Differential kinetic patterns for Shiga toxin production by Escherichia coli

El objetivo de este trabajo fue estudiar la cinetica de produccion de los distintos tipos de toxinas Shiga (Stx1; Stx2c) asociadas a Escherichia coli, en cepas de referencia y aisladas de pacientes con Sindrome Uremico Hemolitico (SUH). Las cepas fueron cultivadas en caldo Penassay e incubadas a 37§ con agitacion (200 rpm), tomandose muestras a distintos tiempos (1,5; 3; 9 y 24 horas) para determinar el crecimiento bacteriano y la citotoxicidad libre y asociada a celulas. Para Stx1, a las 3 horas de incubacion, la relacion entre la concentracion intracelular y la extracelular (ic/ec), estuvo comprendida entre 32 y 200 veces. A las 24 horas, ambas concentraciones se igualaron o (ec) resulto 2 veces mayor, dependiendo de la cepa estudiada. Sin embargo, tanto la actividad citotoxica libre como la asociada a celulas presentaron titulos muy bajos. Esto indico una perdida de actividad durante la fase estacionaria que podria deberse al cese de la sintesis de Stx1 o la accion de enzimas proteoliticas. Para Stx2, a las 3 horas (ic) fue igual o 2 veces superior a (ec), a las 34 horas (ec) fue 16 a 32 veces superior a (ic). Para Stx2c, (ec) aumento logaritmicamente con un rendimiento maximo a las 5 horas, permaneciendo luego constante hasta las 24 horas. En ese tiempo (ic) fue dos veces superior a (ec). El estudio de la cinetica de produccion de Stx por cepas de E. coli aisladas de pacientes con SUH demostro que correspondian al tipo Stx2. Estos resultados fueron confirmados por ensayos de citotoxicidad especifica en celulas Vero y por hibridacion con sondas geneticas. El tipo de Stx es considerado uno de los mayores factores de riesgo en la evolucion a SUH en pacientes infectados con E. coli enterohemorragicos. Por lo tanto, la disminucion de la citotoxicidad de Stx1, durante la fase estacionaria de crecimiento, podria explicar la mayor frecuencia de accion entre SUH y cepas de E. coli productoras de Stx2 en distintos paises, incluyendo Argentina

Differential kinetic patterns for Shiga toxin production by Escherichia coli

El objetivo de este trabajo fue estudiar la cinetica de produccion de los distintos tipos de toxinas Shiga (Stx1; Stx2c) asociadas a Escherichia coli, en cepas de referencia y aisladas de pacientes con Sindrome Uremico Hemolitico (SUH). Las cepas fueron cultivadas en caldo Penassay e incubadas a 37º con agitacion (200 rpm), tomandose muestras a distintos tiempos (1,5; 3; 9 y 24 horas) para determinar el crecimiento bacteriano y la citotoxicidad libre y asociada a celulas. Para Stx1, a las 3 horas de incubacion, la relacion entre la concentracion int

Differential kinetic patterns for Shiga toxin production by Escherichia coli.

We studied the differential kinetic patterns for Shiga toxin (Stx) production (i.e. Stx1, Stx2 and Stx2c) in different reference Escherichia coli strains and in those isolated from hemolytic uremic syndrome (HUS) patients. These results were correlated with those obtained by specific cytotoxic activity assays on Vero cells and hybridization tests with DNA probes for Stx1 and Stx2. Strains cultured in Penassay broth were sampled at 1.5; 3; 5; 9 and 24 hours to determine bacterial growth and its association with cell-bound and free cytotoxicity. Stx1 showed an intracellular/extracellular concentration ratio (ic/ec) between 32 and 200 times after 3 h-growth. At 24 h both Stx1 concentrations were equal or, in some strains, the ec resulted 2-fold higher that the ic. The ic-Stx1 was equal or just 2-fold higher that ec after 3 h-growth. However, at 24 h the released toxin level was 16 to 32 times higher that cell-bound toxin. The ec-Stx2c increased logarithmically, with maximal yields at 5 h, remaining constant up to 24 h. At that time ic-toxin was 2-fold higher than the released one. When the same experiments were performed on strains isolated from HUS patients they showed that the kinetic patterns obtained corresponded to Stx2. These results were confirmed by hybridization assays. In this study we have shown that Stx1 production decreases dramatically during stationary phase while Stx2 is detected at high level at that time. This could explain the higher frequency of association of Stx2-producing E. coli strains and HUS in some countries, including Argentina.

Verocytotoxin-producing Escherichia coli infection in family members of children with hemolytic uremic syndrome.

Thirty-four hemolytic uremic syndrome (HUS) patients and ninety-five family members were studied to determine the frequency of infection with verocytotoxin-producing Escherichia coli (VTEC) in household contacts using three diagnostic criteria: VTEC strains isolation and characterization, detection of free fecal VT (FVT) and VT-neutralizing antibodies (VT-NAbs). Gastrointestinal tract symptoms occurred in one to six family members in 8 (23.5%) of the index cases, the week before admission to hospital or simultaneously. The control group consisted of 34 children with acute gastroenteritis who did not develop HUS. Cumulative evidence of VTEC infection was found in 13 (38.2%) of 34 HUS patients, in 30 (31.6%) of 95 family members and in 10 (29.4%) of 34 control children. The serotypes of VTEC isolated were O157: H7 and O25: H2. The prevalent VT type was VT2 in VTEC and FVT; and VT1 in VT-NAbs. Both parents had the same infection rate by fecal toxin or serological data (11.1% FVT, 32% VT-NAbs). These were higher than those detected in siblings (6.2% FVT, 23.5% VT-NAbs) and grandparents (0% FVT, 18% VT-NAbs). Of 16 patients without evidence of infection, 3 had household contacts with FVT and 13 with VT-NAbs. Our results show the wide dissemination of VTEC in the population of Argentina and that family members of HUS patients are usually infected. Therefore, person-to-person transmission may play an important role in the high incidence of HUS in our country.

Hemolytic uremic syndrome: co-infection with two different serotypes of Shiga-like toxin producing Escherichia coli.

We report a case of a child who developed Hemolytic Uremic Syndrome in whom two Shiga-like toxin (SLT)-producing Escherichia coli strains of different serotypes and genotypes, were simultaneously isolated from stools. In addition, one of these strains represented a new toxin producing serotype. Strain 1 belonged to serotype O157: H7, biotype D, produced SLT II and was susceptible to all antibiotics tested. This strain hybridized with gene probes for SLT II, fimbrial adhesion (EHEC factor) and attaching and effacing factor (eae). Strain 2 belonged to serotype 025: K2: H2, produced SLT II and had a multiresistant antibiotic susceptibility pattern. This strain hybridized with the EHEC gene probe but not with SLT I, SLT II and eae gene probes. Free fecal SLT II cytotoxin was detected in stools of the child and his father, suggesting that the infection may have been acquired from a household contact.

Hemolytic uremic syndrome: co-infection with two different serotypes of Shiga-like toxin producing Escherichia coli.

We report a case of a child who developed Hemolytic Uremic Syndrome in whom two Shiga-like toxin (SLT)-producing Escherichia coli strains of different serotypes and genotypes, were simultaneously isolated from stools. In addition, one of these strains represented a new toxin producing serotype. Strain 1 belonged to serotype O157: H7, biotype D, produced SLT II and was susceptible to all antibiotics tested. This strain hybridized with gene probes for SLT II, fimbrial adhesion (EHEC factor) and attaching and effacing factor (eae). Strain 2 belonged to serotype 025: K2: H2, produced SLT II and had a multiresistant antibiotic susceptibility pattern. This strain hybridized with the EHEC gene probe but not with SLT I, SLT II and eae gene probes. Free fecal SLT II cytotoxin was detected in stools of the child and his father, suggesting that the infection may have been acquired from a household contact.