title: Escherichia coli harboring Shiga toxin 2 gene variants: frequency and association with clinical symptoms.
abstract: Shiga toxin (Stx)-producing Escherichia coli (STEC) from patients with hemolytic-uremic syndrome (HUS), patients with diarrhea without HUS, or asymptomatic subjects were genotyped to assess associations between stx2 variants and clinical manifestations of infection. Neither stx2d nor stx2e was found in 268 STEC isolates from patients with HUS. Of 262 STEC isolates from patients with diarrhea, stx(2d) was found in 41 (15.6%; P<.000001), and stx2e was found in 12 (4.6%; P=.0004). The stx2c genotype frequency was similar among isolates from patients with HUS (3.7%) and diarrhea (5.0%). The frequencies of stx2c, stx2d, and stx2e among 96 STEC isolates from asymptomatic subjects were comparable to those among isolates from patients with diarrhea. None of the 626 STEC isolates contained stx2f. All stx2d-positive or stx2e-positive STEC isolates were eae negative and originated from subjects older than those with STEC isolates with stx2c. stx2c-positive STEC isolates can cause HUS, but the presence of stx2d or stx2e may predict a milder disease with a minimal risk of HUS.
authors.affiliation: Institut für Hygiene und Mikrobiologie der Universität Würzburg, Würzburg, Germany.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Friedrich
authors.forename: Martina
authors.initials: M
authors.lastname: Bielaszewska
authors.forename: Wen-Lan
authors.initials: WL
authors.lastname: Zhang
authors.forename: Matthias
authors.initials: M
authors.lastname: Pulz
authors.forename: Thorsten
authors.initials: T
authors.lastname: Kuczius
authors.forename: Andrea
authors.initials: A
authors.lastname: Ammon
authors.forename: Helge
authors.initials: H
authors.lastname: Karch
mesh_terms: D018829:Adhesins, Bacterial / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics; D003967:Diarrhea / Q000382:microbiology*; D004926:Escherichia coli / Q000235:genetics*; D004927:Escherichia coli Infections / Q000382:microbiology*; D019453:Escherichia coli O157 / Q000302:isolation & purification; D029968:Escherichia coli Proteins; D005243:Feces / Q000382:microbiology; D014644:Genetic Variation; D005838:Genotype; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology*; D006801:Humans; D019081:O Antigens; D012703:Serotyping; D022641:Shiga Toxin 2 / Q000235:genetics*
chemical_list: D018829:Adhesins, Bacterial; D002352:Carrier Proteins; D029968:Escherichia coli Proteins; D019081:O Antigens; D022641:Shiga Toxin 2; C073819:eaeA protein, E coli