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Rodwell EV, Simpson A, Chan YW, Godbole G, McCarthy ND, Jenkins C. The epidemiology of Shiga toxin-producing Escherichia coli O26:H11 (clonal complex 29) in England, 2014-2021. J Infect 2023; 86:552-562. [PMID: 37060924 DOI: 10.1016/j.jinf.2023.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVES We aimed to describe the genomic epidemiology of the foodborne gastrointestinal pathogen, Shiga toxin-producing Escherichia coli (STEC) serotype O26:H11 belonging to clonal complex 29 (CC29) in England. METHODS Between 01 January 2014 and 31 December 2021, 834 human isolates belonging to CC29 were sequenced at the UK Health Security Agency, and the genomic data was integrated with epidemiological data. RESULTS Diagnoses of STEC O26:H11 in England have increased each year from 19 in 2014 to 144 in 2021. Most isolates had the Shiga toxin subtype profiles stx1a (47%), stx1a,stx2a (n=24%) or stx2a (n=28%). Most cases were female (57%), and the highest proportion of cases belonged to the 0-5 age group (38%). Clinical symptoms included diarrhoea (93%), blood-stained stool (48%), and abdominal pain (74%). Haemolytic Uraemic Syndrome (HUS) was diagnosed in 40/459 (9%) cases and three children died. All isolates causing STEC-HUS had stx2a either alone (n=33) or in combination with stx1a (n=7). CONCLUSIONS STEC O26:H11 are a clinically significant, emerging threat to public health in England. Determining the true incidence and prevalence is challenging due to inconsistent national surveillance strategies. Improved diagnostics and surveillance algorithms are required to monitor the true burden, detect outbreaks and to implement effective interventions.
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Affiliation(s)
- Ella V Rodwell
- National Infection Service, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5AT, UK; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK; NIHR HPRU in Gastrointestinal Infections at University of Liverpool, UK
| | - Alex Simpson
- National Infection Service, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5AT, UK
| | - Yung-Wai Chan
- National Infection Service, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5AT, UK
| | - Gauri Godbole
- National Infection Service, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5AT, UK
| | - Noel D McCarthy
- NIHR HPRU in Gastrointestinal Infections at University of Liverpool, UK
| | - Claire Jenkins
- National Infection Service, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5AT, UK; NIHR HPRU in Gastrointestinal Infections at University of Liverpool, UK
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Epidemiological investigations identified an outbreak of Shiga toxin-producing Escherichia coli serotype O26:H11 associated with pre-packed sandwiches. Epidemiol Infect 2021; 149:e178. [PMID: 34635196 PMCID: PMC8365849 DOI: 10.1017/s0950268821001576] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In October 2019, public health surveillance systems in Scotland identified an increase in the number of reported infections of Shiga toxin-producing Escherichia coli (STEC) O26:H11 involving bloody diarrhoea. Ultimately, across the United Kingdom (UK) 32 cases of STEC O26:H11 stx1a were identified, with the median age of 27 years and 64% were male; six cases were hospitalised. Among food exposures there was an association with consuming pre-packed sandwiches purchased at outlets belonging to a national food chain franchise (food outlet A) [odds ratio (OR) = 183.89, P < 0.001]. The common ingredient identified as a component of the majority of the sandwiches sold at food outlet A was a mixed salad of Apollo and Iceberg lettuce and spinach leaves. Microbiological testing of food and environmental samples were negative for STEC O26:H11, although STEC O36:H19 was isolated from a mixed salad sample taken from premises owned by food outlet A. Contamination of fresh produce is often due to a transient event and detection of the aetiological agent in food that has a short-shelf life is challenging. Robust, statistically significant epidemiological analysis should be sufficient evidence to direct timely and targeted on-farm investigations. A shift in focus from testing the microbiological quality of the produce to investigating the processes and practices through the supply chain and sampling the farm environment is recommended.
