ABSTRACT
We investigated the presence of the gene of subtilase cytotoxin (SubAB), described in certain highly virulent verocytotoxigenic E. coli strains, in isolates from Argentina and its relation with other virulence factors. The gene subA was present in eae-negative strains mostly associated with saa, vt2 and ehxA genes.
ABSTRACT
Enterohemorrhagic Escherichia coli (EHEC) is an important cause of bloody diarrhea in children, but is considered to be rare in infants. Herein, a case of infant hemorrhagic colitis of verotoxin-producing E. coli O157:H7 diagnosed by multiplex PCR is reported. A nine-month-old boy was admitted to our hospital with bloody diarrhea for the previous two days. Multiplex PCR using Seeplex(R) Diarrhea ACE Detection Kit (Seegene, Seoul, Korea) was directly applied to the stool specimens. Amplified bands specific for verotoxin, O157, and H7 indicated the presence of O157:H7 EHEC. The stool specimens were inoculated on sorbitol-MacConkey agar (SMA) and tryptic soy broth containing mitomycin C (TSB-M). Colorless colonies on sorbitol-MacConkey agar were O157-positive. TSB-M enrichment cultures of the stool specimen and the isolates were positive for verotoxin according to an enzyme immunoassay (EIA). The prepared ingredients of baby foods for the patient including ground meat, chopped carrot, chopped cabbage, and white rice porridge showed no EHEC on TSB-M and SMA. The patient's parents and three-year-old sister did not recently have any gastrointestinal symptoms. Cefdinir was administered for one day and was ceased after diagnosis of EHEC colitis. The stool culture and verotoxin assay were negative on the second day of hospitalization. Application of multiplex PCR and verotoxin EIA directly to diarrheal stool warrants the rapid diagnosis and appropriate treatment of EHEC colitis.
Subject(s)
Child , Humans , Infant , Agar , Brassica , Caseins , Cephalosporins , Colitis , Daucus carota , Diarrhea , Enterohemorrhagic Escherichia coli , White People , Hospitalization , Immunoenzyme Techniques , Meat , Mitomycin , Multiplex Polymerase Chain Reaction , Parents , Protein Hydrolysates , Shiga Toxins , Shiga-Toxigenic Escherichia coli , SiblingsABSTRACT
BACKGROUND: No outbreak of Enterohemorrhagic Escherichia coli (EHEC) infection has occurred as a group in Korea. On July 2004, an outbreak of EHEC infection occurred in an elementary school in Gwangju metropolitan city. Epidemic investigation was undertaken to track the source of infection and the mode of transmission of EHEC. METHODS: All students and staffs of the elementary school were interviewed and completed questionnaires. We surveyed their clinical symptoms and the foods that they ate. Microbiologic examinations were also carried out on the above school-related persons and many environmental specimens. We also investigated the facilities of the school, some suppliers of food materials, and other associated institutions. All the EHEC-positive persons were isolated in 5 hospitals and tested everyday for verotoxin until they turned out to be negative twice in succession, and their family were also interviewed and tested for EHEC. Pulsed-field gel electrophoresis (PFGE) was performed to find out the genetic relationship between isolates. RESULTS: Of the 1,643 school-related persons, 77 persons (4.7%) were positive for EHEC. Most of them were asymptomatic. All the isolated strains were non-O157 EHEC. Serotype O91 was the most frequent serotype (68 isolates), and the isolates revealing O91 serotypes showed identical PFGE patterns. The school meal was significantly associated with this outbreak (relative risk=13.29, p=0.00). CONCLUSIONS: This is the first EHEC outbreak occurred as a group in Korea, All the isolated strains were non-O157 serotypes and the mode of transmission was most likely by school meal.
Subject(s)
Humans , Electrophoresis, Gel, Pulsed-Field , Enterohemorrhagic Escherichia coli , Korea , Meals , Shiga Toxins , Surveys and QuestionnairesABSTRACT
Verotoxin-producing Escherichia coli O157 is a primary cause of severe and bloody diarrhea. Campylobacter spp. are one of the commonly reported bacterial cause of gastrointestinal infections throughout the world. Only a few cases involving both E. coli O157 and Campylobacter species have been reported. The authors simultaneously isolated verotoxin-producing E. coli O157 and Campylobacter species from the stool of a 3 year-old male with bloody diarrhea, fever and abdominal pain.
Subject(s)
Child, Preschool , Humans , Male , Abdominal Pain , Campylobacter , Diarrhea , Escherichia coli O157 , Escherichia coli , Escherichia , Fever , Gastroenteritis , Shiga Toxins , Shiga-Toxigenic Escherichia coliABSTRACT
Enterohemorrhagic Escherichia coli infection can cause hemorrhagic colitis and hemolytic uremic syndrome. Since 1994 we have carried out surveillance for this infection in the south of Choongnam Province, in Korea. We investigated the patients with diarrhea who had admitted in Soonchunhyang University Chunan Hospital(Total : 130, age; from infant to elderly), from May 1994 through February 1996. E. coli O157 : H7, O26 : H11, O128 : H2, O111 : H- serotype were assessed by the slide agglutination test. E. coli culture was positive in the 53(male 33, female 20) out of 130 patients with diarrhea. One case of E. coli O157 : H7 infection was identified. He was 30 days old infant lived in Dangjin rural area. He suffered from bloody diarrhea and anemia with acute renal failure, suggesting hemolytic uremic syndrome which is a well recognized complication of E. coli O157 : H7 infection. We have to aware of the possibility of outbreaks of E. coli O157 : H7 infection in this area.