Adhesion and its role in the virulence of enteropathogenic Escherichia coli

Association between alpha-hemolysin production and HeLa cell-detaching activity in fecal isolates of Escherichia coli

Escherichia coli isolates that cause detachment of cell monolayers during in vitro adherence assays (cell-detaching E. coli [CDEC]) were recently reported as a potential new group of enteropathogenic bacteria. In the present study, 269 E. coli isolates from feces of children 1 to 5 years of age were identified as CDEC in a detaching assay developed with HeLa cells. The great majority of these isolates were hemolytic within 3 h of growth on blood agar plates and hybridized with a DNA probe for alpha-hemolysin (93.7%), while most of the non-detaching isolates were hemolytic within 24 h (3.6%) or nonhemolytic (94.8%). E. coli isolates that produced alpha-hemolysin were found in 60 (30%) of 200 children with diarrhea and 47 (24%) of 200 age-matched controls. No statistical significance was found for the differences in alpha-hemolysin production among the matched pairs (P = 0.2). These data suggest that CDEC isolates are not associated with diarrhea in the population studied.

Characterization of Hafnia alvei by biochemical tests, random amplified polymorphic DNA PCR, and partial sequencing of 16S rRNA gene

Hafnia alvei strains which possess the attachment-effacement gene (eaeA) may have clinical importance as new diarrhea-causing pathogens and should therefore be differentiated from other H. alvei strains. We characterized diarrheal H. alvei strains, which were positive in the PCR test for the eaeA gene, using biochemical tests not routinely used for identification of members of the family Enterobacteriaceae, and compared them with eaeA-negative strains isolated from different clinical and nonclinical sources to find characteristics useful for identification. Random amplified polymorphic DNA (RAPD)-PCR and partial sequencing of the 16S rRNA gene were utilized to study the genetic diversity of the isolates. The eaeA-positive strains were found to have many characteristic biochemical properties. Negative reactions in the 2-ketogluconate and histidine assimilation tests and a positive reaction in the 3-hydroxybenzoate assimilation test may be useful in routine diagnostics. Nearly identical RAPD-PCR profiles and identical 353-bp fragments of the 16S rRNA genes indicated little genetic diversity among the eaeA-positive strains. The low level of homology (92%) in the partial 16S rRNA genes of eaeA-positive and -negative H. alvei strains raises questions about the taxonomic positioning of eaeA-positive H. alvei.

Evaluation of a simplified HEp-2 cell adherence assay for Escherichia coli isolated from south Indian children with acute diarrhea and controls

A simplified HEp-2 cell adhesion assay was performed with stored Escherichia coli isolates from 761 children with acute diarrhea and 531 matched controls, and the results were evaluated by means of fluorescent actin staining and hybridization with DNA probes. The prevalence rates of localized adherence and aggregative adherence were significantly higher for patients (9.9 and 7.6%, respectively) than for controls (3.7 and 3.9%, respectively).

Identification of EaeA protein in the outer membrane of attaching and effacing Escherichia coli O45 from pigs

We have previously reported that the production of attaching and effacing lesions by Escherichia coli O45 isolates from pigs is associated with the eaeA (E. coli attaching and effacing) gene. In the present study, expression of the EaeA protein, the eaeA gene product, among swine O45 E. coli isolates was examined. The majority (20/22) of attaching and effacing positive, eaeA+ E. coli O45 isolates, but none of ten attaching and effacing negative, eaeA- or eaeA+ isolates, expressed a 97-kDa outer membrane protein as revealed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot analysis. Amino-terminal amino acid sequencing demonstrated a high homology between this 97-kDa protein of swine E. coli O45 and the EaeA protein (intimin) of human enteropathogenic E. coli and enterohemorrhagic E. coli. In addition, a serological relationship between the EaeA proteins of swine O45, rabbit (RDEC-1) and human (E2348/69) attaching and effacing E. coli strains was observed. Our results indicate an association between expression of the EaeA protein and attaching and effacing activity among O45 E. coli isolates. The data also suggest an antigenic relatedness of the EaeA proteins of swine, rabbit, and human attaching and effacing E. coli.

Virulence factors associated with strains of Escherichia coli from cases of sudden infant death syndrome (SIDS)

Strains of Escherichia coli isolated from cases of Sudden Infant Death Syndrome, healthy infants and infants that died of other causes were subjected to a series of tests with particular reference to serotyping, toxigenicity and adherence factors. E. coli from SIDS infants tended to have a low hydrophobicity and high toxigenicity, compared to those from healthy infants, while no notable differences in haemagglutination patterns were observed between these two groups of strains.

Interaction with pig ileal explants of Escherichia coli O45 isolates from swine with postweaning diarrhea

We have previously observed that Escherichia coli O45 isolates from swine postweaning diarrhea (PWD) induced attaching-effacing (A/E) lesions in experimentally inoculated gnotobiotic piglets. In the present work, ileal explant culture has been used as an in vitro model for the study of the development of A/E lesions due to these isolates. The characteristic intimate bacterial attachment and microvilli effacement with cupping and pedestal formation, identical to that observed in gnotobiotic piglets, was demonstrated in pig ileal explants inoculated with O45 E. coli isolates. The initial attachment of bacteria to the enterocytes was observed from 2 to 4 h postinoculation (PI) and full development of A/E lesions was observed within 8 h PI. In this model, we observed that 22 of 25 eaeA-positive O45 isolates induced A/E lesions. However, A/E lesions were not observed for any of 7 eaeA-negative O45 isolates. Thus, we describe a useful in vitro model for the study of A/E capacity of porcine E. coli. Use of this model has enabled us to demonstrate the relatedness of the eaeA gene to A/E capability among porcine O45 E. coli from PWD.

