Comparative Genomics to Delineate Pathogenic Potential in Non-O157 Shiga Toxin-Producing Escherichia coli (STEC) from Patients with and without Haemolytic Uremic Syndrome (HUS) in Norway

Haugum, Kjersti; Johansen, Jostein; Gabrielsen, Christina; Brandal, Lin Thorstensen; Bergh, Kåre; Ussery, David W.; Drabløs, Finn; Afset, Jan Egil

doi:10.1371/journal.pone.0111788

Cited by 33 publications

(36 citation statements)

References 76 publications

(74 reference statements)

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“…Stx variants (e.g. stx2d), which have been shown to be more specific predictors of severe illness than Stx type, are not yet available in BC (13,15,16,(18)(19)(20)38).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Shiga toxin–producing Escherichia coli in British Columbia, 2011–2017: Analysis to inform exclusion guidelines

Noftall¹,

Taylor²,

Hoang³

et al. 2019

CCDR

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Background: Shiga toxin-producing Escherichia coli (STEC) can cause severe illness including bloody diarrhea and hemolytic-uremic syndrome (HUS) through the production of Shiga toxins 1 (Stx1) and 2 (Stx2). E. coli O157:H7 was the most common serotype detected in the 1980s to 1990s, but improvements in laboratory methods have led to increased detection of non-O157 STEC. Non-O157 STEC producing only Stx1 tend to cause milder clinical illness. Exclusion guidelines restrict return to high-risk work or settings for STEC cases, but most do not differentiate between STEC serogroups and Stx type. Objective: To analyze British Columbia (BC) laboratory and surveillance data to inform the BC STEC exclusion guideline. Methods: For all STEC cases reported in BC in 2011-2017, laboratory and epidemiological data were obtained through provincial laboratory and reportable disease electronic systems, respectively. Incidence was measured for all STEC combined as well as by serogroup. Associations were measured between serogroups, Stx types and clinical outcomes. Results: Over the seven year period, 984 cases of STEC were reported. A decrease in O157 incidence was observed, while non-O157 rates increased. The O157 serogroup was significantly associated with Stx2. Significant associations were observed between Stx2 and bloody diarrhea, hospitalization and HUS. Conclusion: The epidemiology of STEC has changed in BC as laboratories increasingly distinguish between O157 and non-O157 cases and identify Stx type. It appears that non-O157 cases with Stx1 are less severe than O157 cases with Stx2. The BC STEC exclusion guidelines were updated as a result of this analysis.

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“…Stx variants (e.g. stx2d), which have been shown to be more specific predictors of severe illness than Stx type, are not yet available in BC (13,15,16,(18)(19)(20)38).…”

Section: Discussionmentioning

confidence: 99%

“…STEC stx genes produce Shiga toxins 1 (Stx1) and 2 (Stx2). Stx2 is associated with severe illness and HUS (8,(12)(13)(14)(15)(16)(17)(18)(19)(20). Furthermore, Stx2 is associated with STEC O157, which explains this serogroup's higher pathogenicity (17,21,22).…”

Section: Introductionmentioning

confidence: 99%

Shiga toxin–producing Escherichia coli in British Columbia, 2011–2017: Analysis to inform exclusion guidelines

Noftall¹,

Taylor²,

Hoang³

et al. 2019

CCDR

View full text Add to dashboard Cite

show abstract

“…Additionally, phylogenetic grouping could be effective for assessing the pathogenicity of these strains further. All hemolytic uremic syndrome (HUS)-associated STEC strains (Haugum et al, 2014) and more than half of the EPEC strains (Staples et al, 2013;Wang et al, 2013) isolated from diarrhea patients are from the phylogroup B1. Phylogenetic grouping examined in this study and other surveys indicated that group A and B1 were predominant among the DEC isolates from foods, consistent with the findings reported by previous studies (Koo et al, 2012;Siriwan-Sirikaew et al, 2015;Ombarak et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Prevalence, antimicrobial resistance and multiple-locus variable-number tandem-repeat analysis profiles of diarrheagenic Escherichia coli isolated from different retail foods

