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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

Robert Koch Institute, D-10963 Berlin, Germany. ammona@rki.deNo affiliation info availableNo affiliation info available

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 -