title: Diversity of virulence patterns among shiga toxin-producing Escherichia coli from human clinical cases-need for more detailed diagnostics.
abstract: Intestinal infections due to shiga toxin-producing Escherichia coli bacteria (STEC) reveal a broad range of clinical symptoms and a large scale of virulence properties of the respective pathogens. The question whether all STEC variants or only a particular group of them need to be considered for clinical and epidemiological purposes was answered throughout this study. Using the PCR technique for the identification of 25 different virulence-associated genes, 266 E. coli strains belonging to 81 different E. coli serotypes from various clinical origins were investigated. A great genetic diversity of the virulence properties and a broad range of virulence marker combinations have been identified. However, distinct virulence marker combinations (e.g. Stx2/LEE/pO157 as well as Stx2dac/pO113) were found to be associated with the same notified clinical symptoms (e.g. HUS). Such an association speaks either for the "shiga toxin-only concept" or for several redundant, but clinically or epidemiologically important virulence properties.
authors.affiliation: Robert Koch-Institut, Burgstrasse 37, D-38855 Wernigerode, Germany.
authors.forename: Rita
authors.initials: R
authors.lastname: Prager
authors.forename: Sigrid
authors.initials: S
authors.lastname: Annemüller
authors.forename: Helmut
authors.initials: H
authors.lastname: Tschäpe
mesh_terms: D004269:DNA, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000145:classification / Q000302:isolation & purification / Q000472:pathogenicity*; D004927:Escherichia coli Infections / Q000382:microbiology*; D005798:Genes, Bacterial; D014644:Genetic Variation; D044404:Genomic Islands / Q000235:genetics; D005858:Germany; D006801:Humans; D010957:Plasmids / Q000032:analysis; D016133:Polymerase Chain Reaction; D012703:Serotyping; D022603:Shiga Toxins / Q000096:biosynthesis*; D013045:Species Specificity; D014774:Virulence / Q000235:genetics; D037521:Virulence Factors / Q000032:analysis / Q000235:genetics*
chemical_list: D004269:DNA, Bacterial; D022603:Shiga Toxins; D037521:Virulence Factors