Abstract
Two Escherichia coli O-rough:K1:H7 strains producing verotoxin 1 that were isolated from stool samples of two travelers with diarrhea who consulted our clinic after trips to the Indian Subcontinent and Central America were characterized. Both strains were sorbitol negative, the same phenotype presented by E. coli O157:H7, but in contrast they were beta-glucuronidase positive. Low-frequency restriction analysis of chromosomal DNA and pulsed-field gel electrophoresis and repetitive extragenic palindrome-PCR showed that both strains were epidemiologically related. The illness was self-limited in both cases but involved long-duration, watery diarrhea (10 to 50 days) accompanied by abdominal cramps and flatulence. This serotype should be taken into account as a possible cause of traveler's diarrhea.
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- Bokete T. N., O'Callahan C. M., Clausen C. R., Tang N. M., Tran N., Moseley S. L., Fritsche T. R., Tarr P. I. Shiga-like toxin-producing Escherichia coli in Seattle children: a prospective study. Gastroenterology. 1993 Dec;105(6):1724–1731. doi: 10.1016/0016-5085(93)91069-t. [DOI] [PubMed] [Google Scholar]
- Burnens A. P., Boss P., Orskov F., Orskov I., Schaad U. B., Müller F., Heinzle R., Nicolet J. Occurrence and phenotypic properties of verotoxin producing Escherichia coli in sporadic cases of gastroenteritis. Eur J Clin Microbiol Infect Dis. 1992 Jul;11(7):631–634. doi: 10.1007/BF01961673. [DOI] [PubMed] [Google Scholar]
- Butler T., Islam M. R., Azad M. A., Jones P. K. Risk factors for development of hemolytic uremic syndrome during shigellosis. J Pediatr. 1987 Jun;110(6):894–897. doi: 10.1016/s0022-3476(87)80405-5. [DOI] [PubMed] [Google Scholar]
- Caprioli A., Luzzi I., Rosmini F., Resti C., Edefonti A., Perfumo F., Farina C., Goglio A., Gianviti A., Rizzoni G. Community-wide outbreak of hemolytic-uremic syndrome associated with non-O157 verocytotoxin-producing Escherichia coli. J Infect Dis. 1994 Jan;169(1):208–211. doi: 10.1093/infdis/169.1.208. [DOI] [PubMed] [Google Scholar]
- Cavalieri S. J., Bohach G. A., Snyder I. S. Escherichia coli alpha-hemolysin: characteristics and probable role in pathogenicity. Microbiol Rev. 1984 Dec;48(4):326–343. doi: 10.1128/mr.48.4.326-343.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chapman P. A., Siddons C. A., Zadik P. M., Jewes L. An improved selective medium for the isolation of Escherichia coli O157. J Med Microbiol. 1991 Aug;35(2):107–110. doi: 10.1099/00222615-35-2-107. [DOI] [PubMed] [Google Scholar]
- Gascon J., Vila J., Valls M. E., Ruiz L., Vidal J., Corachán M., Prats G., Jimenez de Anta M. T. Etiology of traveller's diarrhea in Spanish travellers to developing countries. Eur J Epidemiol. 1993 Mar;9(2):217–223. doi: 10.1007/BF00158796. [DOI] [PubMed] [Google Scholar]
- Gascón J., Ruiz L., Canela J., Mallart M., Corachán M. Epidemiología de la diarrea del viajero en turistas españoles a países en desarrollo. Med Clin (Barc) 1993 Mar 13;100(10):365–367. [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]
- Jackson M. P., Newland J. W., Holmes R. K., O'Brien A. D. Nucleotide sequence analysis of the structural genes for Shiga-like toxin I encoded by bacteriophage 933J from Escherichia coli. Microb Pathog. 1987 Feb;2(2):147–153. doi: 10.1016/0882-4010(87)90106-9. [DOI] [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]
- Kleanthous H., Smith H. R., Scotland S. M., Gross R. J., Rowe B., Taylor C. M., Milford D. V. Haemolytic uraemic syndromes in the British Isles, 1985-8: association with verocytotoxin producing Escherichia coli. Part 2: Microbiological aspects. Arch Dis Child. 1990 Jul;65(7):722–727. doi: 10.1136/adc.65.7.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levine M. M., Xu J. G., Kaper J. B., Lior H., Prado V., Tall B., Nataro J., Karch H., Wachsmuth K. A DNA probe to identify enterohemorrhagic Escherichia coli of O157:H7 and other serotypes that cause hemorrhagic colitis and hemolytic uremic syndrome. J Infect Dis. 1987 Jul;156(1):175–182. doi: 10.1093/infdis/156.1.175. [DOI] [PubMed] [Google Scholar]
- López E. L., Contrini M. M., Devoto S., de Rosa M. F., Graña M. G., Aversa L., Gómez H. F., Genero M. H., Cleary T. G. Incomplete hemolytic-uremic syndrome in Argentinean children with bloody diarrhea. J Pediatr. 1995 Sep;127(3):364–367. doi: 10.1016/s0022-3476(95)70064-1. [DOI] [PubMed] [Google Scholar]
- March S. B., Ratnam S. Sorbitol-MacConkey medium for detection of Escherichia coli O157:H7 associated with hemorrhagic colitis. J Clin Microbiol. 1986 May;23(5):869–872. doi: 10.1128/jcm.23.5.869-872.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marcos M. A., Jimenez de Anta M. T., Vila J. Correlation of six methods for typing nosocomial isolates of Acinetobacter baumannii. J Med Microbiol. 1995 May;42(5):328–335. doi: 10.1099/00222615-42-5-328. [DOI] [PubMed] [Google Scholar]
- Martin D. L., MacDonald K. L., White K. E., Soler J. T., Osterholm M. T. The epidemiology and clinical aspects of the hemolytic uremic syndrome in Minnesota. N Engl J Med. 1990 Oct 25;323(17):1161–1167. doi: 10.1056/NEJM199010253231703. [DOI] [PubMed] [Google Scholar]
- Matushek M. G., Bonten M. J., Hayden M. K. Rapid preparation of bacterial DNA for pulsed-field gel electrophoresis. J Clin Microbiol. 1996 Oct;34(10):2598–2600. doi: 10.1128/jcm.34.10.2598-2600.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Orskov F. Virulence factors of the bacterial cell surface. J Infect Dis. 1978 May;137(5):630–633. doi: 10.1093/infdis/137.5.630. [DOI] [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]
- 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]
- Ratnam S., March S. B., Ahmed R., Bezanson G. S., Kasatiya S. Characterization of Escherichia coli serotype O157:H7. J Clin Microbiol. 1988 Oct;26(10):2006–2012. doi: 10.1128/jcm.26.10.2006-2012.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vila J., Gascon J., Abdalla S., Gomez J., Marco F., Moreno A., Corachan M., Jimenez de Anta T. Antimicrobial resistance of Shigella isolates causing traveler's diarrhea. Antimicrob Agents Chemother. 1994 Nov;38(11):2668–2670. doi: 10.1128/aac.38.11.2668. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Walterspiel J. N., Ashkenazi S., Morrow A. L., Cleary T. G. Effect of subinhibitory concentrations of antibiotics on extracellular Shiga-like toxin I. Infection. 1992 Jan-Feb;20(1):25–29. doi: 10.1007/BF01704889. [DOI] [PubMed] [Google Scholar]
