Ten-Year Trends and Risk Factors for Non-O157 Shiga Toxin-Producing Escherichia coli Found Through Shiga Toxin Testing, Connecticut, 2000-2009

Abstract

Both O157 and non-O157 STEC infection incidence decreased from 2000 through 2009. Although infection due to O157 is the most common and clinically severe STEC infection, it accounts for a minority of all clinically significant STEC infections. STEC appear to be a diverse group of organisms that have some differences as well as many epidemiologic and exposure features in common.

A Sensitive Multiplex, Real-Time PCR Assay for Prospective Detection of Shiga Toxin-Producing Escherichia coli from Stool Samples Reveals Similar Incidences but Variable Severities of Non-O157 and O157 Infections in Northern California

“…Although previously the majority of reported cases were attributed to E. coli O157:H7 and many recent studies indicate higher incidence rates of HUS associated with E. coli O157:H7 (3,4), non-O157 STEC serotypes are emerging as important etiological agents of both sporadic cases and community outbreaks of diarrhea (3)(4)(5)(6)(7)(8). Most notably, in May and June 2011, a large outbreak of E. coli O104:H4-associated diarrheal illness in Germany led to HUS in over 800 patients, many of whom were adults, and ultimately resulted in 54 deaths (5,9).…”

Shiga Toxin/Verocytotoxin-Producing Escherichia coli Infections: Practical Clinical Perspectives

“…Findings from several of these studies are particularly worth mentioning. Of 229 Connecticut patients with infections caused by non-O157:H7 STEC/ VTEC who were studied over a decade-long interval (48), HUS developed in only one, while HUS developed in 45 of the 434 patients in this series who were infected with E. coli O157. In a United States-wide study of 83 patients with HUS (12), 70 patients had stool cultures in which bacteria grew.…”

“…As noted above, E. coli O157:H7 is the overwhelming cause of postdiarrheal HUS (8,12,16,21,(43)(44)(45)(46)(47)(48)(49). If the stool of a patient with HUS does not contain E. coli O157:H7, the most likely explanation is that the specimen was first cultured for this organism at a point in illness when the pathogen had been eliminated (44).…”

“…Most compellingly, E. coli O157:H7 is the STEC/VTEC that remains to this day the near-exclusive cause of postdiarrheal HUS (8,12,16,21,(43)(44)(45)(46)(47)(48)(49). This serotype is also the one most strongly associated with outbreaks (though most infections are sporadic).…”

Prevalence of Asymptomatic Carriers of Shiga Toxin-Producing Escherichia Coli (STEC) in Dairy Cattle Farms in the Governorate of Blida (Algeria)

“…To date, over 100 different serotypes of STEC have been identified, all causing bacterial gastroenteritis in humans and some known to induce haemorrhagic colitis and haemolytic uremic syndrome (HUS) (10). Numerous studies have reported that STEC-related illness is not always associated with fever and haemorrhagic colitis and is not restricted to a particular season (16). Recently, a large outbreak of HUS caused by this bacteria (O104:H4) occurred in Europe, affecting more than 4000 patients with diarrhoeal disease and resulting in the death of about 54 patients (4,11).…”