Isolation of an Escherichia coli O157:H7 strain producing Shiga toxin 1 but not Shiga toxin 2 from a patient with hemolytic uremic syndrome in Korea

In Argentina, Escherichia coli O157:H7/NM (STEC O157) is the prevalent serotype associated with hemolytic uremic syndrome (HUS), which is endemic in the country with more than 400 cases per year. In order to estimate the prevalence and characteristics of STEC O157 in beef cattle at slaughter, a survey of 1,622 fecal and carcass samples was conducted in nine beef exporting abattoirs from November 2006 to April 2008. A total of 54 samples were found positive for STEC O157, with an average prevalence of 4.1% in fecal content and 2.6% in carcasses. Calves and heifers presented higher percentages of prevalence in feces, 10.5 and 8.5%, respectively. All STEC O157 isolates harbored stx2 (Shiga toxin 2), eae (intimin), ehxA (enterohemolysin), and fliCH7 (H7 flagellin) genes, while stx1 (Shiga toxin 1) was present in 16.7% of the strains. The prevalent (56%) stx genotype identified was stx2 combined with variant stx2c (vh-a), the combination of which is also prevalent (>90%) in STEC O157 post–enteric HUS cases in Argentina. The clonal relatedness of STEC O157 strains was established by phage typing and pulsed-field gel electrophoresis (PFGE). The 54 STEC isolates were categorized into 12 different phage types and in 29 XbaI-PFGE patterns distributed in 27 different lots. STEC O157 strains isolated from 5 of 21 carcasses were identical by PFGE (100% similarity) to strains of the fecal content of the same or a contiguous bovine in the lot. Five phage type–PFGE–stx profiles of 10 strains isolated in this study matched with the profiles of the strains recovered from 18 of 122 HUS cases that occurred in the same period.

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Cognitive deficits found in a pro-inflammatory state are independent of ERK 1/2 signaling in the murine brain hippocampus treated with Shiga toxin 2 from enterohemorrhagic Escherichia Coli

10.1101/2020.08.24.264929 ◽

2020 ◽

Author(s):

Clara Berdasco ◽

Alipio Pinto ◽

Mariano Blake ◽

Fernando Correa ◽

Nadia A. Longo Carbajosa ◽

...

Keyword(s):

Escherichia Coli ◽

Central Nervous System ◽

Nervous System ◽

Hemolytic Uremic Syndrome ◽

Signaling Pathway ◽

Shiga Toxin ◽

Enterohemorrhagic Escherichia Coli ◽

Shiga Toxin 2 ◽

Uremic Syndrome ◽

The Brain

AbstractShiga toxin 2 (Stx2) from enterohemorrhagic Escherichia coli (EHEC) produces hemorrhagic colitis, hemolytic uremic syndrome (HUS) and acute encephalopathy. The mortality rate in HUS increases significantly when the central nervous system (CNS) is involved. Besides, EHEC also releases lipopolysaccharide (LPS). Many reports have described cognitive dysfunctions in HUS patients, the hippocampus being one of the brain areas targeted by EHEC infection. In this context, a translational murine model of encephalopathy was employed to establish the deleterious effects of Stx2 and the contribution of LPS in the hippocampus. Results demonstrate that systemic administration of a sublethal dose of Stx2 reduced memory index and produced depression like behavior, pro-inflammatory cytokine release and NF-kB activation independent of the ERK 1/2 signaling pathway. On the other hand, LPS activated NF-kB dependent on ERK 1/2 signaling pathway. Cotreatment of Stx2 with LPS aggravated the pathologic state, while dexamethasone treatment succeeded in preventing behavioral alterations. Our present work suggests that the use of drugs such as corticosteroids or NF-kB signaling inhibitors may serve as neuroprotectors from EHEC infection.Author SummaryShiga toxin (Stx) from enterohemorrhagic Escherichia coli (EHEC) is one of the most virulent factors responsible for hemolytic uremic syndrome (HUS). Stx2, the endemic variant targets the brain, among other organs, thus inducing encephalopathies. Central nervous system (CNS) compromise was the main predictor of death in patients with HUS. Stx2 may exert a direct action in the CNS, by disrupting the neurovascular unit. In this context, we investigate the molecular signaling triggered by Stx2 in the murine brain hippocampus involved in inflammatory mechanisms that altered hippocampal-related cognitive behaviors. The present data underscore that the use of drugs such as dexamethasone or those blocking the cascade by preventing NF-kB translocation to the nucleus may serve as effective neuroprotectors with potentially beneficial use in the clinic.

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Hemolytic Uremic Syndrome Surveillance to Monitor Trends in Infection with Escherichia coli O157:H7 and Other Shiga Toxin-Producing E. coli

Emerging Infectious Diseases ◽

10.3201/eid0303.970329 ◽

1997 ◽

Vol 3 (3) ◽

pp. 409-412 ◽

Cited By ~ 14

Author(s):

Barbara Mahon

Keyword(s):

Escherichia Coli ◽

Hemolytic Uremic Syndrome ◽

Shiga Toxin ◽

Escherichia Coli O157 ◽

E Coli ◽

Uremic Syndrome ◽

Syndrome Surveillance

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Gut–Kidney Axis on Chip for Studying Effects of Antibiotics on Risk of Hemolytic Uremic Syndrome by Shiga Toxin-Producing Escherichia coli

Toxins ◽

10.3390/toxins13110775 ◽

2021 ◽

Vol 13 (11) ◽

pp. 775

Author(s):

Yugyeong Lee ◽

Min-Hyeok Kim ◽

David Rodrigues Alves ◽

Sejoong Kim ◽

Luke P. Lee ◽

...

