A Nursery Outbreak of Multiple-Aminoglycoside-Resistant Escherichia coli

1984 ◽  
Vol 5 (11) ◽  
pp. 519-524 ◽  
Author(s):  
Robert R Gaynes ◽  
Diane Simpson ◽  
Sally A. Reeves ◽  
Robert C. Noble ◽  
Clyde Thornsberry ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Neonatal Intensive Care ◽  
Control Measures ◽  
Effective Control ◽  
Blood Isolate ◽  
E Coli ◽  
Feeding Duration ◽  
Matched Case ◽  
Continuous Feeding ◽  
The One

AbstractIn the neonatal intensive care unit (NICU) of one hospital, 16 infants became colonized or infected with multiply-resistant Escherichia coli (MR-E.coli) over an 8-month period. Isolates were obtained from blood, urine, and sputum of three patients and from rectal surveillance cultures of 13 patients. The one patient with the blood isolate died. A matched case-control study identified continuous feeding (nine of 16 cases vs. one of 16 controls, p ≤ 0.001) and receipt of aminoglycosides (p ≤ 0.03) as risk factors. For case-babies not exposed to continuous feeding, duration of bolus feeding was significantly greater than for their controls (cases, 22 days; controls, 7 days; p ≤ 0.02). All 16 isolates were the same serotype and were resistant to amikacin, tobramycin, kanamycin, and gentamicin. The epidemiologic investigation suggested that MR-E. coli may have spread from person-to-person on the hands of personnel and that MR-E. coli persisted in the NICU for 8 months until effective control measures were instituted.

scholarly journals A Large, Refractory Nosocomial Outbreak of Klebsiella pneumoniae Carbapenemase-Producing Escherichia coli Demonstrates Carbapenemase Gene Outbreaks Involving Sink Sites Require Novel Approaches to Infection Control

2018 ◽  
Vol 62 (12) ◽  
Author(s):  
V. Decraene ◽  
H. T. T. Phan ◽  
R. George ◽  
D. H. Wyllie ◽  
O. Akinremi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Control Measures ◽  
Effective Control ◽  
Infection Prevention And Control ◽  
Content Type ◽  
E Coli ◽  
Incidence Trends ◽  
Carbapenemase Gene ◽  
The Impact

ABSTRACT Carbapenem-resistant Enterobacteriaceae (CRE) represent a health threat, but effective control interventions remain unclear. Hospital wastewater sites are increasingly being highlighted as important potential reservoirs. We investigated a large Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli outbreak and wider CRE incidence trends in the Central Manchester University Hospital NHS Foundation Trust (CMFT) (United Kingdom) over 8 years, to determine the impact of infection prevention and control measures. Bacteriology and patient administration data (2009 to 2017) were linked, and a subset of CMFT or regional hospital KPC-producing E. coli isolates (n = 268) were sequenced. Control interventions followed international guidelines and included cohorting, rectal screening (n = 184,539 screens), environmental sampling, enhanced cleaning, and ward closure and plumbing replacement. Segmented regression of time trends for CRE detections was used to evaluate the impact of interventions on CRE incidence. Genomic analysis (n = 268 isolates) identified the spread of a KPC-producing E. coli outbreak clone (strain A, sequence type 216 [ST216]; n = 125) among patients and in the environment, particularly on 2 cardiac wards (wards 3 and 4), despite control measures. ST216 strain A had caused an antecedent outbreak and shared its KPC plasmids with other E. coli lineages and Enterobacteriaceae species. CRE acquisition incidence declined after closure of wards 3 and 4 and plumbing replacement, suggesting an environmental contribution. However, ward 3/ward 4 wastewater sites were rapidly recolonized with CRE and patient CRE acquisitions recurred, albeit at lower rates. Patient relocation and plumbing replacement were associated with control of a clonal KPC-producing E. coli outbreak; however, environmental contamination with CRE and patient CRE acquisitions recurred rapidly following this intervention. The large numbers of cases and the persistence of blaKPC in E. coli, including pathogenic lineages, are of concern.

