Four Cases of Hemolytic Uremic Syndrome (HUS) Associated with Serotype O165 Verotoxin Producing Escherichia coli (VTEC) Identified by LPS-solid Phase Enzyme-Linked Immunosorbent Assay (ELISA)

The sfp cluster, encoding Sfp fimbriae and located in the large plasmid of sorbitol-fermenting (SF) enterohemorrhagic Escherichia coli (EHEC) O157 (pSFO157), has been considered a unique characteristic of this organism. We discovered and then characterized the sfp cluster in EHEC O165:H25/NM (nonmotile) isolates of human and bovine origin. All seven strains investigated harbored a complete sfp cluster (carrying sfpA, sfpH, sfpC, sfpD, sfpJ, sfpF, and sfpG) of 6,838 bp with >99% nucleotide sequence homology to the sfp cluster of SF EHEC O157:NM. The sfp cluster in EHEC O165:H25/NM strains was located in an ϳ80-kb (six strains) or ϳ120-kb (one strain) plasmid which differed in structure, virulence genes, and sfp flanks from pSFO157. All O165:H25/NM strains belonged to the same multilocus sequence type (ST119) and were only distantly phylogenetically related to SF EHEC O157:NM (ST11). The highly conserved sfp cluster in different clonal backgrounds suggests that this segment was acquired independently by EHEC O165:H25 and SF EHEC O157:NM. Its presence in an additional EHEC serotype extends the diagnostic utility of PCR targeting sfpA as an easy and efficient approach to seek EHEC in patients' stools. The reasons for the convergence of pathogenic EHEC strains on a suite of virulence loci remain unknown.

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“…EHEC O165 strains cause HUS and bloody diarrhea (7,9,17,20,22,27,28,31,44,52). The need to reliably identify such strains is therefore obvious.…”

Section: Discussionmentioning

confidence: 99%

Detection and Characterization of the Fimbrial sfp Cluster in Enterohemorrhagic Escherichia coli O165:H25/NM Isolates from Humans and Cattle

Bielaszewska

Prager

Vandivinit

et al. 2009

Appl Environ Microbiol

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“…These included 05:NM, 0 1 13:H21, 0125:NM, 0165:ET, 0165:H25, 0157:H12, 0157:H19, and 0177(H25) serotypes (Supple mental Table S3), several of which have been reported to be associated with HUS outbreaks (74,79).…”

Section: Resultsmentioning

confidence: 99%

Use of the ecf1 Gene To Detect Shiga Toxin–Producing Escherichia coli in Beef Samples

Livezey¹,

Gröschel²,

Becker³

2015

Journal of Food Protection

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Escherichia coli O157:H7 and six serovars (O26, O103, O121, O111, O145, and O45) are frequently implicated in severe clinical illness worldwide. Standard testing methods using stx, eae, and O serogroup-specific gene sequences for detecting the top six non-O157 STEC bear the disadvantage that these genes may reside, independently, in different nonpathogenic organisms, leading to false-positive results. The ecf operon has previously been identified in the large enterohemolysin-encoding plasmid of eae-positive Shiga toxin-producing E. coli (STEC). Here, we explored the utility of the ecf operon as a single marker to detect eae-positive STEC from pure broth and primary meat enrichments. Analysis of 501 E. coli isolates demonstrated a strong correlation (99.6%) between the presence of the ecf1 gene and the combined presence of stx, eae, and ehxA genes. Two large studies were carried out to determine the utility of an ecf1 detection assay to detect non-O157 STEC strains in enriched meat samples in comparison to the results using the U. S. Department of Agriculture Food Safety and Inspection Service (FSIS) method that detects stx and eae genes. In ground beef samples (n = 1,065), the top six non-O157 STEC were detected in 4.0% of samples by an ecf1 detection assay and in 5.0% of samples by the stx- and eae-based method. In contrast, in beef samples composed largely of trim (n = 1,097), the top six non-O157 STEC were detected at 1.1% by both methods. Estimation of false-positive rates among the top six non-O157 STEC revealed a lower rate using the ecf1 detection method (0.5%) than using the eae and stx screening method (1.1%). Additionally, the ecf1 detection assay detected STEC strains associated with severe illness that are not included in the FSIS regulatory definition of adulterant STEC.

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“…O165 is an uncommon EHEC serogroup; however, EHEC O165 has been reported to be associated with HUS cases not only in Japan but also worldwide (6,9,10). With a bias toward the identification of the O157 serogroup in routine diagnostic processes, minor serotypes such as O165 are comparatively difficult to detect in hospital settings.…”

Section: Discussionmentioning

confidence: 99%

“…Children, particularly those under 5 years of age, are at the greatest risk of developing HUS (4). EHEC O157:H7 is the serotype most frequently isolated from HUS patients; however, non-O157 EHEC has also been implicated in HUS cases (5)(6)(7)(8)(9)(10). These epidemiological studies indicated that no particular serotype of EHEC is associated with progression to HUS.…”

Section: Introductionmentioning

confidence: 99%

Determination of Enterohemorrhagic <i>Escherichia coli</i> Serotype O165:HNM Infection in a Hemolytic Uremic Syndrome Patient with Adenovirus Seroype 41

et al. 2013

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SUMMARY:A 4-year-old girl who was positive for adenovirus according to a rapid immunochromatographic test conducted at a hospital, progressed to hemorrhagic diarrhea and hemolytic uremic syndrome (HUS). The presence of adenovirus serotype 41 (AdV-41) was confirmed by TaqMan real-time PCR and sequence analysis. However, most enteric viral infections cause mild to moderate diarrhea. In the present case, enterohemorrhagic Escherichia coli (EHEC) O165:HNM was isolated concomitantly with AdV-41. In addition, O165 antibody was specifically detected in patient sera. The EHEC isolate was positive for the virulence genes stx1, stx2a, eae type e, ehxA, and norV. Therefore, we concluded that EHEC O165:HNM was the precise pathogen leading to HUS in this patient.

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Four Cases of Hemolytic Uremic Syndrome (HUS) Associated with Serotype O165 Verotoxin Producing Escherichia coli (VTEC) Identified by LPS-solid Phase Enzyme-Linked Immunosorbent Assay (ELISA)

Cited by 11 publications

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Detection and Characterization of the Fimbrial sfp Cluster in Enterohemorrhagic Escherichia coli O165:H25/NM Isolates from Humans and Cattle

Detection and Characterization of the Fimbrial sfp Cluster in Enterohemorrhagic Escherichia coli O165:H25/NM Isolates from Humans and Cattle

Use of the ecf1 Gene To Detect Shiga Toxin–Producing Escherichia coli in Beef Samples

Determination of Enterohemorrhagic <i>Escherichia coli</i> Serotype O165:HNM Infection in a Hemolytic Uremic Syndrome Patient with Adenovirus Seroype 41

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