Abstract
During a 10-week period in the summer of 1990, an epidemiologic investigation of the prevalence of verotoxin (VT)-producing Escherichia coli infection was conducted in Calgary, Alberta, Canada. Consecutive stool specimens (n = 3,577) were cultured for E. coli O157:H7, and fecal filtrates were tested for free VTs (FVTs). E. coli O157:H7 was recovered from 22 specimens (0.6%), but VT was detected in 74 specimens (2.1%). Sixty-nine stool specimens positive for FVTs or E. coli O157:H7 were probed for VT genes by colony blot hybridization; 22 of 38 VT gene probe-positive isolates were non-O157:H7 E. coli organisms. Fourteen of 22 strains could not be induced to produce VT in vitro, despite the presence of FVTs in the stool sample, positivity on colony blot hybridization, positive PCR probes with the primers described by Pollard et al. (D. R. Pollard, W. M. Johnson, H. Lior, S. D. Tyler, and K. R. Rozee, J. Clin. Microbiol. 28:540-545, 1990) or Gannon et al. (V. P. Gannon, R. K. King, J. Y. Kim, and E. J. Golsteyn-Thomas, Appl. Environ. Microbiol. 58:3809-3815, 1992) (but not those described by Karch and Meyer [H. Karch and T. Meyer, J. Clin. Microbiol. 27:2751-2757, 1989]), and positive Southern blot analysis of isolates in 10 of 14 strains. The patient survey questionnaire showed that E. coli O157:H7 infection was associated with bloody diarrhea of short duration, whereas infection with other serotypes or persistence of FVT only was associated with longer-duration nonbloody diarrheal illness.(ABSTRACT TRUNCATED AT 250 WORDS)
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- Beebakhee G., Louie M., De Azavedo J., Brunton J. Cloning and nucleotide sequence of the eae gene homologue from enterohemorrhagic Escherichia coli serotype O157:H7. FEMS Microbiol Lett. 1992 Feb 1;70(1):63–68. doi: 10.1016/0378-1097(92)90563-4. [DOI] [PubMed] [Google Scholar]
- Bettelheim K. A., Brown J. E., Lolekha S., Echeverria P. Serotypes of Escherichia coli that hybridized with DNA probes for genes encoding Shiga-like toxin I, Shiga-like toxin II, and serogroup O157 enterhemorrhagic E. coli fimbriae isolated from adults with diarrhea in Thailand. J Clin Microbiol. 1990 Feb;28(2):293–295. doi: 10.1128/jcm.28.2.293-295.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brown J. E., Echeverria P., Taylor D. N., Seriwatana J., Vanapruks V., Lexomboon U., Neill R. N., Newland J. W. Determination by DNA hybridization of Shiga-like-toxin-producing Escherichia coli in children with diarrhea in Thailand. J Clin Microbiol. 1989 Feb;27(2):291–294. doi: 10.1128/jcm.27.2.291-294.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brown J. E., Sethabutr O., Jackson M. P., Lolekha S., Echeverria P. Hybridization of Escherichia coli producing Shiga-like toxin I, Shiga-like toxin II, and a variant of Shiga-like toxin II with synthetic oligonucleotide probes. Infect Immun. 1989 Sep;57(9):2811–2814. doi: 10.1128/iai.57.9.2811-2814.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cahoon F. E., Thompson J. S. Frequency of Escherichia coli O157:H7 isolation from stool specimens. Can J Microbiol. 1987 Oct;33(10):914–915. doi: 10.1139/m87-158. [DOI] [PubMed] [Google Scholar]
- Calderwood S. B., Mekalanos J. J. Iron regulation of Shiga-like toxin expression in Escherichia coli is mediated by the fur locus. J Bacteriol. 1987 Oct;169(10):4759–4764. doi: 10.1128/jb.169.10.4759-4764.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cleary T. G. Escherichia coli that cause hemolytic uremic syndrome. Infect Dis Clin North Am. 1992 Mar;6(1):163–176. [PubMed] [Google Scholar]