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Smith AM, Tau NP, Kalule BJ, Nicol MP, McCulloch M, Jacobs CA, McCarthy KM, Ismail A, Allam M, Kleynhans J. Shiga toxin-producing Escherichia coli O26:H11 associated with a cluster of haemolytic uraemic syndrome cases in South Africa, 2017. Access Microbiol 2019; 1:e000061. [PMID: 32974561 PMCID: PMC7472548 DOI: 10.1099/acmi.0.000061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/22/2019] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Shiga toxin-producing Escherichia coli (STEC) are foodborne pathogens that may cause diarrhoeal outbreaks and occasionally are associated with haemolytic-uraemic syndrome (HUS). We report on STEC O26:H11 associated with a cluster of four HUS cases in South Africa in 2017. METHODOLOGY All case-patients were female and aged 5 years and under. Standard microbiological tests were performed for culture and identification of STEC from specimens (human stool and food samples). Further analysis of genomic DNA extracted from bacterial cultures and specimens included PCR for specific virulence genes, whole-genome sequencing and shotgun metagenomic sequencing. RESULTS For 2/4 cases, stool specimens revealed STEC O26:H11 containing eae, stx2a and stx2b virulence genes. All food samples were found to be negative for STEC. No epidemiological links could be established between the HUS cases. Dried meat products were the leading food item suspected to be the vehicle of transmission for these cases, as 3/4 case-patients reported they had eaten this. However, testing of dried meat products could not confirm this. CONCLUSION Since STEC infection does not always lead to severe symptoms, it is possible that many more cases were associated with this cluster and largely went unrecognized.
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Affiliation(s)
- Anthony M. Smith
- Centre for Enteric Diseases, National Institute for Communicable Diseases (NICD), National Health Laboratory Service (NHLS), Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nomsa P. Tau
- Centre for Enteric Diseases, National Institute for Communicable Diseases (NICD), National Health Laboratory Service (NHLS), Johannesburg, South Africa
| | - Bosco J. Kalule
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Mark P. Nicol
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Mignon McCulloch
- Red Cross Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Charlene A. Jacobs
- Communicable Disease Control, Department of Health, Cape Town, South Africa
| | - Kerrigan M. McCarthy
- Division of Public Health Surveillance and Response, NICD, NHLS, Johannesburg, South Africa
| | - Arshad Ismail
- Sequencing Core Facility, NICD, NHLS, Johannesburg, South Africa
| | - Mushal Allam
- Sequencing Core Facility, NICD, NHLS, Johannesburg, South Africa
| | - Jackie Kleynhans
- South African Field Epidemiology Training Programme, NICD, NHLS, Johannesburg, South Africa
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Dallman TJ, Greig DR, Gharbia SE, Jenkins C. Phylogenetic context of Shiga toxin-producing Escherichia coli serotype O26:H11 in England. Microb Genom 2019; 7:000551. [PMID: 33760723 PMCID: PMC8627664 DOI: 10.1099/mgen.0.000551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 03/02/2021] [Indexed: 01/09/2023] Open
Abstract
The increasing use of PCR for the detection of gastrointestinal pathogens in hospital laboratories in England has improved the detection of Shiga toxin-producing Escherichia coli (STEC), and the diagnosis of haemolytic uraemic syndrome (HUS). We aimed to analyse the microbiological characteristics and phylogenetic relationships of STEC O26:H11, clonal complex (CC) 29, in England to inform surveillance, and to assess the threat to public health. There were 502 STEC belonging to CC29 isolated between 2014 and 2019, of which 416 were from individual cases. The majority of isolates belonged to one of three major sequence types (STs), ST16 (n=37), ST21 (n=350) and ST29 (n=24). ST16 and ST29 were mainly isolated from cases reporting recent travel abroad. Within ST21, there were three main clades associated with domestic acquisition. All three domestic clades had Shiga toxin subtype gene (stx) profiles associated with causing severe clinical outcomes including STEC-HUS, specifically either stx1a, stx2a or stx1a/stx2a. Isolates from the same patient, same household or same outbreak with an established source for the most part fell within 5-SNP single linkage clusters. There were 19 5-SNP community clusters, of which six were travel-associated and one was an outbreak of 16 cases caused by the consumption of contaminated salad leaves. Of the remaining 12 clusters, 9/12 were either temporally or geographically related or both. Exposure to foodborne STEC O26:H11 ST21 capable of causing severe clinical outcomes, including STEC-HUS, is an emerging risk to public health in England. The lack of comprehensive surveillance of this STEC serotype is a concern, and there is a need to expand the implementation of methods capable of detecting STEC in local hospital settings.
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Affiliation(s)
- Timothy J. Dallman
- National Infection Service, Public Health England, London, NW9 5EQ, UK
- Division of Infection and Immunity, The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, EH25 9RG, UK
| | - David R. Greig
- National Infection Service, Public Health England, London, NW9 5EQ, UK
- Division of Infection and Immunity, The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, EH25 9RG, UK
| | - Saheer E. Gharbia
- National Infection Service, Public Health England, London, NW9 5EQ, UK
| | - Claire Jenkins
- National Infection Service, Public Health England, London, NW9 5EQ, UK
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Status and potential of bacterial genomics for public health practice: a scoping review. Implement Sci 2019; 14:79. [PMID: 31409417 PMCID: PMC6692930 DOI: 10.1186/s13012-019-0930-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 07/26/2019] [Indexed: 01/10/2023] Open
Abstract
Background Next-generation sequencing (NGS) is increasingly being translated into routine public health practice, affecting the surveillance and control of many pathogens. The purpose of this scoping review is to identify and characterize the recent literature concerning the application of bacterial pathogen genomics for public health practice and to assess the added value, challenges, and needs related to its implementation from an epidemiologist’s perspective. Methods In this scoping review, a systematic PubMed search with forward and backward snowballing was performed to identify manuscripts in English published between January 2015 and September 2018. Included studies had to describe the application of NGS on bacterial isolates within a public health setting. The studied pathogen, year of publication, country, number of isolates, sampling fraction, setting, public health application, study aim, level of implementation, time orientation of the NGS analyses, and key findings were extracted from each study. Due to a large heterogeneity of settings, applications, pathogens, and study measurements, a descriptive narrative synthesis of the eligible studies was performed. Results Out of the 275 included articles, 164 were outbreak investigations, 70 focused on strategy-oriented surveillance, and 41 on control-oriented surveillance. Main applications included the use of whole-genome sequencing (WGS) data for (1) source tracing, (2) early outbreak detection, (3) unraveling transmission dynamics, (4) monitoring drug resistance, (5) detecting cross-border transmission events, (6) identifying the emergence of strains with enhanced virulence or zoonotic potential, and (7) assessing the impact of prevention and control programs. The superior resolution over conventional typing methods to infer transmission routes was reported as an added value, as well as the ability to simultaneously characterize the resistome and virulome of the studied pathogen. However, the full potential of pathogen genomics can only be reached through its integration with high-quality contextual data. Conclusions For several pathogens, it is time for a shift from proof-of-concept studies to routine use of WGS during outbreak investigations and surveillance activities. However, some implementation challenges from the epidemiologist’s perspective remain, such as data integration, quality of contextual data, sampling strategies, and meaningful interpretations. Interdisciplinary, inter-sectoral, and international collaborations are key for an appropriate genomics-informed surveillance. Electronic supplementary material The online version of this article (10.1186/s13012-019-0930-2) contains supplementary material, which is available to authorized users.
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Kikuchi K, Lee K, Ueno H, Tomari K, Kobori S, Kaetsu A, Matsui M, Suzuki S, Sekizuka T, Kuroda M, Miyazaki M, Ohnishi M. Enterohaemorrhagic Escherichia coli O121:H19 acquired an extended-spectrum β-lactamase gene during the development of an outbreak in two nurseries. Microb Genom 2019; 5. [PMID: 31215859 PMCID: PMC6700663 DOI: 10.1099/mgen.0.000278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Enterohaemorrhagic Escherichia coli (EHEC) is an important human pathogen worldwide. Although serotype O157 is currently the most dominant and important EHEC strain, serotypes O26, O111, O91, O103 and O121 are also recognized as serious pathogens that affect public health. EHEC outbreaks often occur in nurseries and elderly care facilities. In 2012, a nursery outbreak of EHEC O121 occurred during which the bacterium acquired a plasmid-borne extended-spectrum β-lactamase (ESBL) gene. ESBL-producing E. coli O86 was concurrently isolated from one of the EHEC patients. Therefore, we investigated the isolates by whole-genome sequence (WGS) analysis to elucidate the transmission dynamics of the EHEC strains and the ESBL plasmid. According to WGS-based phylogeny, all 17 EHEC O121 isolates were clonal, while E. coli O86 was genetically distant from the EHEC O121 isolates. The complete sequence of an ESBL plasmid encoding the CTX-M-55 β-lactamase was determined using S1-PFGE bands, and subsequent mapping of the WGS reads confirmed that the plasmid sequences from EHEC O121 and E. coli O86 were identical. Furthermore, conjugation experiments showed that the plasmid was capable of conjugative transfer. These results support the hypothesis that EHEC O121 acquired an ESBL-producing plasmid from E. coli O86 during the outbreak. This report demonstrates the importance of implementing preventive measures during EHEC outbreaks to control both secondary infection and the spread of antimicrobial resistance factors.
