title: Shiga toxin-producing Escherichia coli O104:H4: an emerging pathogen with enhanced virulence.
abstract: Pathogenic Escherichia coli are genetically diverse and encompass a broad variety of pathotypes, such as enteroaggregative E. coli (EAEC) or enterohemorrhagic E. coli (EHEC), which cause distinct clinical syndromes. The historically large 2011 German outbreak of hemolytic uremic syndrome (HUS), caused by a Shiga-toxin producing E. coli (STEC) of the serotype O104:H4, illustrated the emerging importance of non-O157 STEC. STEC O104:H4, with features characteristic of both enteroaggregative E. coli and enterohemorrhagic E. coli, represents a unique and highly virulent pathotype. The German outbreak both allowed for the evaluation of several potential therapeutic approaches to STEC-induced HUS and emphasizes the importance of early and specific detection of both O157 and non-O157 STEC.
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, 750 Washington Street, Boston, MA 02111, USA. Electronic address: djandhyala@tuftsmedicalcenter.org.
authors.forename: Dakshina M
authors.initials: DM
authors.lastname: Jandhyala
authors.forename: Vijay
authors.initials: V
authors.lastname: Vanguri
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Boll
authors.forename: Yushuan
authors.initials: Y
authors.lastname: Lai
authors.forename: Beth A
authors.initials: BA
authors.lastname: McCormick
authors.forename: John M
authors.initials: JM
authors.lastname: Leong
mesh_terms: D021821:Communicable Diseases, Emerging / Q000382:microbiology*; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology*; D005060:Europe / Q000453:epidemiology; D016680:Genome, Bacterial; D006801:Humans; D054323:Shiga-Toxigenic Escherichia coli / Q000235:genetics / Q000472:pathogenicity*; D014774:Virulence / Q000235:genetics
keywords: Bloody diarrhea; EAEC; Foodborne illness; Hemolytic uremic syndrome; O104:H4; STEC; Shiga toxin