Acquisition of Serum Antibodies Reactive With Enterohemorrhagic Escherichia coli Virulence-Associated Factors by Healthy Brazilian Children and Adults

Palmeira, Patrícia; Carbonare, S B; Guth, Beatriz E. C.; Carbonare, Cristiane Barros; Pontes, Gerlândia N.; Tino-De-Franco, Milene; Zapata-Quintanilla, Lucy Beatriz; Carneiro‐Sampaio, Magda

doi:10.1097/inf.0b013e3181aa6b2d

Cited by 10 publications

(7 citation statements)

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“…In line with another previous study performed with the same neonate/mother population (Palmeira et al, 2009), the present work demonstrated high anti-lipopolysaccharide O111 IgM levels in maternal sera from all three groups (except when compared with anti-O6 lipopolysaccharide IgM levels). These findings suggest that these high levels are due to a previous high prevalence of this serogroup in past decades, representing the enteropathogenic E. coli (EPEC) group considered to be the leading causes of diarrhea in infants in many developing countries, including Brazil (Nataro & Kaper, 1998), as well as a reflection of the more recent high prevalence of the Shiga toxin-producing E. coli (STEC) strains group.…”

Section: Discussionsupporting

confidence: 92%

Preterm and term neonates transplacentally acquire IgG antibodies specific to LPS fromKlebsiella pneumoniae, Escherichia coliandPseudomonas aeruginosa

Lessa

Krebs

Brasil

et al. 2011

FEMS Immunol Med Microbiol

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High incidences of Gram-negative bacteria are found in neonatal nosocomial infections. Our aim was to investigate placental transmission of immunoglobulin G (IgG) reactive with lipopolysaccharide from Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli O111, O6 and O26. The total and lipopolysaccharide-specific IgM and IgG were determined in 11 maternal/umbilical-cord sera aged ≤33 weeks (GI); 21 aged >33 and <37 weeks (GII); and 32 term newborns (GIII). The total and lipopolysaccharide-specific IgM concentrations were equivalent in maternal sera. The total IgG concentrations were equivalent in maternal and newborn sera, with the exception of GIII newborns as compared with their mothers (P<0.0001) and with neonates from GI and GII (P<0.05). Lipopolysaccharide-specific IgG concentrations were lower in GI neonates than in their mothers (P<0.01) and lower in GII (P<0.05). Lower lipopolysaccharide-specific IgG levels were observed among neonates only for O111 in GI (P<0.05) and for O26 and Pseudomonas in GII, both as compared with GIII (P<0.05). The anti-lipopolysaccharide IgG transfer ratios were lower in GI (except for O26) and in GII (except for Klebsiella and O111) as compared with GIII (P<0.05). Our results suggest that the greater susceptibility to infections in preterm infants is influenced (besides the humoral response) by factors intrinsic and extrinsic to the condition of prematurity.

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Section: Discussionsupporting

confidence: 92%

Preterm and term neonates transplacentally acquire IgG antibodies specific to LPS fromKlebsiella pneumoniae, Escherichia coliandPseudomonas aeruginosa

Lessa

Krebs

Brasil

et al. 2011

FEMS Immunol Med Microbiol

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“…Pro tective immunity to intimin, the product of the eae gene, is acquired in early childhood, which might explain why adults are less affected by infections with classical LEEpositive EHEC and enteropathogenic E. coli strains (14,30,36,64,79,80). Some LEE-negative STEC strains have other colonization mechanisms that might be more relevant in patients of various age groups (82,83,103,104).…”

Section: Natural Reservoir For Eahec O104:h4 Is Humans In Contrast Tomentioning

confidence: 96%

Outbreak of Shiga Toxin–Producing Escherichia coli (STEC) O104:H4 Infection in Germany Causes a Paradigm Shift with Regard to Human Pathogenicity of STEC Strains