Behavior of Escherichia coli O157:H7 in Leafy Vegetables

2007 ◽  
Vol 70 (8) ◽  
pp. 1966-1974 ◽  
Author(s):  
PASCAL DELAQUIS ◽  
SUSAN BACH ◽  
LAURA-DORINA DINU
Keyword(s):  
Escherichia Coli ◽  
Control Measures ◽  
Leafy Vegetables ◽  
Effective Control ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Health Significance ◽  
Fresh Cut ◽  
Chronic Sequelae

Leafy vegetables, including lettuce and spinach, have been implicated in several outbreaks of foodborne disease caused by Escherichia coli O157:H7, a pathogen of increasing public health significance because of the severity of the gastrointestinal illness and long-term, chronic sequelae that can result from infection. A definitive association between the consumption of leafy vegetables and human disease provides implicit evidence of transfer from animal sources to field crops and retail commodities, including minimally processed or fresh-cut products. Understanding the behavior of E. coli O157:H7 in leafy vegetables during production, after harvest, in storage, during processing, and in packaged fresh-cut products is essential for the development of effective control measures. To this end, previous research on the fate of the species at each step in the production of market-ready leafy vegetables is reviewed in this study. Several critical gaps in knowledge are identified, notably uncertainty about the location of contaminating cells on or in plant tissues, behavior in packaged products stored at low temperatures, and the influence of environmental stresses on growth and infectivity.

Preliminary Estimates of Costs of Foodborne Disease in the United States

1989 ◽  
Vol 52 (8) ◽  
pp. 595-601 ◽  
Author(s):  
EWEN C. D. TODD
Keyword(s):  
United States ◽  
Food Industry ◽  
The United States ◽  
Control Measures ◽  
Effective Control ◽  
Foodborne Diseases ◽  
Hemorrhagic Colitis ◽  
E Coli ◽  
The Cost ◽  
Total Impact

Although the full economic impact of foodborne diseases has yet to be measured, preliminary studies show that the cost of illness, death, and business lost is high indeed. This impact is probably greatest in developing countries, but few facts are known. For the United States, preliminary estimates are 12.6 million cases costing $8.4 billion. These may seem excessive but other authors have postulated even higher case and dollar figures. Microbiological diseases (bacterial and viral) represent 84% of the United States' costs, with salmonellosis and staphylococcal intoxication being the most economically important diseases (annually $4.0 billion and $1.5 billion, respectively). Other costly types of illnesses are toxoplasmosis ($445 million), listeriosis ($313 million), campylobacteriosis ($156 million), trichinosis ($144 million), Clostridium perfringens enteritis ($123 million), and E. coli infections including hemorrhagic colitis ($223 million). Botulism has a high cost per case ($322,200), but its total impact is only $87 million because relatively few cases occur (270). This is because the food industry has been able to introduce effective control measures. Salmonellosis, however, is much more widespread (2.9 million cases) and affects all sectors of the food industry.

scholarly journals afa-8 Gene Cluster Is Carried by a Pathogenicity Island Inserted into the tRNAPhe of Human and Bovine Pathogenic Escherichia coli Isolates

2001 ◽  
Vol 69 (2) ◽  
pp. 937-948 ◽  
Author(s):  
Lila Lalioui ◽  
Chantal Le Bouguénec
Keyword(s):  
Escherichia Coli ◽  
Direct Repeat ◽  
Pathogenicity Island ◽  
Genomic Region ◽  
Open Reading Frames ◽  
Blood Isolate ◽  
Distinctive Features ◽  
E Coli ◽  
Pathogenic Escherichia Coli ◽  
K 12

