Escherichia coli O121 outbreak associated with raw milk Gouda-like cheese in British Columbia, Canada, 2018

Background: In 2018, a Shiga toxin–producing Escherichia coli O121 outbreak that affected seven individuals was associated with raw milk Gouda-like cheese produced in British Columbia, Canada. Objectives: To describe the E. coli O121 outbreak investigation and recommend greater control measures for raw milk Gouda-like cheese. Methods: Cases of E. coli O121 were identified through laboratory testing results and epidemiologic surveillance data. The cases were interviewed on exposures of interest, which were analyzed against Foodbook Report values for British Columbia. Environmental inspection of the dairy plant and the cheese products was conducted to ascertain a source of contamination. Whole genome multi-locus sequence typing (wgMLST) was performed on all positive E. coli O121 clinical and food isolates at the provincial laboratory. Results: Four out of the seven cases consumed the same raw milk Gouda-like cheese between August and October 2018. The implicated cheese was aged longer than the required minimum of 60 days, and no production deficiencies were noted. One sample of the implicated cheese tested positive for E. coli O121. The seven clinical isolates and one cheese isolate matched by wgMLST within 6.5 alleles. Conclusion: Raw milk Gouda and Gouda-like cheese has been implicated in three previous Shiga toxin–producing E. coli outbreaks in North America. It was recommended product labelling to increase consumer awareness and thermization of milk to decrease the risk of illness associated with raw milk Gouda and Gouda-like cheese.

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Prevalence and molecular characterisation of shiga-toxin-producing Escherichia coli in raw milk cheeses from Lazio region, Italy

Italian Journal of Food Safety ◽

10.4081/ijfs.2016.4566 ◽

2016 ◽

Vol 5 (1) ◽

Cited By ~ 3

Author(s):

Selene Marozzi ◽

Paola De Santis ◽

Sarah Lovari ◽

Roberto Condoleo ◽

Stefano Bilei ◽

...

Keyword(s):

Escherichia Coli ◽

Shiga Toxin ◽

Raw Milk ◽

Foodborne Diseases ◽

Control Plan ◽

Lazio Region ◽

Standard Methods ◽

E Coli ◽

Regional Control ◽

Unpasteurized Milk

In recent years, the incidence of foodborne diseases caused by shiga toxin-producing Escherichia coli (STEC) has increased globally. For this reason, within the specific regional control plan for the detection of STEC in food products in Italy, the presence of STEC in unpasteurized milk cheeses was investigated. In total 203 samples obtained from March 2011 to December 2013 were analysed, with two standard methods (ISO 16654:2001 and ISO 13136:2012). Two strains of E. coli O157 were isolated (2/161, 1.2%) but did not carry any virulence-associated genes and 22 stx-positive samples (22/146, 15.1%) were detected in enrichment cultures, mostly from ovine cheeses. Only two strains isolated from different ovine cheeses carried stx gene and none of these was eae-positive. This study confirms the presence of stx-positive E. coli and suggests that this type of food cannot be excluded as a potential vehicle of STEC.

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

Antibiotics ◽

10.3390/antibiotics9090587 ◽

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.

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Prevalence and molecular characterization of Shiga toxin-producing escherichia coli isolates from human and sheep in Al-Madinah Al-Munawarah

Infectio ◽

10.22354/in.v21i2.651 ◽

2017 ◽

Vol 21 (2) ◽

Author(s):

Eman Fathi Sharafa ◽

Iman I. Shabanaa

Keyword(s):

