scholarly journals EHEC outbreak among staff at a children's hospital – use of PCR for verocytotoxin detection and PFGE for epidemiological investigation

2004 ◽  
Vol 132 (1) ◽  
pp. 43-49 ◽  
Author(s):  
C. WELINDER-OLSSON ◽  
K. STENQVIST ◽  
M. BADENFORS ◽  
Å. BRANDBERG ◽  
K. FLORÉN ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Fast Method ◽  
Epidemiological Investigation ◽  
Foodborne Outbreak ◽  
E Coli ◽  
Staff Members ◽  
Children's Hospital ◽  
Source Of Infection ◽  
Children’S Hospital ◽  
Culture Positive

This is the first report of a major foodborne outbreak of enterohaemorrhagic Escherichia coli (EHEC) in Sweden. It occurred among the nursing staff at a children's hospital with approximately 1600 employees. Contaminated lettuce was the most likely source of infection. Nine persons were culture-positive for Escherichia coli (E. coli) O157 and verocytotoxin-positive by PCR and a further two were verocytotoxin-positive by PCR only. All 11 EHEC-positive individuals had attended a party for approximately 250 staff members, which was held at the hospital. In a questionnaire 37 persons stated that they had symptoms consistent with EHEC infection during the weeks after the party. There was no evidence of secondary transmission from staff to patients. The value of PCR as a sensitive and fast method for diagnosis is discussed in this paper. Pulsed-field gel electrophoresis (PFGE) was used to ascertain that staff members were infected by the same clone, and that two patients with E. coli O157 infection were not.

scholarly journals Variation in Resistance Traits, Phylogenetic Backgrounds, and Virulence Genotypes among Escherichia coli Clinical Isolates from Adjacent Hospital Campuses Serving Distinct Patient Populations

2015 ◽  
Vol 59 (9) ◽  
pp. 5331-5339 ◽  
Author(s):  
Sarah M. Drawz ◽  
Stephen Porter ◽  
Michael A. Kuskowski ◽  
Brian Johnston ◽  
Connie Clabots ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Gene ◽  
Clinical Isolates ◽  
Fluoroquinolone Resistance ◽  
Esbl Production ◽  
Content Type ◽  
E Coli ◽  
Children's Hospital ◽  
High Acuity ◽  
Children’S Hospital

ABSTRACTEscherichia colisequence type 13 (ST131), an emergent cause of multidrug-resistant extraintestinal infections, has important phylogenetic subsets, notably theH30 andH30Rx subclones, with distinctive resistance profiles and, possibly, clinical associations. To clarify the local prevalence of these ST131 subclones and their associations with antimicrobial resistance, ecological source, and virulence traits, we extensively characterized 233 consecutiveE. coliclinical isolates (July and August 2013) from the University of Minnesota Medical Center-Fairview Infectious Diseases and Diagnostic Laboratory, Minneapolis, MN, which serves three adjacent facilities (a children's hospital and low- and high-acuity adult facilities). ST131 accounted for 26% of the study isolates (more than any other clonal group), was distributed similarly by facility, and was closely associated with ciprofloxacin resistance and extended-spectrum β-lactamase (ESBL) production. TheH30 andH30Rx subclones accounted for most ST131 isolates and for the association of ST131 with fluoroquinolone resistance and ESBL production. Unlike ST131per se, these subclones were distributed differentially by hospital, being most prevalent at the high-acuity adult facility and were absent from the children's hospital. The virulence gene profiles of ST131 and its subclones were distinctive and more extensive than those of other fluoroquinolone-resistant or ESBL-producing isolates. Within ST131,blaCTX-M-15was confined toH30Rx isolates and otherblaCTX-Mvariants to non-RxH30 isolates. Pulsed-field gel electrophoresis documented a predominance of globally distributed pulsotypes and no local outbreak pattern. These findings help clarify the epidemiology, ecology, and bacterial correlates of theH30 andH30Rx ST131 subclones by documenting a high overall prevalence but significant segregation by facility, strong associations with fluoroquinolone resistance and specific ESBL variants, and distinctive virulence gene associations that may confer fitness advantages over other resistantE. coli.

