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Shiga toxin-producing Escherichia coli clonal complex 32, including serotype O145:H28, in the UK and Ireland
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Rodwell, Ella V., Chan, Yung-Wai, Sawyer, Clare, Carroll, Anne, McNamara, Eleanor, Allison, Lesley, Browning, Lynda, Holmes, Anne, Godbole, Gauri, McCarthy, Noel D. and Jenkins, Claire (2022) Shiga toxin-producing Escherichia coli clonal complex 32, including serotype O145:H28, in the UK and Ireland. Journal of Medical Microbiology, 71 (8). doi:10.1099/jmm.0.001579 ISSN 0022-2615.
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WRAP-Shiga-toxin-producing-Escherichia-coli-clonal-complex-32-including-serotype-O145-H28-UK-Ireland-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (3284Kb) | Preview |
Official URL: http://dx.doi.org/10.1099/jmm.0.001579
Abstract
Introduction. Shiga toxin-producing Escherichia coli (STEC) O157:H7 has been the most clinically significant STEC serotype in the UK for over four decades. Over the last 10 years we have observed a decrease in STEC O157:H7 and an increase in non-O157 STEC serotypes, such as O145:H28.
Gap Statement. Little is known about the microbiology and epidemiology of STEC belonging to CC32 (including O145:H28) in the UK. The aim of this study was to integrate genomic data with patient information to gain a better understanding of the virulence, disease severity, epidemic risk assessment and population structure of this clinically significant clonal complex.
Methodology. Isolates of E. coli belonging to CC32 (n=309) in the archives of public health agencies in the UK and Ireland were whole-genome-sequenced, virulence-profiled and integrated with enhanced surveillance questionnaire (ESQ) data, including exposures and disease severity.
Results. Overall, diagnoses of STEC belonging to CC32 (290/309, 94 %) in the UK have increased every year since 2014. Most cases were female (61 %), and the highest proportion of cases belonged to the 0–4 age group (53/211,25 %). The frequency of symptoms of diarrhoea (92 %), abdominal pain (84 %), blood in stool (71 %) and nausea (51 %) was similar to that reported in cases of STEC O157:H7, although cases of STEC CC32 were more frequently admitted to hospital (STEC CC32 48 % vs O157:H7 34 %) and/or developed haemolytic uraemic syndrome (HUS) (STEC CC32 9 % vs O157:H7 4 %).
The majority of STEC isolates (268/290, 92 %) had the stx2a/eae virulence gene combination, most commonly associated with progression to STEC HUS. There was evidence of person-to-person transmission and small, temporally related, geographically dispersed outbreaks, characteristic of foodborne outbreaks linked to nationally distributed products.
Conclusion. We recommend more widespread use of polymerase chain reaction (PCR) for the detection of all STEC serogroups, the development of consistent strategies for the follow-up testing of PCR-positive faecal specimens, the implementation of more comprehensive and standardized collection of epidemiological data, and routine sharing of sequencing data between public health agencies worldwide.
Item Type: | Journal Article | |||||||||||||||
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Subjects: | Q Science > QP Physiology Q Science > QR Microbiology |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||||||||
Library of Congress Subject Headings (LCSH): | Escherichia coli , Endotoxins | |||||||||||||||
Journal or Publication Title: | Journal of Medical Microbiology | |||||||||||||||
Publisher: | Society for General Microbiology | |||||||||||||||
ISSN: | 0022-2615 | |||||||||||||||
Official Date: | 24 August 2022 | |||||||||||||||
Dates: |
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Volume: | 71 | |||||||||||||||
Number: | 8 | |||||||||||||||
DOI: | 10.1099/jmm.0.001579 | |||||||||||||||
Status: | Peer Reviewed | |||||||||||||||
Publication Status: | Published | |||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||
Date of first compliant deposit: | 18 October 2022 | |||||||||||||||
Date of first compliant Open Access: | 19 October 2022 | |||||||||||||||
RIOXX Funder/Project Grant: |
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