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Affiliation(s)
- Koji Kikuchi
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Kenichi Lee
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroyuki Ueno
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Kentaro Tomari
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Sumie Kobori
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | | | - Mari Matsui
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satowa Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tsuyoshi Sekizuka
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Kuroda
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motonobu Miyazaki
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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Rokney A, Valinsky L, Moran-Gilad J, Vranckx K, Agmon V, Weinberger M. Genomic Epidemiology of Campylobacter jejuni Transmission in Israel. Front Microbiol 2018; 9:2432. [PMID: 30386311 PMCID: PMC6198274 DOI: 10.3389/fmicb.2018.02432] [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: 04/16/2018] [Accepted: 09/21/2018] [Indexed: 01/22/2023] Open
Abstract
Objectives: Campylobacter jejuni is responsible for 80% of Campylobacter infections in Israel, a country with a high incidence reaching 91/100,000 population. We studied the phylogeny, diversity and prevalence of virulence factors using whole genome sequencing (WGS) of a national sample of C. jejuni clinical, food, and animal isolates collected over a 10-year period (2003-2012). Methods: C. jejuni isolates (n = 263) were subject to WGS using Illumina sequencing (PE 250bpx2). Raw reads and de novo assemblies were analyzed with the BioNumerics whole genome MLST (wgMLST) pipeline. Reads were screened for 71 virulence genes by the SRST2 script. Allelic profiles were analyzed to create minimum spanning trees and allelic core distances were investigated to determine a reliable cutoff for strain determination. Results: wgMLST analysis of 263 C. jejuni isolates indicated significant diversity among the prevalent clonal complexes (CCs) with CC-21 and CC-353 being the most diverse, and CC-574 the most clonal. Within CC-21, sequence type (ST)-1359 created a separate clade. Human, poultry and bovine isolates clustered together across the different STs. Forty four percent of studied isolates were assigned to 29 genetic clusters. Temporal and geographical relatedness were found among the minority of clusters, while most phylogenetically associated cases appeared diffuse and unassociated epidemiologically. The majority of virulence factors were highly prevalent across the dataset and not associated with genotype, source of isolation or invasiveness. Conversely, all 13 genes associated with type VI secretion system (T6SS) were lineage-related and identified in only 18% of the isolates. T6SS was detected in 95.2% of ST-1359, a common type in Israel. Conclusions: wgMLST supported the assessment that poultry and cattle are likely food sources of infection in Israel. Substantial genetic clustering among C. jejuni isolates suggested multiple point source and diffuse outbreaks that were previously unreported in Israel. The high prevalence of T6SS among ST-1359 isolates is unique to Israel, and requires further investigation. This study exemplifies the importance of studying foodborne pathogens using advanced genomic approaches across the entire spectrum of One Health.