Keyword(s):

Escherichia Coli ◽

Hemolytic Uremic Syndrome ◽

Shiga Toxin ◽

Low Frequency ◽

Kidney Cells ◽

Number Of Patients ◽

Relevant Situation ◽

Shiga Toxin 2 ◽

Uremic Syndrome ◽

On Chip

Shiga toxin-producing Escherichia coli (STEC) infects humans by colonizing the large intestine, and causes kidney damage by secreting Shiga toxins (Stxs). The increased secretion of Shiga toxin 2 (Stx2) by some antibiotics, such as ciprofloxacin (CIP), increases the risk of hemolytic–uremic syndrome (HUS), which can be life-threatening. However, previous studies evaluating this relationship have been conflicting, owing to the low frequency of EHEC infection, very small number of patients, and lack of an appropriate animal model. In this study, we developed gut–kidney axis (GKA) on chip for co-culturing gut (Caco-2) and kidney (HKC-8) cells, and observed both STEC O157:H7 (O157) infection and Stx intoxication in the gut and kidney cells on the chip, respectively. Without any antibiotic treatment, O157 killed both gut and kidney cells in GKA on the chip. CIP treatment reduced O157 infection in the gut cells, but increased Stx2-induced damage in the kidney cells, whereas the gentamycin treatment reduced both O157 infection in the gut cells and Stx2-induced damage in the kidney cells. This is the first report to recapitulate a clinically relevant situation, i.e., that CIP treatment causes more damage than gentamicin treatment. These results suggest that GKA on chip is very useful for simultaneous observation of O157 infections and Stx2 poisoning in gut and kidney cells, making it suitable for studying the effects of antibiotics on the risk of HUS.

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Adult nondiarrhea hemolytic uremic syndrome associated with shiga toxin escherichia coli O157:H7 bacteremia and urinary tract infection

American Journal of Kidney Diseases ◽

10.1053/ajkd.2003.50022 ◽

2003 ◽

Vol 41 (1) ◽

pp. e4.1-e4.4 ◽

Cited By ~ 27

Author(s):

Carlos Chiurchiu ◽

Anna Firrincieli ◽

Marisa Santostefano ◽

Maurizio Fusaroli ◽

Giuseppe Remuzzi ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Hemolytic Uremic Syndrome ◽

Shiga Toxin ◽

Escherichia Coli O157 ◽

Uremic Syndrome

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Complement activation on platelet-leukocyte complexes and microparticles in enterohemorrhagic Escherichia coli–induced hemolytic uremic syndrome

Blood ◽

10.1182/blood-2010-09-309161 ◽

2011 ◽

Vol 117 (20) ◽

pp. 5503-5513 ◽

Cited By ~ 118

Author(s):

Anne-lie Ståhl ◽

Lisa Sartz ◽

Diana Karpman

Keyword(s):

Escherichia Coli ◽

Hemolytic Uremic Syndrome ◽

Shiga Toxin ◽

Complement Activation ◽

Whole Blood ◽

Enterohemorrhagic Escherichia Coli ◽

Escherichia Coli O157 ◽

Plasma Samples ◽

Uremic Syndrome ◽

Platelet Microparticles

AbstractHemolytic uremic syndrome (HUS) is commonly associated with Shiga toxin (Stx)–producing Escherichia coli O157:H7 infection. This study examined patient samples for complement activation on leukocyte-platelet complexes and microparticles, as well as donor samples for Stx and lipopolysaccharide (O157LPS)–induced complement activation on platelet-leukocyte complexes and microparticles. Results, analyzed by flow cytometry, showed that whole blood from a child with HUS had surface-bound C3 on 30% of platelet-monocyte complexes compared with 14% after recovery and 12% in pediatric controls. Plasma samples from 12 HUS patients were analyzed for the presence of microparticles derived from platelets, monocytes, and neutrophils. Acute-phase samples exhibited high levels of platelet microparticles and, to a lesser extent, monocyte microparticles, both bearing C3 and C9. Levels decreased significantly at recovery. Stx or O157LPS incubated with donor whole blood increased the population of platelet-monocyte and platelet-neutrophil complexes with surface-bound C3 and C9, an effect enhanced by costimulation with Stx and O157LPS. Both Stx and O157LPS induced the release of C3- and C9-bearing microparticles from platelets and monocytes. Released microparticles were phagocytosed by neutrophils. The presence of complement on platelet-leukocyte complexes and microparticles derived from these cells suggests a role in the inflammatory and thrombogenic events that occur during HUS.

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International Comparison of Clinical, Bovine, and Environmental Escherichia coli O157 Isolates on the Basis of Shiga Toxin-Encoding Bacteriophage Insertion Site Genotypes

Applied and Environmental Microbiology ◽

10.1128/aem.01190-08 ◽

2008 ◽

Vol 74 (23) ◽

pp. 7447-7450 ◽

Cited By ~ 16

Author(s):

Joshua H. Whitworth ◽

Narelle Fegan ◽

Jasmin Keller ◽

Kari S. Gobius ◽

James L. Bono ◽

...

Keyword(s):

Escherichia Coli ◽

Hemolytic Uremic Syndrome ◽

Shiga Toxin ◽

Clinical Case ◽

Insertion Site ◽

Escherichia Coli O157 ◽

E Coli ◽

Transmission Chain ◽

Uremic Syndrome ◽

Case Transmission

ABSTRACT Escherichia coli O157:H7 genotypes in the bovine reservoir may differ in virulence. The proportion of clinical genotypes among cattle isolates was weakly (P = 0.054) related to the international incidence of E. coli O157:H7-associated hemolytic-uremic syndrome, varied among clinical isolates internationally, and also differed along the putative cattle-hamburger-clinical case transmission chain.

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