Category Archives: O146

Research – Shiga toxin-producing Escherichia coli (STEC) data: 2019

UKSHA

Main points for 2019

The main points of the 2019 report are:

1. A total of 539 confirmed cases of Shiga toxin-producing Echerichia coli (STEC) O157 were reported in England and Wales in 2019.

2. The lowest incidence of STEC O157 was in the East Midlands region (0.56 per 100,000 population) and the highest in the Yorkshire and Humber region (1.51 per 100,000 population).

3. Children aged 1 to 4 years had the highest incidence of infection (3.28 per 100,000 population, CI 95% 2.63–4.04).

4. Nearly one-third of confirmed STEC O157 cases in England were hospitalised and 3% were reported to have developed haemolytic ureamic syndrome (HUS).

5. In England and Wales, detection of non-O157 STEC increased in line with the growing number of NHS labs implementing gastrointestinal (GI) diagnostics using polymerase chain reaction (PCR); in 2019, 768 culture-positive non-O157 STEC cases (655 in England, 113 in Wales) were reported.

6. A further 347 specimens in England and 66 in Wales were positive for Shiga toxins (stx) genes on PCR at the Gastrointestinal Bacteria Reference Unit (GBRU) but an organism was not cultured.

7. The most commonly isolated non-O157 STEC serogroup was STEC O26 (England: n=109/655, 17% and Wales: n=28/113, 25%).

8. Five outbreaks of STEC involving 65 cases in England were investigated in 2019.

Cases of STEC in England and Wales in 2019

In 2019, 1,720 confirmed cases of STEC were reported in England and Wales; these comprised 539 culture-confirmed cases of STEC serogroup O157 (515 cases in England and 24 in Wales) and 768 cases (655 in England, 113 in Wales) where a serogroup other than O157 was isolated (non-O157). For a further 413 cases, samples were confirmed as STEC by testing positive by PCR for stx genes, but STEC was not cultured (347 in England, 66 in Wales).

Five confirmed cases were infected with multiple serogroups:

  • O157 and O26
  • O26 and O103
  • O76 and O113
  • O91 and O128ab
  • O146 and O91

There were 13 probable cases with serological evidence of STEC infection, with antibodies detected to O157 lipopolysaccharides in 11 cases (England: 10, Wales: 1), for O111 lipopolysaccharides in one case, and for O26 lipopolysaccharides in another case.

The crude incidence rate of confirmed STEC O157 in England and Wales was 0.91 per 100,000 cases (95% CI 0.83–0.99), continuing the downward trend observed since 2015 (Figure 1). It is the lowest number of cases reported annually since 1996, when testing began in England for STEC O157 on all faecal specimens from patients with suspected gastrointestinal infection (7).

Non-O157 STEC cases in England and Wales
Historically, cases of non-O157 STEC have been under ascertained, with 89 cases of STEC non-O157 reported between 2009 and 2013, prior to PCR being implemented.

Following the increase in recent years in frontline laboratories using PCR, there has been a significant increase in the detection of non-O157 STEC in England. It is not possible to estimate a denominator for incidence calculations for non-O157 STEC because details of contract arrangements for referral of samples from primary care and catchment areas of each diagnostic laboratory using PCR are not known.

In 2019, of 5,760 samples received at GBRU for STEC testing, 1,002 non-O157 STEC cases were confirmed in England. Of the 1,002 non-O157 cases, 655 culture positive cases of 72 different serogroups were confirmed. For 21 isolates, a serotype could not be identified as the genes encoding the somatic O antigen did not match any known sequence in the database. Specimens for a further 347 cases in England were positive for stx genes on PCR at GBRU but an organism was not cultured (PCR positive-culture negative).

In Wales, 113 non-O157 cases of 40 different serotypes were confirmed and a further 66 were PCR positive-culture negative. The most common non-O157 serogroups isolated in 2019 were O26 (28/113, 25%), O146 (15/113, 13%), O128ab (10/113, 9%) and O91 (8/113, 7%) followed by O111 (4/113, 4%), O113 (4/113, 4%) and O156 (4/113, 4%).