- Cohen M. B., Giannella R. A. Hemorrhagic colitis associated with Escherichia coli O157:H7. Adv Intern Med. 1992;37:173–195. [PubMed] [Google Scholar]
- Cravioto A., Tello A., Navarro A., Ruiz J., Villafán H., Uribe F., Eslava C. Association of Escherichia coli HEp-2 adherence patterns with type and duration of diarrhoea. Lancet. 1991 Feb 2;337(8736):262–264. doi: 10.1016/0140-6736(91)90868-p. [DOI] [PubMed] [Google Scholar]
- Downes F. P., Barrett T. J., Green J. H., Aloisio C. H., Spika J. S., Strockbine N. A., Wachsmuth I. K. Affinity purification and characterization of Shiga-like toxin II and production of toxin-specific monoclonal antibodies. Infect Immun. 1988 Aug;56(8):1926–1933. doi: 10.1128/iai.56.8.1926-1933.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Farmer J. J., 3rd, Davis B. R. H7 antiserum-sorbitol fermentation medium: a single tube screening medium for detecting Escherichia coli O157:H7 associated with hemorrhagic colitis. J Clin Microbiol. 1985 Oct;22(4):620–625. doi: 10.1128/jcm.22.4.620-625.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gannon V. P., King R. K., Kim J. Y., Thomas E. J. Rapid and sensitive method for detection of Shiga-like toxin-producing Escherichia coli in ground beef using the polymerase chain reaction. Appl Environ Microbiol. 1992 Dec;58(12):3809–3815. doi: 10.1128/aem.58.12.3809-3815.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Griffin P. M., Tauxe R. V. The epidemiology of infections caused by Escherichia coli O157:H7, other enterohemorrhagic E. coli, and the associated hemolytic uremic syndrome. Epidemiol Rev. 1991;13:60–98. doi: 10.1093/oxfordjournals.epirev.a036079. [DOI] [PubMed] [Google Scholar]
- Gunzer F., Böhm H., Rüssmann H., Bitzan M., Aleksic S., Karch H. Molecular detection of sorbitol-fermenting Escherichia coli O157 in patients with hemolytic-uremic syndrome. J Clin Microbiol. 1992 Jul;30(7):1807–1810. doi: 10.1128/jcm.30.7.1807-1810.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harris A. A., Kaplan R. L., Goodman L. J., Doyle M., Landau W., Segreti J., Mayer K., Levin S. Results of a screening method used in a 12-month stool survey for Escherichia coli O157:H7. J Infect Dis. 1985 Oct;152(4):775–777. doi: 10.1093/infdis/152.4.775. [DOI] [PubMed] [Google Scholar]
- Hii J. H., Gyles C., Morooka T., Karmali M. A., Clarke R., De Grandis S., Brunton J. L. Development of verotoxin 2- and verotoxin 2 variant (VT2v)-specific oligonucleotide probes on the basis of the nucleotide sequence of the B cistron of VT2v from Escherichia coli E32511 and B2F1. J Clin Microbiol. 1991 Dec;29(12):2704–2709. doi: 10.1128/jcm.29.12.2704-2709.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Karch H., Meyer T., Rüssmann H., Heesemann J. Frequent loss of Shiga-like toxin genes in clinical isolates of Escherichia coli upon subcultivation. Infect Immun. 1992 Aug;60(8):3464–3467. doi: 10.1128/iai.60.8.3464-3467.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Karch H., Meyer T. Single primer pair for amplifying segments of distinct Shiga-like-toxin genes by polymerase chain reaction. J Clin Microbiol. 1989 Dec;27(12):2751–2757. doi: 10.1128/jcm.27.12.2751-2757.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Karmali M. A. Infection by verocytotoxin-producing Escherichia coli. Clin Microbiol Rev. 1989 Jan;2(1):15–38. doi: 10.1128/cmr.2.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Karmali M. A., Petric M., Lim C., Fleming P. C., Arbus G. S., Lior H. The association between idiopathic hemolytic uremic syndrome and infection by verotoxin-producing Escherichia coli. J Infect Dis. 1985 May;151(5):775–782. doi: 10.1093/infdis/151.5.775. [DOI] [PubMed] [Google Scholar]
