title: Shiga toxin-producing Escherichia coli in Montana: bacterial genotypes and clinical profiles.
abstract: The diseases and virulence genes associated with Shiga toxin-producing Escherichia coli (STEC) are characterized incompletely. We analyzed, by polymerase chain reaction, 82 STEC isolates collected prospectively in Montana and profiled associated illnesses by patient chart review. All E. coli O157:H7 contained stx2-group genes, as well as eae, iha, espA, and ehxA; 84% contained stx1. Non-O157:H7 STEC less frequently contained stx1 (P=.046), stx2 (P<.001), iha (P<.001), eae, and espA (P=.039 for both), were isolated less often from patients treated in emergency departments (P=.022), and tended to be associated less frequently with bloody diarrhea (P=.061). There were no significant associations between stx genotype and bloody diarrhea, but isolates containing stx2c or stx(2d-activatable) were recovered more often from patients who underwent diagnostic or therapeutic procedures (P=.033). Non-O157:H7 STEC are more heterogeneous and cause bloody diarrhea less frequently than do E. coli O157:H7. Bloody diarrhea cannot be attributed simply to the stx genotype of the infecting organism.
authors.affiliation: University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: Jill K
authors.initials: JK
authors.lastname: Jelacic
authors.forename: Todd
authors.initials: T
authors.lastname: Damrow
authors.forename: Gilbert S
authors.initials: GS
authors.lastname: Chen
authors.forename: Srdjan
authors.initials: S
authors.lastname: Jelacic
authors.forename: Martina
authors.initials: M
authors.lastname: Bielaszewska
authors.forename: Marcia
authors.initials: M
authors.lastname: Ciol
authors.forename: Humberto M
authors.initials: HM
authors.lastname: Carvalho
authors.forename: Angela R
authors.initials: AR
authors.lastname: Melton-Celsa
authors.forename: Alison D
authors.initials: AD
authors.lastname: O'Brien
authors.forename: Phillip I
authors.initials: PI
authors.lastname: Tarr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000382:microbiology / Q000503:physiopathology*; D004926:Escherichia coli / Q000145:classification* / Q000235:genetics* / Q000378:metabolism; D004927:Escherichia coli Infections / Q000382:microbiology / Q000503:physiopathology*; D019453:Escherichia coli O157 / Q000145:classification / Q000235:genetics / Q000378:metabolism; D029968:Escherichia coli Proteins / Q000235:genetics / Q000378:metabolism; D005243:Feces / Q000382:microbiology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009009:Montana; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D011446:Prospective Studies; D022622:Shiga Toxin 1 / Q000096:biosynthesis* / Q000737:chemistry / Q000235:genetics; D022641:Shiga Toxin 2 / Q000096:biosynthesis* / Q000737:chemistry / Q000235:genetics
chemical_list: D029968:Escherichia coli Proteins; D022622:Shiga Toxin 1; D022641:Shiga Toxin 2