title: Molecular epidemiology of a household outbreak of Shiga-toxin-producing Escherichia coli in Poland due to secondary transmission of STEC O104:H4 from Germany.
abstract: We characterized two STEC O104 : H4 clinical isolates collected in Poland from a 7-year-old boy with haemolytic uraemic syndrome (HUS) and his nanny. This household outbreak began on 29 May 2011. Because of its time-frame, the outbreak was assumed to be part of the international STEC O104 : H4 outbreak that arose in Germany in May 2011. The two Polish isolates were Shiga-toxin-producing Escherichia coli (stx2 lpf) with enteroaggregative E. coli pathotype (aggR aap aggA), thereby sharing the unique virulence properties of the epidemic STEC O104 : H4 strain from the international outbreak. The Polish isolates were multi-drug resistant and carried bla(TEM), strA, strB, tetA, sul1 and sul2 markers together with the bla(CTX-M-15) gene for CTX-M-15 extended-spectrum β-lactamase. PFGE patterns and plasmid profiles of the Polish isolates and the epidemic STEC O104 : H4 strain corresponded closely. This finding suggested an epidemiological link between the Polish STEC O104 : H4 isolates and the international outbreak. Retrospective serological investigations proved person-to-person transmission of the epidemic STEC O104 : H4 strain from a father who had visited Dortmund, Germany, to his 7-year-old son in Giżycko, Poland. To the best of our knowledge, this is the first report of household transmission of Shiga-toxin-producing E. coli in Poland.
authors.affiliation: Department of Bacteriology, National Institute of Public Health - Public Institute of Hygiene, 24 Chocimska Street, 00-791 Warsaw, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Januszkiewicz
authors.affiliation: Department of Bacteriology, National Institute of Public Health - Public Institute of Hygiene, 24 Chocimska Street, 00-791 Warsaw, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Szych
authors.affiliation: Department of Bacteriology, National Institute of Public Health - Public Institute of Hygiene, 24 Chocimska Street, 00-791 Warsaw, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Rastawicki
authors.affiliation: Department of Bacteriology, National Institute of Public Health - Public Institute of Hygiene, 24 Chocimska Street, 00-791 Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Wołkowicz
authors.affiliation: Department of Bacteriology, National Institute of Public Health - Public Institute of Hygiene, 24 Chocimska Street, 00-791 Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Chróst
authors.affiliation: Department of Paediatrics and Nephrology, Medical University of Warsaw, 24 Marszałkowska Street, 00-576 Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Leszczyńska
authors.affiliation: Department of Paediatrics and Nephrology, Medical University of Warsaw, 24 Marszałkowska Street, 00-576 Warsaw, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Kuźma
authors.affiliation: Department of Paediatrics and Nephrology, Medical University of Warsaw, 24 Marszałkowska Street, 00-576 Warsaw, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Roszkowska-Blaim
authors.affiliation: Department of Bacteriology, National Institute of Public Health - Public Institute of Hygiene, 24 Chocimska Street, 00-791 Warsaw, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Gierczyński
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D004269:DNA, Bacterial / Q000235:genetics; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D005191:Family Characteristics; D005243:Feces / Q000382:microbiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D011044:Poland / Q000453:epidemiology; D054323:Shiga-Toxigenic Escherichia coli / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial