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Dubreuil JD. EAST1 toxin: An enigmatic molecule associated with sporadic episodes of diarrhea in humans and animals. J Microbiol 2019; 57:541-549. [PMID: 31016564 DOI: 10.1007/s12275-019-8651-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/10/2019] [Accepted: 02/07/2019] [Indexed: 11/27/2022]
Abstract
EAST1 is produced by a subset of enteroaggregative Escherichia coli strains. This toxin is a 38-amino acid peptide of 4100 Da. It shares 50% homology with the enterotoxic domain of STa and interacts with the same receptor. The mechanism of action of EAST1is proposed to be identical to that of STa eliciting a cGMP increase. EAST1 is associated with diarrheal disease in Man and various animal species including cattle and swine. Nevertheless, as EAST1-positive strains as well as culture supernatants did not provoke unequivocally diarrhea either in animal models or in human volunteers, the role of this toxin in disease is today still debated. This review intent is to examine the role of EAST1 toxin in diarrheal illnesses.
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Affiliation(s)
- J Daniel Dubreuil
- Faculté de médecine vétérinaire, Université de Montréal, Montréal, Québec, J2S 2M2, Canada.
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Ikumapayi UN, Boisen N, Hossain MJ, Betts M, Lamin M, Saha D, Kwambana-Adams B, Dione M, Adegbola RA, Roca A, Nataro JP, Antonio M. Identification of Subsets of Enteroaggregative Escherichia coli Associated with Diarrheal Disease among Under 5 Years of Age Children from Rural Gambia. Am J Trop Med Hyg 2017; 97:997-1004. [PMID: 28820687 PMCID: PMC5637583 DOI: 10.4269/ajtmh.16-0705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) cause acute and persistent diarrhea, mostly in children worldwide. Outbreaks of diarrhea caused by EAEC have been described, including a large outbreak caused by a Shiga toxin expressing strain. This study investigated the association of EAEC virulence factors with diarrhea in children less than 5 years. We characterized 428 EAEC strains isolated from stool samples obtained from moderate-to-severe diarrhea cases (157) and healthy controls (217) children aged 0–59 months recruited over 3 years as part of the Global Enteric Multicenter Study (GEMS) in The Gambia. Four sets of multiplex polymerase chain reaction were applied to detect 21 EAEC-virulence genes from confirmed EAEC strains that target pCVD432 (aatA) and AAIC (aaiC). In addition, Kirby-Bauer disc diffusion antimicrobial susceptibility testing was performed on 88 EAEC strains following Clinical Laboratory Standard Institute guidelines. We observed that the plasmid-encoded enterotoxin [odds ratio (OR): 6.9, 95% confidence interval (CI): 2.06–29.20, P < 0.001], aggregative adherence fimbriae/I fimbriae (aggA) [OR: 2.2, 95% CI: 1.16–4.29, P = 0.008], and hexosyltransferase (capU) [OR: 1.9, 95% CI 1.02–3.51, P = 0.028] were associated with moderate-to-severe diarrhea among children < 12 months old but not in the older age strata (> 12 months). Our data suggest that some EAEC-virulent factors have age-specific associations with moderate-to-severe diarrhea in infants. Furthermore, our study showed that 85% and 72% of EAEC strains tested were resistant to sulphamethoxazole-trimethoprim and ampicillin, respectively. Sulphamethoxazole-trimethoprim and ampicillin are among the first-line antibiotics used for the treatment of diarrhea in The Gambia.
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Affiliation(s)
- Usman N Ikumapayi
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia.,Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Nadia Boisen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | - Mohammad J Hossain
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Modupeh Betts
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Modou Lamin
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Debasish Saha
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Brenda Kwambana-Adams
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Michel Dione
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Richard A Adegbola
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - Anna Roca
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia
| | - James P Nataro
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia.,Centre for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland
| | - Martin Antonio
- Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, Banjul, The Gambia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Ochi S, Shah M, Odoyo E, Bundi M, Miringu G, Guyo S, Wandera E, Kathiiko C, Kariuki S, Karama M, Tsuji T, Ichinose Y. An Outbreak of Diarrhea in Mandera, Kenya, Due to Escherichia coli Serogroup O-Nontypable Strain That Had a Coding Gene for Enteroaggregative E. coli Heat-Stable Enterotoxin 1. Am J Trop Med Hyg 2016; 96:457-464. [PMID: 27994101 DOI: 10.4269/ajtmh.16-0310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/07/2016] [Indexed: 11/07/2022] Open
Abstract
In an outbreak of gastroenteritis in December 2009, in Mandera, Kenya, Escherichia coli O-nontypable (ONT) strain was isolated from stool specimens of patients (18/24, 75%). The E. coli ONT organisms could not be assigned to any of the recognized diarrheagenic groups of E. coli However, they possessed the enteroaggregative E. coli heat-stable enterotoxin-1 gene. The cell-free culture filtrates of the E. coli ONT strain isolated from the outbreak cases induced considerable amount of fluid accumulation in suckling mouse intestine, indicating production of an enterotoxic factor(s). These results identify E. coli that did not have any diarrheagenic characteristics except astA as the etiological agent of the diarrheal outbreak in Mandera. It is however considered necessary to characterize the fluid accumulation factor(s) to determine whether any novel toxins were responsible for the fluid accumulation. Moreover, it is important to study dissemination of strains producing the enterotoxic factor(s) to assess their public health significance distribution in the environment.
