Category Archives: O91

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%).

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

Research – Shiga Toxin-Producing Escherichia coli (STEC) and STEC-Associated Virulence Genes in Raw Ground Pork in Canada

Journal of Food Protection

Shiga toxin-producing Escherichia coli (STEC) O157:H7/NM and some non-O157 STEC are foodborne pathogens. In response to pork-associated O157 STEC outbreaks in Canada, we investigated the occurrence of STEC in Canadian retail raw ground pork during the period of November 1, 2014 and March 31, 2016. Isolated STEC were characterized to determine the Shiga-toxin gene ( stx ) subtype and the presence of virulence genes encoding intimin ( eae ), and enterohemorrhagic E. coli hemolysin (hlyA) . O157 STEC and non-O157 STEC were isolated from 0.11% (1/879) and 2.24% (13/580) of the pork samples. STEC virulence gene profiles containing both eae and hlyA were found only in the O157 STEC ( stx 2a , eae , hlyA ) isolate. The eae gene was absent from all non-O157 STEC isolates. Of the 13 non-O157 STEC isolates, two virulence genes of stx 1a and hlyA were found in four (30.8%) O91:H14 STEC isolates, while one virulence gene of stx 2e, stx 1a , and stx 2a was identified in five (38.5%), two (15.4%) and one (7.7%) STEC isolates respectively of various serotypes. The remaining non-O157 STEC isolate carried stx 2 , but the subtype is unknown as this isolate could not be recovered for sequencing. O91:H14 STEC ( stx 1a, hlyA ) was previously reported in association with diarrhea illnesses, while the other non-O157 STEC isolates identified in this study are not known to be associated with severe human illnesses. Virulence gene profiles identified in this study indicate that the occurrence of non-O157 STEC capable of causing severe human illness is rare in Canadian retail pork. However, O157 STEC in ground pork can occasionally occur, therefore education regarding the potential risks associated with STEC contamination of pork would be beneficial for the public and those in the food industry in order to help reduce foodborne illnesses.

RASFF Alert – STEC E.coli – Frozen Lamb Loins

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RASFF – shigatoxin-producing Escherichia coli (O91 stx1+ stx2+ eae- /25g) in frozen lamb loins from New Zealand in Italy