Wang

Nakamura

Kage-Nakadai

et al. 2017

International Journal of Food Microbiology

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Diarrheagenic E. coli (DEC) isolates were recovered from local retail markets and the Osaka Municipal Central Wholesale Market in Japan. Retail food samples were collected for analysis in Osaka Japan from 2005 to 2008 and consisted of 32 beef, 28 pork, 20 poultry, 136 fish, 66 fruits and vegetables and 51 ready-to-eat (RTE) food samples. A total of 82 DEC strains were recovered from 64 (19%) food samples with the highest prevalence in poultry (100%, 20/20), followed by pork (54%, 15/28), beef (28%, 9/32), fruits and vegetables (12%, 8/66), fish (6.6%, 9/136) and RTE foods (5.9%, 3/51). Most of the strains belonged to E. coli possessing the enteroaggregative E. coli (EAEC) heat-stable enterotoxin 1 (EAST1) gene (EAST1EC; n=62, P<0.0001) and enteropathogenic E. coli (EPEC; n=16, P<0.01), whereas only 1 strain belonged to Shiga toxin-producing E. coli (STEC), 1 to EAEC and 2 to enterotoxigenic E. coli (ETEC) strains. Of the 82 DEC isolates, 22 O and 13H serogroups were detected, including some specific serogroups (O91, O103, O115, O119, O126, and O157) which have been associated with human diarrheal infections. Phylogenetic group A and B1 were predominant among the DEC isolates. Antimicrobial resistance to tetracycline was most common (49%), followed by nalidixic acid (28%), ampicillin (24%), sulfamethoxazole/trimethoprim (20%), and cephalothin (18%). All isolates were susceptible to aztreonam. Of the resistant strains, 44% (22/50) demonstrated resistance to >3 antimicrobial agents. Isolates resistant to >5 antimicrobials were only found in the meat samples, while isolates from the fruits and vegetables as well as RTE foods showed resistance to only 1 or 2 antimicrobial agents. Sixty one percent of EAST1EC, 56% of EPEC and all of the EAEC and ETEC were resistant to at least 1 antimicrobial agent. Multiple-locus variable-number tandem repeat analysis (MLVA) was used in this study for genotyping of DEC. The 82 isolates collected for this study showed 77 distinct MLVA profiles located among 3 branches. The Simpson's Index of Diversity (D) was 99.9% at its highest. The high diversity of these food strains would suggest their originating from a variety of sources and environments. In conclusion, retail food samples in Japan were contaminated with DEC; EAST1EC, a putative DEC, were detected at high rates in poultry, pork and beef. Isolates resistant to >3 antimicrobials were found only in raw meat and fish. Food animals may act as the reservoir for multi-resistant bacteria. Due to the finding that nearly 1/3 of EAST1EC strains were resistant to >3 antimicrobials, additional surveillance for EAST1EC should be initiated.

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“…Five of these had CRISPR arrays related to the CRISPR array of the “new French clone” (Yin et al, 2013 ; DEC9A, DEC9B, DEC9C, DEC9D, and DEC9E) and one isolated in France in 1952 (DEC10D) with a CRISPR array related to the reference EHEC O26:H11 strain (Hazen et al, 2012 ). Three human O26:H11 stx2a positive strains isolated in Norway (FHI4, FHI24, and FHI27) were also included (Haugum et al, 2014 ).…”

Section: Methodsmentioning

confidence: 99%

The Mobilome; A Major Contributor to Escherichia coli stx2-Positive O26:H11 Strains Intra-Serotype Diversity

et al. 2017

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Shiga toxin-producing Escherichia coli of serotype O26:H11/H- constitute a diverse group of strains and several clones with distinct genetic characteristics have been identified and characterized. Whole genome sequencing was performed using Illumina and PacBio technologies on eight stx2-positive O26:H11 strains circulating in France. Comparative analyses of the whole genome of the stx2-positive O26:H11 strains indicate that several clones of EHEC O26:H11 are co-circulating in France. Phylogenetic analysis of the French strains together with stx2-positive and stx-negative E. coli O26:H11 genomes obtained from Genbank indicates the existence of four clonal complexes (SNP-CCs) separated in two distinct lineages, one of which comprises the “new French clone” (SNP-CC1) that appears genetically closely related to stx-negative attaching and effacing E. coli (AEEC) strains. Interestingly, the whole genome SNP (wgSNP) phylogeny is summarized in the cas gene phylogeny, and a simple qPCR assay targeting the CRISPR array specific to SNP-CC1 (SP_O26-E) can distinguish between the two main lineages. The PacBio sequencing allowed a detailed analysis of the mobile genetic elements (MGEs) of the strains. Numerous MGEs were identified in each strain, including a large number of prophages and up to four large plasmids, representing overall 8.7–19.8% of the total genome size. Analysis of the prophage pool of the strains shows a considerable diversity with a complex history of recombination. Each clonal complex (SNP-CC) is characterized by a unique set of plasmids and phages, including stx-prophages, suggesting evolution through separate acquisition events. Overall, the MGEs appear to play a major role in O26:H11 intra-serotype clonal diversification.

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Comparative Genomics to Delineate Pathogenic Potential in Non-O157 Shiga Toxin-Producing Escherichia coli (STEC) from Patients with and without Haemolytic Uremic Syndrome (HUS) in Norway

Cited by 33 publications

References 76 publications

Shiga toxin–producing Escherichia coli in British Columbia, 2011–2017: Analysis to inform exclusion guidelines

Shiga toxin–producing Escherichia coli in British Columbia, 2011–2017: Analysis to inform exclusion guidelines

Prevalence, antimicrobial resistance and multiple-locus variable-number tandem-repeat analysis profiles of diarrheagenic Escherichia coli isolated from different retail foods

The Mobilome; A Major Contributor to Escherichia coli stx2-Positive O26:H11 Strains Intra-Serotype Diversity

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