Use of heme and hemoglobin by Escherichia coli O157 and other Shiga-like-toxin-producing E. coli serogroups

The virulence properties of Escherichia coli O157 isolates were compared with those of Shiga-like-toxin-producing E. coli of non-O157 serogroups. The growth of all E. coli O157 isolates was stimulated by both heme and hemoglobin, and all produced enterohemolysin. The incidence of these properties was significantly lower in the non-O157 isolates. This may contribute to the greater virulence and higher incidence of human infection caused by E. coli O157.

Virulence of enterococci

Enterococci are commensal organisms well suited to survival in intestinal and vaginal tracts and the oral cavity. However, as for most bacteria described as causing human disease, enterococci also possess properties that can be ascribed roles in pathogenesis. The natural ability of enterococci to readily acquire, accumulate, and share extrachromosomal elements encoding virulence traits or antibiotic resistance genes lends advantages to their survival under unusual environmental stresses and in part explains their increasing importance as nosocomial pathogens. This review discusses the current understanding of enterococcal virulence relating to (i) adherence to host tissues, (ii) invasion and abscess formation, (iii) factors potentially relevant to modulation of host inflammatory responses, and (iv) potentially toxic secreted products. Aggregation substance, surface carbohydrates, or fibronectin-binding moieties may facilitate adherence to host tissues. Enterococcus faecalis appears to have the capacity to translocate across intact intestinal mucosa in models of antibiotic-induced superinfection. Extracellular toxins such as cytolysin can induce tissue damage as shown in an endophthalmitis model, increase mortality in combination with aggregation substance in an endocarditis model, and cause systemic toxicity in a murine peritonitis model. Finally, lipoteichoic acid, superoxide production, or pheromones and corresponding peptide inhibitors each may modulate local inflammatory reactions.

Host specificity of enteropathogenic Escherichia coli from rabbits: lack of correlation between adherence in vitro and pathogenicity for laboratory animals

The pathogenicity of four attaching and effacing strains of enteropathogenic Escherichia coli originally isolated from diarrheic rabbits was investigated by inoculating them perorally into rabbits, guinea pigs, and mice. The ability of the four strains to adhere to cultured epithelial cells, erythrocytes, and intestinal brush borders from various animal species, including rabbits, guinea pigs, and mice, varied considerably. Only one strain carried AF/R1 fimbriae, which are believed to determine the host specificity of these bacteria. Despite these differences, the pattern of behavior of the four strains in experimentally infected animals was similar. Each strain caused fatal diarrhea in rabbits (although the virulence of individual strains for rabbits differed significantly), and none was virulent for guinea pigs or mice. None of the strains colonized the intestinal tract of guinea pigs, but all were able to cause attaching-effacing lesions in ligated loops of guinea pig small intestine. By contrast, all four strains colonized mice, in particular the distal intestine, but none induced attaching-effacing lesions in mouse intestinal loops. These findings suggest that there may be previously unrecognized host-restricted adhesins in enteropathogenic E. coli and indicate that adherence to erythrocytes or intestinal brush borders in vitro does not necessarily reflect colonizing ability or pathogenicity in vivo.

Escherichia coli serogroup O111 includes several clones of diarrheagenic strains with different virulence properties

Genetic variation among isolates of Escherichia coli O111 obtained mostly from patients with diarrhea in Brazil was assessed by multilocus enzyme electrophoresis to characterize chromosomal genotypes and by gene probes and adherence assays to characterize virulence properties. Among the 152 isolates, we resolved 16 distinct electrophoretic types (ETs), which differed on average at 40% of the enzyme loci. We identified four major bacterial O111 clones of different disease classes: ET 12, which includes the bulk of the enteropathogenic E. coli strains, typically showing localized adherence and intimate attachment in tissue culture assays; ET 1, which includes strains with a different set of virulence markers; ET 9, which includes strains that show intimate attachment but lack localized adherence and Shiga-like toxin genes; and ET 8, which includes strains that are Shiga-like toxin producers and have the corresponding traits of enterohemorrhagic E. coli. Enteroaggregative strains constituted ET 10 and also occurred in ET 1. Isolates of the major clones were found in South and North America and matched in ET and virulence factors to previously described diarrheagenic clones that are widely disseminated in the human population. Because the major clones are genetically distantly related and exhibit different combinations of virulence factors, we hypothesize that they have distinct mechanisms of pathogenesis. The results indicate that genetic divergence of bacteria with the O111 antigen, as measured by allelic variation in enzyme loci, is accompanied by divergence in virulence properties of clones so that identification and classification of pathogenic E. coli strains cannot be based solely on serotyping or a single virulence factor.