Epidemiology of Shiga toxin-producingEscherichia coliO157:H7 in Africa in review

Sorbitol non-fermenting Escherichia coli and E. coli O157: prevalence and antimicrobial resistance profile of strains in slaughtered food animals in Southeast Nigeria

Antimicrobial resistance (AMR) is one of the greatest global health challenges. Reliable monitoring of AMR in bacteria in food animals is critical in order to devise mitigation strategies and empiric treatment of infections associated with the organisms. The aim of this study was to isolate sorbitol non-fermenting (SN-F) Escherichia coli from food animals (broiler chickens, cattle and pigs) slaughtered at Ikpa Market, Nsukka, Enugu State, Southeast Nigeria, detect E. coli O157 and determine the in vitro antimicrobial resistance profile of the E. coli strains. A total of 388 faecal samples were collected from randomly selected broiler chickens (n=155), cattle (n=129) and pigs (n=104). Isolation of SN-F E. coli was done using tryptic soy broth and cefixime- and potassium tellurite-supplemented sorbitol MacConkey agar (CT-SMAC). SN-F E. coli strains were confirmed biochemically and E. coli O157 detected serologically using specific E. coli O157 latex agglutination test kit. The antimicrobial resistance profile of all strains was established using the disc diffusion method. Overall, 52 (13.4 %) SN-F E. coli strains were recovered from the broiler chickens (n=31), cattle (n=12) and pigs (n=9). A significant association (χ2=9.70; P <0.05) was observed between the prevalence of SN-F E. coli and animal species. E. coli O157 was detected in two of the samples, representing 0.51% of the 388 samples processed. All the E. coli strains were resistant to at least one antimicrobial agent tested and 76% were multidrug resistant (MDR). The mean multiple antibiotic resistance indices (MARI) for isolates from chickens, cattle and pig were 0.32, 0.18 and 0.23, respectively. This study showed that a considerable percentage of food animals slaughtered in Nsukka Southeastern Nigeria are potential reservoirs of multiple-drug-resistant SN-F E. coli, including E. coli O157 that could spread to humans and the environment.

Review of Escherichia coli O157:H7 Prevalence, Pathogenicity, Heavy Metal and Antimicrobial Resistance, African Perspective

Escherichia coli O157:H7 is an important food-borne and water-borne pathogen that causes hemorrhagic colitis and the hemolytic-uremic syndrome in humans and may cause serious morbidity and large outbreaks worldwide. People with bloody diarrhea have an increased risk of developing serious complications such as acute renal failure and neurological damage. The hemolytic-uremic syndrome (HUS) is a serious condition, and up to 50% of HUS patients can develop long-term renal dysfunction or blood pressure-related complications. Children aged two to six years have an increased risk of developing HUS. Clinical enteropathogenic Escherichia coli (EPEC) infections show fever, vomiting, and diarrhea. The EPEC reservoir is unknown but is suggested to be an asymptomatic or symptomatic child or an asymptomatic adult carrier. Spreading is often through the fecal-oral route. The prevalence of EPEC in infants is low, and EPEC is highly contagious in children. EPEC disease in children tends to be clinically more severe than other diarrheal infections. Some children experience persistent diarrhea that lasts for more than 14 days. Enterotoxigenic Escherichia coli (ETEC) strains are a compelling cause of the problem of diarrheal disease. ETEC strains are a global concern as the bacteria are the leading cause of acute watery diarrhea in children and the leading cause of traveler’s diarrhea. It is contagious to children and can cause chronic diarrhea that can affect the development and well-being of children. Infections with diarrheagenic E. coli are more common in African countries. Antimicrobial agents should be avoided in the acute phase of the disease since studies showed that antimicrobial agents may increase the risk of HUS in children. The South African National Veterinary Surveillance and Monitoring Programme for Resistance to Antimicrobial Drugs has reported increased antimicrobial resistance in E. coli. Pathogenic bacterial strains have developed resistance to a variety of antimicrobial agents due to antimicrobial misuse. The induced heavy metal tolerance may also enhance antimicrobial resistance. The prevalence of antimicrobial resistance depends on the type of the antimicrobial agent, bacterial strain, dose, time, and mode of administration. Developing countries are severely affected by increased resistance to antimicrobial agents due to poverty, lack of proper hygiene, and clean water, which can lead to bacterial infections with limited treatment options due to resistance.

