% (10/83) of the raccoons. Of the raccoons that carried EPEC in their faeces, 60% (6/10) carried EPEC isolates that exhibited characteristics associated with pathogenicity in humans. Raccoons in Madrid can carry pathogenic and antimicrobial-resistant E. coli in their faeces and may be a risk to public health because of their potential to contaminate food and the environment with their faeces.
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Affiliation(s)
- José A Orden
- INMIVET, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Isidro García-Meniño
- Laboratorio de Referencia de Escherichia coli (LREC), Facultade de Veterinaria, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Saskia C Flament-Simon
- Laboratorio de Referencia de Escherichia coli (LREC), Facultade de Veterinaria, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Jorge Blanco
- Laboratorio de Referencia de Escherichia coli (LREC), Facultade de Veterinaria, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ricardo de la Fuente
- INMIVET, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Abel Martínez-Rodrigo
- INMIVET, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Alicia Mas
- INMIVET, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Carrión
- INMIVET, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco Sobrino
- Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Gustavo Domínguez-Bernal
- INMIVET, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
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20
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Nycz BT, Pretty K, Gomez-Trujillo A, Sanchez B, Dominguez SR. Description of Enteropathic Escherichia coli Species in Pediatric Patients at a Quaternary Children's Hospital. J Pediatric Infect Dis Soc 2020; 9:573-579. [PMID: 31803928 DOI: 10.1093/jpids/piz081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/08/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND The epidemiology, demographics, clinical presentations, and outcomes associated with enteroaggregative Escherichia coli (EAEC), enteropathogenic E. coli (EPEC), and enterotoxigenic E. coli (ETEC) pathotypes in US children are not well understood. METHODS This study was a retrospective chart review of all pediatric patients with a stool sample submitted to the Children's Hospital Colorado clinical microbiology laboratory for testing with the BioFire FilmArray Gastrointestinal Pathogen Panel from October 2015 through October 2017. RESULTS During the study period, 5692 patient stool samples were submitted; 679 (13%) were positive for EAEC, EPEC, or ETEC. Of note, 163/232 (70%) patients with EAEC, 282/493 (57%) with EPEC, and 49/58 (85%) with ETEC had detection of at least 1 other pathogen. Of all E. coli-positive stool samples, only 158/679 (23%) were from low-risk patients who were singly infected with EAEC, EPEC, or ETEC. In this cohort, most cases were associated with acute diarrhea (50%), abdominal pain (61%), and/or cramping (49%) and presented without fever (14%), emesis (28%), or lethargy (7%). Thirteen (8%) of these 158 patients received antibiotics at the time of their initial presentation to care. Of the 145 patients who did not receive antibiotics at their initial visit, 23 (16%) returned to care due to persistence of symptoms. CONCLUSIONS Our results suggest that the majority of patients singly infected with EAEC, EPEC, or ETEC present with mild, self-limited, gastrointestinal (GI) complaints. Further research is needed to determine what role these pathogens might play in children who present with chronic or inflammatory GI symptoms.
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Affiliation(s)
- Bryan T Nycz
- Department of Pediatrics, Division of Infectious Diseases, Aurora, Colorado, USA
| | - Kristin Pretty
- Department of Pediatrics, Division of Pathology and Laboratory Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Angel Gomez-Trujillo
- Department of Pediatrics, Division of Pathology and Laboratory Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Brenda Sanchez
- Department of Pediatrics, Division of Pathology and Laboratory Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Samuel R Dominguez
- Department of Pediatrics, Division of Infectious Diseases, Aurora, Colorado, USA.,Department of Pediatrics, Division of Pathology and Laboratory Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Riaz S, Steinsland H, Hanevik K. Human Mucosal IgA Immune Responses against Enterotoxigenic Escherichia coli. Pathogens 2020; 9:pathogens9090714. [PMID: 32872549 PMCID: PMC7558491 DOI: 10.3390/pathogens9090714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/11/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022] Open
Abstract
Infection with enterotoxigenic Escherichia coli (ETEC) is a major contributor to diarrheal illness in children in low- and middle-income countries and travelers to these areas. There is an ongoing effort to develop vaccines against ETEC, and the most reliable immune correlate of protection against ETEC is considered to be the small intestinal secretory IgA response that targets ETEC-specific virulence factors. Since isolating IgA from small intestinal mucosa is technically and ethically challenging, requiring the use of invasive medical procedures, several other indirect methods are used as a proxy for gauging the small intestinal IgA responses. In this review, we summarize the literature reporting on anti-ETEC human IgA responses observed in blood, activated lymphocyte assayss, intestinal lavage/duodenal aspirates, and saliva from human volunteers being experimentally infected with ETEC. We describe the IgA response kinetics and responder ratios against classical and noncanonical ETEC antigens in the different sample types and discuss the implications that the results may have on vaccine development and testing.
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Affiliation(s)
- Saman Riaz
- Department of Clinical Science, University of Bergen, Jonas Lies veg 87, N-5021 Bergen, Norway;
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Hans Steinsland
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway;
- Department of Biomedicine, University of Bergen, 5020 Bergen, Norway
| | - Kurt Hanevik
- Department of Clinical Science, University of Bergen, Jonas Lies veg 87, N-5021 Bergen, Norway;
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Correspondence: ; Tel.: +47-5597-5000; Fax: +47-5597-2950
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Silva SS, Monfardini MV, Scaletsky ICA. Large plasmids encoding antibiotic resistance and localized-like adherence in atypical enteropathogenic Escherichia coli strains. BMC Microbiol 2020; 20:138. [PMID: 32471348 PMCID: PMC7257209 DOI: 10.1186/s12866-020-01809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/30/2020] [Indexed: 12/05/2022] Open
Abstract
Background In previous studies, we have shown that atypical enteropathogenic Escherichia coli (aEPEC) strains are important diarrheal pathogens among Brazilian children. In the characterization of a collection of 126 aEPEC strains, we identified 29 strains expressing the localized-like adherence (LAL) pattern on HEp-2 cells and harboring large plasmids in the range of 60 to 98 MDa. In this study, we examined 18 of these strains for their ability to transfer the LAL phenotype to a E. coli K-12 C600 strain. Results In conjugation experiments, using eight strains which were resistant to one or more antimicrobials and positive for F-pili genes (traA), we were able to cotransfer antimicrobial resistance markers along with adhesion genes. By transforming E. coli DH5α with plasmid DNA from strains A46 (pIS46), A66 (pIS66) and A102 (pIS102), we were able to demonstrate that genes encoding ampicillin, tetracycline and LAL were encoded on a 98-MDa conjugative plasmid. To identify a gene responsible for LAL, we constructed a transposon mutant library of A102 strain. Among 18 mutants that did not adhere to HeLa cells, four carried insertions within fimbrial genes (fimA and traJ) and agglutinin genes (tia and hek). Using these Tn5 mutants as donors, we were able to obtain kanamycin-resistant E. coli MA3456 transconjugants. Sequence analysis of the plasmid genes revealed a region exhibit to 80 and 73% amino acid similarities to the agglutinins Tia and Hek, respectively. Conclusion In this study, we have identified three large conjugative plasmids, pIS46, pIS66 and pIS102, coding for antimicrobial resistance and localized-like adherence (LAL) to HeLa cells. In addition, we identified a tia/hek homolog encoded on the pIS102 plasmid, which seems to be involved in adhesion of A102 strain.
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Affiliation(s)
- Scarlat S Silva
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Botucatu, 862, 3 andar, São Paulo, 04023-062, Brazil
| | - Mariane V Monfardini
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Botucatu, 862, 3 andar, São Paulo, 04023-062, Brazil
| | - Isabel C A Scaletsky
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Botucatu, 862, 3 andar, São Paulo, 04023-062, Brazil.
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Typical and atypical enteropathogenic Escherichia coli in children with acute diarrhoea: Changing trend in East Delhi. Biomed J 2020; 44:471-478. [PMID: 32330679 PMCID: PMC8514793 DOI: 10.1016/j.bj.2020.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background Worldwide around 2 million deaths occur every year due to diarrhoeal illnesses among children less than 5 years of age. Among diarrhoeagenic Escherichia coli, Enteropathogenic E. coli (EPEC) is highly prevalent in both community and hospital settings and is one of the main causes of persistent diarrhea in children in developing countries. EPEC remains underdiagnosed in India due to lack of conventional tools for identification. Methods We in this study investigated the prevalence and regional variation of EPEC in paediatric population suffering from diarrhoea in East Delhi, India. Two hundred stool samples were collected from children, aged between 0.5 and 5 years, with acute diarrhoea. E. coli were identified by conventional tests and PCR. Results We observed 7% atypical EPEC (aEPEC) and 2.5% typical EPEC (tEPEC), with an overall 9.5% EPEC prevalence amongst total samples. E. coli phylogenetic group A was the predominant. The most common age group affected was 6–23 months with common symptoms being vomiting, watery diarrhoea and severe dehydration. High drug resistance pattern was observed in EPEC isolates. Conclusion The study depicts a changing trend of aEPEC over tEPEC in children less than 5 years with diarrhoea, an emerging drug resistant enteropathogen and a public health concern demanding monitoring and surveillance.
