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J Infect Dis ; 188(5): 719-29, 2003 Sep 01.
Article in English | MEDLINE | ID: mdl-12934188

ABSTRACT

The diseases and virulence genes associated with Shiga toxin-producing Escherichia coli (STEC) are characterized incompletely. We analyzed, by polymerase chain reaction, 82 STEC isolates collected prospectively in Montana and profiled associated illnesses by patient chart review. All E. coli O157:H7 contained stx2-group genes, as well as eae, iha, espA, and ehxA; 84% contained stx1. Non-O157:H7 STEC less frequently contained stx1 (P=.046), stx2 (P<.001), iha (P<.001), eae, and espA (P=.039 for both), were isolated less often from patients treated in emergency departments (P=.022), and tended to be associated less frequently with bloody diarrhea (P=.061). There were no significant associations between stx genotype and bloody diarrhea, but isolates containing stx2c or stx(2d-activatable) were recovered more often from patients who underwent diagnostic or therapeutic procedures (P=.033). Non-O157:H7 STEC are more heterogeneous and cause bloody diarrhea less frequently than do E. coli O157:H7. Bloody diarrhea cannot be attributed simply to the stx genotype of the infecting organism.


Subject(s)
Diarrhea/physiopathology , Escherichia coli Infections/physiopathology , Escherichia coli/classification , Escherichia coli/genetics , Shiga Toxin 1/biosynthesis , Shiga Toxin 2/biosynthesis , Adolescent , Adult , Aged , Base Sequence , Child , Child, Preschool , Diarrhea/microbiology , Escherichia coli/metabolism , Escherichia coli Infections/microbiology , Escherichia coli O157/classification , Escherichia coli O157/genetics , Escherichia coli O157/metabolism , Escherichia coli Proteins/genetics , Escherichia coli Proteins/metabolism , Feces/microbiology , Female , Genotype , Humans , Male , Middle Aged , Molecular Sequence Data , Montana , Polymerase Chain Reaction , Population Surveillance , Prospective Studies , Shiga Toxin 1/chemistry , Shiga Toxin 1/genetics , Shiga Toxin 2/chemistry , Shiga Toxin 2/genetics
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