Assessing the Public Health Risk of Shiga Toxin-Producing Escherichia coli by Use of a Rapid Diagnostic Screening Algorithm

Boer, Richard F. de; Ferdous, Mithila; Ott, Alewijn; Scheper, Henk; Wisselink, Guido; Heck, Max; Rossen, John W. A.; Kooistra-Smid, A.M.D.

doi:10.1128/jcm.03590-14

Cited by 35 publications

(35 citation statements)

References 50 publications

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“…Biochemical profiles also play a central role in the isolation and preliminary identification of E. coli strains in general, on media such as McConkey and eosin methylene blue agar, and of EHEC on sorbitol MaConkey (SMAC) agar and CHROMagar STEC medium (de Boer et al, 2015). …”

Section: E Coli Subtypesmentioning

confidence: 99%

Are Escherichia coli Pathotypes Still Relevant in the Era of Whole-Genome Sequencing?

Robins-Browne

Holt

Ingle³

et al. 2016

Front. Cell. Infect. Microbiol.

130

120

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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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Section: E Coli Subtypesmentioning

confidence: 99%

Are Escherichia coli Pathotypes Still Relevant in the Era of Whole-Genome Sequencing?

Robins-Browne

Holt

Ingle³

et al. 2016

Front. Cell. Infect. Microbiol.

130

120

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“…Genomic information is highly complex, and there are many knowledge gaps with respect to the significance of various marker genes to public health [76]. Nonetheless, there is a growing body of evidence linking certain well-defined gene markers to virulence characteristics of bacteria, for example, the role of intimin (coded by the eae gene) in the pathogenesis of STEC, epidemiological associations between certain serotype features and outbreaks of serious foodborne illness (e.g., L. monocytogenes serogroups 1/2a, 1/2b, and 4b, STEC serogroups O26, O45, O103, O111, O121, O145, and O157), and even the type of toxin secreted (e.g., Shiga toxin 2) and the attendant severity of illness [77,78].…”

Section: Is It Dangerous? Rapid Identification Of Virulence Antimicrmentioning

confidence: 99%

Applications of Genomics in Regulatory Food Safety Testing in Canada

Carrillo¹,

Koziol²,

Vary³

et al. 2020

New Insight Into Brucella Infection and Foodborne Diseases

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Recent developments in the field of pathogen genomics herald a new paradigm for analytical food microbiology in which pathogenic bacteria will be characterized on the basis of their genetic profile rather than traditional approaches relying on phenotypic properties. The ability to identify gene markers associated with virulence, antimicrobial resistance, and other properties relevant to the identification, risk profiling, and typing of foodborne bacterial isolates will play a critical role in informing regulatory decisions and tracing sources of food contamination. Here we present several scenarios illustrating current and prospective roles for pathogen genomics in food inspection.

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“…Most of these strains are eae negative (71), so their presence in humans has not received much attention. However, in some studies 10 to 15% of clinical samples from patients with diarrheal illnesses have been positive for stx 1c and/or stx 2b (22,26,32,47).…”

Section: Stx Types and Subtypesmentioning

confidence: 99%

“…The Stx2b subtype was proposed to designate a strain subtype with a variant of the stx 2c gene but that did not cause HUS (124). Analysis of STEC in Europe revealed that stx 2b alone or together with stx 1c is common in STEC from deer droppings and wildlife populations (71, 106) but does not appear to cause severe human illness (21,27,32,47). The Stx2e subtype is mostly found in isolates from pigs and pork meat (9) and is commonly associated with pig edema disease (7).…”

Section: Stx Types and Subtypesmentioning

confidence: 99%

Hazard Identification and Characterization: Criteria for Categorizing Shiga Toxin–Producing Escherichia coli on a Risk Basis†

Expert¹

2019

Journal of Food Protection

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Shiga toxin–producing Escherichia coli (STEC) comprise a large, highly diverse group of strains. Since the emergence of STEC serotype O157:H7 as an important foodborne pathogen, serotype data have been used for identifying STEC strains, and this use continued as other serotypes were implicated in human infections. An estimated 470 STEC serotypes have been identified, which can produce one or more of the 12 known Shiga toxin (Stx) subtypes. The number of STEC serotypes that cause human illness varies but is probably higher than 100. However, many STEC virulence genes are mobile and can be lost or transferred to other bacteria; therefore, STEC strains that have the same serotype may not carry the same virulence genes or pose the same risk. Although serotype information is useful in outbreak investigations and surveillance studies, it is not a reliable means of assessing the human health risk posed by a particular STEC serotype. To contribute to the development of a set of criteria that would more reliably support hazard identification, this review considered each of the factors contributing to a negative human health outcome: mild diarrhea, bloody diarrhea, and hemolytic uremic syndrome (HUS). STEC pathogenesis involves entry into the human gut (often via ingestion), attachment to the intestinal epithelial cells, and elaboration of Stx. Production of Stx, which disrupts normal cellular functions and causes cell damage, alone without adherence of bacterial cells to gut epithelial cells is insufficient to cause severe illness. The principal adherence factor in STEC is the intimin protein coded by the eae gene. The aggregative adherence fimbriae adhesins regulated by the aggR gene of enteroaggregative E. coli strains are also effective adherence factors. The stx2a gene is most often present in locus of enterocyte effacement (eae)–positive STEC strains and has consistently been associated with HUS. The stx2a gene has also been found in eae-negative, aggR-positive STEC that have caused HUS. HUS cases where other stx gene subtypes were identified indicate that other factors such as host susceptibility and the genetic cocktail of virulence genes in individual isolates may affect their association with severe diseases.

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Assessing the Public Health Risk of Shiga Toxin-Producing Escherichia coli by Use of a Rapid Diagnostic Screening Algorithm

Cited by 35 publications

References 50 publications

Are Escherichia coli Pathotypes Still Relevant in the Era of Whole-Genome Sequencing?

Are Escherichia coli Pathotypes Still Relevant in the Era of Whole-Genome Sequencing?

Applications of Genomics in Regulatory Food Safety Testing in Canada

Hazard Identification and Characterization: Criteria for Categorizing Shiga Toxin–Producing Escherichia coli on a Risk Basis†

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