Consecutive Outbreaks of Enterotoxigenic<i>Escherichia coli</i>O6 in Schools in South Korea Caused by Contamination of Fermented Vegetable Kimchi

Shin, Jaeseung; Yoon, Ki-Bok; Jeon, Doo-Young; Oh, Sung-Suk; Oh, Kyunghwan; Chung, Gyung Tae; Kim, Seung-Woo; Cho, Seung-Hak

doi:10.1089/fpd.2016.2147

Cited by 32 publications

(17 citation statements)

References 26 publications

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“…ETEC infection is recognised as one of the most common causes of traveller's diarrhoea and of childhood diarrhoea in developing countries (Anonymous, 2006). Furthermore, foodborne outbreaks of ETEC infection have emerged in developed countries, such as the USA (Dalton et al, 1999), Norway (MacDonald et al, 2015, Denmark (Pakalniskiene et al, 2009) and South Korea (Shin et al, 2016). One of the major virulence factors of ETEC infection includes adherence of the pathogenic strain to the epithelium of the small intestine, which is mediated by several colonisation factors including numerous fimbriate surface antigens (Gaastra and Svennerholm, 1996).…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus rhamnosus GG and Saccharomyces cerevisiae boulardii exert synergistic antipathogenic activity in vitro against enterotoxigenic Escherichia coli

Moens

Duysburgh

Abbeele

et al. 2019

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Short-term colonic in vitro batch incubations were performed to elucidate the possible synergistic effects of Lactobacillus rhamnosus GG (CNCM-I-4798) and Saccharomyces cerevisiae boulardii (CNCM-I-1079) (associated in Smebiocta/Smectaflora Protect®) on the colonic microbial fermentation process, as well as their antipathogenic activity against enterotoxigenic Escherichia coli (LMG2092) (ETEC). These incubations adequately simulate the native microbiota and environmental conditions of the proximal colon of both adult and toddler donors, including the colonic mucosal layer. Results indicated that both strains were capable of growing together without showing antagonistic effects. Co-cultivation of both strains resulted in increased butyrate (stimulated by L. rhamnosus GG), propionate (stimulated by S. boulardii), and ethanol (produced by S. boulardii) production compared to the control incubations, revealing the additive effect of both strains. After inoculation of ETEC under simulated dysbiotic conditions, a 40 and 46% reduction in the concentration of ETEC was observed upon addition of both strains during the experiments with the adult and toddler donor, respectively. Furthermore, ETEC toxin levels decreased upon S. boulardii inoculation, probably due to proteolytic activity of this strain, with a synergistic effect being observed upon co-cultivation of L. rhamnosus GG and S. boulardii resulting in a reduction of 57 and 46% for the adult and toddler donor, respectively. Altogether, the results suggest that both probiotics together may help microbiota functionality, in both adults and toddlers and under healthy or impaired conditions, which could be of great interest when the colonic microbiota is dysbiotic and therefore sensitive to pathogenic invasion such as during antibiotic treatment.

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Section: Introductionmentioning

confidence: 99%

Lactobacillus rhamnosus GG and Saccharomyces cerevisiae boulardii exert synergistic antipathogenic activity in vitro against enterotoxigenic Escherichia coli

Moens

Duysburgh

Abbeele

et al. 2019

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“…The isolated E. coli strains were pathotyped by an 8-plex real-time PCR kit (Kogene Biotech, Seoul, South Korea) to detect specific virulence genes, such as VT1 and VT2 for enterohemorrhagic E. coli (EHEC), LT, and sequence type (ST) for enterotoxigenic E. coli (ETEC), eaeA and bfpA for enteropathogenic E. coli (EPEC), ipaH for enteroinvasive E. coli (EIEC), and aggR for enteroaggregative E. coli (EAEC), according to the manufacturer's instructions (Shin et al, 2016). All isolates were serotyped by a slide agglutination test using E. coli antiserum for the O antigens (Denka Seiken, Tokyo, Japan).…”

