Incidence and virulence determinants of verocytotoxin-producing Escherichia coli infections in Brussels-Capital Region, Belgium, 2008-2010
(2012) Journal of Clinical Microbiology —
Files
No attached file found for this publication.
Details
- Authors
- Abstract
- The incidence of verocytotoxin-producing Escherichia coli (VTEC) was investigated by PCR in all human stools from Universitair Ziekenhuis Brussel (UZB) and selected stools from six other hospital laboratories in Brussels-Capital Region (Belgium) collected between April 2008 and October 2010. Selected stools to be included in this study were those from patients with hemolytic uremic syndrome (HUS), patients with a history of bloody diarrhea, patients linked to clusters of diarrhea, children up to six years of age, and stools containing macroscopic blood. Verocytotoxin genes (vtx) were detected significantly more frequent in stools from patients with selected conditions (2.04%) as compared to unselected stools from UZB (1.20%) (P=0.001). VTEC were most frequently detected in patients with HUS (35.3%), a history of bloody diarrhea (5.15%), and stools containing macroscopic blood (1.85%). Stools of patients up to 17 years of age were significantly more vtx-positive as compared to those from adult patients between 18 and 65 years old (P=0.022). Although stools from patients older than 65 years were also more frequently positive for vtx as compared to those between 18-65 years, this trend was not significant. VTEC were isolated from 140 (67.9%) vtx-positive stools. One sample yielded two different serotypes, thus, 141 isolates could be characterized. Sixty different O:H serotypes harboring 85 different virulence profiles were identified. Serotypes O157:H7/H- (n=34), O26:H11/H- (n=21), O63:H6 (n=8), O111:H8/H- (n=7), and O146:H21/H- (n=6) accounted for 53.9% of isolates. All O157 isolates carried vtx2, eae, and a complete O island 122 (COI-122); 15 also carried vtx1. Non-O157 isolates (n=107), however, accounted for the bulk (75.9%) of isolates. Fifty-nine (55.1%) were positive for vtx1, 36 (33.6%) for vtx2, and 12 (11.2%) carried both vtx1 and vtx2. Pulsed-field gel electrophoresis revealed a wide genetic diversity, however, small clusters of O157, O26 and O63:H6 were identified that could have been part of unidentified outbreaks. Antimicrobial resistance was observed in 63 (44.7%) isolates and 34 (24.1%) showed multi-drug resistance. Our data show that VTEC infections were not limited to patients with HUS or bloody diarrhea. Clinical laboratories should, therefore, screen all stools for O157 and non-O157 VTEC using selective media and a method detecting verocytotoxins or vtx genes.
- Affiliations
Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel Belgian Reference Laboratory for VTEC/STEC, Laboratory for Microbiology and Infection Control Centre Hospitalier Interrégional Edith Cavell Centre Hospitalier Interrégional Edith Cavell Centre Hospitalier Universitaire St-Pierre, Université Libre de Bruxelles Centre Hospitalier Universitaire St-Pierre, Université Libre de Bruxelles Hôpitaux Iris-Sud site Bracops Hôpitaux Iris-Sud site Bracops Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles Cliniques de l’Europe site St-Elisabeth, Brussels, Belgium Cliniques de l’Europe site St-Elisabeth, Brussels, Belgium Statens Serum Institute, Copenhagen, Denmark Centre for Reference and Research on Escherichia and Klebsiella
Citations
Buvens, G., De Gheldre, Y., Dediste, A., De Moreau, A.-I., Mascart, G., Simon, A., Allemeersch, D., Scheutz, F., Lauwers, S., & Piérard, D. (2012). Incidence and virulence determinants of verocytotoxin-producing Escherichia coli infections in Brussels-Capital Region, Belgium, 2008-2010. Journal of Clinical Microbiology. https://doi.org/10.1128/JCM.05317-11