title: Enterohemorrhagic Escherichia coli Hybrid Pathotype O80:H2 as a New Therapeutic Challenge.
abstract: We describe the epidemiology, clinical features, and molecular characterization of enterohemorrhagic Escherichia coli (EHEC) infections caused by the singular hybrid pathotype O80:H2, and we examine the influence of antibiotics on Shiga toxin production. In France, during 2005-2014, a total of 54 patients were infected with EHEC O80:H2; 91% had hemolytic uremic syndrome. Two patients had invasive infections, and 2 died. All strains carried stx2 (variants stx2a, 2c, or 2d); the rare intimin gene (eae-ξ); and at least 4 genes characteristic of pS88, a plasmid associated with extraintestinal virulence. Similar strains were found in Spain. All isolates belonged to the same clonal group. At subinhibitory concentrations, azithromycin decreased Shiga toxin production significantly, ciprofloxacin increased it substantially, and ceftriaxone had no major effect. Antibiotic combinations that included azithromycin also were tested. EHEC O80:H2, which can induce hemolytic uremic syndrome complicated by bacteremia, is emerging in France. However, azithromycin might effectively combat these infections.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Soysal
authors.forename: Patricia
authors.initials: P
authors.lastname: Mariani-Kurkdjian
authors.forename: Yasmine
authors.initials: Y
authors.lastname: Smail
authors.forename: Sandrine
authors.initials: S
authors.lastname: Liguori
authors.forename: Malika
authors.initials: M
authors.lastname: Gouali
authors.forename: Estelle
authors.initials: E
authors.lastname: Loukiadis
authors.forename: Patrick
authors.initials: P
authors.lastname: Fach
authors.forename: Mathias
authors.initials: M
authors.lastname: Bruyand
authors.forename: Jorge
authors.initials: J
authors.lastname: Blanco
authors.forename: Philippe
authors.initials: P
authors.lastname: Bidet
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bonacorsi
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D054324:Enterohemorrhagic Escherichia coli / Q000145:classification* / Q000235:genetics* / Q000378:metabolism / Q000472:pathogenicity; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005838:Genotype; D062306:Geography, Medical; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D065288:Serogroup; D012703:Serotyping; D022621:Shiga Toxin / Q000096:biosynthesis / Q000235:genetics; D014774:Virulence; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D037521:Virulence Factors; D022621:Shiga Toxin
keywords: E. coli; HUS; O80:42; Shiga toxin; antibiotic resistance; antibiotic treatment; antimicrobial; antimicrobial resistance; bacteremia; bacteria; emergence; enteric infections; enterohemorrhagic Escherichia coli; extraintestinal virulence factors; hemolytic uremic syndrome; pS88 plasmid