Phylogenetic Clades 6 and 8 of Enterohemorrhagic Escherichia coli O157:H7 With Particular stx Subtypes are More Frequently Found in Isolates From Hemolytic Uremic Syndrome Patients Than From Asymptomatic Carriers. (12th August 2014)

• Record Type: Journal Article
• Authors: Iyoda, Sunao; Manning, Shannon D.; Seto, Kazuko; Kimata, Keiko; Isobe, Junko; Etoh, Yoshiki; Ichihara, Sachiko; Migita, Yuji; Ogata, Kikuyo; Honda, Mikiko; Kubota, Tsutomu; Kawano, Kimiko; Matsumoto, Kazutoshi; Kudaka, Jun; Asai, Norio; Yabata, Junko; Tominaga, Kiyoshi; Terajima, Jun; Morita-Ishihara, Tomoko; Izumiya, Hidemasa; Ogura, Yoshitoshi; Saitoh, Takehito; Iguchi, Atsushi; Kobayashi, Hideki; Hara-Kudo, Yukiko; Ohnishi, Makoto; Arai, Reiko; Kawase, Masao; Asano, Yukiko; Asoshima, Nanami; Chiba, Kazuki; Furukawa, Ichiro; Kuroki, Toshiro; Hamada, Madoka; Harada, Seiya; Hatakeyama, Takashi; Hirochi, Takashi; Sakamoto, Yumiko; Hiroi, Midori; Takashi, Kanda; Horikawa, Kazumi; Iwabuchi, Kaori; Kameyama, Mitsuhiro; Kasahara, Hitomi; Kawanishi, Shinya; Kikuchi, Koji; Ueno, Hiroyuki; Kitahashi, Tomoko; Kojima, Yuka; Konishi, Noriko; Obata, Hiromi; Kai, Akemi; Kono, Tomomi; Kurazono, Takayuki; Matsumoto, Masakado; Matsumoto, Yuko; Nagai, Yuhki; Naitoh, Hideki; Nakajima, Hiroshi; Nakamura, Hiromi; Nakane, Kunihiko; Nishi, Keiko; Saitoh, Etsuko; Satoh, Hiroaki; Takamura, Mitsuteru; Shiraki, Yutaka; Tanabe, Junichi; Tanaka, Keiko; Tokoi, Yuki; Yatsuyanagi, Jun;
• Is Part Of: Open forum infectious diseases. Volume 1:Number 2(2014)
• Publication Date: 2014-08-12
• Subjects: clade -- EHEC -- HUS -- O157 -- stx; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofu061
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract : EHEC O157:H7 clade 6 strains harboring stx2a and/or stx2c and clade 8 strains harboring stx2a or stx2a / stx2c were frequently associated with childhood HUS cases in Japan. Rapid and specific detection of such lineages are required for infection control measures. Abstract: Background. Enterohemorrhagic Escherichia coli (EHEC) O157:H7 infection causes severe diseases such as bloody diarrhea and hemolytic uremic syndrome (HUS). Although EHEC O157:H7 strains have exhibited high genetic variability, their abilities to cause human diseases have not been fully examined. Methods. Clade typing and stx subtyping of EHEC O157:H7 strains, which were isolated in Japan during 1999–2011 from 269 HUS patients and 387 asymptomatic carriers (ACs) and showed distinct pulsed-field gel electrophoresis patterns, were performed to determine relationships between specific lineages and clinical presentation. Results. Clades 6 and 8 strains were more frequently found among the isolates from HUS cases than those from ACs ( P = .00062 for clade 6, P < .0001 for clade 8). All clade 6 strains isolated from HUS patients harbored stx2a and/or stx2c, whereas all clade 8 strains harbored either stx2a or stx2a / stx2c . However, clade 7 strains were predominantly found among the AC isolates but less frequently found among the HUS isolates, suggesting a significant association between clade 7 and AC ( P < .0001). Logistic regression analysis revealed that 0–9 year old age is a significant predictor of the association between clade 8 and HUS. We also found an intact norV gene, which encodes for a nitric oxide reductase that inhibits Shiga toxin activity under anaerobic condition, in all clades 1–3 isolates but not in clades 4–8 isolates. Conclusions. Early detection of EHEC O157:H7 strains that belonged to clades 6/8 and harbored specific stx subtypes may be important for defining the risk of disease progression in EHEC-infected 0- to 9-year-old children.