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Phylogenetic Clades 6 and 8 of Enterohemorrhagic Escherichia coli O157:H7 With Particular stx Subtypes are More Frequently Found in Isolates From Hemolytic Uremic Syndrome Patients Than From Asymptomatic Carriers

2014; Oxford University Press; Volume: 1; Issue: 2 Linguagem: Inglês

10.1093/ofid/ofu061

2328-8957

Sunao Iyoda, Shannon D. Manning, Kazuko Seto, Keiko Kimata, Junko Isobe, Yoshiki Etoh, Sachiko Ichihara, Yuji Migita, Kikuyo Ogata, Mikiko Honda, Tsutomu Kubota, Kimiko Kawano, Kazutoshi Matsumoto, Jun Kudaka, Norio Asai, Junko Yabata, Kiyoshi Tominaga, Jun Terajima, Tomoko Morita‐Ishihara, Hidemasa Izumiya, Yoshitoshi Ogura, Takehito Saitoh, Atsushi Iguchi, Hideki Kobayashi, Yukiko Hara‐Kudo, Makoto Ohnishi, Reiko Arai, Masao Kawase, Yukiko Asano, Nanami Asoshima, Kazuki Chiba, Ichiro Furukawa, Toshiro Kuroki, Madoka Hamada, Seiya Harada, Takashi Hatakeyama, Takashi Hirochi, Yumiko Sakamoto, Midori Hiroi, Takashi Kanda, Kazumi Horikawa, Kaori Iwabuchi, Mitsuhiro Kameyama, Hitomi Kasahara, Shinya Kawanishi, Koji Kikuchi, Hiroyuki Ueno, Tomoko Kitahashi, Yuka Kojima, Noriko Konishi, Hiromi Obata, Akemi Kai, Tomomi Kono, Takayuki Kurazono, Masakado Matsumoto, Yuko Matsumoto, Yuhki Nagai, Hideki Naitoh, Hiroshi Nakajima, Hiromi Nakamura, Kunihiko Nakane, Keiko Nishi, Etsuko Saitoh, Hiroaki Satoh, Mitsuteru Takamura, Yutaka Shiraki, Junichi Tanabe, Keiko Tanaka, Yuki Tokoi, Jun Yatsuyanagi,

Enterobacteriaceae and Cronobacter Research

Enterohemorrhagic Escherichia coli (EHEC) O157:H7 infection causes severe diseases such as bloody diarrhea and hemolytic uremic syndrome (HUS). Although EHEC O157:H7 strains have exhibited high genetic variability, their abilities to cause human diseases have not been fully examined.Clade typing and stx subtyping of EHEC O157:H7 strains, which were isolated in Japan during 1999-2011 from 269 HUS patients and 387 asymptomatic carriers (ACs) and showed distinct pulsed-field gel electrophoresis patterns, were performed to determine relationships between specific lineages and clinical presentation.Clades 6 and 8 strains were more frequently found among the isolates from HUS cases than those from ACs (P = .00062 for clade 6, P < .0001 for clade 8). All clade 6 strains isolated from HUS patients harbored stx2a and/or stx2c, whereas all clade 8 strains harbored either stx2a or stx2a/stx2c. However, clade 7 strains were predominantly found among the AC isolates but less frequently found among the HUS isolates, suggesting a significant association between clade 7 and AC (P < .0001). Logistic regression analysis revealed that 0-9 year old age is a significant predictor of the association between clade 8 and HUS. We also found an intact norV gene, which encodes for a nitric oxide reductase that inhibits Shiga toxin activity under anaerobic condition, in all clades 1-3 isolates but not in clades 4-8 isolates.Early detection of EHEC O157:H7 strains that belonged to clades 6/8 and harbored specific stx subtypes may be important for defining the risk of disease progression in EHEC-infected 0- to 9-year-old children.