Yonsei Med J.  2011 Nov;52(6):1039-1043. 10.3349/ymj.2011.52.6.1039.

A Case of a Shiga Toxin Producing Escherichia Coli

Affiliations
  • 1Division of Enteric Bacterial Infections, Center for Infectious Diseases, Korea National Institute of Health, Osong, Korea.
  • 2Division of Health Research and Planning, Gyeonggi-do Research Institute of Health and Environment, Suwon, Korea.
  • 3Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea.
  • 4Department of Laboratory Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea. hkl@catholic.ac.kr

Abstract

We encountered a patient with hemolytic uremic syndrome (HUS) with persistent isolation of shiga toxin-producing Escherichia coli (STEC) for 3 weeks despite of having no clinical symptoms. STEC has been recognized as an important food-borne pathogen that causes severe diseases such as HUS. We characterized this STEC strain via a polymerase chain reaction, reverse-passive latex agglutination and the slide agglutination method. In this STEC strain, stx2 (shiga toxin), eaeA, tir, iha (adherence genes), espADB (type III secretion genes), and hlyA, ehxA, clyA (hemolysin genes) were present. The O antigen of the strain was non-typable.

Keyword

Shiga toxin-producing Escherichia coli; hemolytic uremic syndrome; non-typable serotype STEC strain

MeSH Terms

Child, Preschool
Female
Hemolytic-Uremic Syndrome/diagnosis/*microbiology
Humans
Shiga-Toxigenic Escherichia coli/*isolation & purification/*pathogenicity

Reference

1. Nataro JP, Kaper JB. Diarrheagenic Escherichia coli. Clin Microbiol Rev. 1998. 11:142–201.
2. Tozzi AE, Caprioli A, Minelli F, Gianviti A, De Petris L, Edefonti A, et al. Shiga toxin-producing Escherichia coli infections associated with hemolytic uremic syndrome, Italy, 1988-2000. Emerg Infect Dis. 2003. 9:106–108.
Article
3. Melton-Celsa AR, O'Brien AD. Animal models for STEC-mediated disease. Methods Mol Med. 2003. 73:291–305.
Article
4. Makino S, Tobe T, Asakura H, Watarai M, Ikeda T, Takeshi K, et al. Distribution of the secondary type III secretion system locus found in enterohemorrhagic Escherichia coli O157:H7 isolates among Shiga toxin-producing E. coli strains. J Clin Microbiol. 2003. 41:2341–2347.
Article
5. Clarke SC, Haigh RD, Freestone PP, Williams PH. Virulence of enteropathogenic Escherichia coli, a global pathogen. Clin Microbiol Rev. 2003. 16:365–378.
Article
6. Tarr PI, Bilge SS, Vary JC Jr, Jelacic S, Habeeb RL, Ward TR, et al. Iha: a novel Escherichia coli O157:H7 adherence-conferring molecule encoded on a recently acquired chromosomal island of conserved structure. Infect Immun. 2000. 68:1400–1407.
7. Nicholls L, Grant TH, Robins-Browne RM. Identification of a novel genetic locus that is required for in vitro adhesion of a clinical isolate of enterohaemorrhagic Escherichia coli to epithelial cells. Mol Microbiol. 2000. 35:275–288.
Article
8. Paton AW, Srimanote P, Woodrow MC, Paton JC. Characterization of Saa, a novel autoagglutinating adhesin produced by locus of enterocyte effacement-negative Shiga-toxigenic Escherichia coli strains that are virulent for humans. Infect Immun. 2001. 69:6999–7009.
Article
9. Tatsuno I, Horie M, Abe H, Miki T, Makino K, Shinagawa H, et al. toxB gene on pO157 of enterohemorrhagic Escherichia coli O157:H7 is required for full epithelial cell adherence phenotype. Infect Immun. 2001. 69:6660–6669.
Article
10. Welch RA, Forestier C, Lobo A, Pellett S, Thomas W Jr, Rowe G. The synthesis and function of the Escherichia coli hemolysin and related RTX exotoxins. FEMS Microbiol Immunol. 1992. 5:29–36.
11. Bauer ME, Welch RA. Characterization of an RTX toxin from enterohemorrhagic Escherichia coli O157:H7. Infect Immun. 1996. 64:167–175.
Article
12. König B, Ludwig A, Goebel W, König W. Pore formation by the Escherichia coli alpha-hemolysin: role for mediator release from human inflammatory cells. Infect Immun. 1994. 62:4611–4617.
Article
13. Guinée PA, Agterberg CM, Jansen WH. Escherichia coli O antigen typing by means of a mechanized microtechnique. Appl Microbiol. 1972. 24:127–131.
Article
14. Ostroff SM, Tarr PI, Neill MA, Lewis JH, Hargrett-Bean N, Kobayashi JM. Toxin genotypes and plasmid profiles as determinants of systemic sequelae in Escherichia coli O157:H7 infections. J Infect Dis. 1989. 160:994–998.
15. Tarr PI, Gordon CA, Chandler WL. Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome. Lancet. 2005. 365:1073–1086.
16. Jerse AE, Gicquelais KG, Kaper JB. Plasmid and chromosomal elements involved in the pathogenesis of attaching and effacing Escherichia coli. Infect Immun. 1991. 59:3869–3875.
17. Toma C, Martínez Espinosa E, Song T, Miliwebsky E, Chinen I, Iyoda S, et al. Distribution of putative adhesins in different seropathotypes of Shiga toxin-producing Escherichia coli. J Clin Microbiol. 2004. 42:4937–4946.
18. Oscarsson J, Westermark M, Löfdahl S, Olsen B, Palmgren H, Mizunoe Y, et al. Characterization of a pore-forming cytotoxin expressed by Salmonella enterica serovars typhi and paratyphi A. Infect Immun. 2002. 70:5759–5769.
Article
19. Coombes BK, Wickham ME, Mascarenhas M, Gruenheid S, Finlay BB, Karmali MA. Molecular analysis as an aid to assess the public health risk of non-O157 Shiga toxin-producing Escherichia coli strains. Appl Environ Microbiol. 2008. 74:2153–2160.
20. Mukherjee J, Chios K, Fishwild D, Hudson D, O'Donnell S, Rich SM, et al. Human Stx2-specific monoclonal antibodies prevent systemic complications of Escherichia coli O157:H7 infection. Infect Immun. 2002. 70:612–619.
21. Stephan R, Untermann F. Virulence factors and phenotypical traits of verotoxin-producing Escherichia coli strains isolated from asymptomatic human carriers. J Clin Microbiol. 1999. 37:1570–1572.
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