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Characteristics of O157 versus non-O157 Shiga toxin-producing Escherichia coli infections in Minnesota, 2000-2006.
Clin Infect Dis. 2009 Aug 01; 49(3):358-64.CI

Abstract

BACKGROUND

Escherichia coli O157:H7 (O157) is the Shiga toxin-producing E. coli (STEC) serotype most frequently isolated and most often associated with hemolytic uremic syndrome (HUS) in the United States. Non-O157 STEC serotypes can also cause serious illness, but their impact as pathogens remains undefined. We compared characteristics of non-O157 and O157 STEC infections identified through sentinel surveillance.

METHODS

Sentinel sites included a metropolitan health maintenance organization laboratory and a hospital laboratory serving a small city and rural area. We received sorbitol-MacConkey agar plates from every stool culture performed at both sites during 2000-2006. Colony sweeps were screened for stx1 and stx2 by polymerase chain reaction. E. coli identity, serotype, and presence of stx1 and/or stx2 were confirmed on individual isolates.

RESULTS

Two hundred six STEC isolates were identified: 108 (52%) were non-O157 serotypes, and 98 (48%) were O157. Of non-O157 cases, 54% involved bloody diarrhea, and 8% involved hospitalization. Non-O157 isolates with at least stx2 were not more likely to cause severe illness (bloody diarrhea, hospitalization, or HUS) than were non-O157 isolates with only stx1. O157 cases were more likely than non-O157 cases to involve bloody diarrhea (78% vs 54%; P < .001), hospitalization (34% vs 8%; P < .001 and HUS (7% vs 0%; P = .005). When including only isolates with at least stx2, O157 cases were still more likely to involve bloody diarrhea (78% vs 56%; P = .02) and hospitalization (33% vs 12%; P = .01) than non-O157 cases.

CONCLUSIONS

Differences in severity among STEC infections could not be explained by stx2, suggesting that additional factors are important in STEC virulence.

Authors+Show Affiliations

Acute Disease Investigation and Control Section and 2Public Health Laboratory, Minnesota Department of Health, St. Paul.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

19548834

Citation

Hedican, Erin B., et al. "Characteristics of O157 Versus non-O157 Shiga Toxin-producing Escherichia Coli Infections in Minnesota, 2000-2006." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 49, no. 3, 2009, pp. 358-64.
Hedican EB, Medus C, Besser JM, et al. Characteristics of O157 versus non-O157 Shiga toxin-producing Escherichia coli infections in Minnesota, 2000-2006. Clin Infect Dis. 2009;49(3):358-64.
Hedican, E. B., Medus, C., Besser, J. M., Juni, B. A., Koziol, B., Taylor, C., & Smith, K. E. (2009). Characteristics of O157 versus non-O157 Shiga toxin-producing Escherichia coli infections in Minnesota, 2000-2006. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 49(3), 358-64. https://doi.org/10.1086/600302
Hedican EB, et al. Characteristics of O157 Versus non-O157 Shiga Toxin-producing Escherichia Coli Infections in Minnesota, 2000-2006. Clin Infect Dis. 2009 Aug 1;49(3):358-64. PubMed PMID: 19548834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of O157 versus non-O157 Shiga toxin-producing Escherichia coli infections in Minnesota, 2000-2006. AU - Hedican,Erin B, AU - Medus,Carlota, AU - Besser,John M, AU - Juni,Billie A, AU - Koziol,Bonnie, AU - Taylor,Charlott, AU - Smith,Kirk E, PY - 2009/6/25/entrez PY - 2009/6/25/pubmed PY - 2009/9/1/medline SP - 358 EP - 64 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 49 IS - 3 N2 - BACKGROUND: Escherichia coli O157:H7 (O157) is the Shiga toxin-producing E. coli (STEC) serotype most frequently isolated and most often associated with hemolytic uremic syndrome (HUS) in the United States. Non-O157 STEC serotypes can also cause serious illness, but their impact as pathogens remains undefined. We compared characteristics of non-O157 and O157 STEC infections identified through sentinel surveillance. METHODS: Sentinel sites included a metropolitan health maintenance organization laboratory and a hospital laboratory serving a small city and rural area. We received sorbitol-MacConkey agar plates from every stool culture performed at both sites during 2000-2006. Colony sweeps were screened for stx1 and stx2 by polymerase chain reaction. E. coli identity, serotype, and presence of stx1 and/or stx2 were confirmed on individual isolates. RESULTS: Two hundred six STEC isolates were identified: 108 (52%) were non-O157 serotypes, and 98 (48%) were O157. Of non-O157 cases, 54% involved bloody diarrhea, and 8% involved hospitalization. Non-O157 isolates with at least stx2 were not more likely to cause severe illness (bloody diarrhea, hospitalization, or HUS) than were non-O157 isolates with only stx1. O157 cases were more likely than non-O157 cases to involve bloody diarrhea (78% vs 54%; P < .001), hospitalization (34% vs 8%; P < .001 and HUS (7% vs 0%; P = .005). When including only isolates with at least stx2, O157 cases were still more likely to involve bloody diarrhea (78% vs 56%; P = .02) and hospitalization (33% vs 12%; P = .01) than non-O157 cases. CONCLUSIONS: Differences in severity among STEC infections could not be explained by stx2, suggesting that additional factors are important in STEC virulence. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/19548834/full_citation L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/600302 DB - PRIME DP - Unbound Medicine ER -