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

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

Verotoxin-producing Escherichia coli O157 is a primary cause of severe and bloody diarrhea. Campylobacter spp. are one of the commonly reported bacterial cause of gastrointestinal infections throughout the world. Only a few cases involving both E. coli O157 and Campylobacter species have been reported. The authors simultaneously isolated verotoxin-producing E. coli O157 and Campylobacter species from the stool of a 3 year-old male with bloody diarrhea, fever and abdominal pain.
Abdominal Pain ; Campylobacter* ; Child, Preschool ; Diarrhea ; Escherichia coli O157* ; Escherichia coli* ; Escherichia* ; Fever ; Gastroenteritis* ; Humans ; Male ; Shiga Toxins ; Shiga-Toxigenic Escherichia coli

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

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.
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

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

Hemolytic uremic syndrome (HUS) is defined by the triad of renal failure, thrombocytopenia and hemolytic anemia. HUS is usually developed by infectious disease in children, but occasionally in adults. Infectious disease associated with HUS is characterized by fever and diarrhea-commonly related with Escherichia coli O157:H7. Verotoxin (Shiga-like toxin) produced by E. coli damage the endothelial cells, promote local thrombosis and finally step to HUS. Other causes of HUS include drugs, pregnancy, organ transplantation and malignant tumor. We report two adult patients cases of HUS associated with infectious diarrhea.
Adult* ; Anemia, Hemolytic ; Child ; Communicable Diseases ; Diarrhea* ; Endothelial Cells ; Escherichia coli ; Fever ; Hemolytic-Uremic Syndrome ; Humans ; Organ Transplantation ; Pregnancy ; Renal Insufficiency ; Shiga Toxins ; Thrombocytopenia ; Thrombosis ; Transplants

OBJECTIVETo explore the etiologic characteristics of bacillary dysentery found in Henan province, between year 2009 and 2010.

METHODSIn order to explore the distribution of bacterial types, drug susceptibility and the virulence gene carrier situation, 482 strains of Shigella isolated in Henan province between 2009 and 2010 were pathogen-detected and analyzed by serotype screening, anti microbial sensitivity test and PCR methods.

RESULTSThe 482 isolated strains were confirmed to be Shigella by both morphological and biochemical tests. The Shigella strains were divided into 13 serotypes in 2 groups, namely Shigella flexneri (B group) accounting for 72.0% (347/482) and Shigella sonnei (D group), accounting for 28.0% (135/482). The detection rate of Serotype F2a, as the dominant type of Shigella flexneri, decreased from 43.4% (106/245) in 2009 to 33.8% (80/237) in 2010; while the detection rate of Shigella sonnei increased from 13.1% (32/245) to 43.5% (103/237) in the same period. The results of microbial sensitivity tests carried out in year 2009 and 2010, both showed that over 98% of the 185 studied strains were resistant to ampicillin (AMP), trimethoprim-pyrimidine (TMP), tetracycline (TE), streptomycin (S) and nalidixic acid (NA).182 strains were recruited in the virulence factors detection, 67.6% (123/182) of which carried Shigella Enterotoxin 1B (set1B), Shigella Enterotoxin 2 (set2), invasive plasmid antigen H (ipaH) or invasion-related virulence factors (ial) and 24.2% (44/182) of which carried 3 virulence factors mentioned above.

CONCLUSIONThe prevalent serotypes of Shigella in Henan province have changed in recent years. The isolated strains showed high resistance to common antibacterial drugs and generally carried virulence factors.

China ; epidemiology ; Dysentery, Bacillary ; epidemiology ; microbiology ; prevention & control ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Population Surveillance ; Prevalence ; Serotyping ; Shiga Toxins ; genetics ; Shigella ; genetics ; isolation & purification

OBJECTIVETo evaluate the etiology of Shiga like toxin producing Escherichia coli (SLTEC) in children with diarrhea.

METHODSWe designed and synthesized 3 pairs of primers located in the SLT1, SLT2, and eaeA genes of enterohaemorrhagic Escherichia coli (EHEC), while the virulent genes SLT1, SLT2, and eaeA from E.coli species were amplified by polymerase chain reaction (PCR).

RESULTSOne strain of EHEC with SLT1, SLT2, and eaeA in 29 reference strains of diarrhea-causing E.coli (DCEC) and 10 strains of other enterobacteria detected by PCR had positive reactions, while all other DCEC and enterobacteria were negative. Of 474 strains of E. coli isolated from 1032 children with diarrhea and detected by PCR, 20 strains of SLT1 producing E. coli (4.2%) positive, and 7 strains of SLT2 producing E. coli (1.5%) positive; while of 74 strains of entero-SLTs-producing and invasive Escherichia coli (ESIEC), 15 strains of SLT1 (20.3%) and 5 strains of SLT2 (6.8%) were positive.

CONCLUSIONShiga-like toxin E. coli has been identified as a major etiologic agent of children with diarrhea in Taiyuan, China.

Child ; Diarrhea ; microbiology ; Escherichia coli ; classification ; isolation & purification ; pathogenicity ; Feces ; microbiology ; Humans ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; Shiga Toxins ; genetics

Enterohemorrhagic Escherichia coli serotype O157:H7 is a pathotype of diarrheagenic E. coli that produces one or more Shiga toxins, forms a characteristic histopathology described as attaching and effacing lesions, and possesses the large virulence plasmid pO157. The bacterium is recognized worldwide, especially in developed countries, as an emerging food-borne bacterial pathogen, which causes disease in humans and in some animals. Healthy cattle are the principal and natural reservoir of E. coli O157:H7, and most disease outbreaks are, therefore, due to consumption of fecally contaminated bovine foods or dairy products. In this review, we provide a general overview of E. coli O157:H7 infection, especially focusing on the bacterial characteristics rather than on the host responses during infection.
Animals ; Cattle ; Cattle Diseases/blood/epidemiology ; Developing Countries ; *Enterohemorrhagic Escherichia coli ; Escherichia coli Infections/blood/*epidemiology/veterinary ; *Escherichia coli O157/genetics/pathogenicity ; Feces/microbiology ; Hemolytic-Uremic Syndrome/blood/epidemiology/veterinary ; Operon ; Shiga Toxins/analysis ; Shigella dysenteriae ; Virulence