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Enterohemorrhagic Escherichia coli as causes of hemolytic uremic syndrome in the Czech Republic.
PLoS One. 2013; 8(9):e73927.Plos

Abstract

BACKGROUND

Enterohemorrhagic Escherichia coli (EHEC) cause diarrhea-associated hemolytic uremic syndrome (D+ HUS) worldwide, but no systematic study of EHEC as the causative agents of HUS was performed in the Czech Republic. We analyzed stools of all patients with D+ HUS in the Czech Republic between 1998 and 2012 for evidence of EHEC infection. We determined virulence profiles, phenotypes, antimicrobial susceptibilities and phylogeny of the EHEC isolates.

METHODOLOGY/PRINCIPAL FINDINGS

Virulence loci were identified using PCR, phenotypes and antimicrobial susceptibilities were determined using standard procedures, and phylogeny was assessed using multilocus sequence typing. During the 15-year period, EHEC were isolated from stools of 39 (69.4%) of 56 patients. The strains belonged to serotypes [fliC types] O157:H7/NM[fliC(H7)] (50% of which were sorbitol-fermenting; SF), O26:H11/NM[fliC(H11)], O55:NM[fliC(H7)], O111:NM[fliC(H8)], O145:H28[fliC(H28)], O172:NM[fliC(H25)], and Orough:NM[fliC(H250]. O26:H11/NM[fliC(H11)] was the most common serotype associated with HUS (41% isolates). Five stx genotypes were identified, the most frequent being stx(2a) (71.1% isolates). Most strains contained EHEC-hlyA encoding EHEC hemolysin, and a subset (all SF O157:NM and one O157:H7) harbored cdt-V encoding cytolethal distending toxin. espPα encoding serine protease EspPα was found in EHEC O157:H7, O26:H11/NM, and O145:H28, whereas O172:NM and Orough:NM strains contained espPγ. All isolates contained eae encoding adhesin intimin, which belonged to subtypes β (O26), γ (O55, O145, O157), γ2/θ (O111), and ε (O172, Orough). Loci encoding other adhesins (efa1, lpfA(O26), lpfA(O157OI-141), lpfA(O157OI-154), iha) were usually associated with particular serotypes. Phylogenetic analysis demonstrated nine sequence types (STs) which correlated with serotypes. Of these, two STs (ST660 and ST1595) were not found in HUS-associated EHEC before.

CONCLUSIONS/SIGNIFICANCE

EHEC strains, including O157:H7 and non-O157:H7, are frequent causes of D+ HUS in the Czech Republic. Identification of unusual EHEC serotypes/STs causing HUS calls for establishment of an European collection of HUS-associated EHEC, enabling to study properties and evolution of these important pathogens.

Authors+Show Affiliations

National Reference Laboratory for E. coli and Shigella, National Institute of Public Health, Prague, Czech Republic ; The 3rd Medical Faculty, Charles University Prague, Prague, Czech Republic.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24040117

Citation

Marejková, Monika, et al. "Enterohemorrhagic Escherichia Coli as Causes of Hemolytic Uremic Syndrome in the Czech Republic." PloS One, vol. 8, no. 9, 2013, pp. e73927.
Marejková M, Bláhová K, Janda J, et al. Enterohemorrhagic Escherichia coli as causes of hemolytic uremic syndrome in the Czech Republic. PLoS One. 2013;8(9):e73927.
Marejková, M., Bláhová, K., Janda, J., Fruth, A., & Petráš, P. (2013). Enterohemorrhagic Escherichia coli as causes of hemolytic uremic syndrome in the Czech Republic. PloS One, 8(9), e73927. https://doi.org/10.1371/journal.pone.0073927
Marejková M, et al. Enterohemorrhagic Escherichia Coli as Causes of Hemolytic Uremic Syndrome in the Czech Republic. PLoS One. 2013;8(9):e73927. PubMed PMID: 24040117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enterohemorrhagic Escherichia coli as causes of hemolytic uremic syndrome in the Czech Republic. AU - Marejková,Monika, AU - Bláhová,Květa, AU - Janda,Jan, AU - Fruth,Angelika, AU - Petráš,Petr, Y1 - 2013/09/06/ PY - 2013/03/26/received PY - 2013/07/26/accepted PY - 2013/9/17/entrez PY - 2013/9/17/pubmed PY - 2014/6/16/medline SP - e73927 EP - e73927 JF - PloS one JO - PLoS One VL - 8 IS - 9 N2 - BACKGROUND: Enterohemorrhagic Escherichia coli (EHEC) cause diarrhea-associated hemolytic uremic syndrome (D+ HUS) worldwide, but no systematic study of EHEC as the causative agents of HUS was performed in the Czech Republic. We analyzed stools of all patients with D+ HUS in the Czech Republic between 1998 and 2012 for evidence of EHEC infection. We determined virulence profiles, phenotypes, antimicrobial susceptibilities and phylogeny of the EHEC isolates. METHODOLOGY/PRINCIPAL FINDINGS: Virulence loci were identified using PCR, phenotypes and antimicrobial susceptibilities were determined using standard procedures, and phylogeny was assessed using multilocus sequence typing. During the 15-year period, EHEC were isolated from stools of 39 (69.4%) of 56 patients. The strains belonged to serotypes [fliC types] O157:H7/NM[fliC(H7)] (50% of which were sorbitol-fermenting; SF), O26:H11/NM[fliC(H11)], O55:NM[fliC(H7)], O111:NM[fliC(H8)], O145:H28[fliC(H28)], O172:NM[fliC(H25)], and Orough:NM[fliC(H250]. O26:H11/NM[fliC(H11)] was the most common serotype associated with HUS (41% isolates). Five stx genotypes were identified, the most frequent being stx(2a) (71.1% isolates). Most strains contained EHEC-hlyA encoding EHEC hemolysin, and a subset (all SF O157:NM and one O157:H7) harbored cdt-V encoding cytolethal distending toxin. espPα encoding serine protease EspPα was found in EHEC O157:H7, O26:H11/NM, and O145:H28, whereas O172:NM and Orough:NM strains contained espPγ. All isolates contained eae encoding adhesin intimin, which belonged to subtypes β (O26), γ (O55, O145, O157), γ2/θ (O111), and ε (O172, Orough). Loci encoding other adhesins (efa1, lpfA(O26), lpfA(O157OI-141), lpfA(O157OI-154), iha) were usually associated with particular serotypes. Phylogenetic analysis demonstrated nine sequence types (STs) which correlated with serotypes. Of these, two STs (ST660 and ST1595) were not found in HUS-associated EHEC before. CONCLUSIONS/SIGNIFICANCE: EHEC strains, including O157:H7 and non-O157:H7, are frequent causes of D+ HUS in the Czech Republic. Identification of unusual EHEC serotypes/STs causing HUS calls for establishment of an European collection of HUS-associated EHEC, enabling to study properties and evolution of these important pathogens. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24040117/Enterohemorrhagic_Escherichia_coli_as_causes_of_hemolytic_uremic_syndrome_in_the_Czech_Republic_ L2 - https://dx.plos.org/10.1371/journal.pone.0073927 DB - PRIME DP - Unbound Medicine ER -