Abstract
Enterotoxigenic Escherichia coli (ETEC) is a major cause of diarrhoea in children below 5 years of age in endemic areas, and is a primary cause of diarrhoea in travellers visiting developing countries. Epidemiological analysis of E. coli pathovars is traditionally carried out based on the results of serotyping. However, genomic analysis of a global ETEC collection of 362 isolates taken from patients revealed nine novel O-antigen biosynthesis gene clusters that were previously unrecognized, and have collectively been called unclassified. When put in the context of all isolates sequenced, one of the novel O-genotypes, OgN5, was found to be the second most common ETEC O-genotype causing disease, after O6, in a globally representative ETEC collection. It’s also clear that ETEC OgN5 isolates have spread globally. These novel O-genotypes have now been included in our comprehensive O-genotyping scheme, and can be detected using a PCR-based and an in silico typing method. This will assist in epidemiological studies, as well as in ETEC vaccine development.
Highlights
The first diarrhoeal illness that infants often experience in endemic areas is caused by enterotoxigenic Escherichia coli (ETEC) [1]
We focused on characterizing the O-genotype untypeable (OgUT) ETEC isolates detected in our previous study [3]
We identified nine novel O-genotypes (OgN) in a global collection of enterotoxigenic Escherichia coli (ETEC) isolates
Summary
The first diarrhoeal illness that infants often experience in endemic areas is caused by enterotoxigenic Escherichia coli (ETEC) [1]. ETEC is a primary cause of diarrhoea in travellers visiting developing countries. We sequenced 362 globally representative ETEC isolates collected between 1980 and 2011 from 20 countries, including isolates from children and adults in endemic areas, as well as from travellers visiting such areas [3]. Genome-wide analysis showed that, contrary to previous understanding, there are long-term stable associations of ETEC lineages with specific virulence factors, such as plasmid-encoded heat-labile toxin (LT) and/or heat-stable toxin (ST; including two subtypes, STh and STp), and colonization factors (CFs), and that these lineages are globally distributed
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