ABSTRACT We recently described a new afimbrial adhesin, AfaE-VIII, produced by animal strains associated with diarrhea and septicemia and by human isolates associated with extraintestinal infections. Here, we report that the afa-8 operon, encoding AfaE-VIII adhesin, from the human blood isolate Escherichia coli AL862 is carried by a 61-kb genomic region with characteristics typical of a pathogenicity island (PAI), including a size larger than 10 kb, the presence of an integrase-encoding gene, the insertion into a tRNA locus (pheR), and the presence of a small direct repeat at each extremity. Moreover, the G+C content of the afa-8 operon (46.4%) is lower than that of the E. coli K-12/MG1655 chromosome (50.8%). Within this PAI, designated PAI IAL862, we identified open reading frames able to code for products similar to proteins involved in sugar utilization. Four probes spanning these sequences hybridized with 74.3% of pathogenicafa-8-positive E. coli strains isolated from humans and animals, 25% of human pathogenic afa-8-negativeE. coli strains, and only 8% of fecal strains (P = 0.05), indicating that these sequences are strongly associated with the afa-8 operon and that this genetic association may define a PAI widely distributed among human and animal afa-8-positive strains. One of the distinctive features of this study is that E. coli AL862 also carries another afa-8-containing PAI (PAI IIAL862), which appeared to be similar in size and genetic organization to PAI IAL862 and was inserted into the pheV gene. We investigated the insertion sites of afa-8-containing PAI in human and bovine pathogenic E. coli strains and found that this PAI preferentially inserted into the pheV gene.

scholarly journals Escherichia coli O157:H7 outbreak linked to salami, British Columbia, Canada, 1999

2004 ◽  
Vol 132 (2) ◽  
pp. 283-289 ◽  
Author(s):  
D. M. MacDONALD ◽  
M. FYFE ◽  
A. PACCAGNELLA ◽  
A. TRINIDAD ◽  
K. LOUIE ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Meat Products ◽  
Case Control ◽  
Pfge Pattern ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

An outbreak of E. coli O157:H7 infections was identified in November 1999 with a fivefold increase in the occurrence of laboratory-confirmed cases of E. coli O157:H7 infection. A matched case-control study was conducted. Samples of food from cases and from retailers were analysed for the presence of E. coli O157:H7. A total of 143 cases were identified over a 12-week period with the same pulsed-field gel electrophoresis (PFGE) pattern. The case-control study found that Company A salami was significantly associated with illness (Mantel–Haenszel matched odds ratio 10·0, 95% CI 1·4–434, P=0·01). Company A salami tested positive for E. coli O157:H7 and isolates had the same PFGE pattern as case isolates. An immediate voluntary national recall of Company A dry fermented meat products took place. Findings from the investigation of this outbreak suggest that the hold-and-test option may not be adequate to prevent shiga-toxigenic Escherichia coli (STEC) infection in salami consumers.

scholarly journals Outbreak of Shiga toxin-producing Escherichia coli O157:H7 linked to raw drinking milk resolved by rapid application of advanced pathogen characterisation methods, England, August to October 2017

2019 ◽  
Vol 24 (16) ◽  
Author(s):  
Juli Treacy ◽  
Claire Jenkins ◽  
Karthik Paranthaman ◽  
Frieda Jorgensen ◽  
Doris Mueller-Doblies ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Genetic Relatedness ◽  
Control Measures ◽  
Public Access ◽  
Epidemiological Surveillance ◽  
Effective Control ◽  
Whole Genome Sequencing Data ◽  
Sequencing Data ◽  
Drinking Milk

An outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 occurred on the Isle of Wight between August and October 2017. Of the seven cases linked to the outbreak, five were identified through the statutory notification process and two were identified through national surveillance of whole genome sequencing data. Enhanced surveillance questionnaires established a common link to a farm, and link to the likely food vehicle, raw drinking milk (RDM). Microbiological investigations, including PCR, identified the presence of STEC O157:H7 in samples of RDM. Analysis of core genome single nucleotide polymorphism (SNP) data of STEC O157:H7 from human stool specimens, animal faecal samples and RDM demonstrated a one SNP difference between isolates, and therefore close genetic relatedness. Control measures that were put in place included suspension of sales and recall of RDM, as well as restrictions on public access to parts of the farm. Successful integration of traditional epidemiological surveillance and advanced laboratory methods for the detection and characterisation of STEC O157:H7 from human, animal and environmental samples enabled prompt identification of the outbreak vehicle and provided evidence to support the outbreak control team’s decision-making, leading to implementation of effective control measures in a timely manner.