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Affiliation(s)
| | - Mohammad Shah
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya
| | - Erick Odoyo
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya
| | - Martin Bundi
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya
| | - Gabriel Miringu
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya
| | - Sora Guyo
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Ernest Wandera
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya
| | - Cyrus Kathiiko
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya
| | | | | | - Takao Tsuji
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya
| | - Yoshio Ichinose
- Nagasaki University Institute of Tropical Medicine, Kenya Research Station, Nairobi, Kenya.
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Meraz IM, Arikawa K, Ogasawara J, Hase A, Nishikawa Y. Epithelial Cells Secrete Interleukin-8 in Response to Adhesion and Invasion of Diffusely AdheringEscherichia coliLacking Afa/Dr Genes. Microbiol Immunol 2013; 50:159-69. [PMID: 16547413 DOI: 10.1111/j.1348-0421.2006.tb03781.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Escherichia coli that sparsely adhere to human epithelial cells are known as diffusely adherent E. coli (DAEC), and the role of the Afa/Dr family of adhesins is now understood. Strains that do not possess Afa/Dr, however, comprise another group of DAEC, of which the pathogenicity remains unknown. The ability to induce interleukin-8 (IL-8) secretion from intestinal epithelial cells might be a feature of enterovirulent bacteria. We previously found that some Afa/Dr DAEC strains induce IL-8 by stimulating epithelial cells with flagella. The present study examines whether non-Afa/Dr DAEC can induce IL-8 in epithelial cells (HEp-2, INT407, and T84). Among 21 strains, 11 (52%; 11/21) induced as much IL-8 as high inducer strains of Afa/Dr DAEC. Adhesion did not significantly differ between high and low inducers; therefore diffuse adhesion alone is probably insufficient to induce IL-8. It was shown that IL-8 induction and the number of intracellular bacteria directly correlated. Wortmannin, an inhibitor of the phosphatidylinositol-3-phosphate kinase, reduced both intracellular bacteria and IL-8 secretion. Motile strains were significantly more prevalent among high (10/11) than low (4/10) inducers. However, 4 low invasive strains hardly induced IL-8 despite their motility. In conclusion, some non-Afa/Dr DAEC invoke the induction of high levels of inflammatory cytokines. Unlike Afa/Dr DAEC, however, non-Afa/Dr strains may require invasion to cause strong induction. These non-Afa/Dr high inducers can be enteropathogenic for the cytokine-inducing properties.
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Affiliation(s)
- Ismail Mustafa Meraz
- Department of Food and Human Health Sciences, Graduate School of Human Life Science, Osaka City University, Osaka 558-8585, Japan
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Konno T, Yatsuyanagi J, Saito S. Virulence gene profiling of enteroaggregative Escherichia coli heat-stable enterotoxin 1-harboring E. coli (EAST1EC) derived from sporadic diarrheal patients. ACTA ACUST UNITED AC 2011; 64:314-20. [PMID: 22106844 DOI: 10.1111/j.1574-695x.2011.00913.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 10/24/2011] [Accepted: 11/08/2011] [Indexed: 11/27/2022]
Abstract
Between 2007 and 2009, a total of 2168 Escherichia coli strains derived from diarrheal patients, defined as putative diarrheagenic E. coli (DEC), were collected from medical institutions in Akita prefecture, Japan. Thirty five of the strains lacked typical pathogenic determinants of DEC other than astA, which encodes enteroaggregative E. coli (EAggEC) heat-stable enterotoxin 1 (EAST1). These E. coli strains are referred to as EAST1EC. Several studies have suggested a role of EAST1 in diarrhea; however, the correlation between diarrhea and the presence of astA remains inconclusive. To investigate whether EAST1EC strains derived from diarrheal patients shared pathogenic factors other than EAST1, virulence gene profiling of 12 virulence genes - iha, lpfA, ldaG, pilS, pic, pet, irp2, daa, aah, aid, cdtB and hlyA - was carried out. PCR analysis revealed that four of the 35 EAST1EC strains harbored only astA, 24 harbored genes associated with adhesins and intestinal colonization, three strains harbored the gene for α-hemolysin, and 24 strains harbored the gene for a siderophore. These results indicated that some EAST1EC strains harbor various virulence genes associated with distinct E. coli pathotypes, primarily enterohemorrhagic E. coli and EAggEC, which may represent additional pathogenic determinants of EAST1EC.
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Affiliation(s)
- Takayuki Konno
- Health and Hygiene Division, Akita Prefectural Research Center for Public Health and Environment, Akita, Japan.
