Defining pathogenic verocytotoxin-producing Escherichia coli (VTEC) from cases of human infection in the European Union, 2007-2010.
During 2007-2010, 13 545 confirmed human verocytotoxin (VT)-producing Escherichia coli (VTEC) infections were reported in the European Union, including 777 haemolytic uraemic syndrome (HUS) cases. Clinical manifestations were reported for 53% of cases, 64% of which presented with diarrhoea alone and 10% with HUS. Isolates from 85% of cases were not fully serotyped and could not be classified on the basis of the Karmali seropathotype concept. There is no single or combination of phenotypic or genetic marker(s) that fully define 'pathogenic' VTEC. Isolates which contain the vtx2 (verocytotoxin 2) gene in combination with the eae (intimin-encoding) gene or aaiC (secreted protein of enteroaggregative E. coli) and aggR (plasmid-encoded regulator) genes have been associated with a higher risk of more severe illness. A molecular approach targeting genes encoding VT and other virulence determinants is thus proposed to allow an assessment of the potential severity of disease that may be associated with a given VTEC isolate.
Unit on Biological Hazards and Contaminants (BIOCONTAM),European Food Safety Authority (EFSA),Parma,Italy.
W
W
Messens
Food Safety Department,Teagasc Food Research Centre,Ashtown,Dublin,Ireland.
D
D
Bolton
MRC Centre for Molecular Bacteriology and Infection,Department of Life Sciences,Imperial College,London,UK.
G
G
Frankel
Unit on Biological Hazards and Contaminants (BIOCONTAM),European Food Safety Authority (EFSA),Parma,Italy.
E
E
Liebana
Public Health England,Food Water and Environmental Microbiology Services,London,UK.
J
J
McLAUCHLIN
EU Reference Laboratory for E. coli,Foodborne Zoonoses Unit,Veterinary Public Health and Food Safety,Istituto Superiore di Sanità,Rome,Italy.
S
S
Morabito
INRA,USC 1360 Molecular and Cellular Pathogenesis of Escherichia coli Infections,Toulouse,France.
E
E
Oswald
Formerly Health Protection Agency,London,UK.
E J
EJ
Threlfall
D018829:Adhesins, Bacterial / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000235:genetics*; D005060:Europe / Q000453:epidemiology; D005062:European Union; D060005:Genotyping Techniques; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008875:Middle Aged; D017720:Molecular Epidemiology; D012703:Serotyping; D022622:Shiga Toxin 1 / Q000235:genetics; D022641:Shiga Toxin 2 / Q000235:genetics; D054323:Shiga-Toxigenic Escherichia coli / Q000235:genetics* / Q000276:immunology; D015534:Trans-Activators / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
D018829:Adhesins, Bacterial; C088603:AggR protein, E coli; D004269:DNA, Bacterial; D029968:Escherichia coli Proteins; D022622:Shiga Toxin 1; D022641:Shiga Toxin 2; D015534:Trans-Activators; D037521:Virulence Factors; C430449:verocytotoxin 2; C073819:eaeA protein, E coli
virulence factors