GASTROENTERITIS IN INFANTS ASSOCIATED WITH SPECIFIC SEROTYPES OF ESCHERICHIA COLI

PEDIATRICS ◽  
1956 ◽  
Vol 17 (2) ◽  
pp. 192-195
Author(s):  
Aaron H. Stock ◽  
Mary E. Shuman
Keyword(s):  
Escherichia Coli ◽  
Diarrheal Disease ◽  
Enteric Bacteria ◽  
E Coli ◽  
Children's Hospital ◽  
Salmonella Infections ◽  
Children’S Hospital ◽  
The Face ◽  
Pittsburgh Area

Except in the face of an epidemic the incidence of isolation of E. coli 0111:B4 and 055:B5 in the Pittsburgh area, as reflected by bacteriologic studies carried out on all patients with gastroenteritis admitted to a children's hospital, was low in a 3-year period. The incidence of salmonella infections was relatively higher. No shigella infections were found. It may be seen from the tables that in approximately 80 per cent of the patients with diarrheal disease no enteric bacteria known to be pathogenic could be isolated.

scholarly journals High burden of infections caused by ESBL-producing MDR Escherichia coli in paediatric patients, Yangon, Myanmar

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Thida San ◽  
Ingyin Moe ◽  
Elizabeth A Ashley ◽  
Nilar San
Keyword(s):  
Escherichia Coli ◽  
Microbiology Laboratory ◽  
Middle Income ◽  
Clinical Specimens ◽  
High Burden ◽  
E Coli ◽  
Children's Hospital ◽  
Paediatric Patients ◽  
Children’S Hospital ◽  
Diagnostic Microbiology

Abstract Background There is mounting evidence of a high burden of antimicrobial-resistant infections in children in low- and middle-income countries (LMICs). Objectives To detect the frequency of ESBL-producing Escherichia coli in clinical specimens from paediatric patients attending Yangon Children’s Hospital in Myanmar. Methods All children attending Yangon Children’s Hospital who had clinical specimens submitted to the hospital diagnostic microbiology laboratory from June 2019 to December 2019 were included in the study. Specimens were processed routinely using standard methods with BD Phoenix used for pathogen identification and susceptibility testing. Presence of ESBLs was determined using the cephalosporin/clavulanate combination disc method with confirmation by PCR. Results From 3462 specimens submitted to the Microbiology Laboratory, a total of 123 E. coli were isolated. Among them, 100 isolates were phenotypically ESBL producers, 94 (76.4%) of which were confirmed by PCR [82/94 (87%) CTX-M, 72/94 (77%) TEM, 1/94 (1%) SHV]. Most of the ESBL-producing E. coli were isolated from urine samples (52.1%, 49/94) and the majority were from the surgical unit (61.7%, 58/94). Only 34/94 (36%) isolates were susceptible to meropenem. Conclusions This study confirms a high proportion of infections caused by ESBL-producing and MDR E. coli in children hospitalized in Yangon, where access to effective second-line antimicrobials is limited.

Description of Enteropathic Escherichia coli Species in Pediatric Patients at a Quaternary Children’s Hospital

2019 ◽  
Vol 9 (5) ◽  
pp. 573-579 ◽  
Author(s):  
Bryan T Nycz ◽  
Kristin Pretty ◽  
Angel Gomez-Trujillo ◽  
Brenda Sanchez ◽  
Samuel R Dominguez
Keyword(s):  
Escherichia Coli ◽  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Clinical Microbiology Laboratory ◽  
E Coli ◽  
Children's Hospital ◽  
Positive Stool ◽  
Gi Symptoms ◽  
Children’S Hospital ◽  
Stool Samples

Abstract Background The epidemiology, demographics, clinical presentations, and outcomes associated with enteroaggregative Escherichia coli (EAEC), enteropathogenic E. coli (EPEC), and enterotoxigenic E. coli (ETEC) pathotypes in US children are not well understood. Methods This study was a retrospective chart review of all pediatric patients with a stool sample submitted to the Children’s Hospital Colorado clinical microbiology laboratory for testing with the BioFire FilmArray Gastrointestinal Pathogen Panel from October 2015 through October 2017. Results During the study period, 5692 patient stool samples were submitted; 679 (13%) were positive for EAEC, EPEC, or ETEC. Of note, 163/232 (70%) patients with EAEC, 282/493 (57%) with EPEC, and 49/58 (85%) with ETEC had detection of at least 1 other pathogen. Of all E. coli–positive stool samples, only 158/679 (23%) were from low-risk patients who were singly infected with EAEC, EPEC, or ETEC. In this cohort, most cases were associated with acute diarrhea (50%), abdominal pain (61%), and/or cramping (49%) and presented without fever (14%), emesis (28%), or lethargy (7%). Thirteen (8%) of these 158 patients received antibiotics at the time of their initial presentation to care. Of the 145 patients who did not receive antibiotics at their initial visit, 23 (16%) returned to care due to persistence of symptoms. Conclusions Our results suggest that the majority of patients singly infected with EAEC, EPEC, or ETEC present with mild, self-limited, gastrointestinal (GI) complaints. Further research is needed to determine what role these pathogens might play in children who present with chronic or inflammatory GI symptoms.