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24
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Antibiotic resistance and virulence patterns of pathogenic Escherichia coli strains associated with acute gastroenteritis among children in Qatar. BMC Microbiol 2020; 20:54. [PMID: 32143566 PMCID: PMC7060563 DOI: 10.1186/s12866-020-01732-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/21/2020] [Indexed: 12/29/2022] Open
Abstract
Background The treatment of Enterobacteriaceae family including diarrheagenic E. coli (DEC) has been increasingly complicated due to the emergence of resistant strains. Here we report on the phenotypic resistance profiles and ESBL genotype and virulence profiles of Enteroaggregative E. coli (EAEC) and Enteropathogenic E. coli (EPEC) isolated from children hospitalized with acute gastroenteritis in Qatar (AGE). Results E. coli were isolated and characterized from 76 diarrheagenic stool positive samples, collected from hospitalized children less than 10 years old. Isolates were tested for antibiotic susceptibility against eighteen clinically relevant antibiotics using E-test method. Conventional PCR was performed to detect genes encoding ESBL and virulence factors. Chi-square test was performed to compare the individual antibiotic resistance between EPEC and EAEC. A significant percentage (73.7%) of isolates were resistant to at least one antibiotic. Overall, high resistance (70%) was reported to the first-line antibiotics such as ampicillin, tetracycline (46.4%), and sulfamethoxazole-trimethoprim (42.9%). Further, 39.5% of the isolates were multidrug resistant (MDR), with 22.4% being ESBL producers. On the other hand, all isolates were susceptible to carbapenem, fosfomycin, amikacin and colistin. The incidences of resistance to the 18 antibiotics between EPEC and EAEC were not significantly different by Pearson chi -square test (P > 0.05). Genetic analysis revealed that 88.23% of ESBL production was blaCTX-M-G1 (blaCTX-M-15, blaCTX-M-3) - encoded. Several different combinations of virulence markers were observed, however, there was no specific trend among the isolates apart from absence of the bundle-forming pilus (bfpA) gene, which encodes the type IV fimbriae in EPEC adherence factor (EAF) plasmid (pEAF), among all EPEC (atypical). 15% of the EAEC strains were positive for a combination of astA, aap & capU, while 10% were positive for three different combinations. The aap, aatA, capU and aggR virulence genes showed the highest frequency of 65, 60, 55 and 55% respectively. Others genes, east, astA, and aai, showed frequencies of 35, 30 and 20% respectively. Conclusions Atypical EPEC and EAEC were the primary etiological agents of diarrhea in children among DEC pathotypes. Our results indicated high rate of antimicrobial resistance pattern of DEC strains, which necessities the development of regulatory programs and reporting systems of antimicrobial resistance in DEC and other AGE-associated bacteria to insure effective control of diarrheal diseases. Results from this study demand a further research on identifying the phenotypic and genotypic profiles of more DEC pathotypes in various clinical samples.
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25
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Virulence-Related Genes and Coenteropathogens Associated with Clinical Outcomes of Enteropathogenic Escherichia coli Infections in Children from the Brazilian Semiarid Region: a Case-Control Study of Diarrhea. J Clin Microbiol 2019; 57:JCM.01777-18. [PMID: 30728193 DOI: 10.1128/jcm.01777-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/26/2019] [Indexed: 12/26/2022] Open
Abstract
Enteropathogenic Escherichia coli (EPEC) is a major cause of diarrhea in children from developing countries and presents high genetic variability. We aimed to characterize the EPEC virulence-related gene (VRG) distribution and copathogens associated with diarrhea and nutrition-related outcomes in children from the low-income Brazilian semiarid region. A cross-sectional case-control study of diarrhea was conducted in 1,191 children aged 2 to 36 months from the northeast region of Brazil. Stool samples were collected and clinical, epidemiological, and anthropometric data were identified from each child. A broad molecular evaluation of enteropathogens was performed, and EPEC-positive samples were further investigated for 18 VRGs using five multiplex PCRs. EPEC was detected in 28.2% of the study population, with similar proportions among cases and controls. Typical EPEC (tEPEC) infections were more often associated with diarrhea than atypical EPEC (aEPEC) infections, while aEPEC infections presented a higher prevalence. The VRG ler, a negative regulator of the locus of enterocyte effacement, was associated with the absence of diarrhea in aEPEC-positive children; espB, a major component of the type 3 secretion system, was associated with diarrhea in tEPEC-positive children; the presence of procolonization VRGs-the combination of cesT positivity, espP negativity, and the presence of the map gene-was associated with undernutrition; and Campylobacter spp., norovirus, and enteroaggregative E. coli (EAEC) coinfections were associated with increased clinical severity in EPEC-infected children. These data identified tEPEC strains associated with diarrhea and specific VRGs of EPEC (ler, espB, cesT, and map genes) and Campylobacter spp., norovirus, and EAEC to be major contributors to diarrhea and undernutrition in children from a low-income Brazilian region.
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26
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Ingle DJ, Levine MM, Kotloff KL, Holt KE, Robins-Browne RM. Dynamics of antimicrobial resistance in intestinal Escherichia coli from children in community settings in South Asia and sub-Saharan Africa. Nat Microbiol 2018; 3:1063-1073. [PMID: 30127495 PMCID: PMC6787116 DOI: 10.1038/s41564-018-0217-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 07/09/2018] [Indexed: 11/30/2022]
Abstract
The dynamics of antimicrobial resistance (AMR) in developing countries are poorly understood, especially in community settings, due to a sparsity of data on AMR prevalence and genetics. We used a combination of phenotyping, genomics and antimicrobial usage data to investigate patterns of AMR amongst atypical enteropathogenic Escherichia coli (aEPEC) strains isolated from children younger than five years old in seven developing countries (four in sub-Saharan Africa and three in South Asia) over a three-year period. We detected high rates of AMR, with 65% of isolates displaying resistance to three or more drug classes. Whole-genome sequencing revealed a diversity of known genetic mechanisms for AMR that accounted for >95% of phenotypic resistance, with comparable rates amongst aEPEC strains associated with diarrhoea or asymptomatic carriage. Genetic determinants of AMR were associated with the geographic location of isolates, not E. coli lineage, and AMR genes were frequently co-located, potentially enabling the acquisition of multi-drug resistance in a single step. Comparison of AMR with antimicrobial usage data showed that the prevalence of resistance to fluoroquinolones and third-generation cephalosporins was correlated with usage, which was higher in South Asia than in Africa. This study provides much-needed insights into the frequency and mechanisms of AMR in intestinal E. coli in children living in community settings in developing countries.
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Affiliation(s)
- Danielle J Ingle
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Melbourne, Victoria, Australia
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Myron M Levine
- Departments of Pediatrics and Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Karen L Kotloff
- Departments of Pediatrics and Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kathryn E Holt
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Melbourne, Victoria, Australia
- London School of Hygiene and Tropical Medicine, London, UK
| | - Roy M Robins-Browne
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
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27
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Platenkamp A, Mellies JL. Environment Controls LEE Regulation in Enteropathogenic Escherichia coli. Front Microbiol 2018; 9:1694. [PMID: 30140259 PMCID: PMC6094958 DOI: 10.3389/fmicb.2018.01694] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/09/2018] [Indexed: 12/11/2022] Open
Abstract
Enteropathogenic Escherichia coli (EPEC) is a significant cause of infant morbidity and mortality in developing regions of the world. Horizontally acquired genetic elements encode virulence structures, effectors, and regulators that promote bacterial colonization and disease. One such genetic element, the locus of enterocyte effacement (LEE), encodes the type three secretion system (T3SS) which acts as a bridge between bacterial and host cells to pass effector molecules that exert changes on the host. Due to its importance in EPEC virulence, regulation of the LEE has been of high priority and its investigation has elucidated many virulence regulators, including master regulator of the LEE Ler, H-NS, other nucleoid-associated proteins, GrlA, and PerC. Media type, environmental signals, sRNA signaling, metabolic processes, and stress responses have profound, strain-specific effects on regulators and LEE expression, and thus T3SS formation. Here we review virulence gene regulation in EPEC, which includes approaches for lessening disease by exploiting the elucidated regulatory pathways.