scholarly journals Molecular Epidemiology and Genome Dynamics of New Delhi Metallo-β-Lactamase-Producing Extraintestinal Pathogenic Escherichia coli Strains from India

2016 ◽  
Vol 60 (11) ◽  
pp. 6795-6805 ◽  
Author(s):  
Amit Ranjan ◽  
Sabiha Shaik ◽  
Agnismita Mondal ◽  
Nishant Nandanwar ◽  
Arif Hussain ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Effective Means ◽  
Genomic Analysis ◽  
Virulence Gene ◽  
Carbapenem Resistance ◽  
Control Measures ◽  
Large Sample Size ◽  
Gene Repertoire ◽  
Content Type ◽  
E Coli

ABSTRACTThe global dissemination and increasing incidence of carbapenem-resistant, Gram-negative organisms have resulted in acute public health concerns. Here, we present a retrospective multicenter study on molecular characterization of metallo-β-lactamase (MBL)-producing clinicalEscherichia coliisolates recovered from extraintestinal infections in two hospitals in Pune, India. We screened a large sample size of 510E. coliisolates for MBL production wherein we profiled their molecular determinants, antimicrobial resistance phenotypes, functional virulence properties, genomic features, and transmission dynamics. Approximately 8% of these isolates were MBL producers, the majority of which were of the NDM-1 (69%) type, followed by NDM-5 (19%), NDM-4 (5.5%), and NDM-7 (5.5%). MBL producers were resistant to all antibiotics tested except for colistin, fosfomycin, and chloramphenicol, which were effective to various extents. Plasmids were found to be an effective means of dissemination of NDM genes and other resistance traits. All MBL producers adhered to and invaded bladder epithelial (T24) cells and demonstrated significant serum resistance. Genomic analysis of MBL-producingE. coliisolates revealed higher resistance but a moderate virulence gene repertoire. A subset of NDM-1-positiveE. coliisolates was identified as dominant sequence type 101 (ST101) while two strains belonging to ST167 and ST405 harbored NDM-5. A majority of MBL-producingE. colistrains revealed unique genotypes, suggesting that they were clonally unrelated. Overall, the coexistence of virulence and carbapenem resistance in clinicalE. coliisolates is of serious concern. Moreover, the emergence of NDM-1 among the globally dominantE. coliST101 isolates warrants stringent surveillance and control measures.

scholarly journals Virulence Characteristics and Antibiotic Resistance Profiles of Shiga Toxin-Producing Escherichia coli Isolates from Diverse Sources

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 587
Author(s):  
Momna Rubab ◽  
Deog-Hwan Oh
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Shiga Toxin ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Diffusion Method ◽  
Shiga Toxins ◽  
E Coli ◽  
And Control ◽  
High Degree

Shiga toxin-producing Escherichia coli (STEC) is an enteric pathogen that causes several gastrointestinal ailments in humans across the world. STEC’s ability to cause ailment is attributed to the presence of a broad range of known and putative virulence factors (VFs) including those that encode Shiga toxins. A total of 51 E. coli strains belonging to serogroups O26, O45, O103, O104, O113, O121, O145, and O157 were tested for the presence of nine VFs via PCR and for their susceptibility to 17 frequently used antibiotics using the disc diffusion method. The isolates belonged to eight different serotypes, including eight O serogroups and 12 H types. The frequency of the presence of key VFs were stx1 (76.47%), stx2 (86.27%), eae (100%), ehxA (98.03%), nleA (100%), ureC (94.11%), iha (96.07%), subA (9.80%), and saa (94.11%) in the E. coli strains. All E. coli strains carried seven or more distinct VFs and, among these, four isolates harbored all tested VFs. In addition, all E. coli strains had a high degree of antibiotic resistance and were multidrug resistant (MDR). These results show a high incidence frequency of VFs and heterogeneity of VFs and MDR profiles of E. coli strains. Moreover, half of the E. coli isolates (74.5%) were resistant to > 9 classes of antibiotics (more than 50% of the tested antibiotics). Thus, our findings highlight the importance of appropriate epidemiological and microbiological surveillance and control measures to prevent STEC disease in humans worldwide.