- Kleanthous H., Fry N. K., Smith H. R., Gross R. J., Rowe B. The use of sorbitol-MacConkey agar in conjunction with a specific antiserum for the detection of Vero cytotoxin-producing strains of Escherichia coli O 157. Epidemiol Infect. 1988 Oct;101(2):327–335. doi: 10.1017/s0950268800054261. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lopez E. L., Diaz M., Grinstein S., Devoto S., Mendilaharzu F., Murray B. E., Ashkenazi S., Rubeglio E., Woloj M., Vasquez M. Hemolytic uremic syndrome and diarrhea in Argentine children: the role of Shiga-like toxins. J Infect Dis. 1989 Sep;160(3):469–475. doi: 10.1093/infdis/160.3.469. [DOI] [PubMed] [Google Scholar]
- MacDonald K. L., O'Leary M. J., Cohen M. L., Norris P., Wells J. G., Noll E., Kobayashi J. M., Blake P. A. Escherichia coli O157:H7, an emerging gastrointestinal pathogen. Results of a one-year, prospective, population-based study. JAMA. 1988 Jun 24;259(24):3567–3570. [PubMed] [Google Scholar]
- MacLeod D. L., Gyles C. L. Effects of culture conditions on yield of Shiga-like toxin-IIv from Escherichia coli. Can J Microbiol. 1989 Jun;35(6):623–629. doi: 10.1139/m89-100. [DOI] [PubMed] [Google Scholar]
- Marshall W. F., McLimans C. A., Yu P. K., Allerberger F. J., Van Scoy R. E., Anhalt J. P. Results of a 6-month survey of stool cultures for Escherichia coli O157:H7. Mayo Clin Proc. 1990 Jun;65(6):787–792. doi: 10.1016/s0025-6196(12)62567-1. [DOI] [PubMed] [Google Scholar]
- Moxley R. A., Francis D. H. Natural and experimental infection with an attaching and effacing strain of Escherichia coli in calves. Infect Immun. 1986 Aug;53(2):339–346. doi: 10.1128/iai.53.2.339-346.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Newland J. W., Neill R. J. DNA probes for Shiga-like toxins I and II and for toxin-converting bacteriophages. J Clin Microbiol. 1988 Jul;26(7):1292–1297. doi: 10.1128/jcm.26.7.1292-1297.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pai C. H., Ahmed N., Lior H., Johnson W. M., Sims H. V., Woods D. E. Epidemiology of sporadic diarrhea due to verocytotoxin-producing Escherichia coli: a two-year prospective study. J Infect Dis. 1988 May;157(5):1054–1057. doi: 10.1093/infdis/157.5.1054. [DOI] [PubMed] [Google Scholar]
- Pai C. H., Gordon R., Sims H. V., Bryan L. E. Sporadic cases of hemorrhagic colitis associated with Escherichia coli O157:H7. Clinical, epidemiologic, and bacteriologic features. Ann Intern Med. 1984 Dec;101(6):738–742. doi: 10.7326/0003-4819-101-6-738. [DOI] [PubMed] [Google Scholar]
- Piérard D., Van Etterijck R., Breynaert J., Moriau L., Lauwers S. Results of screening for verocytotoxin-producing Escherichia coli in faeces in Belgium. Eur J Clin Microbiol Infect Dis. 1990 Mar;9(3):198–201. doi: 10.1007/BF01963837. [DOI] [PubMed] [Google Scholar]