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Affiliation(s)
- Amy Platenkamp
- Department of Biology, Reed College, Portland, OR, United States
| | - Jay L Mellies
- Department of Biology, Reed College, Portland, OR, United States
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Natarajan M, Kumar D, Mandal J, Biswal N, Stephen S. A study of virulence and antimicrobial resistance pattern in diarrhoeagenic Escherichia coli isolated from diarrhoeal stool specimens from children and adults in a tertiary hospital, Puducherry, India. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2018; 37:17. [PMID: 30005599 PMCID: PMC6045864 DOI: 10.1186/s41043-018-0147-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 06/23/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Emergence of atypical enteropathogenic Escherichia coli (EPEC) and hybrid E. coli (harboring genes of more than one DEC pathotypes) strains have complicated the issue of growing antibiotic resistance in diarrhoeagenic Escherichia coli (DEC). This ongoing evolution occurs in nature predominantly via horizontal gene transfers involving the mobile genetic elements like integrons notably class 1 integron. This study was undertaken to determine the virulence pattern and antibiotic resistance among the circulating DEC strains in a tertiary care center in south of India. METHODS Diarrhoeal stool specimens were obtained from 120 children (< 5 years) and 100 adults (> 18 years), subjected to culture and isolation of diarrhoeal pathogens. Conventional PCR was performed to detect 10 virulence and 27 antimicrobial resistance (AMR) genes among the E. coli isolated. RESULTS DEC infection was observed in 45 (37.5%) children and 18 (18%) adults, among which [18 (40%), 10 (10%)] atypical EPEC was most commonly detected followed by [6 (13.3%), 4 (4%)] ETEC, [5 (11.1%) 2 (2%)] EAEC, [(3 (6.6%), 0 (0%)] EIEC, [3 (6.6%), 0 (0%] typical EPEC, and [4 (8.8%), 1 (1%)] STEC, and no NTEC and CDEC was detected. DEC co-infection in 3 (6.6%) children, and 1(1%) adult and sole hybrid DEC infection in 3 (6.6%) children was detected. The distribution of sulphonamide resistance genes (sulI, sulII, and sulIII were 83.3 and 21%, 60.41 and 42.1%, and 12.5 and 26.3%, respectively) and class 1 integron (int1) genes (41.6 and 26.31%) was higher in DEC strains isolated from children and adults, respectively. Other AMR genes detected were qnrS, qnrB, aac(6')Ib-cr, dhfr1, aadB, aac(3)-IV, tetA, tetB, tetD, catI, blaCTX, blaSHV, and blaTEM. None harbored qnrA, qnrC, qepA, tetE, tetC, tetY, ermA, mcr1, int2, and int3 genes. CONCLUSIONS Atypical EPEC was a primary etiological agent of diarrhea in children and adults among the DEC pathotypes. Detection of high numbers of AMR genes and class 1 integron genes indicate the importance of mobile genetic elements in spreading of multidrug resistance genes among these strains.
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Affiliation(s)
- Mailan Natarajan
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
| | - Deepika Kumar
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
| | - Jharna Mandal
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
| | - Niranjan Biswal
- Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
| | - Selvaraj Stephen
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), Puducherry, 607 402 India
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Abraham S, Kirkwood RN, Laird T, Saputra S, Mitchell T, Singh M, Linn B, Abraham RJ, Pang S, Gordon DM, Trott DJ, O'Dea M. Dissemination and persistence of extended-spectrum cephalosporin-resistance encoding IncI1-bla CTXM-1 plasmid among Escherichia coli in pigs. ISME JOURNAL 2018; 12:2352-2362. [PMID: 29899511 PMCID: PMC6155088 DOI: 10.1038/s41396-018-0200-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/24/2018] [Accepted: 03/12/2018] [Indexed: 01/09/2023]
Abstract
This study investigated the ecology, epidemiology and plasmid characteristics of extended-spectrum cephalosporin (ESC)-resistant E. coli in healthy pigs over a period of 4 years (2013–2016) following the withdrawal of ESCs. High carriage rates of ESC-resistant E. coli were demonstrated in 2013 (86.6%) and 2014 (83.3%), compared to 2015 (22%) and 2016 (8.5%). ESC resistance identified among E. coli isolates was attributed to the carriage of an IncI1 ST-3 plasmid (pCTXM1-MU2) encoding blaCTXM-1. Genomic characterisation of selected E. coli isolates (n = 61) identified plasmid movement into multiple commensal E. coli (n = 22 STs). Major STs included ST10, ST5440, ST453, ST2514 and ST23. A subset of the isolates belong to the atypical enteropathogenic E. coli (aEPEC) pathotype that harboured multiple LEE pathogenic islands. pCTXM1-MU2 was similar (99% nt identity) to IncI1-ST3 plasmids reported from Europe, encoded resistance to aminoglycosides, sulphonamides and trimethoprim, and carried colicin Ib. pCTXM1-MU2 appears to be highly stable and readily transferable. This study demonstrates that ESC resistance may persist for a protracted period following removal of direct selection pressure, resulting in the emergence of ESC-resistance in both commensal E. coli and aEPEC isolates of potential significance to human and animal health.
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Affiliation(s)
- Sam Abraham
- Antimicrobial Resistance and Infectious Diseases Laboratory, School of Veterinary and Life Sciences, Murdoch University, Melbourne, Western Australia, Australia.
| | - Roy N Kirkwood
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, Australia.,Australian Centre for Antimicrobial Resistance Ecology, University of Adelaide, Adelaide, Australia
| | - Tanya Laird
- Antimicrobial Resistance and Infectious Diseases Laboratory, School of Veterinary and Life Sciences, Murdoch University, Melbourne, Western Australia, Australia
| | - Sugiyono Saputra
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, Australia.,Australian Centre for Antimicrobial Resistance Ecology, University of Adelaide, Adelaide, Australia.,Research Center for Biology, Indonesian Institute of Sciences, West Java, Cibinong, Indonesia
| | - Tahlia Mitchell
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, Australia.,Australian Centre for Antimicrobial Resistance Ecology, University of Adelaide, Adelaide, Australia
| | - Mohinder Singh
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, Australia.,Australian Centre for Antimicrobial Resistance Ecology, University of Adelaide, Adelaide, Australia
| | - Benjamin Linn
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, Australia.,Australian Centre for Antimicrobial Resistance Ecology, University of Adelaide, Adelaide, Australia
| | - Rebecca J Abraham
- Australian Centre for Antimicrobial Resistance Ecology, University of Adelaide, Adelaide, Australia
| | - Stanley Pang
- Antimicrobial Resistance and Infectious Diseases Laboratory, School of Veterinary and Life Sciences, Murdoch University, Melbourne, Western Australia, Australia
| | - David M Gordon
- Evolution, Ecology and Genetics, Research School of Biology, The Australian National University, Canberra, Australia
| | - Darren J Trott
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, Australia.,Australian Centre for Antimicrobial Resistance Ecology, University of Adelaide, Adelaide, Australia
| | - Mark O'Dea
- Antimicrobial Resistance and Infectious Diseases Laboratory, School of Veterinary and Life Sciences, Murdoch University, Melbourne, Western Australia, Australia
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Shigatoxigenic and atypical enteropathogenic Escherichia coli in fish for human consumption. Braz J Microbiol 2018; 49:936-941. [PMID: 29891415 PMCID: PMC6175746 DOI: 10.1016/j.bjm.2018.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/07/2018] [Accepted: 02/28/2018] [Indexed: 11/22/2022] Open
Abstract
Shigatoxigenic and enteropathogenic Escherichia coli with virulence and multidrug resistance profile were isolated from Nile tilapia. This study finding is of great importance to public health because they help understand this pathogen epidemiology in fish and demonstrate how these animals can transmit E. coli related diseases to humans.