scholarly journals Characterization of human and mouse granulocyte-macrophage-colony-stimulating factors derived from Escherichia coli

1987 ◽  
Vol 247 (1) ◽  
pp. 195-199 ◽  
Author(s):  
J L Schrimsher ◽  
K Rose ◽  
M G Simona ◽  
P Wingfield
Keyword(s):  
Escherichia Coli ◽  
Amino Acid ◽  
Amino Acid Sequences ◽  
Natural Material ◽  
Animal Cells ◽  
Colony Stimulating Factors ◽  
E Coli ◽  
Macrophage Colony ◽  
The One ◽  
Human And Mouse

Human and mouse granulocyte-macrophage-colony-stimulating factors (hGM-CSF and mGM-CSF, respectively), isolated from Escherichia coli cells expressing the corresponding human and mouse genes, have been characterized. The observed properties of the proteins have been compared with those properties which can be deduced from the DNA sequence alone and the published properties of natural GM-CSFs. The purified E. coli-derived proteins were found to have the expected molecular masses, amino acid compositions and N- and C-terminal amino acid sequences. The finding of 70-90% unprocessed N-terminal methionine for both proteins is discussed. The four Cys residues were found to be involved in two intramolecular disulphide bonds, linking the first and third, and second and fourth Cys residues. This disulphide bond arrangement is probably the one existing in natural material, since, although not glycosylated, both E. coli-derived proteins showed biological activity (colony stimulating assay for hGM-CSF, and cell proliferation assay for mGM-CSF) comparable with that reported for the respective proteins purified from animal cells.

Outbreak of Escherichia coli O157:H7 Infections Associated with Consumption of Beef Donair

2007 ◽  
Vol 70 (6) ◽  
pp. 1483-1488 ◽  
Author(s):  
ANDREA CURRIE ◽  
JUDY MACDONALD ◽  
ANDREA ELLIS ◽  
JENNIFER SIUSHANSIAN ◽  
LINDA CHUI ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Food Safety ◽  
Significant Risk ◽  
Ground Beef ◽  
Significant Risk Factor ◽  
Case Control ◽  
Control Measures ◽  
Escherichia Coli O157 ◽  
Fourfold Increase ◽  
Matched Case

The Calgary Health Region identified an outbreak of Escherichia coli O157:H7 infection in September 2004 following a fourfold increase in laboratory reports. Clinical isolates were indistinguishable by pulsed-field gel electrophoresis (PFGE), and the PFGE pattern was unique in North America. Most affected individuals reported beef donair consumption in 10-day food histories. We conducted a matched case-control study, inspected the implicated food premises, and conducted a traceback investigation of suspect ground beef to determine the source of the outbreak and implement prevention and control measures. A total of 43 laboratory-confirmed cases were identified, with symptom onsets between 8 September and 1 October 2004. Among 26 matched case-control pairs, consumption of beef donair from one of two locations of a local restaurant chain was the only statistically significant risk factor for infection (matched odds ratio undefined; P < 0.01). No samples of the implicated ground beef were available for microbiological testing. We identified several opportunities for time-temperature abuse and other factors that may have contributed to the serving of unsafe donair meat at the implicated restaurants. This outbreak highlighted gaps in food safety policy related to beef donair and similar products in Canada. Immediately following the outbreak, the Region implemented new safe food handling requirements and a Federal/Provincial/Territorial Working Group was established to make recommendations for national food safety policies specific to these products.

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