No abstract available.
Enterohemorrhagic Escherichia coli*

Enterohemorrhagic Escherichia coli ; Escherichia coli Infections ; epidemiology ; Germany ; epidemiology ; Humans

No Abstract Available.
Anti-Infective Agents* ; Enterohemorrhagic Escherichia coli* ; Quinolones* ; Shiga Toxins*

Attaching and effacing Escherichia coli (AEEC) cause enteric infections in humans and animals. Attaching indicates the intimate attachment of bacteria to the enterocyte, and effacing relates to the localized effacement of brush border microvilli. Enteropathogenic (EPEC) and enterohemorrhagic Escherichia coli (EHEC) infections are characterized by the formation of attaching and effacing (AE) lesion on the intestinal epithelial cells. Therefore, they are often grouped together as AEEC. Development of multiplex PCR allowed us to type five of the most important genes implicated in the formation of the AE lesion. A total of 60 AEEC strains isolated from diarrheal patients were investigated by multiplex PCR for the presence of the insertion site of locus of enterocyte effacement (LEE) and LEE-related (eae, tir, espA, espB, and espD) genes. Associating the results of LEE genes typing in the AEEC strains, three different pathotypes are determined: eae(gamma)-tir(gamma)-espA(gamma)-espB(gamma)-espD(gamma) (O157:H7), eae(beta)-tir(beta)-espA(beta)-espB(beta)-espD(beta) (O26:H11), and eae(alpha)-tir(alpha)-espA(alpha)-espB(alpha)-espD(alpha) (O55:H6). These results indicate that AEEC are a heterogenous groups of organisms.
Animals ; Bacteria ; Enterocytes* ; Enterohemorrhagic Escherichia coli* ; Enteropathogenic Escherichia coli* ; Epithelial Cells ; Escherichia coli ; Humans ; Microvilli ; Multiplex Polymerase Chain Reaction

BACKGROUND: Non-O157 human isolates among enterohemorrhagic Escherichia coli (EHEC) serogroup have been reported with increasing frequency in recent years; the serotype O26 is the most common among the non-O157 isolates. We performed serotyping of E. coli isolates with O157, O26, and O111 antisera at Ulsan University Hospital and identified 27 isolates of O26. The purpose of this study was to investigate the clinical significance of E. coli O26 isolates. METHODS: During the 24-month period from January 2002 to December 2003, E. coli isolates were serotyped when requested by the physician because of bloody diarrhea or when blood was noted in the stool specimen at the laboratory. The isolates were identified biochemically by Vitek 1 (BioMerieux Vitek Inc., Mo., USA) and serotyped using diagnostic antisera of O157, O26, and O111 (NIH, Korea). When a positive agglutination reaction was shown, the patient's was reviewed retrospectively. RESULTS: Of 4,921 isolates of E. coli during the 2-year period, 200 isolates were serotyped and 27 (13.5%) were identified as serotype O26. These were isolated from stool (13 isolates), urine (9), pus (1), blood (1), and bile (1). Among the 13 patients whose stool specimens grew E. coli O26, 12 had watery diarrhea and 7 bloody diarrhea; two patients had thrombocytopenia and purpura simultaneously. Two patients with watey diarrhea, two with bloody diarrhea, and one with TTP were among the 7 patients with E. coli O26 in the urine. Finally, one patient each with blood isolate and bile isolate of E. coli O26 both had acute gastroenteritis. CONCLUSIONS: Most of the patients infected with E. coli O26 had clinical manifestations consistent with EHEC infections. E. coli isolates from patients with boody diarrhea should be serotyped with O157 and O26 antisera.
Agglutination ; Bile ; Diarrhea ; Enterohemorrhagic Escherichia coli ; Escherichia coli* ; Escherichia* ; Gastroenteritis ; Humans ; Immune Sera ; Purpura ; Retrospective Studies ; Serotyping ; Suppuration ; Thrombocytopenia ; Ulsan

BACKGROUND: Since 1982, many countries has reported outbreaks or sporadic cases caused by enterohaemorrhagic Escherichia coli (EHEC) serogroup strains, mainly E. coli O157:H7 type strain. However, systemic investigation about EHEC agents, including E. coli O157:H7, have not been done in Korea. Therefore, we investigated serogroup and verotoxin productivity of E. coli strains isolated from diarrheal patients and estimated risk of human infection in comparison with the EHEC strains isolated from cow, pig, and food material in Korea. METHODS: Diarrheal patient stool samples were collected and E. coli strains were isolated, according to biochemical characteristics. In order to isolate E. coli O157:H7, D-Sorbitol negative E. coli strains were selected. Serogrouping of the E. coli isolates was done by agglutination test. Verocytotoxin productivity was investigated by polymerase chain reaction (PCR) and reversed passive latex agglutination (RPLA). Human infection risk was estimated in comparison with EHEC strains isolated from cow, pig and food materials in Korea. RESULTS: Twenty-five E. coli strains were isolated from the diarrheal patients who were suspected to be infected with EHEC. However, none of these E. coli strains produced verocytotoxin. Out of 25 E. coli isolates, 16 serogroups of E. coli O1, O6, O8, O15, O20, O25, O26, O28, O29, O44, O86a, O119, O126, O128, O152 and 157:H- were found. In each of the E. coli O157:H- and O25 serogrorps 3 strains were found. CONCLUSION: None of 25 E. coli isolated from diarrheal patients who were suspected of EHEC infection produced verocytotoxin producing E. coli have been reported recently in Korea.
Agglutination ; Agglutination Tests ; Disease Outbreaks ; Efficiency* ; Enterohemorrhagic Escherichia coli ; Escherichia coli* ; Escherichia* ; Humans ; Korea* ; Latex ; Polymerase Chain Reaction ; Shiga Toxins