Designing of immunodiagnostic assay using polyclonal antibodies for detection of Shiga toxin producing pathogenic E. coli (STEC) strains

Shiga toxin-producing Escherichia coli (STEC) are the leading causes of diarrhea and death of humans worldwide. Many diagnostic assays have been developed to aid for the diagnosis of STEC strain; however, they have limitations. Thus, this study was aimed at designing rapid, effective, sensitive and specific immunodiagnostic assay for STEC strain detection. Thus, a STEC isolate from Ethiopia was processed for LPS extraction and the LPS was used to immunize mice.. The produced antibody showed positive agglutination both on the purified LPS as well as the STEC isolate carrying LPS on their surface; however, agglutination of STEC was more pronounced. Mice immunized with LPS produced highest agglutination on tertiary immunization showing the progressive buildup of the antibody response against the antigen. Cultures from tryptone soya agar and when they refresh showed better agglutination than cultures on EMB as well as tryptone soya broth. Immunodiagnostic assay developed in this study could detect STEC strains including STEC in human feces rapidly (1-2 min), with high sensitivity (90.2%), specificity (89.5%) and accuracy (90.6%). However, further studies are still required to improve the sensitivity, specificity and reproducibility. Overall this diagnostic assay provided promising results that may curb current problem with detection methods in clinical health care and research laboratories.

A Novel Electrochemical Genosensor for Specific Detection of xanQ Genein Escherichia coli Strains in Water

Background:

A rapid and specific detection of pathogens is of great importance from public health viewpoint as well as from economic perspectives. Genosensor based on sequence specific detection of Escherichia coli facilitates significant improvements in rapidity and specificity over traditional microbiological methods.

Objective:

The present study was aimed to identify a sequence of xanQ genetic marker for designing the DNA sensing probe and to fabricate a genosensor using the interdigitated gold electrode (IDE). A label-free genosensor for E. coli detection in water by a novel nucleic acid sensing probe, URecA1016 is reported. The URecA1016 sensing probe-functionalized gold-interdigitated electrode surface by covalent coupling using 11Mercaptoundecanoic acid (crosslinker) to develop the electrochemical genosensor.

Results:

Upon DNA hybridization, the non-Faradaic sensing measurements showed a decreasing capacitance value with 10 min response time at 120 Hz frequency and 10 mV applied potential. The linearity range of the genosensor was between 1 and 1000 pg/mL for DNA of E. coli with limit of quantification (LoQ) of 1.27 pg DNA/mL of E. coli (equivalent to approximately 150 CFU/mL) at 95% confidence. Whilst the genosensor was E. coli species-specific as has been tested for detection of E. coli MTCC 3221, E. coli O157:H7 ATCC 43895, E. coli O78:H11 MTCC 723 any cross-reactivity could not be observed with DNA of Shigella flexneri MTCC 9543 and Bacillus subtilis MTCC 736. The capacitance change responses were also recorded and discussed.

Conclusions:

The URecA1016 sensing probe was found to be specific for detection of different E. coli species spiked in water. The results obtained in our study demonstrated the possible application potential of genosensor for E. coli detection in real water samples.

Quantitative microbial risk assessment for waterborne pathogens in a wastewater treatment plant and its receiving surface water body

BACKGROUND

Access to safe water for drinking and domestic activities remains a challenge in emerging economies like South Africa, forcing resource-limited communities to use microbiologically polluted river water for personal and household purposes, posing a public health risk. This study quantified bacterial contamination and the potential health hazards that wastewater treatment plant (WWTP) workers and communities may face after exposure to waterborne pathogenic bacteria in a WWTP and its associated surface water, respectively.

