Abstract
Foodborne diseases affect an estimated 600 million people worldwide annually, with the majority of these illnesses caused by Norovirus, Vibrio, Listeria, Campylobacter, Salmonella, and Escherichia coli. To elicit infections in humans, bacterial pathogens express a combination of virulence factors and toxins. AB5 toxins are an example of such toxins that can cause various clinical manifestations, including dehydration, diarrhea, kidney damage, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Treatment of most bacterial foodborne illnesses consists of fluid replacement and antibiotics. However, antibiotics are not recommended for infections caused by Shiga toxin-producing E. coli (STEC) because of the increased risk of HUS development, although there are conflicting views and results in this regard. Lack of effective treatment strategies for STEC infections pose a public health threat during outbreaks; therefore, the debate on antibiotic use for STEC infections could be further explored, along with investigations into antibiotic alternatives. The overall goal of this review is to provide a succinct summary on the mechanisms of action and the pathogenesis of AB5 and related toxins, as expressed by bacterial foodborne pathogens, with a primary focus on Shiga toxins (Stx). The role of Stx in human STEC disease, detection methodologies, and available treatment options are also briefly discussed.
Highlights
Foodborne illnesses are a common occurrence worldwide
The goal of this review is to succinctly summarize AB toxin-mediated pathogenesis, with a focus on Shiga toxins—the characteristic AB5 toxin produced by Shiga toxin-producing E. coli (STEC)
STEC poses a clinical challenge in various ways through detection, isolation, and treatment
Summary
The Centers for Disease Control and Prevention (CDC) estimates that 1 in 6 Americans, or 48 million people, acquire a foodborne illness each year in the United States [1], while the World Health Organization (WHO) reports that 1 in 10 people, or 600 million, obtain a foodborne illness annually worldwide [2]. The Gram-negative bacteria naturally inhabit the intestinal tracts of animals, leading to their wide distribution in soil, water, and sewage. These bacterial pathogens can cause urinary tract infections (UTIs), bacteremia, pneumonia, and meningitis, in addition to foodborne illnesses [5,6]
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