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31
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Culler HF, Couto SCF, Higa JS, Ruiz RM, Yang MJ, Bueris V, Franzolin MR, Sircili MP. Role of SdiA on Biofilm Formation by Atypical Enteropathogenic Escherichia coli. Genes (Basel) 2018; 9:genes9050253. [PMID: 29762495 PMCID: PMC5977193 DOI: 10.3390/genes9050253] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/19/2018] [Accepted: 02/21/2018] [Indexed: 01/11/2023] Open
Abstract
Atypical enteropathogenic Escherichia coli are capable to form biofilm on biotic and abiotic surfaces, regardless of the adherence pattern displayed. Several E. coli mechanisms are regulated by Quorum sensing (QS), including virulence factors and biofilm formation. Quorum sensing is a signaling system that confers bacteria with the ability to respond to chemical molecules known as autoinducers. Suppressor of division inhibitor (SdiA) is a QS receptor present in atypical enteropathogenic E.coli (aEPEC) that detects acyl homoserine lactone (AHL) type autoinducers. However, these bacteria do not encode an AHL synthase, but they are capable of sensing AHL molecules produced by other species, establishing an inter-species bacterial communication. In this study, we performed experiments to evaluate pellicle, ring-like structure and biofilm formation on wild type, sdiA mutants and complemented strains. We also evaluated the transcription of genes involved in different stages of biofilm formation, such as bcsA, csgA, csgD, fliC and fimA. The sdiA mutants were capable of forming thicker biofilm structures and showed increased motility when compared to wild type and complemented strains. Moreover, they also showed denser pellicles and ring-like structures. Quantitative real-time PCR (qRT-PCR) analysis demonstrated increased csgA, csgD and fliC transcription on mutant strains. Biofilm formation, as well as csgD, csgA and fimA transcription decreased on wild type strains by the addition of AHL. These results indicate that SdiA participates on the regulation of these phenotypes in aEPEC and that AHL addition enhances the repressor effect of this receptor on the transcription of biofilm and motility related genes.
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Affiliation(s)
- Hebert F Culler
- Laboratory of Genetics, Butantan Institute, São Paulo 05503-900, Brazil.
| | - Samuel C F Couto
- Laboratory of Genetics, Butantan Institute, São Paulo 05503-900, Brazil.
| | - Juliana S Higa
- Laboratory of Genetics, Butantan Institute, São Paulo 05503-900, Brazil.
| | - Renato M Ruiz
- Laboratory of Genetics, Butantan Institute, São Paulo 05503-900, Brazil.
| | - Min J Yang
- Laboratory of Genetics, Butantan Institute, São Paulo 05503-900, Brazil.
| | - Vanessa Bueris
- Laboratory of Genetics, Butantan Institute, São Paulo 05503-900, Brazil.
| | - Marcia R Franzolin
- Laboratory of Bacteriology, Butantan Institute, São Paulo 05503-900, Brazil.
| | - Marcelo P Sircili
- Laboratory of Genetics, Butantan Institute, São Paulo 05503-900, Brazil.
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Ramya Raghavan P, Roy S, Thamizhmani R, Sugunan AP. Diarrheagenic Escherichia coli infections among the children of Andaman Islands with special reference to pathotype distribution and clinical profile. J Epidemiol Glob Health 2017; 7:305-308. [PMID: 29110874 PMCID: PMC7384565 DOI: 10.1016/j.jegh.2017.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 07/12/2017] [Accepted: 07/21/2017] [Indexed: 11/16/2022] Open
Abstract
Diarrhoeagenic E. coli (DEC) is one of the most common causes of diarrhoeal death in children less than five years globally. It is responsible for 30%-40% of all diarrhoeal episodes in developing countries. It is estimated that 0.12million children died of diarrhoea caused by DEC in 2011 globally. There is no baseline data on the occurrence of DEC diarrhoea in Andaman Islands, the remote islands of India. The study is particularly important as these strains are the emerging enteric pathogen in both developed and developing countries. DEC was screened from E. coli isolates obtained from diarrhoeal stool samples by multiplex PCR with specific primers using stasndard protocols. During the study period, among the 1394 stool samples collected, 95 (6.82%) patients were found infected with DEC. Of the 97 isolates from 95 patients, 68 (70.1%) were EAEC, 19 (19.6%) were EPEC and 10 (10.3%) were ETEC. Of the 19 EPEC isolates, 63.2% were atypical EPEC which is the emerging enteric pathogen among the children in developing as well as developed countries. More than 80% of the patients had watery diarrhoea and 6% of them had invasive diarrhoea. Persistent diarrhoea was also found in three infected children. This study documents the occurrence and type of DEC diarrhoea in Andaman Islands first time and highlights the significant proportions of E. coli diarrhoea being caused by EAEC and atypical EPEC strains.
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Affiliation(s)
- P Ramya Raghavan
- Dept. Microbiology, Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands, India
| | - Subarna Roy
- Dept. Microbiology, National Institute of Traditional Medicine, Belgaum, Karnataka, India
| | - Ramanathan Thamizhmani
- Dept. Microbiology, Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands, India
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Molecular characterization of diarrheagenic Escherichia coli isolated from vegetables in Argentina. Int J Food Microbiol 2017; 261:57-61. [DOI: 10.1016/j.ijfoodmicro.2017.09.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 11/22/2022]
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Abbott AN, Fang FC. Clinical Impact of Multiplex Syndromic Panels in the Diagnosis of Bloodstream, Gastrointestinal, Respiratory, and Central Nervous System Infections. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.clinmicnews.2017.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
Archetypal pathogenic bacterial strains are often used to elucidate regulatory networks of an entire pathovar, which encompasses multiple lineages and phylogroups. With enteropathogenic Escherichia coli (EPEC) as a model system, Hazen and colleagues (mSystems 6:e00024-17, 2017, https://doi.org/10.1128/mSystems.00024-17) used 9 isolates representing 8 lineages and 3 phylogroups to find that isolates with similar genomic sequences exhibit similarities in global transcriptomes under conditions of growth in medium that induces virulence gene expression, and they found variation among individual isolates. Archetypal pathogenic bacterial strains are often used to elucidate regulatory networks of an entire pathovar, which encompasses multiple lineages and phylogroups. With enteropathogenic Escherichia coli (EPEC) as a model system, Hazen and colleagues (mSystems 6:e00024-17, 2017, https://doi.org/10.1128/mSystems.00024-17) used 9 isolates representing 8 lineages and 3 phylogroups to find that isolates with similar genomic sequences exhibit similarities in global transcriptomes under conditions of growth in medium that induces virulence gene expression. They also found variation among individual isolates. Their work illustrates the importance of moving beyond observing regulatory phenomena of a limited number of regulons in a few archetypal strains, with the possibility of correlating clinical symptoms to key transcriptional pathways across lineages and phylogroups.
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Association of Atypical Enteropathogenic Escherichia coli with Diarrhea and Related Mortality in Kittens. J Clin Microbiol 2017; 55:2719-2735. [PMID: 28659315 DOI: 10.1128/jcm.00403-17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/19/2017] [Indexed: 12/19/2022] Open
Abstract
Diarrhea is responsible for the death of approximately 900,000 children per year worldwide. In children, typical enteropathogenic Escherichia coli (EPEC) is a common cause of diarrhea and is associated with a higher hazard of death. Typical EPEC infection is rare in animals and poorly reproduced in experimental animal models. In contrast, atypical EPEC (aEPEC) infection is common in both children and animals, but its role in diarrhea is uncertain. Mortality in kittens is often attributed to diarrhea, and we previously identified enteroadherent EPEC in the intestines of deceased kittens. The purpose of this study was to determine the prevalence and type of EPEC in kittens and whether infection was associated with diarrhea, diarrhea-related mortality, gastrointestinal pathology, or other risk factors. Kittens with and without diarrhea were obtained from two shelter facilities and determined to shed atypical EPEC at a culture-based prevalence of 18%. In contrast, quantitative PCR detected the presence of the gene for intimin (eae) in feces from 42% of kittens. aEPEC was isolated from kittens with and without diarrhea. However, kittens with diarrhea harbored significantly larger quantities of aEPEC than kittens without diarrhea. Kittens with aEPEC had a significantly greater severity of small intestinal and colonic lesions and were significantly more likely to have required subcutaneous fluid administration. These findings identify aEPEC to be prevalent in kittens and a significant primary or contributing cause of intestinal inflammation, diarrhea, dehydration, and associated mortality in kittens.
