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A large outbreak of hemolytic uremic syndrome caused by an unusual sorbitol-fermenting strain of Escherichia coli O157:H-.
J Infect Dis. 1999 May; 179(5):1274-7.JI

Abstract

Escherichia coli O157:H7 does not ferment sorbitol, a factor used to differentiate it from other E. coli. From December 1995 to March 1996, 28 children with hemolytic uremic syndrome in Bavaria, Germany, were identified; many had a sorbitol-fermenting (sf) E. coli O157:H- cultured. A case-control study showed a dose-response relationship between sausage consumption and illness. A second case-control study showed a relationship between mortadella and teewurst consumption and illness, particularly during December (mortadella odds ratio [OR], 10.5, P=.004; teewurst OR, 6.2, P=.02). Twelve sf O157:H- were characterized to determine clonality and virulence traits. The strains possessed the Stx2, eae, and EHEC-hlyA genes but were nonhemolytic on blood agar plates. The O157:H- isolates belonged to phage type 88 and had identical pulsed-field gel electrophoresis patterns. This outbreak was caused by sf E. coli O157:H-, which is not detectable by culture on sorbitol MacConkey's agar. Consumption of two sausages, including a raw beef-containing sausage, was statistically related to illness.

Authors+Show Affiliations

Ammon A
Robert Koch Institute, D-10963 Berlin, Germany. ammona@rki.de
Petersen LR
No affiliation info available
Karch H
No affiliation info available

MeSH

Case-Control StudiesChildChild, PreschoolDisease OutbreaksEscherichia coli InfectionsEscherichia coli O157FermentationFood MicrobiologyGermanyHemodialysis Units, HospitalHemolytic-Uremic SyndromeHospital RecordsHumansInfantMeat ProductsSorbitol

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10191236

Citation

Ammon, A, et al. "A Large Outbreak of Hemolytic Uremic Syndrome Caused By an Unusual Sorbitol-fermenting Strain of Escherichia Coli O157:H-." The Journal of Infectious Diseases, vol. 179, no. 5, 1999, pp. 1274-7.
Ammon A, Petersen LR, Karch H. A large outbreak of hemolytic uremic syndrome caused by an unusual sorbitol-fermenting strain of Escherichia coli O157:H-. J Infect Dis. 1999;179(5):1274-7.
Ammon, A., Petersen, L. R., & Karch, H. (1999). A large outbreak of hemolytic uremic syndrome caused by an unusual sorbitol-fermenting strain of Escherichia coli O157:H-. The Journal of Infectious Diseases, 179(5), 1274-7.
Ammon A, Petersen LR, Karch H. A Large Outbreak of Hemolytic Uremic Syndrome Caused By an Unusual Sorbitol-fermenting Strain of Escherichia Coli O157:H-. J Infect Dis. 1999;179(5):1274-7. PubMed PMID: 10191236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A large outbreak of hemolytic uremic syndrome caused by an unusual sorbitol-fermenting strain of Escherichia coli O157:H-. AU - Ammon,A, AU - Petersen,L R, AU - Karch,H, PY - 1999/4/7/pubmed PY - 2000/3/21/medline PY - 1999/4/7/entrez SP - 1274 EP - 7 JF - The Journal of infectious diseases JO - J Infect Dis VL - 179 IS - 5 N2 - Escherichia coli O157:H7 does not ferment sorbitol, a factor used to differentiate it from other E. coli. From December 1995 to March 1996, 28 children with hemolytic uremic syndrome in Bavaria, Germany, were identified; many had a sorbitol-fermenting (sf) E. coli O157:H- cultured. A case-control study showed a dose-response relationship between sausage consumption and illness. A second case-control study showed a relationship between mortadella and teewurst consumption and illness, particularly during December (mortadella odds ratio [OR], 10.5, P=.004; teewurst OR, 6.2, P=.02). Twelve sf O157:H- were characterized to determine clonality and virulence traits. The strains possessed the Stx2, eae, and EHEC-hlyA genes but were nonhemolytic on blood agar plates. The O157:H- isolates belonged to phage type 88 and had identical pulsed-field gel electrophoresis patterns. This outbreak was caused by sf E. coli O157:H-, which is not detectable by culture on sorbitol MacConkey's agar. Consumption of two sausages, including a raw beef-containing sausage, was statistically related to illness. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/10191236/A_large_outbreak_of_hemolytic_uremic_syndrome_caused_by_an_unusual_sorbitol_fermenting_strain_of_Escherichia_coli_O157:H__ DB - PRIME DP - Unbound Medicine ER -