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. 1983 Sep;18(3):512–520. doi: 10.1128/jcm.18.3.512-520.1983

Laboratory investigation of hemorrhagic colitis outbreaks associated with a rare Escherichia coli serotype.

J G Wells, B R Davis, I K Wachsmuth, L W Riley, R S Remis, R Sokolow, G K Morris
PMCID: PMC270845  PMID: 6355145

Abstract

Two outbreaks of hemorrhagic colitis, a newly recognized syndrome characterized by bloody diarrhea, severe abdominal pain, and little or no fever, occurred in 1982. No previously recognized pathogens were recovered from stool specimens from persons in either outbreak. However, a rare E. coli serotype, O157:H7, was isolated from 9 of 20 cases and from no controls. It was also recovered from a meat patty from the implicated lot eaten by persons in one outbreak. No recovery of this organism was made from stools collected 7 or more days after onset of illness; whereas 9 of 12 culture-positive stools had been collected within 4 days of onset of illness. The isolate was not invasive or toxigenic by standard tests, and all strains has a unique biotype. Plasmid profile analysis indicates that all outbreak-associated E. coli O157:H7 isolates are closely related. These results suggest that E. coli O157:H7 was the causative agent of illness in the two outbreaks.

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Selected References

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  1. Birnboim H. C., Doly J. A rapid alkaline extraction procedure for screening recombinant plasmid DNA. Nucleic Acids Res. 1979 Nov 24;7(6):1513–1523. doi: 10.1093/nar/7.6.1513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Blaser M. J., Berkowitz I. D., LaForce F. M., Cravens J., Reller L. B., Wang W. L. Campylobacter enteritis: clinical and epidemiologic features. Ann Intern Med. 1979 Aug;91(2):179–185. doi: 10.7326/0003-4819-91-2-179. [DOI] [PubMed] [Google Scholar]
  3. Dean A. G., Ching Y. C., Williams R. G., Harden L. B. Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhea in children in Honolulu. J Infect Dis. 1972 Apr;125(4):407–411. doi: 10.1093/infdis/125.4.407. [DOI] [PubMed] [Google Scholar]
  4. Evans D. G., Evans D. J., Jr New surface-associated heat-labile colonization factor antigen (CFA/II) produced by enterotoxigenic Escherichia coli of serogroups O6 and O8. Infect Immun. 1978 Aug;21(2):638–647. doi: 10.1128/iai.21.2.638-647.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Farmer J. J., 3rd, Potter M. E., Riley L. W., Barrett T. J., Blake P. A., Bopp C. A., Cohen M. L., Kaufmann A., Morris G. K., Remis R. S. Animal models to study Escherichia coli O157:H7 isolated from patients with haemorrhagic colitis. Lancet. 1983 Mar 26;1(8326 Pt 1):702–703. doi: 10.1016/s0140-6736(83)91988-8. [DOI] [PubMed] [Google Scholar]
  6. Harris J. R., Wachsmuth I. K., Davis B. R., Cohen M. L. High-molecular-weight plasmid correlates with Escherichia coli enteroinvasiveness. Infect Immun. 1982 Sep;37(3):1295–1298. doi: 10.1128/iai.37.3.1295-1298.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hickman F. W., Farmer J. J., 3rd Salmonella typhi: identification, antibiograms, serology, and bacteriophage typing. Am J Med Technol. 1978 Dec;44(12):1149–1159. [PubMed] [Google Scholar]
  8. Jarvis W., Nunez-Montiel O., Thompson F., Dowell V., Towns M., Morris G., Hill E. Comparison of bacterial isolation, cytotoxicity assay, and counterimmunoelectrophoresis for the detection of Clostridium difficile and its toxin. J Infect Dis. 1983 Apr;147(4):778–778. doi: 10.1093/infdis/147.4.778. [DOI] [PubMed] [Google Scholar]
  9. Labrec E. H., Schneider H., Magnani T. J., Formal S. B. EPITHELIAL CELL PENETRATION AS AN ESSENTIAL STEP IN THE PATHOGENESIS OF BACILLARY DYSENTERY. J Bacteriol. 1964 Nov;88(5):1503–1518. doi: 10.1128/jb.88.5.1503-1518.1964. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Levine M. M., Bergquist E. J., Nalin D. R., Waterman D. H., Hornick R. B., Young C. R., Sotman S. Escherichia coli strains that cause diarrhoea but do not produce heat-labile or heat-stable enterotoxins and are non-invasive. Lancet. 1978 May 27;1(8074):1119–1122. doi: 10.1016/s0140-6736(78)90299-4. [DOI] [PubMed] [Google Scholar]
