Hemolytic Uremic Syndrome and Death in Persons with<i>Escherichia coli</i>O157:H7 Infection, Foodborne Diseases Active Surveillance Network Sites, 2000–2006

Gould, L. Hannah; Demma, Linda J.; Jones, Timothy F.; Hurd, Sharon; Vugia, Duc J.; Smith, Kirk E.; Shiferaw, Beletshachew; Segler, Suzanne; Palmer, Amanda; Zansky, Shelley; Griffin, Patricia M.

doi:10.1086/644621

Cited by 221 publications

(159 citation statements)

References 19 publications

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“…Multiple studies have demonstrated sensitivity of Ͼ97% for nucleic acid amplification tests (NAATs) designed to detect STEC (stx 1 and stx 2 ) and E. coli serotype O:157 (rfbE) directly from preserved stool specimens in as little as 1 to 4 h (7,(12)(13)(14)(15). Some of these NAATs are specific for STEC, while others are highly multiplexed to enable detection of numerous bacterial, viral, and toxin targets associated with AGE.…”

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confidence: 99%

Clinical Evaluation and Cost Analysis of Great Basin Shiga Toxin Direct Molecular Assay for Detection of Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Specimens

et al. 2017

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The Shiga Toxin Direct molecular assay (ST Direct) relies on nucleic acid amplification and solid array-based amplicon detection to identify Shiga toxinproducing Escherichia coli (STEC) in preserved stool specimens. Genes encoding Shiga toxin (stx 1 and stx 2 ), as well as the E. coli serotype O:157-specific marker rfbE, are simultaneously detected within 2 h. ST Direct was evaluated using 1,084 prospectively collected preserved stool specimens across five clinical centers. An additional 55 retrospectively collected, frozen specimens were included to increase the number of positive specimens evaluated. Results were compared to results from routine culture and an enzyme immunoassay (EIA) specific for the recovery and identification of STEC. ST Direct was found to be 93.2% sensitive and 99.3% specific for detection of stx 1 and stx 2 and 95.7% sensitive and 99.3% specific for detection of E. coli serotype O:157. All specimens with false-positive results were found to contain stx 1 or stx 2 or were found to be positive for serotype O:157 when analyzed using alternative molecular methods. All 4 false-negative stx 1 or stx 2 results were reported for frozen, retrospectively tested specimens. In all cases, the specimens tested positive for stx by an alternative FDA-cleared nucleic acid amplification test (NAAT) but were negative for stx 1 and stx 2 following nucleic acid sequence analysis. Based on these data, culture and EIA-based methods for detection of STEC are only 33% sensitive compared to molecular tests. A retrospective cost analysis demonstrated 59% of the cost of routine stool culture to be attributable to the identification of STEC. Taken together, these data suggest that ST Direct may provide a costeffective, rapid molecular alternative to routine culture for the identification of STEC in preserved stool specimens.

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confidence: 99%

Clinical Evaluation and Cost Analysis of Great Basin Shiga Toxin Direct Molecular Assay for Detection of Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Specimens

et al. 2017

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“…Shiga toxin-producing Escherichia coli STEC bacteria, including the O157 serogroup, are welldescribed human pathogens associated with bloody diarrhea, hemolytic-uremic syndrome HUS , and death Gould et al, 2009 . Illnesses are often attributed to the consumption of contaminated food or water; however, transmission by animal contact may also be important Hale et al, 2012, Rangel et al, 2005 .…”

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Influence of Detection Methods in Characterizing <i>Escherichia coli</i> O157:H7 in Raw Goat Meat Using Conventional and Molecular Methods

et al. 2016

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Presence of Escherichia coli O157:H7 on fresh goat meat samples n= 40 of Dhaka city was analyzed using conventional and molecular methods. A total of 86 presumptive E. coli O157:H7 colonies were isolated from 60% of the samples using selective agar plating method. After conventional biochemical assay followed by API 20E assay, only 11 isolates were found to be E. coli O157:H7. Further serological test identified only four isolates that has strong agglutination reaction against anti-H7 sensitized latex. The biochemically and serologically confirmed isolates were then screened for major virulence factors include eaeA, rfbE, fliC, stx1 and stx2 genes by PCR. PCR analysis of positive isolates showed, 10 isolates were eaeA and rfbE genes positive but fliC gene was only in six, indicating that these isolates were H7 positive with flagellum antigens which might not expressed or detected in serotyping tests. Multiplex PCR against eaeA, stx1 and stx2 genes of the isolates showed similar results as when done individually. These results revealed that only 7% of the primary presumptive E. coli O157:H7 was found to be stx producing E. coli O157:H7 and thus greatly influenced the detection of the pathogen in meat samples.

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“…Among patients diagnosed with STEC, 6 % subsequently develop hemolytic uremic syndrome. 1 Microbiologic detection of STEC is highly dependent on obtaining stool cultures within 6 days of symptom onset, and the presence of fecal leukocytes indicates a higher yield sample. 2 The gold standard for diagnosis is stool culture on sorbitol MacConkey agar, followed by latex agglutination.…”

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confidence: 99%

A Couple’s Colitis

2015

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A 32-year-old woman was admitted with 4 days of bloody diarrhea, abdominal pain, leukocytosis, and fever following fast food consumption and use of methamphetamine. An abdominal CT scan revealed continuous colonic mural thickening from the cecum to the splenic flexure (Fig. 1). Stool cultures for bacteria, ova and parasites, and fecal leukocytes were negative. Her symptoms resolved with supportive care, and on the day of discharge, her partner presented with identical symptoms (Fig. 2). His stool cultures grew shiga toxin 2-producing E. coli, serogroup O157:H7 (STEC). Based on his positive stool culture and the presence of diffuse colitis on both scans, a final diagnosis of STEC was given to both patients.STEC is a common cause of hemorrhagic colitis, usually occurring in food-borne outbreaks. Among patients diagnosed with STEC, 6 % subsequently develop hemolytic uremic syndrome. 1 Microbiologic detection of STEC is highly dependent on obtaining stool cultures within 6 days of symptom onset, and the presence of fecal leukocytes indicates a higher yield sample. 2 The gold standard for diagnosis is stool culture on sorbitol MacConkey agar, followed by latex agglutination. ELISA, direct toxin assays, and toxin PCR methods all provide rapid diagnosis, with comparable sensitivity and specificity (77-96 % sensitivity, 98-99 % specificity). 3

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Hemolytic Uremic Syndrome and Death in Persons withEscherichia coliO157:H7 Infection, Foodborne Diseases Active Surveillance Network Sites, 2000–2006

Cited by 221 publications

References 19 publications

Clinical Evaluation and Cost Analysis of Great Basin Shiga Toxin Direct Molecular Assay for Detection of Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Specimens

Clinical Evaluation and Cost Analysis of Great Basin Shiga Toxin Direct Molecular Assay for Detection of Shiga Toxin-Producing Escherichia coli in Diarrheal Stool Specimens

Influence of Detection Methods in Characterizing <i>Escherichia coli</i> O157:H7 in Raw Goat Meat Using Conventional and Molecular Methods

A Couple’s Colitis

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