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Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1994 Apr;32(4):955–959. doi: 10.1128/jcm.32.4.955-959.1994

Serodiagnosis by passive hemagglutination test and verotoxin enzyme-linked immunosorbent assay of toxin-producing Escherichia coli infections in patients with hemolytic-uremic syndrome.

S Yamada 1, A Kai 1, Y Kudoh 1
PMCID: PMC267161  PMID: 8027349

Abstract

Eight cases of hemolytic-uremic syndrome in which no pathogens were isolated were diagnosed serologically by a passive hemagglutination assay and a verotoxin (VT; Shiga-like toxin) enzyme-linked immunosorbent assay (ELISA). The passive hemagglutination assay employed formalinized sheep erythrocytes sensitized with soluble native antigen or heat-treated antigen (lipopolysaccharide [LPS]) from Escherichia coli O26, O111, O128, and O157 or flagellar antigen of nine different H serogroups of E. coli: H2, H7, H8, H10, H11, H12, H18, H19, and H25. All patients had antibodies against the native antigen and/or the LPS of E. coli O157, but positive agglutination with H7 was observed only in one patient. In the VT-ELISA with plates coated with purified VT 1 or VT 2, antibody against VT 2 was observed in the sera of five of six patients examined, but none of the patients possessed VT 1 antibody. These results indicate that the causative pathogen in these eight hemolytic-uremic syndrome cases is likely to be VT-producing E. coli O157. The passive hemagglutination assay described here is a very sensitive, simple, and rapid method. This assay is highly recommended for the serological diagnosis of VT-producing E. coli infections, particularly in patients infected by serogroup O157 strains. Furthermore, the VT-ELISA is useful in studying the role of VT in hemolytic-uremic syndrome.

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Selected References

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  1. Bitzan M., Karch H. Indirect hemagglutination assay for diagnosis of Escherichia coli O157 infection in patients with hemolytic-uremic syndrome. J Clin Microbiol. 1992 May;30(5):1174–1178. doi: 10.1128/jcm.30.5.1174-1178.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bitzan M., Klemt M., Steffens R., Müller-Wiefel D. E. Differences in verotoxin neutralizing activity of therapeutic immunoglobulins and sera from healthy controls. Infection. 1993 May-Jun;21(3):140–145. doi: 10.1007/BF01710530. [DOI] [PubMed] [Google Scholar]
  3. Chart H., Scotland S. M., Rowe B. Serum antibodies to Escherichia coli serotype O157:H7 in patients with hemolytic uremic syndrome. J Clin Microbiol. 1989 Feb;27(2):285–290. doi: 10.1128/jcm.27.2.285-290.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chart H., Smith H. R., Scotland S. M., Rowe B., Milford D. V., Taylor C. M. Serological identification of Escherichia coli O157:H7 infection in haemolytic uraemic syndrome. Lancet. 1991 Jan 19;337(8734):138–140. doi: 10.1016/0140-6736(91)90801-u. [DOI] [PubMed] [Google Scholar]
  5. DAVIS B. J. DISC ELECTROPHORESIS. II. METHOD AND APPLICATION TO HUMAN SERUM PROTEINS. Ann N Y Acad Sci. 1964 Dec 28;121:404–427. doi: 10.1111/j.1749-6632.1964.tb14213.x. [DOI] [PubMed] [Google Scholar]
  6. DEUTSCH H. F., MORTON J. I. Dissociation of human serum macroglobulins. Science. 1957 Mar 29;125(3248):600–601. doi: 10.1126/science.125.3248.600. [DOI] [PubMed] [Google Scholar]
  7. Ibrahim G. F., Fleet G. H., Lyons M. J., Walker R. A. Method for the isolation of highly purified Salmonella flagellins. J Clin Microbiol. 1985 Dec;22(6):1040–1044. doi: 10.1128/jcm.22.6.1040-1044.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. 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]
  9. 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]
  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., 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]
  12. Levin M., Walters M. D., Barratt T. M. Hemolytic uremic syndrome. Adv Pediatr Infect Dis. 1989;4:51–81. [PubMed] [Google Scholar]
  13. Lingwood C. A., Law H., Richardson S., Petric M., Brunton J. L., De Grandis S., Karmali M. Glycolipid binding of purified and recombinant Escherichia coli produced verotoxin in vitro. J Biol Chem. 1987 Jun 25;262(18):8834–8839. [PubMed] [Google Scholar]
  14. Milford D. V., Taylor C. M., Guttridge B., Hall S. M., Rowe B., Kleanthous H. Haemolytic uraemic syndromes in the British Isles 1985-8: association with verocytotoxin producing Escherichia coli. Part 1: Clinical and epidemiological aspects. Arch Dis Child. 1990 Jul;65(7):716–721. doi: 10.1136/adc.65.7.716. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Noda M., Yutsudo T., Nakabayashi N., Hirayama T., Takeda Y. Purification and some properties of Shiga-like toxin from Escherichia coli O157:H7 that is immunologically identical to Shiga toxin. Microb Pathog. 1987 May;2(5):339–349. doi: 10.1016/0882-4010(87)90076-3. [DOI] [PubMed] [Google Scholar]
  16. Riley L. W. The epidemiologic, clinical, and microbiologic features of hemorrhagic colitis. Annu Rev Microbiol. 1987;41:383–407. doi: 10.1146/annurev.mi.41.100187.002123. [DOI] [PubMed] [Google Scholar]
  17. 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]
  18. Stuart F. A., Corbel M. J. Identification of a serological cross-reaction between Brucella abortus and Escherichia coli 0:157. Vet Rec. 1982 Feb 27;110(9):202–203. doi: 10.1136/vr.110.9.202-a. [DOI] [PubMed] [Google Scholar]
  19. Thomas L. V., Gross R. J., Cheasty T., Shipp C. R., Rowe B. Antigenic relationships among type strains of Yersinia enterocolitica and those of Escherichia coli, Salmonella spp., and Shigella spp. J Clin Microbiol. 1983 Jan;17(1):109–111. doi: 10.1128/jcm.17.1.109-111.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Yamada S., Matsushita S., Kai A., Sasaki M., Tsuji A., Kanemitsu T., Yamashita N., Anzai E., Kudoh Y. Detection of verocytotoxin from stool and serological testing of patients with diarrhea caused by Escherichia coli O157 : H7. Microbiol Immunol. 1993;37(2):111–118. doi: 10.1111/j.1348-0421.1993.tb03187.x. [DOI] [PubMed] [Google Scholar]
  21. Yutsudo T., Honda T., Miwatani T., Takeda Y. Characterization of purified Shiga toxin from Shigella dysenteriae 1. Microbiol Immunol. 1986;30(11):1115–1127. doi: 10.1111/j.1348-0421.1986.tb03041.x. [DOI] [PubMed] [Google Scholar]

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