RESULTS

Escherichia coli (Colilert®-18/ Quanti-Tray® 2000) and enterococci (Enterolert®/ Quanti-Tray® 2000) were quantified and definitively identified by real-time polymerase chain reaction targeting the uidA and tuf genes, respectively. An approximate beta-Poisson dose-response model was used to estimate the probability of infection (Pi) with pathogenic E. coli. Mean E. coli concentration ranged from 2.60E+ 02/100 mL to 4.84E+ 06/100 mL; enterococci ranged from 2.60E+ 02/100 mL to 3.19E+ 06/100 mL across all sampled sites. Of the 580 E. coli isolates obtained from this study, 89.1% were intestinal, and 7.6% were extraintestinal pathogenic E. coli. The 579 enterococci obtained were 50.4% E. faecalis (50.4%), 31.4% E. faecium, 3.5%, E. casseliflavus and 0.7% E. gallinarum. The community health risk stemming from the use of the water for recreational and domestic purposes revealed a greater health risk (Pi) from the ingestion of 1 mL of river water from upstream (range, 55.1-92.9%) than downstream (range, 26.8-65.3%) sites. The occupational risk of infection with pathogenic E. coli for workers resulting from a once-off unintentional consumption of 1 mL of water was 0% (effluent) and 23.8% (raw influent). Multiple weekly exposures of 1 mL over a year could result in a Pi of 1.2 and 100% for the effluent and influent, respectively.

CONCLUSION

Our findings reveal that there is a potentially high risk of infection for WWTP workers and communities that use river water upstream and downstream of the investigated WWTP.

Occurrence of Multi-Drug Resistant Escherichia Coli and Escherichia Coli O157:H7 in Meat and Swab Samples of Various Contact Surfaces at Abattoir and Butcher Shops in Jimma Town, Southwest District of Ethiopia

Background

Raw meat is one of the commonly consumed traditional diets in Ethiopia. However, unhygienic processing and distribution practices are risky for contamination of meat leading to human infection. This study was conducted to assess the presence of multi-drug resistant E. coli with special emphasis on E. coli O157:H7 from meat of cattle and swab samples at abattoir houses and butcher shops in Jimma town, Southwest district of Ethiopia.

Methodology

A cross-sectional descriptive study was conducted from April to July, 2018. The isolation and identification processes passed through enrichment of samples with modified tryptone soy broth (mTSB), streaked onto MacConkey agar and Cefixime-tellurite sorbitol MacConkey agar, biochemical testing (indole and TSI), followed by latex agglutination testing.

Results

Out of 505 samples, 102 (20.2%) and 27 (5.4%) were positive for E. coli and E. coli O157:H7, respectively. Of these, 55 (19.3%) and 47 (21.4%) of E. coli and 17 (6.0%) and 10 (4.5%) of E. coli O157:H7 were isolated from the abattoir and butcher shop samples, respectively. A significant difference in the occurrences was observed among sample sources. Antimicrobial susceptibility test results showed that, 92.2% to 96.1% of E. coli and 85.5% to 96.3% of E. coli O157:H7 were susceptible to third generation cephalosporin, ciprofloxacin, gentamycin, kanamycin, streptomycin, and chloramphenicol. About 91.2% and 97.1% of E. coli and 88.9% and 92.6% of E. coli 0157:H7 were resistant to ampicillin and erythromycin, respectively. A total of 57 (44.2%) E. coli and E. coli O157:H7 isolates were resistant to three or more classes of antibiotics. All abattoir and butcher shop workers did not have any formal education or training certificates on food safety, and unhygienic practices were also observed.

Conclusion

The presence of E. coli and E. coli O157:H7 including multi-drug resistant isolates in raw meat highlights how the current meat processing and distribution practice was unhygienic. Therefore, strategies in the prevention and control of food-borne infections that could be caused by multi-drug resistant strains will depend greatly on hygienic processing and distribution practices of meat.

Occurrence, Molecular Characteristics, and Antimicrobial Resistance of Escherichia coli O157 in Cattle, Beef, and Humans in Bishoftu Town, Central Ethiopia

