Abstract
In 2011, a large outbreak caused by a Shiga toxin producing E. coli (STEC) occurred in Northern Germany, with a satellite outbreak in Western France, including the highest number of hemolytic uremic syndrome (HUS) cases ever encountered during a STEC outbreak. The outbreak strain was characterized as an enteroaggregative E. coli of serotype O104:H4 expressing a phage-encoded Shiga toxin 2. The majority of STEC infections and HUS cases were observed in adults, with a preponderance of the female gender. The outbreak imposed huge challenges on clinicians, microbiologists, and epidemiologists but also provided important new insight for the understanding of STEC infection. Thus, novel therapeutic strategies in the treatment of HUS in adults and for decolonization of long-term STEC carriers were evaluated. This review highlights the unusual features of the recent O104:H4 outbreak and focuses on emerging new strategies in diagnostics and treatment of acute STEC-related disease, as well as STEC long-term carriage.
Highlights
Shiga toxin (Stx) producing Escherichia coli (STEC) were first described as Vero toxin producing E. coli (VTEC)S
This review focuses on the 2011 outbreak of a Shiga toxin producing E. coli (STEC) of serotype O104:H4, with unusual genetic properties leading to atypical epidemiologic and clinical presentation
In 1992, STEC O111:H2 was isolated from the stools of 5 out of 10 children hospitalized with hemolytic uremic syndrome (HUS) and of 3 healthy contact persons in South Picardy, France [34]
Summary
Shiga toxin (Stx) producing Escherichia coli (STEC) were first described as Vero toxin producing E. coli (VTEC). As well as sporadic cases of STEC infections and HUS, have been documented worldwide. STEC strains carry phages that encode Shigatoxins 1 and/or 2, known as Vero toxins or Verocytotoxins [2, 4] For both Stx 1 and Stx 2, several allelic variants are described [5]. O157:H7 is the serotype that was documented in the vast majority of HUS cases [9]. In some geographic regions, including Germany, non-O157 serotypes have been reported to account for up to half of HUS cases [10, 11]. Before 2011, about 1,000 infections per year and fewer than 100 cases of HUS were registered throughout Germany [12]. New developments in the diagnosis and treatment of STEC and HUS are highlighted, as well as questions remaining open
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