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Petit F, Clermont O, Delannoy S, Servais P, Gourmelon M, Fach P, Oberlé K, Fournier M, Denamur E, Berthe T. Change in the Structure of Escherichia coli Population and the Pattern of Virulence Genes along a Rural Aquatic Continuum. Front Microbiol 2017; 8:609. [PMID: 28458656 PMCID: PMC5394106 DOI: 10.3389/fmicb.2017.00609] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/24/2017] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to investigate the diversity of the Escherichia coli population, focusing on the occurrence of pathogenic E. coli, in surface water draining a rural catchment. Two sampling campaigns were carried out in similar hydrological conditions (wet period, low flow) along a river continuum, characterized by two opposite density gradients of animals (cattle and wild animals) and human populations. While the abundance of E. coli slightly increased along the river continuum, the abundance of both human and ruminant-associated Bacteroidales markers, as well as the number of E. coli multi-resistant to antibiotics, evidenced a fecal contamination originating from animals at upstream rural sites, and from humans at downstream urban sites. A strong spatial modification of the structure of the E. coli population was observed. At the upstream site close to a forest, a higher abundance of the B2 phylogroup and Escherichia clade strains were observed. At the pasture upstream site, a greater proportion of both E and B1 phylogroups was detected, therefore suggesting a fecal contamination of mainly bovine origin. Conversely, in downstream urban sites, A, D, and F phylogroups were more abundant. To assess the occurrence of intestinal pathogenic strains, virulence factors [afaD, stx1, stx2, eltB (LT), estA (ST), ipaH, bfpA, eae, aaiC and aatA] were screened among 651 E. coli isolates. Intestinal pathogenic strains STEC O174:H21 (stx2) and EHEC O26:H11 (eae, stx1) were isolated in water and sediments close to the pasture site. In contrast, in the downstream urban site aEPEC/EAEC and DAEC of human origin, as well as extra-intestinal pathogenic E. coli belonging to clonal group A of D phylogroup, were sampled. Even if the estimated input of STEC (Shiga toxin-producing E. coli) - released in water at the upstream pasture site - at the downstream site was low, we show that STEC could persist in sediment. These results show that, the run-off of small cattle farms contributed, as much as the wastewater effluent, in the dissemination of pathogenic E. coli in both water and sediments, even if the microbiological quality of the water was good or to average quality according to the French water index.
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Affiliation(s)
- Fabienne Petit
- Normandie Université, UniRouen, UniCaen, CNRS UMR M2CRouen, France.,Sorbonne Universités, UPMC, CNRS, EPHE, UMR 7619 METISParis, France
| | - Olivier Clermont
- INSERM UMR1137, IAME, Université Paris Diderot, Sorbonne Paris CitéParis, France
| | - Sabine Delannoy
- Université Paris-Est, Anses, Food Safety Laboratory, IdentyPath Platform, Maisons-AlfortFrance
| | - Pierre Servais
- Ecologie des Systèmes Aquatiques, Université Libre de Bruxelles, Campus de la PlaineBruxelles, Belgium
| | - Michèle Gourmelon
- Institut Français de Recherche pour l'Exploitation de la Mer, RBE-SG2M-LSEMPlouzané, France
| | - Patrick Fach
- Université Paris-Est, Anses, Food Safety Laboratory, IdentyPath Platform, Maisons-AlfortFrance
| | - Kenny Oberlé
- Normandie Université, UniRouen, UniCaen, CNRS UMR M2CRouen, France
| | | | - Erick Denamur
- INSERM UMR1137, IAME, Université Paris Diderot, Sorbonne Paris CitéParis, France
| | - Thierry Berthe
- Normandie Université, UniRouen, UniCaen, CNRS UMR M2CRouen, France
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Mellies JL, Platenkamp A, Osborn J, Ben-Avi L. PerC Manipulates Metabolism and Surface Antigens in Enteropathogenic Escherichia coli. Front Cell Infect Microbiol 2017; 7:32. [PMID: 28224117 PMCID: PMC5293775 DOI: 10.3389/fcimb.2017.00032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 01/23/2017] [Indexed: 11/13/2022] Open
Abstract
Enteropathogenic Escherichia coli is an important cause of profuse, watery diarrhea in infants living in developing regions of the world. Typical strains of EPEC (tEPEC) possess a virulence plasmid, while related clinical isolates that lack the pEAF plasmid are termed atypical EPEC (aEPEC). tEPEC and aEPEC tend to cause acute vs. more chronic type infections, respectively. The pEAF plasmid encodes an attachment factor as well as a regulatory operon, perABC. PerC, a poorly understood regulator, was previously shown to regulate expression of the type III secretion system through Ler. Here we elucidate the regulon of PerC using RNA sequencing analysis to better our understanding of the role of the pEAF in tEPEC infection. We demonstrate that PerC controls anaerobic metabolism by increasing expression of genes necessary for nitrate reduction. A tEPEC strain overexpressing PerC exhibited a growth advantage compared to a strain lacking this regulator, when grown anaerobically in the presence of nitrate, conditions mimicking the human intestine. We show that PerC strongly down-regulates type I fimbriae expression by manipulating fim phase variation. The quantities of a number of non-coding RNA molecules were altered by PerC. In sum, this protein controls niche adaptation, and could help to explain the function of the PerC homologs (Pch), many of which are encoded within prophages in related, Gram-negative pathogens.
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Affiliation(s)
| | | | - Jossef Osborn
- Molecular Microbiology and Immunology, Oregon Health and Science University Portland, OR, USA
| | - Lily Ben-Avi
- Biology Department, Reed College Portland, OR, USA
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Canizalez-Roman A, Flores-Villaseñor HM, Gonzalez-Nuñez E, Velazquez-Roman J, Vidal JE, Muro-Amador S, Alapizco-Castro G, Díaz-Quiñonez JA, León-Sicairos N. Surveillance of Diarrheagenic Escherichia coli Strains Isolated from Diarrhea Cases from Children, Adults and Elderly at Northwest of Mexico. Front Microbiol 2016; 7:1924. [PMID: 27965648 PMCID: PMC5127799 DOI: 10.3389/fmicb.2016.01924] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/16/2016] [Indexed: 01/17/2023] Open
Abstract
Diarrheagenic Escherichia coli (DEC) strains are a main cause of gastrointestinal disease in developing countries. In this study we report the epidemiologic surveillance in a 4-year period (January 2011 to December 2014) of DEC strains causing acute diarrhea throughout the Sinaloa State, Mexico. DEC strains were isolated from outpatients of all ages with acute diarrhea (N = 1,037). Specific DEC pathotypes were identified by PCR-amplification of genes encoding virulence factors. The adhesion phenotype and antibiotic resistance were also investigated. DEC strains were detected in 23.3% (242/1037) of cases. The most frequently DEC strain isolated was EAEC [(12.2%), 126/242] followed by EPEC [(5.1%), 53/242], ETEC [(4.3%), 43/242] DAEC [(1.4%), 15/242], STEC [(0.3%), 3/242], and EIEC [(0.2%), 2/242]. EHEC strains were not detected. Overall DEC strains were more prevalent in children ≤2 years of age with EPEC strains the most common of DEC pathotypes. While ∼65% of EAEC strains were classified as typical variant based on the aggregative adherence to in vitro cultures of HEp-2 cells, a high proportion of EPEC strains was classified as atypical strains. EAEC, EPEC, ETEC, and DAEC strains were distributed in the north, central and south regions of Sinaloa state. Among all DEC strains, >90% were resistant to at least one commonly prescribed antibiotic. Strains were commonly resistant to first-line antibiotics such as tetracycline, ampicillin, and sulfamethoxazole-trimethoprim. Furthermore, more than 80% of DEC isolates were multi-drug resistant and EPEC and DAEC were the categories with major proportion of this feature. In conclusion, in nearly one out of four cases of acute diarrhea in Northwestern Mexico a multi-drug resistant DEC strain was isolated, in these cases EAEC was the most prevalent (52%) pathotype.