  11. Macrina F. L., Kopecko D. J., Jones K. R., Ayers D. J., McCowen S. M. A multiple plasmid-containing Escherichia coli strain: convenient source of size reference plasmid molecules. Plasmid. 1978 Jun;1(3):417–420. doi: 10.1016/0147-619x(78)90056-2. [DOI] [PubMed] [Google Scholar]
  12. Malathi P., Preiser H., Fairclough P., Mallett P., Crane R. K. A rapid method for the isolation of kidney brush border membranes. Biochim Biophys Acta. 1979 Jun 13;554(1):259–263. doi: 10.1016/0005-2736(79)90023-3. [DOI] [PubMed] [Google Scholar]
  13. Meyers J. A., Sanchez D., Elwell L. P., Falkow S. Simple agarose gel electrophoretic method for the identification and characterization of plasmid deoxyribonucleic acid. J Bacteriol. 1976 Sep;127(3):1529–1537. doi: 10.1128/jb.127.3.1529-1537.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Morris G. K., Merson M. H., Sack D. A., Wells J. G., Martin W. T., Dewitt W. E., Feeley J. C., Sack R. B., Bessudo D. M. Laboratory investigation of diarrhea in travelers to Mexico: evaluation of methods for detecting enterotoxigenic Echerichia coli. J Clin Microbiol. 1976 May;3(5):486–495. doi: 10.1128/jcm.3.5.486-495.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Moseley S. L., Echeverria P., Seriwatana J., Tirapat C., Chaicumpa W., Sakuldaipeara T., Falkow S. Identification of enterotoxigenic Escherichia coli by colony hybridization using three enterotoxin gene probes. J Infect Dis. 1982 Jun;145(6):863–869. doi: 10.1093/infdis/145.6.863. [DOI] [PubMed] [Google Scholar]
  16. Riley L. W., Remis R. S., Helgerson S. D., McGee H. B., Wells J. G., Davis B. R., Hebert R. J., Olcott E. S., Johnson L. M., Hargrett N. T. Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med. 1983 Mar 24;308(12):681–685. doi: 10.1056/NEJM198303243081203. [DOI] [PubMed] [Google Scholar]
  17. SERENY B. Experimental shigella keratoconjunctivitis; a preliminary report. Acta Microbiol Acad Sci Hung. 1955;2(3):293–296. [PubMed] [Google Scholar]
  18. Sack D. A., Sack R. B. Test for enterotoxigenic Escherichia coli using Y-1 adrenal cells in miniculture. Infect Immun. 1975 Feb;11(2):334–336. doi: 10.1128/iai.11.2.334-336.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sakurai Y., Tsuchiya H., Ikegami F., Funatomi T., Takasu S., Uchikoshi T. Acute right-sided hemorrhagic colitis associated with oral administration of ampicillin. Dig Dis Sci. 1979 Dec;24(12):910–915. doi: 10.1007/BF01311944. [DOI] [PubMed] [Google Scholar]
  20. Schroeder S. A., Caldwell J. R., Vernon T. M., White P. C., Granger S. I., Bennett J. V. A waterborne outbreak of gastroenteritis in adults associated with Escherichia coli. Lancet. 1968 Apr 6;1(7545):737–740. doi: 10.1016/s0140-6736(68)92181-8. [DOI] [PubMed] [Google Scholar]
  21. Skirrow M. B. Campylobacter enteritis: a "new" disease. Br Med J. 1977 Jul 2;2(6078):9–11. doi: 10.1136/bmj.2.6078.9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Toffler R. B., Pingoud E. G., Burrell M. I. Acute colitis related to penicillin and penicillin derivatives. Lancet. 1978 Sep 30;2(8092 Pt 1):707–709. doi: 10.1016/s0140-6736(78)92704-6. [DOI] [PubMed] [Google Scholar]
  23. Totani T. [Acute hemorrhagic enteritis with Klebsiella oxytoca]. Nihon Rinsho. 1978 May;Suppl:1308–1309. [PubMed] [Google Scholar]
  24. Yolken R. H., Greenberg H. B., Merson M. H., Sack R. B., Kapikian A. Z. Enzyme-linked immunosorbent assay for detection of Escherichia coli heat-labile enterotoxin. J Clin Microbiol. 1977 Nov;6(5):439–444. doi: 10.1128/jcm.6.5.439-444.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]

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