Escherichia coli O157 is an important serotype of enterohemorrhagic E. coli that causes hemorrhagic colitis worldwide. Outbreaks of E. coli O157 have been assocoated with contaminated food like meat, raw milk, and water, but recently vegetables and fruits have accounted for a growing number of recognized outbreaks. We isolated verotoxin producing E. coli O157 from the stool of a 3 year-old female with bloody diarrhea and abdominal pain. The child had been eating salad with vegetables and fruits frequently.
Abdominal Pain ; Child ; Colitis ; Diarrhea ; Disease Outbreaks ; Eating ; Enterohemorrhagic Escherichia coli ; Escherichia ; Escherichia coli ; Escherichia coli O157 ; Female ; Fruit ; Humans ; Meat ; Milk ; Shiga Toxins ; Vegetables

This report summarizes recent food-borne disease outbreaks in Korea by month, pathogen, dining place, and scale. In particular, imported cases are described separately. Sources of information include surveillance and statistic data and reports of KCDC/MOHW and KFDA, and scientific journals from home and abroad. Investigation results indicate that reports of food-borne disease cases and imported cases are increasing continuously in Korea. Many cases still occur in May and June, and new cases increasingly occur in December. Other new characteristic of the recent outbreaks is that they are increasingly attributable to pathogens such as Norovirus and EHEC. Outbreaks at mass meal preparation facilities represent a large proportion of cases, mainly due to the increase in the possibilities for common exposure, pathogen mobility, meat consumption, and the detection itself. To address this health problem, water and sewer service must be widely provided, food materials must be handled thoroughly, and good personal hygiene including proper hand washing must be further underscored. As a responsible agency, KCDC will also need to conduct thorough epidemiological investigations, establish an efficient surveillance system, work in a prompt manner, and enhance partnerships with various agencies.
Disease Outbreaks* ; Enterohemorrhagic Escherichia coli ; Foodborne Diseases* ; Hand Disinfection ; Humans ; Hygiene ; Korea* ; Meals ; Meat ; Norovirus ; Water

BACKGROUND: No outbreak of Enterohemorrhagic Escherichia coli (EHEC) infection has occurred as a group in Korea. On July 2004, an outbreak of EHEC infection occurred in an elementary school in Gwangju metropolitan city. Epidemic investigation was undertaken to track the source of infection and the mode of transmission of EHEC. METHODS: All students and staffs of the elementary school were interviewed and completed questionnaires. We surveyed their clinical symptoms and the foods that they ate. Microbiologic examinations were also carried out on the above school-related persons and many environmental specimens. We also investigated the facilities of the school, some suppliers of food materials, and other associated institutions. All the EHEC-positive persons were isolated in 5 hospitals and tested everyday for verotoxin until they turned out to be negative twice in succession, and their family were also interviewed and tested for EHEC. Pulsed-field gel electrophoresis (PFGE) was performed to find out the genetic relationship between isolates. RESULTS: Of the 1,643 school-related persons, 77 persons (4.7%) were positive for EHEC. Most of them were asymptomatic. All the isolated strains were non-O157 EHEC. Serotype O91 was the most frequent serotype (68 isolates), and the isolates revealing O91 serotypes showed identical PFGE patterns. The school meal was significantly associated with this outbreak (relative risk=13.29, p=0.00). CONCLUSIONS: This is the first EHEC outbreak occurred as a group in Korea, All the isolated strains were non-O157 serotypes and the mode of transmission was most likely by school meal.
Electrophoresis, Gel, Pulsed-Field ; Enterohemorrhagic Escherichia coli* ; Gwangju ; Humans ; Korea ; Meals ; Shiga Toxins ; Surveys and Questionnaires

OBJECTIVES: Cattle slaughterhouse workers are known as the high risk group for the zoonoses. We surveyed the awareness of zoonoses among cattle slaughterhouse workers to suggest direction of education and public relations. METHODS: We evaluated the epidemiological characteristics of zoonoses and the process of cattle slaughtering. We designed different questionnaires for the workers involved in slaughtering, the handlers of residual products, the inspectors and their assistants, and the grading testers and their assistants respectively. We visited 73 cattle slaughterhouses and 62 residual products handle houses across the country and conducted a questionnaire survey of the general characteristics and the awareness of zoonoses. The data collected was evaluated using the SPSS 17.0 statistical package. RESULTS: The awareness rate of brucellosis, Q fever and Enterohemorrhagic Escherichia coli (EHEC) were 83.9%, 18.5%, 62.7% among cattle slaughterhouse workers. The awareness rate of zoonoses among the workers involved in slaughtering and the handlers of residual products was lower than other workers. The awareness rate of zoonoses tended to increase as the school career. In the correct awareness rate of the transmission of zoonoses, 'transmission by tick bite', 'person to person' and 'air transmission' were lower than other transmission items. The most common reason why cattle slaughterhouse workers think that it is difficult to prevent zoonoses was the ignorance of how to prevent. CONCLUSIONS: An educational program is needed for the cattle slaughterhouse workers on zoonoses especially Q fever. And publicity activities about prevention of infection are needed for high risk groups.
Abattoirs ; Animals ; Brucellosis ; Cattle ; Enterohemorrhagic Escherichia coli ; Humans ; Korea ; Q Fever ; Ticks ; Zoonoses ; Surveys and Questionnaires