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Affiliation(s)
- Adrian Canizalez-Roman
- CIASaP, School of Medicine, Autonomous University of SinaloaCuliacan, Mexico; The Women's Hospital, Secretariat of HealthCuliacan, Mexico
| | - Héctor M Flores-Villaseñor
- CIASaP, School of Medicine, Autonomous University of SinaloaCuliacan, Mexico; The Sinaloa State Public Health Laboratory, Secretariat of HealthCuliacan, Mexico
| | - Edgar Gonzalez-Nuñez
- The Sinaloa State Public Health Laboratory, Secretariat of Health Culiacan, Mexico
| | | | - Jorge E Vidal
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | | | - Gerardo Alapizco-Castro
- CIASaP, School of Medicine, Autonomous University of SinaloaCuliacan, Mexico; Coordinación de Enseñanza e InvestigaciónCuliacan, Mexico
| | - J Alberto Díaz-Quiñonez
- Instituto de Diagnóstico y Referencia EpidemiológicosMexico City, Mexico; Facultad de Medicina, Universidad Nacional Autónoma de MéxicoMexico City, Mexico
| | - Nidia León-Sicairos
- CIASaP, School of Medicine, Autonomous University of SinaloaCuliacan, Mexico; Pediatric Hospital of SinaloaCuliacan, Mexico
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40
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Wang L, Nakamura H, Kage-Nakadai E, Hara-Kudo Y, Nishikawa Y. Comparison by multilocus variable-number tandem repeat analysis and antimicrobial resistance among atypical enteropathogenic Escherichia coli strains isolated from food samples and human and animal faecal specimens. J Appl Microbiol 2016; 122:268-278. [PMID: 27718315 DOI: 10.1111/jam.13322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/20/2016] [Accepted: 10/03/2016] [Indexed: 01/05/2023]
Abstract
AIM This study assessed whether multilocus variable-number tandem repeat analysis (MLVA) and antimicrobial susceptibility testing discriminated diarrhoeagenic atypical enteropathogenic Escherichia coli (aEPEC) from aEPEC indigenous to domestic animals or healthy people. METHODS AND RESULTS MLVA genotyping of 142 aEPEC strains isolated from foods and faecal samples of domestic animals and humans revealed 126 distinct MLVA profiles that distributed to four clusters, yielding a Simpson's index of diversity (D) of 99·8%. Cluster 2 included 87% of cattle isolates and 67% of patient isolates. The plurality (15/34, 44%) of strains from healthy humans mapped to Cluster 1, while half (18/41, 44%) of the swine strains belonged to Cluster 4. Testing for antimicrobial susceptibility revealed that 52 strains (37%) of aEPEC were resistant to one or more agents; only 10 strains (7%) exhibited resistance to more than three agents. Strains isolated from swine or food exhibited a wider variety of resistance phenotypes than bovine or human strains. CONCLUSIONS MLVA assigned the aEPEC isolates from cattle and patients to Cluster 2, distinct from aEPEC from other sources. Hog yards may be a larger source of drug-resistant strains than are cattle ranches. SIGNIFICANCE AND IMPACT OF THE STUDY MLVA suggests that human diarrhoeagenic aEPEC are derived from cattle and are distinct from strains carried by healthy people and other animals. Cattle appear to be reservoirs of human diarrhoeagenic aEPEC.
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Affiliation(s)
- L Wang
- School of Life Science and Biotechnology, Dalian University of Technology, Dalian, China.,Graduate School of Human Life Science, Osaka City University, Osaka, Japan
| | - H Nakamura
- Department of Microbiology, Osaka City Institute of Public Health and Environmental Sciences, Osaka, Japan
| | - E Kage-Nakadai
- Graduate School of Human Life Science, Osaka City University, Osaka, Japan.,The OCU Advanced Research Institute for Natural Science and Technology, Osaka City University, Graduate School of Human Life Science, Osaka, Japan
| | - Y Hara-Kudo
- Division of Microbiology, National Institute of Health Sciences, Tokyo, Japan
| | - Y Nishikawa
- Graduate School of Human Life Science, Osaka City University, Osaka, Japan
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41
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Robins-Browne RM, Holt KE, Ingle DJ, Hocking DM, Yang J, Tauschek M. Are Escherichia coli Pathotypes Still Relevant in the Era of Whole-Genome Sequencing? Front Cell Infect Microbiol 2016; 6:141. [PMID: 27917373 PMCID: PMC5114240 DOI: 10.3389/fcimb.2016.00141] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 10/13/2016] [Indexed: 12/15/2022] Open
Abstract
The empirical and pragmatic nature of diagnostic microbiology has given rise to several different schemes to subtype E.coli, including biotyping, serotyping, and pathotyping. These schemes have proved invaluable in identifying and tracking outbreaks, and for prognostication in individual cases of infection, but they are imprecise and potentially misleading due to the malleability and continuous evolution of E. coli. Whole genome sequencing can be used to accurately determine E. coli subtypes that are based on allelic variation or differences in gene content, such as serotyping and pathotyping. Whole genome sequencing also provides information about single nucleotide polymorphisms in the core genome of E. coli, which form the basis of sequence typing, and is more reliable than other systems for tracking the evolution and spread of individual strains. A typing scheme for E. coli based on genome sequences that includes elements of both the core and accessory genomes, should reduce typing anomalies and promote understanding of how different varieties of E. coli spread and cause disease. Such a scheme could also define pathotypes more precisely than current methods.
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Affiliation(s)
- Roy M Robins-Browne
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of MelbourneParkville, VIC, Australia; Murdoch Childrens Research Institute, Royal Children's HospitalParkville, VIC, Australia
| | - Kathryn E Holt
- Centre for Systems Genomics, The University of MelbourneParkville, VIC, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of MelbourneParkville, VIC, Australia
| | - Danielle J Ingle
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of MelbourneParkville, VIC, Australia; Centre for Systems Genomics, The University of MelbourneParkville, VIC, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of MelbourneParkville, VIC, Australia
| | - Dianna M Hocking
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne Parkville, VIC, Australia
| | - Ji Yang
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne Parkville, VIC, Australia
| | - Marija Tauschek
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne Parkville, VIC, Australia
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de Souza CS, Torres AG, Caravelli A, Silva A, Polatto JM, Piazza RMF. Characterization of the universal stress protein F from atypical enteropathogenic Escherichia coli and its prevalence in Enterobacteriaceae. Protein Sci 2016; 25:2142-2151. [PMID: 27616205 PMCID: PMC5119564 DOI: 10.1002/pro.3038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/25/2016] [Accepted: 09/06/2016] [Indexed: 01/06/2023]
Abstract
Atypical enteropathogenic Escherichia coli (aEPEC) are heterogeneous strains in terms of serotypes, adherence patterns and the presence of novel virulence factors. This heterogeneity is intriguing, promoting studies trying to characterize these novel proteins and to better comprehend this pathotype group. In a previous study analyzing low-molecular mass proteomes of four representative aEPEC strains of three different adhesion phenotypes, we classified proteins according to their annotated function, with most of them being involved in metabolism and transport; while some of them were classified as hypothetical proteins. The majority of the hypothetical proteins were homologue products of genes identified in the genome of enterohemorrhagic E. coli. One of the hypothetical proteins was annotated as Z2335, with orthologue in EPEC, and by bioinformatics analysis, this protein was revealed to be the universal stress protein F (UspF). Thus, herein we successfully obtained a recombinant UspF protein from aEPEC, which is a α/β, ATP-binding protein involved in stress response, with comparable protein production among the four studied strains, but showing noteworthy differences when cultivated in different stress conditions, also present in other enterobacterial species, such as Shigella sonnei and Citrobacter freundii. Furthermore, our results confirm that the Usp protein superfamily encompasses a conserved group of proteins involved in stress resistance in aEPEC and other Enterobacteriaceae.
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Affiliation(s)
| | - Alfredo G Torres
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas
| | | | - Anderson Silva
- Laboratório de Bacteriologia, Instituto Butantan, São Paulo, SP, Brazil
| | - Juliana M Polatto
- Laboratório de Bacteriologia, Instituto Butantan, São Paulo, SP, Brazil
| | - Roxane M F Piazza
- Laboratório de Bacteriologia, Instituto Butantan, São Paulo, SP, Brazil
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43
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Julian TR. Environmental transmission of diarrheal pathogens in low and middle income countries. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2016; 18:944-955. [PMID: 27384220 DOI: 10.1039/c6em00222f] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Every year, more than half a million children die due to diarrheal diseases. Recent studies have identified the most important etiologies of diarrheal disease are enterotoxigenic and enteropathogenic E. coli, Shigella spp., rotavirus, norovirus and Cryptosporidium spp. These etiologies are unsurprisingly characterized by a combination of high shedding, high infectivity, and transmissibility through multiple environmental reservoirs. The relative importance of the transmission routes is likely site-specific. So the impact of interventions, which typically target only one or two environmental reservoirs, is likely also site-specific. The factors influencing the transmission routes most important for diarrheal disease are complex, including - at a minimum - etiology of endemic disease; and water, sanitation, and hygiene infrastructure and practices. The site-specific nature - and complexity of transmission - helps explain the observed variation in impacts of water, sanitation, and hygiene interventions. It may also render efforts to estimate or quantify global means for interventions' impacts irrelevant. The theme of this Perspective is that greater reductions in diarrheal disease transmission in LMICs can be achieved by designing interventions to interrupt the most important environmental transmission pathways. Intervention choice should be informed by site-specific conditions, most notably: diarrheal etiology and existing water, sanitation, and hygiene infrastructure and practices. The theme is discussed through the lens of the characteristics of the most important diarrheal diseases (shedding, infectivity, growth, and persistence) and the general characteristics of environmental reservoirs (exposure pathways and fecal contamination). The discussion highlights when interventions - and combinations of interventions - will be most effective at reducing diarrheal disease burden.