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Affiliation(s)
- Assaf Rokney
- Central Government Laboratories, Israel Ministry of Health, Jerusalem, Israel
| | - Lea Valinsky
- Central Government Laboratories, Israel Ministry of Health, Jerusalem, Israel
| | - Jacob Moran-Gilad
- Public Health Services, Israel Ministry of Health, Jerusalem, Israel.,Department of Health Policy and Management, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.,ESCMID Study Group for Genomic and Molecular Diagnostics, Basel, Switzerland
| | | | - Vered Agmon
- Central Government Laboratories, Israel Ministry of Health, Jerusalem, Israel
| | - Miriam Weinberger
- Infectious Diseases Unit, Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Karnisova L, Marejkova M, Hrbackova H, Mellmann A, Karch H, Fruth A, Drevinek P, Blahova K, Bielaszewska M, Nunvar J. Attack of the clones: whole genome-based characterization of two closely related enterohemorrhagic Escherichia coli O26 epidemic lineages. BMC Genomics 2018; 19:647. [PMID: 30170539 PMCID: PMC6119250 DOI: 10.1186/s12864-018-5045-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/27/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Enterohemorrhagic Escherichia coli (EHEC) O26:H11/H-, the most common non-O157 serotype causing hemolytic uremic syndrome worldwide, are evolutionarily highly dynamic with new pathogenic clones emerging rapidly. Here, we investigated the population structure of EHEC O26 isolated from patients in several European countries using whole genome sequencing, with emphasis on a detailed analysis of strains of the highly virulent new European clone (nEC) which has spread since 1990s. RESULTS Genome-wide single nucleotide polymorphism (SNP)-based analysis of 32 EHEC O26 isolated in the Czech Republic, Germany, Austria and Italy demonstrated a split of the nEC (ST29C2 clonal group) into two distinct lineages, which we termed, based on their temporal emergence, as "early" nEC and "late" nEC. The evolutionary divergence of the early nEC and late nEC is marked by the presence of 59 and 70 lineage-specific SNPs (synapomorphic mutations) in the genomes of the respective lineages. In silico analyses of publicly available E. coli O26 genomic sequences identified the late nEC lineage worldwide. Using a PCR designed to target the late nEC synapomorphic mutation in the sen/ent gene, we identified the early nEC decline accompanied by the late nEC rise in Germany and the Czech Republic since 2004 and 2013, respectively. Most of the late nEC strains harbor one of two major types of Shiga toxin 2a (Stx2a)-encoding prophages. The type I stx2a-phage is virtually identical to stx2a-phage of EHEC O104:H4 outbreak strain, whereas the type II stx2a-phage is a hybrid of EHEC O104:H4 and EHEC O157:H7 stx2a-phages and carries a novel mutation in Stx2a. Strains harboring these two phage types do not differ by the amounts and biological activities of Stx2a produced. CONCLUSIONS Using SNP-level analyses, we provide the evidence of the evolutionary split of EHEC O26:H11/H- nEC into two distinct lineages, and a recent replacement of the early nEC by the late nEC in Germany and the Czech Republic. PCR targeting the late nEC synapomorphic mutation in ent/sen enables the discrimination of early nEC strains and late nEC strains in clinical and environmental samples, thereby facilitating further investigations of their geographic distribution, prevalence, clinical significance and epidemiology.
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Affiliation(s)
- Lucia Karnisova
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Monika Marejkova
- National Reference Laboratory for E. coli and Shigella, National Institute of Public Health, Prague, Czech Republic
| | - Hana Hrbackova
- Laboratory for Tissue Cultures, National Institute of Public Health, Prague, Czech Republic
| | - Alexander Mellmann
- Institute for Hygiene and the National Consulting Laboratory on Hemolytic Uremic Syndrome, University of Münster, Münster, Germany
| | - Helge Karch
- Institute for Hygiene and the National Consulting Laboratory on Hemolytic Uremic Syndrome, University of Münster, Münster, Germany
| | - Angelika Fruth
- National Reference Center for Salmonella and Other Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Pavel Drevinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kveta Blahova
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Martina Bielaszewska
- National Reference Laboratory for E. coli and Shigella, National Institute of Public Health, Prague, Czech Republic
| | - Jaroslav Nunvar
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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Scavia G, Gianviti A, Labriola V, Chiani P, Maugliani A, Michelacci V, Minelli F, Tozzoli R, Caprioli A, Morabito S. A case of haemolytic uraemic syndrome (HUS) revealed an outbreak of Shiga toxin-2-producing Escherichia coli O26:H11 infection in a nursery, with long-lasting shedders and person-to-person transmission, Italy 2015. J Med Microbiol 2018; 67:775-782. [DOI: 10.1099/jmm.0.000738] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Gaia Scavia
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandra Gianviti
- Dipartimento di Nefrologia-Urologia, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Vincenzo Labriola
- Dipartimento di Prevenzione, Servizio di Igiene e Sanità Pubblica, ASL Roma 3, Roma, Italy
| | - Paola Chiani
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Antonella Maugliani
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Valeria Michelacci
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Fabio Minelli
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Rosangela Tozzoli
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Alfredo Caprioli
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Morabito
- European Union and National Reference Laboratory for E. coli, Dip. Sicurezza Alimentare, Nutrizione, Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, Rome, Italy
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Motro Y, Carriço JA, Friedrich AW, Rossen JW, Moran-Gilad J. ESCMID postgraduate education course: regional capacity building for integration of next-generation sequencing in the clinical microlab. Microbes Infect 2018; 20:275-280. [DOI: 10.1016/j.micinf.2018.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 01/16/2023]
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