All blood, No stool: enterohemorrhagic Escherichia coli O157:H7 infection

Enterohemorrhagic Escherichia coli serotype O157:H7 is a pathotype of diarrheagenic E. coli that produces one or more Shiga toxins, forms a characteristic histopathology described as attaching and effacing lesions, and possesses the large virulence plasmid pO157. The bacterium is recognized worldwide, especially in developed countries, as an emerging food-borne bacterial pathogen, which causes disease in humans and in some animals. Healthy cattle are the principal and natural reservoir of E. coli O157:H7, and most disease outbreaks are, therefore, due to consumption of fecally contaminated bovine foods or dairy products. In this review, we provide a general overview of E. coli O157:H7 infection, especially focusing on the bacterial characteristics rather than on the host responses during infection.

Epidemiologia del síndrome urémco hemolítico en Argentina: diagnóstico del agente etiológico, reservorios y vías de transmissión / The epidemiology of hemolytic uremic syndrome in Argentina. Diagnosis of the etiologic agent, reservoirs and routes of transmission

Shiga toxin-producing Escherichia coli (STEC) cause sporadic cases and outbreaks of nonbloody and bloody diarrhea, and hemolytic uremic syndrome (HUS). E. coil O157:H7 is the most prevalent STEC serotype. However, other serotypes (O26:H11; O103:H2; O111:NM; O121:H19; O145:NM, among others) can cause a similar disease spectrum. Shiga toxins (Stx1, Stx2, and their variants), intimin, and enterohemolysin are the main virulence factors. Three different diagnostic criteria are used to determine the frequency of STEC infection: 1) isolation and characterization of STEC strains; 2) detection of specifically neutralizable free fecal Stx; and 3) Serological tests to detect Stx-antibodies. The surveillance of the STEC strains is performed using subtyping techniques: a) genotyping of Stx and eae by PCR-RFLP; b) phage typing of E. coil O157 strains; and c) pulsed-field gel electrophoresis. STEC O157 and non-O157 strains are recovered from clinic, animal, food and environmental samples, and E. coli O157:H7, a Stx2 and Stx2c producer, harboring eae and ehxA genes, is the most common serotype. During a prospective case-control study conducted to evaluate risk factors for sporadic STEC infection in Mendoza Province and Buenos Aires City and its surroundings during 2001-2002, exposures associated with risk included eating undercooked beef, contact with a child < 5 years with diarrhea and living in or visiting a place with farm animals. Both washing hands after handling raw beef, and eating fruits and vegetables were frequently protective. Strategies of prevention and control are necessary to decrease the incidence of STEC infections in Argentina.

Evaluation of a QIAamp DNA stool purification kit for Shiga-toxigenic Escherichia coli detection in bovine fecal swabs by PCR / Evaluación del kit QIAamp DNA stool purification para la detección de Escherichia coli productor de toxina Shiga en hisopados de materia fecal bovina por PCR[

A commercial kit intended for Taq polymerase inhibitor removal was tested to detect Shiga-toxigenic Escherichia coli (STEC) by polymersase chain reaction (PCR) directly from cattle fecal samples. Forty-five samples were analysed for the presence of stx genes. Results were compared to those obtained by two other methods: amplification of DNA purified by a non-commercial procedure (heat lysis protocol), and amplification of DNA from samples cultured in solid media, commonly used in our lab. Identical numbers of positive samples (33/45, 73 %) were obtained with the QIAamp DNA stool purification kit and the culturing procedure, suggesting an adequate removal of inhibitors that interfere in PCR amplification from the feces. Besides, the number of positive samples detected using DNA purified by the non-commercial protocol was lower, 25/39 (64%) than that achieved by using the kit. In conclusion, the use of the QIAamp DNA stool purification kit provided a rapid stx gene detection by PCR in bovine fecal samples.

Un kit comercial diseñado para la eliminación de inhibidores de la polimerasa Taq fue ensayado para la detección de STEC por PCR en muestras fecales de bovinos. Cuarenta y cinco muestras fueron evaluadas por la presencia de genes stx. Los resultados fueron comparados con aquéllos obtenidos por otros dos métodos: amplificación de ADN purificado por un procedimiento no comercial (protocolo de lisis por calor), y amplificación de ADN de muestras cultivadas en medio sólido, comúnmente usado en nuestro laboratorio. El mismo número de muestras positivas (33/45, 73 %), fueron obtenidas con el QIAamp DNA stool purification kit y el procedimiento de cultivo, sugiriendo una eliminación adecuada de inhibidores que interfieren con la amplificación en materia fecal. Por otro lado, el número de muestras positivas detectadas usando ADN purificado por el protocolo no comercial fue menor, 25/39 (64%). En conclusión, el uso del kit QIAamp DNA stool purification permitió una detección rápida de genes stx por PCR en muestras fecales bovinas.