Escherichia coli O157 is a Shiga toxin-producing E. coli causing disease in humans. Cattle are the primary reservoir of the pathogen. Information regarding the contribution of cattle to diarrheal illnesses in humans through consumption of contaminated beef is scarce in Ethiopia. We collected samples from 240 cattle, 127 beef, and 216 diarrheic patients in Bishoftu town in Ethiopia to assess the occurrence and determine the virulence genes, genetic relatedness, and antimicrobial resistance of E. coli O157. E. coli O157 was detected in 7.1% of the rectal content samples from cattle in slaughterhouses, in 6.3% (n = 127) of the beef samples, and in 2.8% of the diarrheic patients' stool samples. All isolates were positive for eae gene, 24 (77%) of them were positive for stx2 gene (21 stx2c and 3 stx2a), whereas stx1 gene was not detected. Molecular typing grouped the isolates into eight pulsed-field gel electrophoresis pulsotypes with three pulsotypes containing isolates from all three sources, one pulsotype containing one isolate from human origin and one isolate from beef. The remaining four pulsotypes contained isolates unique either to beef or to humans. With the exception of 1 multidrug-resistant isolate from beef, which was resistant to 8 antimicrobial drugs, the remaining 30 isolates were susceptible to the 14 antimicrobials tested. In conclusion, the finding of genetically similar isolates in cattle, beef, and humans may indicate a potential transmission of E. coli O157 from cattle to humans through beef. However, more robust studies are required to confirm this epidemiological link.

Sandwich immunoassay based on antimicrobial peptide-mediated nanocomposite pair for determination of Escherichia coli O157:H7 using personal glucose meter as readout

A sandwich immunoassay was developed for determination of E. coli O157:H7. This is based on an antimicrobial peptide-mediated nanocomposite pair and uses a personal glucose meter as signal readout. The antimicrobial peptides, magainins I, and cecropin P1 were employed as recognition molecules for the nanocomposite pair, respectively. With a one-step process, copper phosphate nanocomposites embedded by magainins I and Fe₃O₄ were used as "capturing" probes for bacterial magnetic isolation, and calcium phosphate nanocomplexes composed of cecropin P1 and invertase were used as signal tags. After magnetic separation, the invertase of the signal tags hydrolyzed sucrose to glucose, thereby converting E. coli O157:H7 levels to glucose levels. This latter can be quantified by a personal glucose meter. Under optimal conditions, the concentration of E. coli O157:H7 can be determined in a linear range of 10 to 10⁷ CFU·mL^-1 with a detection limit of 10 CFU·mL^-1. The method was successfully applied to the determination of E. coli O157:H7 in milk samples. Graphical abstract Schematic representation of sandwich immunoassay for E. coli O157:H7. One-pot synthetic of Fe₃O₄-magainins I nanocomposites (MMP) were used for magnetic capture. Cecropin P1-invertase nanocomposites (PIP) were used as signal tags. A personal glucose meter was used as readout to determine the target.

Molecular characteristics and genotypic diversity of enterohaemorrhagic Escherichia coli O157:H7 isolates in Gauteng region, South Africa

Enterohaemorrhagic Escherichia coli (EHEC) O157:H7 is one of the major foodborne and waterborne pathogens causing severe diseases and outbreaks worldwide. There is scarcity of EHEC O157:H7 data in South Africa. This study was carried out to determine the molecular characteristics and genotypic diversity of EHEC O157:H7 isolates in the Gauteng region, South Africa. Samples were cultured on selective chromogenic media. Antibiotic susceptibility profile of isolates was determined using the VITEK®-2 automated system. Isolates were characterised using multiplex PCR assays and the genetic diversity was determined using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). A total of 520 samples of which 270 environmental water samples and 250 stool specimens were collected and analysed. Overall, EHEC O157:H7 was recovered from 2.3% (12/520) of samples collected. Environmental water samples and clinical stool specimens showed a prevalence of 4.07% (11/270) and 0.4% (1/250) respectively. Antibiotic susceptibility profile varied from isolates with full susceptibility to isolates with resistance to multiple antibiotics. Most resistance was detected to the penicillins, specifically ampicillin (7/12), amoxicillin (3/12) and piperacillin/Tazobactam (3/12) followed by one of the folate inhibitors, trimethoprim (3/12) and the carbapenems, imipenem and meropenem (2/12) each. Three isolates harboured a combination of Shiga-toxins (Stx)-2, intimin (eae) and enterohaemolysin (hlyA) genes, while two isolates harboured the Stx-1, Stx-2 and hlyA genes. The PFGE performed showed that EHEC O157:H7 isolates were genetically diverse, with two minor pulsotypes and eight singletons. The MLST analysis identified three sequence types (STs) (ST10, ST11 and ST1204) that have been previously reported associated with outbreaks. The STs identified in this study pose a potential public health risk to consumers of untreated environmental water and closed human contacts. There is necessity to enhance surveillance in reducing the propagation of this bacterium which is a public health problem.