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Affiliation(s)
- Timothy R Julian
- Pathogens and Human Health, Department of Environmental Microbiology, Swiss Federal Research Institute of Aquatic Science and Technology, Eawag, BU-F08, Überlandstrasse 133, 8600 Dübendorf, Switzerland.
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44
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Vieira MA, Dos Santos LF, Dias RCB, Camargo CH, Pinheiro SRS, Gomes TAT, Hernandes RT. Atypical enteropathogenic Escherichia coli as aetiologic agents of sporadic and outbreak-associated diarrhoea in Brazil. J Med Microbiol 2016; 65:998-1006. [PMID: 27412254 DOI: 10.1099/jmm.0.000313] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Enteropathogenic Escherichia coli (EPEC) are important agents of diarrhoea in industrialized as well as developing countries, such as Brazil. The hallmark of EPEC pathogenesis is the establishment of attaching and effacing lesions in enterocytes, in which pedestal-like structures are formed underneath adherent bacteria. EPEC are divided into two subgroups, typical (tEPEC) and atypical (aEPEC), based on the presence of the EPEC adherence factor plasmid in tEPEC and its absence in aEPEC. This study was designed to characterize 82 aEPEC isolates obtained from stool samples of diarrhoeic patients during 2012 and 2013 in Brazil. The majority of the aEPEC were assigned to the phylo-group B1 (48.8 %), and intimin subtypes θ (20.7 %), β1 (9.7 %) and λ (9.7 %) were the most prevalent among the isolates. The nleB and nleE genes were concomitantly detected in 32.9 % of the isolates, demonstrating the occurrence of the pathogenicity island O122 among them. The O157-plasmid genes (ehxA and/or espP) were detected in 7.3 % of the isolates, suggesting that some aEPEC could be derived from Shiga-toxin-producing E. coli that lost the stx genes while trafficking in the host. PFGE of 14 aEPEC of serotypes O2 : H16, O33 : H34, O39 : H9, O108 : H- and ONT : H19 isolated from five distinct outbreaks showed serotype-specific PFGE clusters, indicating a high degree of similarity among the isolates from the same event, thus highlighting these serotypes as potential aetiologic agents of diarrhoeal outbreaks in Brazil.
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Affiliation(s)
- Melissa A Vieira
- Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista 'Júlio de Mesquita Filho' (UNESP), Botucatu, SP, Brazil
| | - Luís F Dos Santos
- Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), São Paulo, SP, Brazil
| | - Regiane C B Dias
- Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista 'Júlio de Mesquita Filho' (UNESP), Botucatu, SP, Brazil
| | - Carlos H Camargo
- Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), São Paulo, SP, Brazil
| | | | - Tânia A T Gomes
- Departamento de Microbiologia, Imunologia e Parasitologia da Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rodrigo T Hernandes
- Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista 'Júlio de Mesquita Filho' (UNESP), Botucatu, SP, Brazil
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Qu M, Lv B, Zhang X, Yan H, Huang Y, Qian H, Pang B, Jia L, Kan B, Wang Q. Prevalence and antibiotic resistance of bacterial pathogens isolated from childhood diarrhea in Beijing, China (2010-2014). Gut Pathog 2016; 8:31. [PMID: 27303446 PMCID: PMC4906916 DOI: 10.1186/s13099-016-0116-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 06/03/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Diarrhea is one of the main causes of morbidity and mortality among children less than 5 years of age worldwide, and its causes vary by region. This study aimed to determine the etiologic spectrum, prevalent characteristics and antimicrobial resistance patterns of common enteropathogenic bacteria from diarrheagenic children in Beijing, the capital of China. METHODS Stool samples were collected from 2524 outpatients who were aged 0-5 years in Beijing, China during 2010-2014. Microbiological methods, real-time PCR and antimicrobial susceptibility test were used to identify the bacterial causes and antimicrobial resistance patterns in the isolates. RESULTS Of the 2524 patients screened, we identified the causes of 269 cases (10.7 %) as follows: diarrheagenic Escherichia coli (4.6 %), Salmonella (4.3 %), Shigella (1.4 %) and Vibrio parahaemolyticus (0.4 %). Atypical EPEC, Salmonella enteritidis, Shigella sonnei and serotype O3:K6 were the most common serogroups or serotypes of the four etiological bacteria. The prevalence of pathogens was correlated with age, season and clinical symptoms. The highest proportion of all causative bacteria was found in children aged 3-5 years and in summer. The clinical symptoms associated with specific bacterial infection, such as fever; abdominal pain; vomiting; and watery, mucus, and bloody stool, were observed frequently in diarrheal patients. Salmonella showed moderate rates of resistance (40-60 %) to ampicillin, nalidixic acid, streptomycin and sulfisoxazole. Resistance to at least three antimicrobials was found in 50 % of isolates. Of the top three serotypes in Salmonella, high-level antimicrobial resistance to single and multiple antibiotics was more common among Salmonella typhimurium and Salmonella 1, 4, [5], 12:i:- than among S. enteritidis. More than 90 % of Shigella isolates showed more alarming resistance to most antibiotics, with a widened spectrum compared to Salmonella. CONCLUSION Constant antibiotic surveillance is warranted because the bacteria were highly resistant to various antimicrobials. Our study contributes to the strengthening of the existing surveillance system and provides aid for effective prevention and control strategies for childhood diarrhea.
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Affiliation(s)
- Mei Qu
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
| | - Bing Lv
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
| | - Xin Zhang
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
| | - Hanqiu Yan
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
| | - Ying Huang
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
| | - Haikun Qian
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
| | - Bo Pang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, 102206 People's Republic of China
| | - Lei Jia
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
| | - Biao Kan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, 102206 People's Republic of China
| | - Quanyi Wang
- Department of Infectious and Endemic Diseases Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, No. 16 He Ping Li Middle Street, Beijing, 100013 People's Republic of China
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Mercado EH, Piscoche C, Contreras C, Durand D, Riveros M, Ruiz J, Ochoa TJ. Pathogenicity Island O-122 in enteropathogenic Escherichia coli strains is associated with diarrhea severity in children from Lima Peru. Int J Med Microbiol 2016; 306:231-6. [PMID: 27236730 DOI: 10.1016/j.ijmm.2016.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 05/05/2016] [Accepted: 05/08/2016] [Indexed: 01/03/2023] Open
Abstract
EPEC is an attaching and effacing diarrheal pathogen that carries a large pathogenicity island, locus for enterocyte effacement (LEE). Recently, the pathogenicity island PAI O-122 was described among non-LEE effectors and found to be associated with diarrhea among atypical EPEC strains. It is unknown if incomplete PAI O-122 could be associated with diarrhea duration and severity. To identify these virulence determinants we analyzed 379 EPEC strains isolated from Peruvian children. EPEC was diagnosed by PCR(eae+, stx-) and classified as typical(t-EPEC) or atypical(a-EPEC). To characterize PAI O-122 we amplified three modules by PCR: Module 1(pagC), Module 2(senA, nleB and nleE) and Module 3(lifA/efa-1). To characterize the large ORF lifA/efa-1 we amplified the regions known as efa-N, efa-M and efa-C. Clinical information was obtained from the cohort study. A total of 379 EPEC strains were able to analyze PAI O-122 genes, 128 (10.4%) EPEC strains were isolated from 1235 diarrhea episodes and 251(9.2%) from 2734 healthy controls. t-EPEC strains were isolated from 14.8% (19/128) of children with diarrhea and 25/251(10.0%) from healthy controls. The most frequent PAI O-122 genes were nleE(37.7%), senA(34.6%) and nleB(37.5%), with similar prevalence among diarrhea and control samples. However, lifA/efa-1 was more common among diarrhea cases than healthy control cases (30.5% vs. 21.1%, p<0.05). The presence of complete PAI O-122 was associated with diarrhea episodes of higher severity among single pathogen infection (33.3% vs. 1.8%, p<0.05) mainly due to the presence of a complete lifA/efa-1 gene. In summary, the gene lifA/efa-1 is significantly associated with diarrheal episodes of higher severity, suggesting to be an important virulent factor.
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Affiliation(s)
- Erik H Mercado
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cristian Piscoche
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carmen Contreras
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Durand
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maribel Riveros
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Joaquim Ruiz
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Theresa J Ochoa
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; University of Texas School of Public Health, Houston, TX, USA.