Bacteria and Viral Profile of Severe Acute Respiratory Infections of Children Attending Yangon Children’s Hospital and Yankin Children’s Hospital

2019 ◽  
Vol 31 (1) ◽  
pp. 44-51
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Antibiotic Sensitivity ◽  
Parainfluenza Virus ◽  
Sensitivity Testing ◽  
E Coli ◽  
Children's Hospital ◽  
Severe Acute Respiratory Infection ◽  
Children’S Hospital ◽  
Syncytial Virus

Objectives of study are (1) to reinforce the national capacity for diagnosis and antibiogram of some infectious diseases causing severe acute respiratory infection (SARI) and (2) to build a network between hospital and laboratory for the diagnosis and surveillance of SARI in Yangon. This study is a crosssectional hospital- and laboratory-based descriptive study. A total of 825 samples including respiratory samples and blood samples from 511 children attending Yangon Children’s Hospital and Yankin Children’s Hospital from December 2014 to April 2016 for treatment of SARI were included. Identification and antibiotic sensitivity testing were done using Vitek 2. Out of 129 gram-negative bacilli (GNB), K. pneumoniae 32%, P. aeruginosa 18%, A. baumannii 13%, E. coli 9% were mostly isolated. Among 35 gram-positive cocci (GPC), S. aureus 42% and S. pneumoniae 6% were mostly isolated. Multidrug resistance rates were E. coli 100%, K. pneumoniae 95%, A. baumanii 82% and P. aeruginosa 17%. Extended-spectrum beta-latamase (ESBL)-producing K. pneumoniae and E. coli was 6 out of 10 tested organisms. Carbarpenemase-producing GNB and methicillin-resistant Staphylococcus aureus (MRSA) were 21% and 33%, respectively. Virology section tested 529 samples of 490 patients using the FTD33 Multiplex PCR method which can detect 33 pathogens including 20 viruses, 12 bacteria and 1 fungus. Out of 490 patients, 374 were PCR positive. Different types of samples including nasopharyngeal, throat, endotracheal and laryngeal swab, tracheal secretion and bronchoalveolar lavage, were tested. Out of 566 viruses, respiratory syncytial virus (RSV) (19.3%), rhinovirus (17.0%), parechovirus (14.3%), bocavirus (11.1%), adenovirus (10.2%), metapneumo-virus A and B (10.2%), parainfluenza virus (5.7%), enterovirus (3.0%), influenza A virus (2.8%), coronavirus (4%), parainfluenza virus (0.9%) and influenza C virus (0.4%) were detected. This study highlighted the etiological agents of bacteria, viruses and drug-resistant bacterial pathogens in SARI.

Assessment of Awareness About Biomedical Waste Among Doctors and Nurses of Children Hospital Lahore

2021 ◽  
Author(s):  
Taimoor Hassan ◽  
Sidra Siddique ◽  
Sana Saeed ◽  
Muhammad Moazzam ◽  
Azmat Tahira ◽  
...  
Keyword(s):  
Sampling Technique ◽  
Medical Waste ◽  
Basic Knowledge ◽  
Human Beings ◽  
Biomedical Waste ◽  
Staff Members ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Study Population ◽  
Doctors And Nurses

Bio Medical waste refers to any type of waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research purposes pertaining to or in the fabrication or testing of biologicals. Objective: To assess the awareness about bio-medical waste management among Doctors and Nurses of Children Hospital.  Methods: Descriptive study was conducted in Children's Hospital and Institute of Child Health Lahore. Convenient Sampling Technique was applied to gather data. This was a hospital-based study in which staff members of both genders were included. The study population divided into two strata and these strata consisted of doctors and nurses. A total of 139 staff members were involved out of which there were 77 doctors, 62 nurses. Their responses checked by a Performa about problems in the management of biomedical waste. Results: The result showed that majority (62%) staff members had knowledge about bio-medical waste. The remaining staff had very basic knowledge about bio-medical waste. Conclusions: The awareness about BMW management among Children's Hospital Operation theater staff is satisfactory. But still, they need to improve their knowledge to ensure more patient safety by organizing seminars, workshops.

