Abstract

O80:H2 enterohemorrhagic Escherichia coli (EHEC) of sequence type ST301 is one of the main serotypes causing European hemolytic and uremic syndrome, but also invasive infections, due to extra-intestinal virulence factors (VFs). Here, we determined whether other such heteropathotypes exist among ST301. EnteroBase was screened for ST301 strains that were included in a general SNP-phylogeny. French strains belonging to a new heteropathotype clone were sequenced. ST, hierarchical clusters (HC), serotype, resistome, and virulome were determined using EnteroBase, the CGE website, and local BLAST. The ST301 general phylogeny shows two groups. Group A (n = 25) is mainly composed of enteropathogenic E. coli, whereas group B (n = 55) includes mostly EHEC. Three serotypes, O186:H2, O45:H2 and O55:H9, share the same virulome as one of the O80:H2 sub-clones from which they derive subsequent O-antigen switches. The O55:H9 clone, mainly present in France (n = 29), as well as in the UK (n = 5) and Germany (n = 1), has a low background of genetic diversity (four HC20), although it has three Stx subtypes, an H-antigen switch, and genes encoding the major extra-intestinal VF yersiniabactin, and extended-spectrum beta-lactamases. Diverse heteropathotype clones genetically close to the O80:H2 clone are present among the ST301, requiring close European monitoring, especially the virulent O55:H9 clone.

Highlights

  • Enterohemorrhagic Escherichia coli (EHEC) infections represent a major public health concern because of their outbreak potential and the severe morbidity related to hemolytic uremic syndrome (HUS)

  • We determined whether other heteropathotypes are present within ST301 (CC165)

  • Of 15 their were assigned to hierarchical clusters (HC) based on core genome MLST using EnteroBase to 4assess genomic relatedness

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Summary

Introduction

Enterohemorrhagic Escherichia coli (EHEC) infections represent a major public health concern because of their outbreak potential and the severe morbidity related to hemolytic uremic syndrome (HUS). This complication, associated with 3% to 5% mortality worldwide [1], results from the action of the Shiga toxin (Stx) on its target organs, in particular the intestine, kidneys, and brain. Another major virulence factor (VF) in typical EHEC is the intimin protein (eae), which is involved in intestinal adhesion with the effacement of microvilli, leading to so-called A/E lesions. Described in France [3,4], serotype

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