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Hidaka A, Hokyo T, Arikawa K, Fujihara S, Ogasawara J, Hase A, Hara-Kudo Y, Nishikawa Y. Multiplex real-time PCR for exhaustive detection of diarrhoeagenic Escherichia coli. J Appl Microbiol 2010; 106:410-20. [PMID: 19200309 DOI: 10.1111/j.1365-2672.2008.04043.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The source and routes of diarrhoeagenic Escherichia coli (DEC) have not been clarified because it is difficult to detect these organisms in samples with numerous coliform bacteria. We have developed multiplex real-time PCR assays for exhaustive detection of DEC. METHODS AND RESULTS Primers and TaqMan probes were designed to amplify and quantify one gene (eae, stx1, stx2, elt, est, virB, aggR, astA, and afaB) from each of seven pathotypes of DEC, in duplex or triplex reactions under the same PCR cycling conditions. Specificity was confirmed using 860 strains including 88 DEC strains. The fluorescence threshold cycle and DNA concentrations correlated with decision coefficients of more than 0.99. Subsequently, meat samples and enrichment broths were spiked with DEC and the assays used to detect the genes. The detection limits varied from 7.1 x 10(2) to 1.1 x 10(4) CFU ml(-1), depending on the target genes. All meat samples spiked with a variety of DEC (more than 10 CFU 10 g(-1)) were found to be positive by the method. CONCLUSIONS The present system allows for the efficient and simultaneous determination of various DEC pathotypes. SIGNIFICANCE AND IMPACT OF THE STUDY This system makes epidemiological investigations for DEC sensitive and quick, and is a useful tool to clarify the source and routes of DEC.
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Affiliation(s)
- A Hidaka
- Graduate School of Human Life Science, Osaka City University, Osaka, Japan
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Hussain MI, Wani SA, Nagamani K, Fayaz I, Mir MA, Nabi A, Qureshi K, Khan MA, Nishikawa Y. Isolation and characterization of enteroaggregative, enterotoxigenic, diffusely adherent Escherichia coli and Salmonella Worthington from human diarrhoeic faecal samples in Kashmir and Secunderabad, India. World J Microbiol Biotechnol 2010. [DOI: 10.1007/s11274-010-0370-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Choi SK, Lee MH, Lee BH, Jung JY, Choi CS. Virulence Factor Profiles of Escherichia coli Isolated from Pork and Chicken Meats Obtained from Retail Markets. Korean J Food Sci Anim Resour 2010. [DOI: 10.5851/kosfa.2010.30.1.148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Hussein HS, Bollinger LM. Influence of Selective Media on Successful Detection of Shiga Toxin–ProducingEscherichia coliin Food, Fecal, and Environmental Samples. Foodborne Pathog Dis 2008; 5:227-44. [DOI: 10.1089/fpd.2008.0081] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Hussein S. Hussein
- Department of Animal Biotechnology, University of Nevada—Reno, Reno, Nevada
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Hussein HS, Bollinger LM, Hall MR. Growth and enrichment medium for detection and isolation of Shiga toxin-producing Escherichia coli in cattle feces. J Food Prot 2008; 71:927-33. [PMID: 18522025 DOI: 10.4315/0362-028x-71.5.927] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Detection methods of Shiga toxin-producing Escherichia coli (STEC) in cattle feces varied in using enrichment media containing different antibiotic combinations. To examine efficacy of a new detection method for STEC, three O157:H7 (ATCC 43889, 43890, and 43895) and 41 non-O157:H7 (members of the O1, O15, O26, O86, O103, O111, O125, O127, O128, O136, O146, O153, O158, O165, O166, and O169 serogroups) isolates were tested. These isolates were grown in tryptic soy broth for 6 h, and their concentrations were determined before inoculation of tubes containing 1 g of cattle feces (sterile [experiment 1; evaluating growth] and fresh [experiment 2; evaluating enrichment]) to simulate the high and low levels of STEC shedding by cattle (10(5) versus 102 CFU/g feces, respectively). Eight STEC isolates (the three O157:H7 and five non-O157:H7 selected at random) were tested at a very low level (10 CFU/g feces). The feces were incubated in 50 ml of brain heart infusion broth containing potassium tellurite, novobiocin, and vancomycin (2.5, 20, and 40 mg/liter, respectively) and cefixime (50 microg/liter) at 37 degrees C for 12 h and tested for STEC (VTEC [verotoxin-producing E. coli]-Screen assay [agglutination immunoassay]). Potential STEC isolates were recovered, characterized biochemically, serotyped, and tested for toxin production using Vero (African green monkey kidney) cell toxicity assay and agglutination immunoassay. In both experiments, all the STEC isolates used for fecal inoculation were recovered at the concentrations tested. Our medium supported growth of and enrichment for a wide range of STEC isolates.
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Affiliation(s)
- Hussein S Hussein
- Department of Animal Biotechnology, University of Nevada-Reno, Reno, Nevada 89557, USA.
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