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. 1992 Jul;30(7):1807–1810. doi: 10.1128/jcm.30.7.1807-1810.1992

Molecular detection of sorbitol-fermenting Escherichia coli O157 in patients with hemolytic-uremic syndrome.

F Gunzer 1, H Böhm 1, H Rüssmann 1, M Bitzan 1, S Aleksic 1, H Karch 1
PMCID: PMC265385  PMID: 1629338

Abstract

Shiga-like toxin-producing Escherichia coli strains of serogroup O157 were identified in 26 of 104 patients with hemolytic-uremic syndrome and in 18 of 668 patients with diarrhea. All strains were identified by colony hybridization with DNA probes complementary to Shiga-like toxin I and Shiga-like toxin II gene sequences and characterized by biochemical tests and serotyping. Seventeen of these 44 patients had E. coli O157 strains which were unusual because they fermented sorbitol within 24 h of incubation and were positive for beta-glucuronidase activity. Culture filtrates of these sorbitol-fermenting strains were highly toxic to Vero cells in culture. Serological tests and DNA analysis performed by restriction endonuclease digestion of B-subunit toxin genes revealed that all 17 isolates produced Shiga-like toxin II. Although by using molecular probes we established a high frequency of sorbitol-fermenting E. coli O157 strains in the patients we examined, further studies on the prevalence of such isolates in other areas of endemic disease are clearly warranted.

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Selected References

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  1. Aleksić S., Karch H., Bockemühl J. A biotyping scheme for Shiga-like (Vero) toxin-producing Escherichia coli O157 and a list of serological cross-reactions between O157 and other gram-negative bacteria. Zentralbl Bakteriol. 1992 Jan;276(2):221–230. doi: 10.1016/s0934-8840(11)80009-5. [DOI] [PubMed] [Google Scholar]
  2. Bitzan M., Moebius E., Ludwig K., Müller-Wiefel D. E., Heesemann J., Karch H. High incidence of serum antibodies to Escherichia coli O157 lipopolysaccharide in children with hemolytic-uremic syndrome. J Pediatr. 1991 Sep;119(3):380–385. doi: 10.1016/s0022-3476(05)82049-9. [DOI] [PubMed] [Google Scholar]
  3. Doyle M. P., Schoeni J. L. Survival and growth characteristics of Escherichia coli associated with hemorrhagic colitis. Appl Environ Microbiol. 1984 Oct;48(4):855–856. doi: 10.1128/aem.48.4.855-856.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. 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]
  5. Haldane D. J., Damm M. A., Anderson J. D. Improved biochemical screening procedure for small clinical laboratories for vero (Shiga-like)-toxin-producing strains of Escherichia coli O157:H7. J Clin Microbiol. 1986 Oct;24(4):652–653. doi: 10.1128/jcm.24.4.652-653.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ito H., Terai A., Kurazono H., Takeda Y., Nishibuchi M. Cloning and nucleotide sequencing of Vero toxin 2 variant genes from Escherichia coli O91:H21 isolated from a patient with the hemolytic uremic syndrome. Microb Pathog. 1990 Jan;8(1):47–60. doi: 10.1016/0882-4010(90)90007-d. [DOI] [PubMed] [Google Scholar]
  7. Karch H., Meyer T. Evaluation of oligonucleotide probes for identification of shiga-like-toxin-producing Escherichia coli. J Clin Microbiol. 1989 Jun;27(6):1180–1186. doi: 10.1128/jcm.27.6.1180-1186.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Karch H., Wiss R., Gloning H., Emmrich P., Aleksić S., Bockemühl J. Hämolytisch-urämisches Syndrom bei Kleinkindern durch Verotoxin-produzierende Escherichia coli. Dtsch Med Wochenschr. 1990 Mar 30;115(13):489–495. doi: 10.1055/s-2008-1065036. [DOI] [PubMed] [Google Scholar]
  9. 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]
  10. Karmali M. A., Steele B. T., Petric M., Lim C. Sporadic cases of haemolytic-uraemic syndrome associated with faecal cytotoxin and cytotoxin-producing Escherichia coli in stools. Lancet. 1983 Mar 19;1(8325):619–620. doi: 10.1016/s0140-6736(83)91795-6. [DOI] [PubMed] [Google Scholar]
  11. 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]
  12. Krishnan C., Fitzgerald V. A., Dakin S. J., Behme R. J. Laboratory investigation of outbreak of hemorrhagic colitis caused by Escherichia coli O157:H7. J Clin Microbiol. 1987 Jun;25(6):1043–1047. doi: 10.1128/jcm.25.6.1043-1047.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. 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]
  14. Meyer T., Karch H., Hacker J., Bocklage H., Heesemann J. Cloning and sequencing of a Shiga-like toxin II-related gene from Escherichia coli O157:H7 strain 7279. Zentralbl Bakteriol. 1992 Jan;276(2):176–188. doi: 10.1016/s0934-8840(11)80004-6. [DOI] [PubMed] [Google Scholar]
  15. 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]
  16. Schmitt C. K., McKee M. L., O'Brien A. D. Two copies of Shiga-like toxin II-related genes common in enterohemorrhagic Escherichia coli strains are responsible for the antigenic heterogeneity of the O157:H- strain E32511. Infect Immun. 1991 Mar;59(3):1065–1073. doi: 10.1128/iai.59.3.1065-1073.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Smith H. W., Green P., Parsell Z. Vero cell toxins in Escherichia coli and related bacteria: transfer by phage and conjugation and toxic action in laboratory animals, chickens and pigs. J Gen Microbiol. 1983 Oct;129(10):3121–3137. doi: 10.1099/00221287-129-10-3121. [DOI] [PubMed] [Google Scholar]
  18. Strockbine N. A., Marques L. R., Newland J. W., Smith H. W., Holmes R. K., O'Brien A. D. Two toxin-converting phages from Escherichia coli O157:H7 strain 933 encode antigenically distinct toxins with similar biologic activities. Infect Immun. 1986 Jul;53(1):135–140. doi: 10.1128/iai.53.1.135-140.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Tyler S. D., Johnson W. M., Lior H., Wang G., Rozee K. R. Identification of verotoxin type 2 variant B subunit genes in Escherichia coli by the polymerase chain reaction and restriction fragment length polymorphism analysis. J Clin Microbiol. 1991 Jul;29(7):1339–1343. doi: 10.1128/jcm.29.7.1339-1343.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]

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