Germany – E. coli in lamb and flour prompts warning in Germany

Food Safety News

Findings of E. coli in lamb and flour has triggered a warning from German authorities.

Basic rules of kitchen hygiene, such as using different cutting boards for raw meat and vegetables, should be followed. Proper cooking is one of the best ways to avoid food poisoning from E. coli.

As part of zoonosis monitoring in Germany in 2020, Shiga toxin-producing E. coli (STEC) were detected in 50 of 380 samples of fresh lamb.

Lamb from Germany was significantly more often STEC-positive than that from other countries with 36 of 190 samples positive compared to 12 of 177.

Consumers, especially small children, the elderly, the immunocompromised and pregnant women, should only consume lamb that has been well cooked, advised the Federal Office for Consumer Protection and Food Safety (BVL).

“An infection with STEC should not be underestimated. In children in particular, it can lead to the development of hemolytic uremic syndrome (HUS), which is often associated with acute kidney failure,” said Friedel Cramer, BVL president.

STEC was detected in 22 of 242 samples of wheat flour from milling operations. Consumers can minimize this risk by not eating raw dough, cake batter or other foods containing raw flour. E. coli was also found in six of 318 samples of raw milk soft cheese sold at retail, from wholesale and at import points.

In total, 94 isolates belonged to 28 different O serogroups with O146 as the most common while O157 was not detected.

Research – High Occurrence of Shiga Toxin-Producing Escherichia coli in Raw Meat-Based Diets for Companion Animals—A Public Health Issue

MDPI

Feeding pets raw meat-based diets (RMBDs) is becoming increasingly popular but comes with a risk of pathogenic bacteria, including Shiga toxin-producing Escherichia coli (STEC). In humans, STEC may cause gastrointestinal illnesses, including diarrhea, hemorrhagic colitis (HC), and the hemolytic uremic syndrome (HUS). The aim of this study was to evaluate commercially available RMBDs with regard to the occurrence of STEC. Of 59 RMBD samples, 59% tested positive by real-time PCR for the presence of Shiga toxin genes stx1 and/or stx2. STECs were recovered from 41% of the 59 samples, and strains were subjected to serotyping and virulence gene profiling, using whole genome sequencing (WGS)-based methods. Of 28 strains, 29% carried stx2a or stx2d, which are linked to STEC with high pathogenic potential. Twenty different serotypes were identified, including STEC O26:H11, O91:H10, O91:H14, O145:H28, O146:H21, and O146:H28, which are within the most common non-O157 serogroups associated with human STEC-related illnesses worldwide. Considering the low infectious dose and potential severity of disease manifestations, the high occurrence of STEC in RMBDs poses an important health risk for persons handling raw pet food and persons with close contact to pets fed on RMBDs, and is of concern in the field of public health.

Research – High Occurrence of Shiga Toxin-Producing Escherichia coli in Raw Meat-Based Diets for Companion Animals—A Public Health Issue

MDPI

Feeding pets raw meat-based diets (RMBDs) is becoming increasingly popular but comes with a risk of pathogenic bacteria, including Shiga toxin-producing Escherichia coli (STEC). In humans, STEC may cause gastrointestinal illnesses, including diarrhea, hemorrhagic colitis (HC), and the hemolytic uremic syndrome (HUS). The aim of this study was to evaluate commercially available RMBDs with regard to the occurrence of STEC. Of 59 RMBD samples, 59% tested positive by real-time PCR for the presence of Shiga toxin genes stx1 and/or stx2. STECs were recovered from 41% of the 59 samples, and strains were subjected to serotyping and virulence gene profiling, using whole genome sequencing (WGS)-based methods. Of 28 strains, 29% carried stx2a or stx2d, which are linked to STEC with high pathogenic potential. Twenty different serotypes were identified, including STEC O26:H11, O91:H10, O91:H14, O145:H28, O146:H21, and O146:H28, which are within the most common non-O157 serogroups associated with human STEC-related illnesses worldwide. Considering the low infectious dose and potential severity of disease manifestations, the high occurrence of STEC in RMBDs poses an important health risk for persons handling raw pet food and persons with close contact to pets fed on RMBDs, and is of concern in the field of public health. View Full-Text