A Case of Verotoxin-producing Escherichia coli O157:H7 with Hemorrhagic Colitis in an Infant, Diagnosed by Multiplex PCR.
10.5145/KJCM.2010.13.2.85
- Author:
Hae Sun CHO
1
;
Min Chul CHO
;
Shinae NOH
;
Mi Na KIM
;
Kyoung Mo KIM
Author Information
1. Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. mnkim@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Eshcherichia coli O157:H7;
Enterohemorrhagic Eshcherichia coli;
Verotoxin;
Multiplex PCR
- MeSH:
Agar;
Brassica;
Caseins;
Cephalosporins;
Child;
Colitis;
Daucus carota;
Diarrhea;
Enterohemorrhagic Escherichia coli;
European Continental Ancestry Group;
Hospitalization;
Humans;
Immunoenzyme Techniques;
Infant;
Meat;
Mitomycin;
Multiplex Polymerase Chain Reaction;
Parents;
Protein Hydrolysates;
Shiga Toxins;
Shiga-Toxigenic Escherichia coli;
Siblings
- From:Korean Journal of Clinical Microbiology
2010;13(2):85-89
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Enterohemorrhagic Escherichia coli (EHEC) is an important cause of bloody diarrhea in children, but is considered to be rare in infants. Herein, a case of infant hemorrhagic colitis of verotoxin-producing E. coli O157:H7 diagnosed by multiplex PCR is reported. A nine-month-old boy was admitted to our hospital with bloody diarrhea for the previous two days. Multiplex PCR using Seeplex(R) Diarrhea ACE Detection Kit (Seegene, Seoul, Korea) was directly applied to the stool specimens. Amplified bands specific for verotoxin, O157, and H7 indicated the presence of O157:H7 EHEC. The stool specimens were inoculated on sorbitol-MacConkey agar (SMA) and tryptic soy broth containing mitomycin C (TSB-M). Colorless colonies on sorbitol-MacConkey agar were O157-positive. TSB-M enrichment cultures of the stool specimen and the isolates were positive for verotoxin according to an enzyme immunoassay (EIA). The prepared ingredients of baby foods for the patient including ground meat, chopped carrot, chopped cabbage, and white rice porridge showed no EHEC on TSB-M and SMA. The patient's parents and three-year-old sister did not recently have any gastrointestinal symptoms. Cefdinir was administered for one day and was ceased after diagnosis of EHEC colitis. The stool culture and verotoxin assay were negative on the second day of hospitalization. Application of multiplex PCR and verotoxin EIA directly to diarrheal stool warrants the rapid diagnosis and appropriate treatment of EHEC colitis.