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Dupont A, Sommer F, Zhang K, Repnik U, Basic M, Bleich A, Kühnel M, Bäckhed F, Litvak Y, Fulde M, Rosenshine I, Hornef MW. Age-Dependent Susceptibility to Enteropathogenic Escherichia coli (EPEC) Infection in Mice. PLoS Pathog 2016; 12:e1005616. [PMID: 27159323 PMCID: PMC4861285 DOI: 10.1371/journal.ppat.1005616] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 04/15/2016] [Indexed: 01/14/2023] Open
Abstract
Enteropathogenic Escherichia coli (EPEC) represents a major causative agent of infant diarrhea associated with significant morbidity and mortality in developing countries. Although studied extensively in vitro, the investigation of the host-pathogen interaction in vivo has been hampered by the lack of a suitable small animal model. Using RT-PCR and global transcriptome analysis, high throughput 16S rDNA sequencing as well as immunofluorescence and electron microscopy, we characterize the EPEC-host interaction following oral challenge of newborn mice. Spontaneous colonization of the small intestine and colon of neonate mice that lasted until weaning was observed. Intimate attachment to the epithelial plasma membrane and microcolony formation were visualized only in the presence of a functional bundle forming pili (BFP) and type III secretion system (T3SS). Similarly, a T3SS-dependent EPEC-induced innate immune response, mediated via MyD88, TLR5 and TLR9 led to the induction of a distinct set of genes in infected intestinal epithelial cells. Infection-induced alterations of the microbiota composition remained restricted to the postnatal period. Although EPEC colonized the adult intestine in the absence of a competing microbiota, no microcolonies were observed at the small intestinal epithelium. Here, we introduce the first suitable mouse infection model and describe an age-dependent, virulence factor-dependent attachment of EPEC to enterocytes in vivo.
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Affiliation(s)
- Aline Dupont
- Institute for Medical Microbiology, RWTH Aachen University Hospital, Aachen, Germany
- Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
- * E-mail: (AD); (MWH)
| | - Felix Sommer
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Kaiyi Zhang
- Institute for Medical Microbiology, RWTH Aachen University Hospital, Aachen, Germany
- Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Urska Repnik
- Department of Biosciences, University of Oslo, Oslo, Norway
| | - Marijana Basic
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - André Bleich
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Mark Kühnel
- Institute for Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Fredrik Bäckhed
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Yael Litvak
- Department for Microbiology and Molecular Genetics, Institute of Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Marcus Fulde
- Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Ilan Rosenshine
- Department for Microbiology and Molecular Genetics, Institute of Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mathias W. Hornef
- Institute for Medical Microbiology, RWTH Aachen University Hospital, Aachen, Germany
- Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
- * E-mail: (AD); (MWH)
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Alonso MZ, Sanz ME, Irino K, Krüger A, Lucchesi PMA, Padola NL. Isolation of atypical enteropathogenic Escherichia coli from chicken and chicken-derived products. Br Poult Sci 2016; 57:161-4. [PMID: 26810335 DOI: 10.1080/00071668.2015.1135502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Atypical enteropathogenic Escherichia coli (EPEC) strains from chicken and chicken-derived products were isolated and characterised. The strains presented a wide variety of serotypes, some have been reported in other animal species (O2:H40, O5:H40) and in children with diarrhoea (O8:H-). Most of the strains carried intimin β. The results indicate that chicken and chicken products are important sources of atypical EPEC strains that could be associated with human disease, and highlight the need to improve hygiene practices in chicken slaughtering and meat handling.
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Affiliation(s)
- M Z Alonso
- a Laboratorio de Inmunoquímica y Biotecnología, Centro de Investigación Veterinaria de Tandil (CIVETAN), CONICET, Departamento de Sanidad Animal y Medicina Preventiva, Facultad de Ciencias Veterinarias , UNCPBA , Tandil , Argentina
| | | | - K Irino
- c Department of Bacteriology , Instituto Adolfo Lutz , Sao Paulo , Brazil
| | - A Krüger
- a Laboratorio de Inmunoquímica y Biotecnología, Centro de Investigación Veterinaria de Tandil (CIVETAN), CONICET, Departamento de Sanidad Animal y Medicina Preventiva, Facultad de Ciencias Veterinarias , UNCPBA , Tandil , Argentina
| | - P M A Lucchesi
- a Laboratorio de Inmunoquímica y Biotecnología, Centro de Investigación Veterinaria de Tandil (CIVETAN), CONICET, Departamento de Sanidad Animal y Medicina Preventiva, Facultad de Ciencias Veterinarias , UNCPBA , Tandil , Argentina
| | - N L Padola
- a Laboratorio de Inmunoquímica y Biotecnología, Centro de Investigación Veterinaria de Tandil (CIVETAN), CONICET, Departamento de Sanidad Animal y Medicina Preventiva, Facultad de Ciencias Veterinarias , UNCPBA , Tandil , Argentina
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Xu Y, Bai X, Zhao A, Zhang W, Ba P, Liu K, Jin Y, Wang H, Guo Q, Sun H, Xu J, Xiong Y. Genetic Diversity of Intimin Gene of Atypical Enteropathogenic Escherichia coli Isolated from Human, Animals and Raw Meats in China. PLoS One 2016; 11:e0152571. [PMID: 27031337 PMCID: PMC4816571 DOI: 10.1371/journal.pone.0152571] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 03/16/2016] [Indexed: 01/08/2023] Open
Abstract
Atypical enteropathogenic Escherichia coli (aEPEC) is considered to be an emerging enteropathogen that is more prevalent than typical EPEC in developing and developed countries. The major adherence factor, intimin, an outer membrane protein encoded by eae, plays a pivotal role in the pathogenesis of aEPEC. This study investigated the distribution and polymorphisms of intimin subtypes of 143 aEPEC strains from diarrheal patients, healthy carriers, animals, and raw meats in China. These aEPEC strains belonged to more than 71 different serotypes, which comprised 52 O serogroups and 24 H types. Sixty-eight different eae genotypes and 19 intimin subtypes were detected. Eighteen, eight, seven, and five intimin subtypes were identified from 86 diarrheal patients, 14 healthy carriers, 19 animals, and 24 raw meats strains, respectively. Intimin β1 was the most prevalent subtype in strains from diarrheal patients (34.88%) and animals (47.37%). There was a statistically significant difference in the distribution of eae-β1 between diarrheal patients and healthy carriers (P = 0.004). Intimin-θ was more predominant among raw meat strains (50%) than among diarrheal patients strains (12.79%, P = 0.0003), healthy carrier strains (7.14%, P = 0.007), or animal strains (15.79%, P = 0.020). The two predominant subtypes (eae-β1 and eae-θ) had considerable polymorphisms with no significant differences among the four sources. PFGE analysis revealed 119 distinct patterns and the strains were clustered into 11 groups with similarity indices ranging from 63% to 100%. These results suggest that in China, aEPEC strains from different sources are highly heterogeneous. Animals and raw meats are important sources of genetically diverse intimin-harboring aEPEC, which might serve as important transmission vehicles of these bacteria.
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Affiliation(s)
- Yanmei Xu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiangning Bai
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailan Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wang Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Pengbin Ba
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kai Liu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yujuan Jin
- Longgang Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Hong Wang
- Zigong Center for Disease Control and Prevention, Zigong, Sichuan Province, China
| | - Qiusheng Guo
- Suixian Center for Disease Control and Prevention, Shangqiu, Henan Province, China
| | - Hui Sun
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianguo Xu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanwen Xiong
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail:
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Dias RCB, dos Santos BC, dos Santos LF, Vieira MA, Yamatogi RS, Mondelli AL, Sadatsune T, Sforcin JM, Gomes TAT, Hernandes RT. DiarrheagenicEscherichia colipathotypes investigation revealed atypical enteropathogenicE. colias putative emerging diarrheal agents in children living in Botucatu, São Paulo State, Brazil. APMIS 2016; 124:299-308. [DOI: 10.1111/apm.12501] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/27/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Regiane C. B. Dias
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Bruna C. dos Santos
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Luis F. dos Santos
- Centro de Bacteriologia; Instituto Adolfo Lutz (IAL); São Paulo SP Brazil
| | - Melissa A. Vieira
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Ricardo S. Yamatogi
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Alessandro L. Mondelli
- Departamento de Patologia Clínica; Faculdade de Medicina; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Terue Sadatsune
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - José M. Sforcin
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
| | - Tânia A. T. Gomes
- Departamento de Microbiologia, Imunologia e Parasitologia da; Universidade Federal de São Paulo (UNIFESP); São Paulo SP Brazil
| | - Rodrigo T. Hernandes
- Departamento de Microbiologia e Imunologia; Instituto de Biociências; Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP); Botucatu SP Brazil
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