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Outbreak ofEscherichia coli O157:H7 infection in a large family

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Abstract

An outbreak of bloody and nonbloody diarrhoea caused byEscherichia coli O157:H7 including one case of haemolytic uraemic syndrome (HUS) and two cases of haemolytic anaemia, in five siblings (aged 2.5 to 11.3 years) and their playmate was investigated. Using sorbitol-MacConkey agar, colony blot hybridisation, and immunomagnetic separation, Shiga toxin 2-producingEscherichia coli O157:H7 was isolated from all children but the HUS patient; however, this patient had high immunoglobulin M antibody titres againstEscherichia coli O157 lipopolysaccharide.Escherichia coli 0157 isolates from all patients were indistinguishable in serotype, virulence properties, and genomic background, indicating that the same strain caused the infections. These data confirm the importance of person-to-person transmission.

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References

  1. Carter AO, Borczyk AA, Carlson JAK, Harvey B, Hockin JC, Karmali MA, Krishnan C, Korn DA, Lior H: A severe outbreak ofEscherichia coli O157:H7-associated hemorrhagic colitis in a nursing home. New England Journal of Medicine 1987, 317: 1496–1500.

    Google Scholar 

  2. Karmali MA, Steele BT, Petric M, Lim C: Sporadic cases of hemolytic uremic syndrome associated with fecal cytotoxin and cytotoxin-producingEscherichia coli, Lancet 1983, i: 619–620.

    Google Scholar 

  3. Reida R, Wolff M, Pohls HW, Kuhlmann W, Lehmacher A, Aleksic S, Karch H, Bockemühl J: An outbreak due to enterohaemorrhagicEscherichia coli O157:H7 in a children's day care centre characterised by person-toperson transmission and environmental contamination. International Journal of Medical Microbiology, Virology, Parasitology & Infectious Diseases 1994, 281: 534–543.

    Google Scholar 

  4. Schmidt H, Rüssmann H, Schwarzkopf A, Aleksic S, Heesemann J, Karch H: Prevalence of attaching and effacingEscherichia coli in stool samples from patients and controls. Zentralblatt für Bakteriologie, Mikrobiologie und Hygiene (A) 1994, 281: 201–213.

    Google Scholar 

  5. Karmali MA, Petric M, Lim C, Fleming PC, Arbus GS, Lior H: The association between hemolytic uremic syndrome and infection by Verotoxin-producingEscherichia coli. Journal of Infectious Diseases 1985, 151: 775–782.

    Google Scholar 

  6. Karch H, Janetzki-Mittmann C, Aleksic S, Datz M: Isolation of enterohemorrhagicEscherichia coli O157 strains from patients with hemolytic-uremic syndrome by using immunomagnetic separation, DNA-based methods, and direct culture. Journal of Clinical Microbiology 1996, 34: 516–519.

    Google Scholar 

  7. Aleksic S, Karch H, Bockemühl J: A biotyping scheme for Shiga-like (Vero) toxin-producingEscherichia coli O157 and a list of serological cross-reactions between O157 and other gram-negative bacteria. International Journal of Medical Microbiology, Virology, Parasitology & Infectious Diseases 1992, 276: 221–230.

    Google Scholar 

  8. Böhm H, Karch H: DNA fingerprinting ofEscherichia coli O157:H7 strains by pulsed-field gel electrophoresis. Journal of Clinical Microbiology 1992, 30: 2169–2172.

    Google Scholar 

  9. Rüssmann H, Schmidt H, Heesemann J, Caprioli A, Karch H: Variants of Shiga-like toxin II constitute a major toxin component inEscherichia coli O157 strains from patients with haemolytic uraemic syndrome. Journal of Medical Microbiology 1994, 40: 338–343.

    Google Scholar 

  10. Bitzan M, Ludwig K, Klemt M, König H, Buren J, Müller-Wiefel DE: The role ofEscherichia coli O157 infections in the classical (enteropathic) haemolytic uraemic syndrome: results of a Central European, multicentre study. Epidemiology & Infection 1993, 110: 183–196.

    Google Scholar 

  11. Bitzan M, Moebius E, Ludwig K, Müller-Wiefel DE, Heesemann J, Karch H: High incidence of serum antibodies toEscherichia coli O157 lipopolysaccharide in children with hemolytic-uraemic syndrome. Journal of Pediatrics 1991, 119: 380–385.

    Google Scholar 

  12. Karch H, Rüssmann H, Schmidt H, Schwarzkopf A, Heesemann J: Long-term shedding and clonal turnover of enterohemorrhagicEscherichia coli O157 in diarrheal diseases. Journal of Clinical Microbiology 1995, 33: 1602–1605.

    Google Scholar 

  13. Bell BP, Goldoft M, Griffin PM: A multistate outbreak ofEscherichia coli O157:H7-associated bloody diarrhea and hemolytic-uraemic syndrome from hamburgers: the Washington experience. JAMA 1994, 272: 1349–1353.

    Google Scholar 

  14. Karmali MA, Arbus GS, Ish-Shalom N, Fleming PC, Malkin D, Petric M, Cheung R, Louie S, Humphreys GR, Strachau M: A family outbreak of hemolytic-uraemic syndrome associated with verotoxin-producingEscherichia coli serotype O157:H7. Pediatric Nephrology 1988, 2: 409–414.

    Google Scholar 

  15. Ludwig K, Ruder H, Rott HD, Karch H: Outcome of an enterohaemorrhagicEscherichia coli O157 infection in monozygotic twins. Lancet 1996, 347: 196–197.

    Google Scholar 

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Ludwig, K., Ruder, H., Bitzan, M. et al. Outbreak ofEscherichia coli O157:H7 infection in a large family. Eur. J. Clin. Microbiol. Infect. Dis. 16, 238–241 (1997). https://doi.org/10.1007/BF01709588

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