Section: Bacterial Isolatesmentioning

confidence: 99%

Co-infection With Chromosomally-Located blaCTX-M-14 and Plasmid-Encoding blaCTX-M-15 in Pathogenic Escherichia coli in the Republic of Korea

et al. 2020

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The emergence of third-generation cephalosporin resistance in Escherichia coli is increasing at an alarming rate in many countries. Thus, the aim of this study was to analyze co-infecting bla CTX-M -producing pathogenic E. coli isolates linked to three school outbreaks. Among 66 E. coli isolates, 44 were identified as ETEC O25, an ETEC isolate serotype was O2, and the other 21 were confirmed as EAEC O44. Interestingly, six patients were co-infected with EAEC O44 and ETEC O25. For these isolates, molecular analysis [antibiotic susceptibility testing, identification of the β-lactamase gene, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE)] was performed for further characterization. In addition, the transmission capacity of bla CTX-M genes was examined by conjugation experiments. Whole-genome sequencing (WGS) was performed on representative EAEC O44 and ETEC O25 isolates associated with co-infection and single-infection. All isolates were resistant to cefotaxime and ceftriaxone. All EAEC isolates carried the bla CTX-M-14 gene and all ETEC isolates the bla CTX-M-15 gene, as detected by multiplex PCR and sequencing analysis. Sequence type and PFGE results indicated three different patterns depending on the O serotype. WGS results of representative isolates revealed that the ETEC O25 strains harbored bla CTX-M-15 located on IncK plasmids associated with the Δ bla TEM - bla CTX-M-15 - orf477 transposon. The representative EAEC O44 isolates carried bla CTX-M-14 on the chromosome, which was surrounded by the IS Ecp1 - bla CTX-M-14 - IS903 transposon. To the best of our knowledge, this is the first report of co-infection with chromosomally located bla CTX-M-14 and plasmid-encoding bla CTX-M-15 in pathogenic E. coli . Our findings indicate that resistance genes in clinical isolates can spread through concurrent combinations of chromosomes and plasmids.

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“…In 2012, 1642 cases of E. coli O169 infections linked to kimchi consumption were reported (Cho, Kim, et al., ). There was also an outbreak of E. coli O6 infections in South Korea in 2013 and 2014 linked to kimchi (Shin et al., ). Also, Choi, Lee, Kim, Lee, Kim, Lee, Ha, Oh, Choi, et al.…”

Section: Introductionmentioning

confidence: 99%

Microbial quality of reduced‐sodium napa cabbage kimchi and its processing

Song

Chung

Kang

et al. 2019

Food Science & Nutrition

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This study evaluated the microbial safety of reduced‐sodium napa cabbage kimchi products by comparing with conventional kimchi samples. Five commercial kimchi samples were collected from different manufacturers in Korea. Total aerobic plate counts and coliforms counts between regular and reduced‐sodium kimchi were not significantly (p > 0.05) different and major foodborne pathogens, including Escherichia coli O157:H7, Salmonella spp., Listeria monocytogenes, Staphylococcus aureus, and Yersinia enterocolitica were not detected in any sample. Bacillus cereus contamination among all kimchi samples was less than the regulation level (3.0 log CFU/g). However, high levels of coliforms were observed in both types of samples. To investigate microbial hazards of kimchi processing, we analyzed specific kimchi production processes and found five control points which can reduce coliform levels in kimchi samples. The results of this study could be helpful for the kimchi industry to produce safe reduced‐sodium kimchi products.

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Consecutive Outbreaks of EnterotoxigenicEscherichia coliO6 in Schools in South Korea Caused by Contamination of Fermented Vegetable Kimchi

Abstract: The suspected food vehicle in these two consecutive outbreaks was kimchi contaminated with ETEC O6. We recommend continued monitoring and stricter sanitation requirements for the food supply process in Korea, especially in relation to kimchi.

Cited by 32 publications

References 26 publications

Lactobacillus rhamnosus GG and Saccharomyces cerevisiae boulardii exert synergistic antipathogenic activity in vitro against enterotoxigenic Escherichia coli

Lactobacillus rhamnosus GG and Saccharomyces cerevisiae boulardii exert synergistic antipathogenic activity in vitro against enterotoxigenic Escherichia coli

Co-infection With Chromosomally-Located blaCTX-M-14 and Plasmid-Encoding blaCTX-M-15 in Pathogenic Escherichia coli in the Republic of Korea

Microbial quality of reduced‐sodium napa cabbage kimchi and its processing

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