Prevalence of Hemolysin Genes and Comparison ofehxASubtype Patterns in Shiga Toxin-Producing Escherichia coli (STEC) and Non-STEC Strains from Clinical, Food, and Animal Sources
ABSTRACTShiga toxin-producingEscherichia coli(STEC) belonging to certain serogroups (e.g., O157 and O26) can cause serious conditions like hemolytic-uremic syndrome (HUS), but other strains might be equally pathogenic. While virulence factors, likestxandeae, have been well studied, little is known about the prevalence of theE. colihemolysin genes (hlyA,ehxA,e-hlyA, andsheA) in association with these factors. Hemolysins are potential virulence factors, andehxAandhlyAhave been associated with human illness, but the significance ofsheAis unknown. Hence, 435E. colistrains belonging to 62 different O serogroups were characterized to investigate gene presence and phenotypic expression of hemolysis. We further investigatedehxAsubtype patterns inE. coliisolates from clinical, animal, and food sources. WhilesheAandehxAwere widely distributed,e-hlyAandhlyAwere rarely found. Most strains (86.7%) were hemolytic, and significantly more hemolytic (95%) than nonhemolytic strains (49%) carriedstxand/oreae(P< 0.0001).ehxAsubtyping, as performed by using PCR in combination with restriction fragment length polymorphism analysis, resulted in six closely related subtypes (>94.2%), with subtypes A/D beingeae-negative STECs and subtypes B, C, E, and Feaepositive. Unexpectedly,ehxAsubtype patterns differed significantly between isolates collected from different sources (P< 0.0001), suggesting that simple linear models of exposure and transmission need modification; animal isolates carried mostly subtypes A/C (39.3%/42.9%), food isolates carried mainly subtype A (81.9%), and clinical isolates carried mainly subtype C (66.4%). Certain O serogroups correlated with particularehxAsubtypes: subtype A with O104, O113, and O8; B exclusively with O157; C with O26, O111, and O121.