Escherichia Coli ◽

Foodborne Pathogens ◽

Shiga Toxin ◽

Genetic Relatedness ◽

Control Measures ◽

Health Concern ◽

Global Public Health ◽

E Coli ◽

Life Threatening

Shiga toxin-producing Escherichia coli (STEC) strains have emerged as important foodborne pathogens of global public health concern, causing life-threatening diseases. Sheep and their products have been documented as important reservoirs for STECs, especially E. coli O157. The aim of this study was to investigate STECs from diarrheal human and sheep in Al-Madinah Al-Munawarah, Saudi Arabia. Fecal samples were collected between June and August, 2015 from diarrheal humans (n = 134) and sheep (n = 87). Presumptive E. coli human-and sheep-isolated strains were identified for their serotypes, the associated virulence genes (Shiga toxin [stx1 , stx2 ], haemolysin [ehxA] and intimin [eae]) by polymerase chain reaction and their susceptibility to antibiotics. Pulsed-field gel electrophoresis (PFGE) was used to demonstrate the genetic relatedness between Serotype O157:H7 human- and sheep-isolated strains. Forty eight (48/221; 21.7%) STECs were recovered from both human and sheep, their serotypes were as follows: O157:H7, O26:H11, O157:HNM, O26:HNM, O128:H2, O48:HNM, O111:HNM and OUT:HUT. Various virulence profiles and multiple antibiotic resistance were observed among the isolates. Twenty eight O157:H7 serotypes (17 human isolates and 11 sheep isolates) were identified in 13 PFGE pulsotypes, where human and sheep isolates were highly related. PFGE banding profiles together with serotypes and genotypes afford proof that human and sheep can be colonized and infected with similar E. coli O157:H7 strains. Our findings highlight the importance of epidemiological and microbiological surveillance of STECs; as well as the development of control measures to decrease risks associated with zoonotic O157:H7.

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Genetic heterogeneity of Escherichia coli strains isolated from raw milk, Minas Frescal cheese, and food handlers

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/s0102-09352009000500025 ◽

2009 ◽

Vol 61 (5) ◽

pp. 1203-1209 ◽

Cited By ~ 6

Author(s):

M.R.H. Campos ◽

M.C.D.P.B. André ◽

L.J. Borges ◽

A. Kipnis ◽

F.C. Pimenta ◽

...

Keyword(s):

Escherichia Coli ◽

Food Industry ◽

Raw Milk ◽

Pulsed Field Gel Electrophoresis ◽

Processing Plant ◽

Food Handlers ◽

E Coli ◽

Epidemiological Tool ◽

Dairy Plant ◽

High Diversity

From February 2004 to March 2005, 140 samples of food handlers - hands and nostrils - (92), raw milk (24), and minas frescal cheese (24) were analyzed for the presence of Escherichia coli in a dairy processing plant of Goiás State. Forty-seven E. coli strains were obtained and compared by DNA macrorestriction patterns obtained from pulsed-field gel electrophoresis following XbaI restriction in order to investigate the possible sources of cheese contaminations. Based on PFGE genotyping, one strain isolated from food the hands of a handler and five strains isolated from raw milk were identical or closely related to six strains from cheese suggesting, in these cases, the probable source of E. coli contamination in cheeses. No strain isolated from the nostrils was related to those found in cheeses or milk strains. The results showed high diversity among the strains, demonstrating a lack of predominance of an endemic clone in the dairy plant. This paper highlights the usefulness of PFGE as an epidemiological tool for determining the source of E. coli contamination in the food industry.

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Outbreak of Escherichia coli O157:H7 Infections Linked to Aged Raw Milk Gouda Cheese, Canada, 2013

Journal of Food Protection ◽

10.4315/0362-028x.jfp-17-283 ◽

2017 ◽

Vol 81 (2) ◽

pp. 325-331 ◽

Cited By ~ 12

Author(s):

Andrea Currie ◽

Eleni Galanis ◽

Pedro A. Chacon ◽

Regan Murray ◽

Lynn Wilcott ◽

...

Keyword(s):

Escherichia Coli ◽

Primary Source ◽

Raw Milk ◽

Core Sample ◽

Escherichia Coli O157 ◽

E Coli ◽

Aging Period ◽

Dairy Plant ◽

Gouda Cheese ◽

Canadian Provinces

ABSTRACT Between 12 July and 29 September 2013, 29 individuals in five Canadian provinces became ill following infection with the same strain of Escherichia coli O157:H7 as defined by molecular typing results. Five case patients were hospitalized, and one died. Twenty-six case patients (90%) reported eating Gouda cheese originating from a dairy plant in British Columbia. All of the 22 case patients with sufficient product details available reported consuming Gouda cheese made with raw milk; this cheese had been produced between March and July 2013 and was aged for a minimum of 60 days. The outbreak strain was isolated from the implicated Gouda cheese, including one core sample obtained from an intact cheese wheel 83 days after production. The findings indicate that raw milk was the primary source of the E. coli O157:H7, which persisted through production and the minimum 60-day aging period. This outbreak is the third caused by E. coli O157:H7 traced to Gouda cheese made with raw milk in North America. These findings provide further evidence that a 60-day ripening period cannot ensure die-off of pathogens that might be present in raw milk Gouda cheese after production and have triggered an evaluation of processing conditions, physicochemical parameters, and options to mitigate the risk of E. coli O157:H7 infection associated with raw milk Gouda cheese produced in Canada.

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Presence of Escherichia coli O157 and O157:H7 in raw milk and Van herby cheese

Bulletin of the Veterinary Institute in Pulawy ◽

10.1515/bvip-2015-0076 ◽

2015 ◽

Vol 59 (4) ◽

pp. 511-514 ◽

Cited By ~ 5

Author(s):

Yakup Can Sancak ◽

Hakan Sancak ◽

Ozgur Isleyici

Keyword(s):

Public Health ◽

Escherichia Coli ◽

Drug Administration ◽

Shiga Toxin ◽

Raw Milk ◽

Escherichia Coli O157 ◽

Human Pathogens ◽

Emerging Pathogens ◽

E Coli ◽

Milk Samples

Abstract The Shiga toxin-producing Escherichia coli (STEC) strains are currently considered important emerging pathogens threatening public health. Among Shiga toxin-producing Escherichia coli, E. coli O157:H7 strains have emerged as important human pathogens. This study was conducted to determine the presence of Escherichia coli O157 and O157:H7 in raw milk samples and Van herby cheese samples. For this purpose, 100 samples of raw milk were collected and 100 samples of herby cheese sold for consumption in Van province in Turkey were obtained from grocers and markets in order to detect the presence of Escherichia coli O157 and O157:H7. The method of E. coli O157 and O157:H7 isolation proposed by the Food and Drug Administration (FDA) was used. E. coli O157 in raw milk and herby cheese samples was found in 11% and 6% of samples respectively, and E. coli O157:H7 was found in 2% of herby cheese samples. No E. coli O157:H7 was detected in raw milk samples. This study showed that raw milk was contaminated with E. coli O157 and herby cheese was contaminated with both E. coli O157 and E. coli O157:H7; therefore, herby cheese poses a serious risk to public health.

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Outbreak of multiple strains of non-O157 Shiga toxin-producing and enteropathogenic Escherichia coli associated with rocket salad, Finland, autumn 2016

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.35.1700666 ◽

2018 ◽

Vol 23 (35) ◽

Cited By ~ 11

Author(s):

Sohvi Kinnula ◽

Kaisa Hemminki ◽

Hannele Kotilainen ◽

Eeva Ruotsalainen ◽

Eveliina Tarkka ◽

...

Keyword(s):

Escherichia Coli ◽

Shiga Toxin ◽

Food Samples ◽

Control Measures ◽

National Surveillance ◽

Enteropathogenic Escherichia Coli ◽

E Coli ◽

Clinical Laboratories ◽

Helsinki Metropolitan Area ◽

Multiple Strains

In August 2016, an outbreak of Shiga toxin-producing Escherichia coli (STEC) and enteropathogenic E. coli (EPEC) with 237 cases occurred in the Helsinki metropolitan area, Finland. Gastroenteritis cases were reported at 11 events served by one catering company. Microbiological and epidemiological investigations suggested rocket salad as the cause of the outbreak. STEC ONT:H11 and EPEC O111:H8 strains isolated from food samples containing rocket were identical to the patient isolates. In this outbreak, the reported symptoms were milder than considered before for STEC infection, and the guidelines for STEC control measures need to be updated based on the severity of the illness. Based on our experience in this outbreak, national surveillance criteria for STEC have been updated to meet the practice in reporting laboratories covering both PCR-positive and culture-confirmed findings. We suggest that EPEC could be added to the national surveillance since diagnostics for EPEC are routinely done in clinical laboratories.

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Shiga Toxin–Producing Escherichia coli in Beef Heifers Grazing an Irrigated Pasture

Journal of Food Protection ◽

10.4315/0362-028x-64.10.1613 ◽

2001 ◽

Vol 64 (10) ◽

pp. 1613-1616 ◽

Cited By ~ 27

Author(s):

B. H. THRAN ◽

H. S. HUSSEIN ◽

M. R. HALL ◽

S. F. KHAIBOULLINA

Keyword(s):

Escherichia Coli ◽

Foodborne Pathogens ◽

Shiga Toxin ◽

Vero Cells ◽

Control Measures ◽

Fecal Samples ◽

E Coli ◽

Microbiological Testing ◽

Angus Heifers ◽

Postharvest Control

Shiga toxin–producing Escherichia coli (STEC) produce toxins that have been associated with several human illnesses. E. coli O157:H7 is the most well-studied STEC and was first associated with consumption of improperly cooked ground beef in 1982. E. coli O157:H7 is not the only foodborne STEC because other STEC serotypes are also associated with human illnesses. The objective of this study was to assess prevalence of STEC in 23 yearling beef (Angus) heifers grazing an irrigated grass pasture in spring (April), summer (July), fall (October), and winter (December) of 1999. A total of 86 fecal samples were rectally collected and were subjected to microbiological testing for the presence of STEC. Nine E. coli isolates from five heifers (one in spring and fall and three in winter) were toxic to Vero cells. Of these isolates, four were E. coli O157:H7, two belonged to the serogroup O6, one O39:NM, one O113:H−, and the final isolate was untypable. The STEC prevalence rate in our herd ranged from 4% (spring) to 15% (winter). Based on detecting both O157:H7 and non-O157:H7 STEC in our heifers, it is clear that screening fecal samples should not be limited to E. coli O157:H7. Identification of STEC-positive cattle prior to slaughter should help in reducing the risk of beef contamination with such foodborne pathogens if pre- and/or postharvest control measures are applied to such animals.

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Detection of Hemolysin Variants of Shiga Toxin-Producing Escherichia coli by PCR and Culture on VancomycinCefixime-Cefsulodin Blood Agar

Applied and Environmental Microbiology ◽

10.1128/aem.64.7.2449-2453.1998 ◽

1998 ◽

Vol 64 (7) ◽

pp. 2449-2453 ◽

Cited By ~ 27

Author(s):

Anselm Lehmacher ◽

Heidi Meier ◽

Stojanka Aleksic ◽

Jochen Bockemühl

Keyword(s):

Escherichia Coli ◽

Nucleotide Sequence ◽

Shiga Toxin ◽

Raw Milk ◽

Food Samples ◽

Blood Agar ◽

Simple Method ◽

E Coli ◽

Alpha Hemolysin ◽

Pcr Products

ABSTRACT The presence of a hemolysin-encoding gene, elyA orhlyA, from Shiga toxin-producing Escherichia coli (STEC) was detected by PCR in each of 95 strains tested. PCR products of elyA from human STEC isolates of serovars frequently detected in Germany, such as O157:H−, O103:H2, O103:H−, O26:H11, and O26:H−, showed nucleotide sequences identical to previously reported ones for O157:H7 and O111:H− strains. Compared to them, four elyA amplicons derived from human isolates of rare STEC serovars showed identity of about 98% but lacked anAluI restriction site. However, the nucleotide sequence of an amplicon derived from a porcine O138:K81:H− STEC strain was identical to the corresponding region of hlyA, encoding alpha-hemolysin, from E. coli. This hlyAamplicon showed 68% identity with the nucleotide sequence of the corresponding elyA fragment. It differed from theelyA PCR product in restriction fragments generated byAluI, EcoRI, and MluI. Of the 95 representative STEC strains, 88 produced hemolysin on blood agar supplemented with vancomycin (30 mg/liter), cefixime (20 μg/liter), and cefsulodin (3 mg/liter) (BVCC). The lowest added numbers of two to six STEC CFU per g of stool or per ml of raw milk were detectable on BVCC plates after seeding of the preenrichment broth, modified tryptic soy broth (mTSB) supplemented with novobiocin (10 mg/liter), with 16 STEC strains. These strains represented the seven prevailing serovars diagnosed from German patients. However, with ground-beef samples, PCR was essential to identify the lowest added numbers of two to six STEC CFU among colonies of hemolyzing Enterobacteriaceae, such as Serratia spp. and alpha-hemolysin-producing E. coli. We conclude that preenrichment of stool and food samples in mTSB for 6 h followed by overnight culturing on BVCC is a simple method for the isolation and presumptive identification of STEC.

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