scholarly journals Comparative Whole Genome Analysis of Escherichia coli O157:H7 Isolates From Feedlot Cattle to Identify Genotypes Associated With the Presence and Absence of stx Genes

2021 ◽  
Vol 12 ◽  
Author(s):  
Mo Jia ◽  
Ifigenia Geornaras ◽  
Jennifer N. Martin ◽  
Keith E. Belk ◽  
Hua Yang
Keyword(s):  
Escherichia Coli ◽  
Metabolic Pathway ◽  
Genome Analysis ◽  
Feedlot Cattle ◽  
Phylogenomic Analysis ◽  
Whole Genome ◽  
Foodborne Outbreak ◽  
Whole Genome Analysis ◽  
E Coli ◽  
Red Recombination

A comparative whole genome analysis was performed on three newly sequenced Escherichia coli O157:H7 strains with different stx profiles, previously isolated from feedlot cattle [C1-010 (stx1−, stx2c+), C1-057 (stx−), and C1-067 (stx1+, stx2a+)], as well as five foodborne outbreak strains and six stx-negative strains from NCBI. Phylogenomic analysis demonstrated that the stx2c-carrying C1-010 and stx-negative C1-057 strains were grouped with the six NCBI stx-negative E. coli O157:H7 strains in Cluster 1, whereas the stx2a-carrying C1-067 and five foodborne outbreak strains were clustered together in Cluster 2. Based on different clusters, we selected the three newly sequenced strains, one stx2a-carrying strain, and the six NCBI stx-negative strains and identify their prophages at the stx insertion sites. All stx-carrying prophages contained both the three Red recombination genes (exo, bet, gam) and their repressor cI. On the other hand, the majority of the stx-negative prophages carried only the three Red recombination genes, but their repressor cI was absent. In the absence of the repressor cI, the consistent expression of the Red recombination genes in prophages might result in more frequent gene exchanges, potentially increasing the probability of the acquisition of stx genes. We further investigated each of the 10 selected E. coli O157:H7 strains for their respective unique metabolic pathway genes. Seven unique metabolic pathway genes in the two stx2a-carrying strains and one in the single stx2c-carrying and seven stx-negative strains were found to be associated with an upstream insertion sequence 629 within a conserved region among these strains. The presence of more unique metabolic pathway genes in stx2a-carrying E. coli O157:H7 strains may potentially increase their competitiveness in complex environments, such as feedlot cattle. For the stx2c-carrying and stx-negative E. coli O157:H7 strains, the fact that they were grouped into the same phylogenomic cluster and had the same unique metabolic pathway genes suggested that they may also share closely related evolutionary pathways. As a consequence, gene exchange between them is more likely to occur. Results from this study could potentially serve as a basis to help develop strategies to reduce the prevalence of pathogenic E. coli O157:H7 in livestock and downstream food production environments.

scholarly journals Lymphoid Follicle-Dense Mucosa at the Terminal Rectum Is the Principal Site of Colonization of Enterohemorrhagic Escherichia coli O157:H7 in the Bovine Host

2003 ◽  
Vol 71 (3) ◽  
pp. 1505-1512 ◽  
Author(s):  
Stuart W. Naylor ◽  
J. Christopher Low ◽  
Thomas E. Besser ◽  
Arvind Mahajan ◽  
George J. Gunn ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Primary Source ◽  
Detailed Examination ◽  
Lymphoid Follicle ◽  
Enterohemorrhagic Escherichia Coli ◽  
Escherichia Coli O157 ◽  
Associated Bacteria ◽  
E Coli ◽  
Source Of Infection ◽  
Specific Distribution

ABSTRACT Escherichia coli O157:H7 causes bloody diarrhea and potentially fatal systemic sequelae in humans. Cattle are most frequently identified as the primary source of infection, and E. coli O157:H7 generally colonizes the gastrointestinal tracts of cattle without causing disease. In this study, persistence and tropism were assessed for four different E. coli O157:H7 strains. Experimentally infected calves shed the organism for at least 14 days prior to necropsy. For the majority of these animals, as well as for a naturally colonized animal obtained from a commercial beef farm, the highest numbers of E. coli O157:H7 were found in the feces, with negative or significantly lower levels detected in lumen contents taken from the gastrointestinal tract. Detailed examination demonstrated that in these individuals the majority of tissue-associated bacteria were adherent to mucosal epithelium within a defined region extending up to 5 cm proximally from the recto-anal junction. The tissue targeted by E. coli O157:H7 was characterized by a high density of lymphoid follicles. Microcolonies of the bacterium were readily detected on the epithelium of this region by immunofluorescence microscopy. As a consequence of this specific distribution, E. coli O157:H7 was present predominately on the surface of the fecal stool. In contrast, other E. coli serotypes were present at consistent levels throughout the large intestine and were equally distributed in the stool. This is a novel tropism that may enhance dissemination both between animals and from animals to humans. The accessibility of this site may facilitate simple intervention strategies.

