Environmental and food contamination with Shiga toxin-producing Escherichia coli (STEC) pose a threat to public health worldwide, with notable geographic differences in incidence of human disease caused by these organisms. The prevalence of E. coli O157 and total stx-positive specimens collected from mature dairy cattle in Ohio and Norwegian dairy farms was compared using identical laboratory methods in a cross-sectional survey. E. coli O157 was isolated from 5/750 (0.66%) of Ohio dairy cows from 4/50 (8%) different herds, whereas E. coli O157 was not isolated from any (0/680) cattle present in 50 Norwegian dairy herds. In contrast, at least one stx-positive faecal sample was identified by PCR on all (50/50) Norwegian farms but only on 70% (35/50) of Ohio farms. Average animal stx prevalence on Ohio farms was also lower; 14% vs. 61% in Ohio and Norwegian herds, respectively. Livestock feed contamination with generic E. coli was uncommon in Norway, 1/50 feeds testing positive, whereas 19/50 (38%) of feeds collected from Ohio farms were contaminated, some as high as 10(5) CFU/g. Despite extreme differences in on-farm management practices between countries, stx appear to be widely disseminated in cattle in both countries, while the human pathogenic O157 serotype is less widely disseminated in Norway than it is in Ohio. Geographic distribution differences of human pathogenic STEC serogroups in the bovine reservoir, as opposed to specific farm management practices affecting on farm STEC prevalence, may be an important defining factor influencing the incidence of human illnesses associated in different areas of the world.
The purpose of this study was to evaluate the value of real-time molecular typing of Shiga toxin (Verocytotoxin)-producing Escherichia coli (STEC) infections in order to detect possible outbreaks of infections. All laboratory confirmed STEC infections in Denmark from 2003 to mid 2005 were routinely characterized by serotyping, virulence genes characterization, and subtyping by pulsed-field gel electrophoresis (PFGE) using the PulseNet protocol for STEC O157. The study included 312 STEC isolates representing 50 different O groups and 75 O:H-serotypes, and 68% of the isolates belonged to the eight most common O-groups: O157 (26%), O103 (13%), O146 (8%), O26 (8%), O117 (4%), O145 (3%), O128 (3%), and O111 (2%). The remaining O-groups constituted less than 2% each, and 8.1% of the isolates were O-rough. The eae gene was found in 60% of all isolates, and detection of the two main Shiga toxin genes showed that 40% had stx1 only, 31% had stx2 only, and 29% had both stx1 and stx2. A high diversity was seen within all O groups, and for most of the rare O groups, the number of PFGE profiles equaled the number of isolates. However, one outbreak of E. coli O157 was detected by the routine PFGE typing. The value of "real-time' PFGE typing of the infrequent serotypes is limited if the full scheme for O-grouping or O:H-serotyping is used routinely for all STEC isolates. Possible outbreaks can then be detected by the increased number of isolates within a particular serotype. PFGE typing would then be valuable in subsequent steps of the outbreak investigation. However, routine PFGE typing of the three to five most common O groups will enable early recognition of possible outbreaks.
Infections with verocytotoxigenic Escherichia coli (VTEC) other than O157 have been assumed to have the same epidemiology as those with VTEC O157, but the source of infection is rarely defined for sporadic cases. This report describes a child with VTEC O111:H- infection who was probably infected by playing in a cattle stable and/or by drinking raw milk from the cows in this stable. E. coli O111 isolates colonising the cattle were indistinguishable from the patient isolate by the use of serotyping, pulsed-field gel electrophoresis, and virulence profiling.
In 1997, a Swedish dairy farm was implicated in a human case of verocytotoxigenic Escherichia coli (VTEC) infection. The bacterium was found in a faecal sample from the human case and in faecal samples from cattle on the farm. Subtyping with pulsed field gel electrophoresis (PFGE) showed that the isolates were identical. The farm was further studied to assess the occurrence and the epidemiology of the agent at the farm level. The objective of this part of the study presented here was to examine the persistence of VTEC O157:H7 in calves that were kept on pasture and indoors, respectively, during the summer. Twelve calves in the herd, with one positive faecal sample each of VTEC O157:H7 in April 1999, were followed by faecal sampling during the summer months. Six calves were kept indoors and six were kept on pasture. Faecal samples from each calf were collected once a month on five occasions from April to September. Bacterial examination was performed with immunomagnetic separation (IMS) and cultivation on CT-SMAC. PCR was used to test for the presence of genes encoding for verocytotoxin (VT), intimin (eaeA), enterohemorrhagic E. coli-hemolysin (EHEC-Hly) and the flagellar antigen H7. PFGE was used for genotyping the isolates. The faecal samples from the calves kept on pasture were negative during the whole period. It is possible that the faecal samples had bacterial counts lower than the detection limits for our procedure, or that the faecal samples were free from the bacteria at the time of sampling. This suggests that calves on pasture may be less exposed to the bacteria or that they clear themselves. In the pen group, there were between one and six culture positive individuals per sampling occasion. One of the calves that was housed indoors was positive in faecal culture on four consecutive samplings.
A prevalence study of verotoxin-producing Escherichia coli O157 (VTEC O157) was performed in 371 randomly selected dairy herds distributed throughout Sweden. Faecal and manure samples were collected and analysed by immunomagnetic separation and culturing. Data were recorded for each herd regarding herd size, age of sampled animals and whether, in addition to cattle, the farm kept other animals. VTEC O157 was isolated from 33 (8.9%) of the 371 investigated herds. The prevalence was higher (23.3%) in Halland county than in the rest of Sweden (P > 0.01). Halland was also the county in Sweden that during the study period had the highest incidence of human VTEC O157 cases. VTEC O157 was not detected on any farm in northern Sweden. Identified risk factors, in the multivariate analyses, for herds being VTEC O157 positive were herd size, geographical localization, presence of pigs on the farm and median age of sampled animals.
In 1993, 2 cases of urinary tract infection (UTI) caused by verotoxin-producing Escherichia coli were diagnosed at Rigshospitalet in Copenhagen, Denmark. Neither of the patients had any previous history of diarrhea. We suggest that E. coli strains isolated from UTI be examined for the production of verotoxin when hemolytic uremic syndrome is clinically suspected.