title: Cluster investigation of mixed O76:H19 Shiga toxin-producing Escherichia coli and atypical enteropathogenic E. coli infection in a Spanish household.
abstract: A Spanish household was identified through a Public Health follow up on a Shiga toxin-producing Escherichia coli (STEC)-positive 14-month-old girl reporting bloody diarrhoea, with the four household members experiencing either symptomatic or asymptomatic STEC and/or atypical enteropathogenic E. coli (aEPEC) shedding. In total, two different O76:H19 STEC strains and six aEPEC strains belonging to multiple serotypes were isolated and characterized in the household during a 5-month period. Prolonged asymptomatic shedding of O76:H19 STEC and O51:H49 aEPEC was detected in two family members. Although there was no conclusive evidence, consumption of vegetables fertilized with sheep manure was the suspected source of infection. This study highlights the risk of cross-infections posed by prolonged asymptomatic carriage and close household contact between family members, and illustrates the importance of molecular epidemiology in understanding disease clusters.
authors.affiliation: Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Sánchez
authors.affiliation: Instituto de Salud Pública de Navarra, Pamplona, Spain.
authors.forename: M García
authors.initials: MG
authors.lastname: Cenoz
authors.affiliation: Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Martín
authors.affiliation: Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Beristain
authors.affiliation: Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
authors.forename: M T
authors.initials: MT
authors.lastname: Llorente
authors.affiliation: Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Herrera-León
mesh_terms: D000328:Adult; D002675:Child, Preschool; D060085:Coinfection / Q000382:microbiology*; D054308:Enteropathogenic Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000235:genetics; D005190:Family; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054323:Shiga-Toxigenic Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D014774:Virulence / Q000235:genetics
chemical_list: D029968:Escherichia coli Proteins
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