- Pollard D. R., Johnson W. M., Lior H., Tyler S. D., Rozee K. R. Rapid and specific detection of verotoxin genes in Escherichia coli by the polymerase chain reaction. J Clin Microbiol. 1990 Mar;28(3):540–545. doi: 10.1128/jcm.28.3.540-545.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ramotar K., Boyd B., Tyrrell G., Gariepy J., Lingwood C., Brunton J. Characterization of Shiga-like toxin I B subunit purified from overproducing clones of the SLT-I B cistron. Biochem J. 1990 Dec 15;272(3):805–811. doi: 10.1042/bj2720805. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ramotar K., Waldhart B., Church D., Szumski R., Louie T. J. Direct detection of verotoxin-producing Escherichia coli in stool samples by PCR. J Clin Microbiol. 1995 Mar;33(3):519–524. doi: 10.1128/jcm.33.3.519-524.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ratnam S., March S. B. Sporadic occurrence of hemorrhagic colitis associated with Escherichia coli O157:H7 in Newfoundland. CMAJ. 1986 Jan 1;134(1):43-5, 49. [PMC free article] [PubMed] [Google Scholar]
- Remis R. S., MacDonald K. L., Riley L. W., Puhr N. D., Wells J. G., Davis B. R., Blake P. A., Cohen M. L. Sporadic cases of hemorrhagic colitis associated with Escherichia coli O157:H7. Ann Intern Med. 1984 Nov;101(5):624–626. doi: 10.7326/0003-4819-101-5-624. [DOI] [PubMed] [Google Scholar]
- Rowe P. C., Orrbine E., Wells G. A., McLaine P. N. Epidemiology of hemolytic-uremic syndrome in Canadian children from 1986 to 1988. The Canadian Pediatric Kidney Disease Reference Centre. J Pediatr. 1991 Aug;119(2):218–224. doi: 10.1016/s0022-3476(05)80730-9. [DOI] [PubMed] [Google Scholar]
- Samadpour M., Liston J., Ongerth J. E., Tarr P. I. Evaluation of DNA probes for detection of Shiga-like-toxin-producing Escherichia coli in food and calf fecal samples. Appl Environ Microbiol. 1990 May;56(5):1212–1215. doi: 10.1128/aem.56.5.1212-1215.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scotland S. M., Rowe B., Smith H. R., Willshaw G. A., Gross R. J. Vero cytotoxin-producing strains of Escherichia coli from children with haemolytic uraemic syndrome and their detection by specific DNA probes. J Med Microbiol. 1988 Apr;25(4):237–243. doi: 10.1099/00222615-25-4-237. [DOI] [PubMed] [Google Scholar]
- Seriwatana J., Brown J. E., Echeverria P., Taylor D. N., Suthienkul O., Newland J. DNA probes to identify Shiga-like toxin I- and II-producing enteric bacterial pathogens isolated from patients with diarrhea in Thailand. J Clin Microbiol. 1988 Aug;26(8):1614–1615. doi: 10.1128/jcm.26.8.1614-1615.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strockbine N. A., Marques L. R., Holmes R. K., O'Brien A. D. Characterization of monoclonal antibodies against Shiga-like toxin from Escherichia coli. Infect Immun. 1985 Dec;50(3):695–700. doi: 10.1128/iai.50.3.695-700.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tzipori S., Gibson R., Montanaro J. Nature and distribution of mucosal lesions associated with enteropathogenic and enterohemorrhagic Escherichia coli in piglets and the role of plasmid-mediated factors. Infect Immun. 1989 Apr;57(4):1142–1150. doi: 10.1128/iai.57.4.1142-1150.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tzipori S., Wachsmuth K. I., Smithers J., Jackson C. Studies in gnotobiotic piglets on non-O157:H7 Escherichia coli serotypes isolated from patients with hemorrhagic colitis. Gastroenterology. 1988 Mar;94(3):590–597. doi: 10.1016/0016-5085(88)90228-4. [DOI] [PubMed] [Google Scholar]
- Waters J. R. Enterohemorrhagic Escherichia coli and hemolytic uremic syndrome--the Alberta experience. Can Dis Wkly Rep. 1989 Jan 14;15(2):9–12. [PubMed] [Google Scholar]
- Wells J. G., Davis B. R., Wachsmuth I. K., Riley L. W., Remis R. S., Sokolow R., Morris G. K. Laboratory investigation of hemorrhagic colitis outbreaks associated with a rare Escherichia coli serotype. J Clin Microbiol. 1983 Sep;18(3):512–520. doi: 10.1128/jcm.18.3.512-520.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]