title: Molecular epidemiological view on Shiga toxin-producing Escherichia coli causing human disease in Germany: Diversity, prevalence, and outbreaks.
abstract: Infections by intestinal pathogenic Escherichia coli (E. coli) are among those causing a high mortality and morbidity due to diarrheal disease and post infection sequelae worldwide. Since introduction of the Infection Protection Act in Germany 2001, these pathogens rank third among bacterial infections of the gastrointestinal tract. As a major pathovar Shiga toxin-producing E. coli (STEC) which include enterohemorrhagic E. coli (EHEC) play a leading role in occurrence of sporadic cases and disease outbreaks. An outstanding example is the large outbreak in spring 2011 caused by EHEC/EAEC O104:H4. To monitor and trace back STEC infections, national surveillance programs have been implemented including activities of the German National Reference Centre for Salmonella and other Enteric Bacterial Pathogens (NRC). This review highlights advances in our understanding of STEC in the last 20 years of STEC surveillance by the NRC. Here important characteristics of STEC strains from human infections and outbreaks in Germany between 1997 and 2013 are summarized.
authors.affiliation: Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Fruth
authors.affiliation: Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany.
authors.forename: Rita
authors.initials: R
authors.lastname: Prager
authors.affiliation: Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany.
authors.forename: Erhard
authors.initials: E
authors.lastname: Tietze
authors.affiliation: Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rabsch
authors.affiliation: Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany. Electronic address: fliegera@rki.de.
authors.forename: Antje
authors.initials: A
authors.lastname: Flieger
mesh_terms: D004196:Disease Outbreaks; D062665:Epidemiological Monitoring; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology*; D005858:Germany / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D015995:Prevalence; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*
keywords: Antibiotic resistance; Diversity; EHEC; HUS; Outbreak investigations; Phage type; STEC; Serovar