Beutin¹,

Martin

2012

Journal of Food Protection

217

168

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An outbreak that comprised 3,842 cases of human infections with enteroaggregative hemorrhagic Escherichia coli (EAHEC) O104:H4 occurred in Germany in May 2011. The high proportion of adults affected in this outbreak and the unusually high number of patients that developed hemolytic uremic syndrome makes this outbreak the most dramatic since enterohemorrhagic E. coli (EHEC) strains were first identified as agents of human disease. The characteristics of the outbreak strain, the way it spread among humans, and the clinical signs resulting from EAHEC infections have changed the way Shiga toxin–producing E. coli strains are regarded as human pathogens in general. EAHEC O104:H4 is an emerging E. coli pathotype that is endemic in Central Africa and has spread to Europe and Asia. EAHEC strains have evolved from enteroaggregative E. coli by uptake of a Shiga toxin 2a (Stx2a)–encoding bacteriophage. Except for Stx2a, no other EHEC-specific virulence markers including the locus of enterocyte effacement are present in EAHEC strains. EAHEC O104:H4 colonizes humans through aggregative adherence fimbrial pili encoded by the enteroaggregative E. coli plasmid. The aggregative adherence fimbrial colonization mechanism substitutes for the locus of enterocyte effacement functions for bacterial adherence and delivery of Stx2a into the human intestine, resulting clinically in hemolytic uremic syndrome. Humans are the only known natural reservoir known for EAHEC. In contrast, Shiga toxin–producing E. coli and EHEC are associated with animals as natural hosts. Contaminated sprouted fenugreek seeds were suspected as the primary vehicle of transmission of the EAHEC O104:H4 outbreak strain in Germany. During the outbreak, secondary transmission (human to human and human to food) was important. Epidemiological investigations revealed fenugreek seeds as the source of entry of EAHEC O104:H4 into the food chain; however, microbiological analysis of seeds for this pathogen produced negative results. The survival of EAHEC in seeds and the frequency of human carriers of EAHEC should be investigated for a better understanding of EAHEC transmission routes.

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“…However, the data obtained in this study cannot support the notion that these transferred Stx2 antibodies afford protection to children. A relatively high frequency of serum samples of healthy adults living in São Paulo City showed neutralizing activity against Stx2, as demonstrated by Vero cell culture assays [23]. We tested the serum of two HUS patients and two controls, but did not detect neutralizing activity in HUS serum, although a partial neutralization was observed in one control serum (data not shown).…”

Section: Discussionmentioning

confidence: 95%

“…Palmeira et al [23] investigated the ability of sera obtained from healthy adults to neutralize Stx2. Thus, seroepidemiological data regarding anti-Stx2 antibodies in the Brazilian population and the use of serodiagnosis could help to explain the epidemiological profile of the illness.…”

Section: Introductionmentioning

confidence: 99%

Humoral immune response to Shiga Toxin 2 (Stx2) among Brazilian urban children with hemolytic uremic syndrome and healthy controls

et al. 2014

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BackgroundShiga toxin (Stx)-producing Escherichia coli (STEC) infection is associated with hemolytic uremic syndrome (HUS), the main cause of acute renal failure in early childhood. Stx is essential in the pathogenesis of HUS, which has been mostly related to Stx2-producing isolates. Very limited data exist on the immune response to STEC in the Brazilian population. In this study, the prevalence of immunoglobulin G (IgG) antibodies to Stx2 was investigated in sera of children diagnosed with HUS and of healthy children in the city of São Paulo, Brazil.MethodsIgG-antibody reactivity to Stx2 was determined by immunoblotting (WB) and enzyme-linked immunosorbent assay (ELISA) in sera from 13 children with HUS aged 8 months to 6 years and 54 healthy urban children aged 5 months to 7 years.ResultsA positive immune response to the A and B subunits of Stx2 was observed in 46.1% HUS patients and in 16.6% healthy individuals by WB. All HUS patients and 62.9% healthy children showed IgG antibodies to the Stx2 A subunit. The frequency of antibodies to both subunits or only to the A subunit of Stx2 was significantly higher in HUS patients than controls (p < 0.05). Also, the mean OD value obtained by ELISA was higher in that group. Considering children’s age, the frequency of reactivity to either the A subunit or both subunits of Stx2 was considerably higher in HUS children up to three years old compared to controls in the same age range. Moreover, in almost 37% of healthy children, no immune response to Stx2 was detected independently of the child’s age.ConclusionsThe seroepidemiolgy of anti-Stx2 antibodies was described for the first time in healthy children and children with HUS in Brazil. The percentage of individuals showing antibodies against Stx2 was higher among HUS patients than controls, and in spite of the low number of notified HUS cases, STEC strains are circulating in our settings. In addition, the results obtained also corroborated previous data on the increased sensitivity and specificity of WB compared to toxin-based enzyme immunoassays.

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Acquisition of Serum Antibodies Reactive With Enterohemorrhagic Escherichia coli Virulence-Associated Factors by Healthy Brazilian Children and Adults

Abstract: Our results demonstrate an increasing anti-LPS and antiprotein antibody response with age, which could provide protection against EHEC infections.

Cited by 10 publications

References 38 publications

Preterm and term neonates transplacentally acquire IgG antibodies specific to LPS fromKlebsiella pneumoniae, Escherichia coliandPseudomonas aeruginosa

Preterm and term neonates transplacentally acquire IgG antibodies specific to LPS fromKlebsiella pneumoniae, Escherichia coliandPseudomonas aeruginosa

Outbreak of Shiga Toxin–Producing Escherichia coli (STEC) O104:H4 Infection in Germany Causes a Paradigm Shift with Regard to Human Pathogenicity of STEC Strains

Humoral immune response to Shiga Toxin 2 (Stx2) among Brazilian urban children with hemolytic uremic syndrome and healthy controls

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