scholarly journals Escherichia coli O157:H7 in Environments of Culture-Positive Cattle

2005 ◽  
Vol 71 (11) ◽  
pp. 6816-6822 ◽  
Author(s):  
Margaret A. Davis ◽  
Karen A. Cloud-Hansen ◽  
John Carpenter ◽  
Carolyn J. Hovde
Keyword(s):  
Escherichia Coli ◽  
Room Temperature ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Different Temperatures ◽  
Farm Structures ◽  
On Farm ◽  
Culture Positive ◽  
Culture Negative ◽  
Over Time

ABSTRACT Outbreaks of Escherichia coli O157:H7 disease associated with animal exhibits have been reported with increasing frequency. Transmission can occur through contact with contaminated haircoats, bedding, farm structures, or water. We investigated the distribution and survival of E. coli O157:H7 in the immediate environments of individually housed, experimentally inoculated cattle by systematically culturing feed, bedding, water, haircoat, and feed bunk walls for E. coli O157:H7 for 3 months. Cedar chip bedding was the most frequently culture-positive environmental sample tested (27/96 or 28.15%). Among these, 12 (44.0%) of positive bedding samples were collected when the penned animal was fecal culture negative. Survival of E. coli O157:H7 in experimentally inoculated cedar chip bedding and in grass hay feed was determined at different temperatures. Survival was longest in feed at room temperature (60 days), but bacterial counts decreased over time. The possibility that urine plays a role in the environmental survival of E. coli O157:H7 was investigated. Cedar chip bedding moistened with sterile water or bovine urine was inoculated with E. coli O157:H7. Bedding moistened with urine supported growth of E. coli O157:H7, whereas inoculated bedding moistened with only water yielded decreasing numbers of bacteria over time. The findings that environmental samples were frequently positive for E. coli O157:H7 at times when animals were culture negative and that urine provided a substrate for E. coli O157:H7 growth have implications for understanding the on-farm ecology of this pathogen and for the safety of ruminant animal exhibits, particularly petting zoos and farms where children may enter animal pens.

scholarly journals Cotrimoxazole-ResistantEscherichia coliBacteremia in Neutropenic Patients at a Regional Oncology Hospital

1992 ◽  
Vol 3 (1) ◽  
pp. 14-18
Author(s):  
Daniel B Gregson ◽  
Anne G Matlow ◽  
Andrew E Simor ◽  
Peter G Tuffnell ◽  
Donald E Low ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Marrow Transplant ◽  
Single Strain ◽  
Gram Negative ◽  
E Coli ◽  
Staff Members ◽  
Cotrimoxazole Prophylaxis ◽  
Neutropenic Patients ◽  
Chemotherapy Induced Neutropenia ◽  
High Level

In a regional oncology hospital using cotrimoxazole (trimethoprim-sulphamethoxazole) prophylaxis during chemotherapy-induced neutropenia, a single strain ofEscherichia coli(indole negative) caused 15 of 27 episodes of Gram-negative rod bacteremia in 1987, and four of 32 such episodes in 1988. This biotype had not been recovered in 1986. Investigations during this ‘outbreak’ of bacteremias revealed enteric colonization with this strain ofE coliin 37% of patients on leukemia or bone marrow transplant wards and in several staff members in July 1987. In 1988, 11 of 32 Gram-negative rod bacteremias were secondary to other strains of indole positiveE coliof several different biotypes and plasmid profiles. Indole negative strains all exhibited low level trimethoprim resistance, whereas indole positive strains which subsequently appeared exhibited high level trimethoprim resistance. Failure of cotrimoxazole prophylaxis was initially due to the clonal dissemination of a single strain ofE coliwithin the institution, with the subsequent appearance of multipleE colistrains with probable differing genetic bases for their resistance.

Sign in / Sign up

Export Citation Format

Share Document