Prevalence and characterization of Shiga toxin-producing Escherichia coli O157 and O26 in beef farms

A systematic review and meta-analysis of published literature on prevalence of non-O157 Shiga toxin-producing Escherichia coli serogroups (O26, O45, O103, O111, O121, and O145) and virulence genes in feces, hides, and carcasses of pre- and peri-harvest cattle worldwide

OBJECTIVE

The objective of this study was to summarize peer-reviewed literature on the prevalence and concentration of non-O157 STEC (O26, O45, O103, O111, O121, and O145) serogroups and virulence genes (stx and eae) in fecal, hide, and carcass samples in pre- and peri-harvest cattle worldwide, using a systematic review of the literature and meta-analyses.

DATA SYNTHESIS

Seventy articles were eligible for meta-analysis inclusion; data from 65 articles were subjected to random-effects meta-analysis models to yield fecal prevalence estimates. Meta-regression models were built to explore variables contributing to the between-study heterogeneity.

RESULTS

Worldwide pooled non-O157 serogroup, STEC, and EHEC fecal prevalence estimates (95% confidence interval) were 4.7% (3.4-6.3%), 0.7% (0.5-0.8%), and 1.0% (0.8-1.1%), respectively. Fecal prevalence estimates significantly differed by geographic region (P < 0.01) for each outcome classification. Meta-regression analyses identified region, cattle type, and specimen type as factors that contribute to heterogeneity for worldwide fecal prevalence estimates.

CONCLUSIONS

The prevalence of these global foodborne pathogens in the cattle reservoir is widespread and highly variable by region. The scarcity of prevalence and concentration data for hide and carcass matrices identifies a large data gap in the literature as these are the closest proxies for potential beef contamination at harvest.

Shiga Toxin (Verotoxin)-producing Escherichia coli and Foodborne Disease: A Review

Shiga toxin (verotoxin)-producing Escherichia coli (STEC) is an important cause of foodborne disease. Since outcomes of the infections with STEC have a broad range of manifestation from asymptomatic infection or mild intestinal discomfort, to bloody diarrhea, hemolytic uremic syndrome (HUS), end-stage renal disease (ESRD), and death, the disease is a serious burden in public health and classified as a notifiable infectious disease in many countries. Cattle and other ruminants are considered to be the major reservoirs of STEC though isolation of STEC from other animals have been reported. Hence, the source of contamination extends to a wide range of foods, not only beef products but also fresh produce, water, and environment contaminated by excretes from the animals, mainly cattle. A low- infectious dose of STEC makes the disease relatively contagious, and causes outbreaks with unknown contamination sources and, therefore, as a preventive measure against STEC infection, it is important to obtain characteristics of prevailing STEC isolates in the region through robust surveillance. Analysis of the isolates by pulsed-field gel electrophoresis (PFGE) and multiple-locus variable-number tandem repeat analysis (MLVA) could help finding unrecognized foodborne outbreaks due to consumption of respective contaminated sources. However, though the results of molecular analysis of the isolates could indicate linkage of sporadic cases of STEC infection, it is hardly concluded that the cases are related via contaminated food source if it were not for epidemiological information. Therefore, it is essential to combine the results of strain analysis and epidemiological investigation rapidly to detect rapidly foodborne outbreaks caused by bacteria. This article reviews STEC infection as foodborne disease and further discusses key characteristics of STEC including pathogenesis, clinical manifestation, prevention and control of STEC infection. We also present the recent situation of the disease in Japan based on the surveillance of STEC infection.

Nationwide investigation of Shiga toxin-producing Escherichia coli among cattle in Japan revealed the risk factors and potentially virulent subgroups

A nationwide study of Shiga toxin-producing Escherichia coli (STEC) was performed to determine the prevalence, characteristics and risk factors for fecal shedding of STEC among cattle in Japan. Information on rearing practices was also collected to identify risk factors for fecal shedding of STEC. STEC was isolated from 24·1% of samples (133/551) collected from 59·1% of farms (65/110). Bayesian clustering using the virulence marker profiles of the isolates subdivided the isolates into four genetically distinct groups, two of which corresponded to eae- or saa-positive STEC, which can cause severe disease in human. Both STEC groups exhibited characteristic phylogeny and virulence marker profiles. It is noteworthy that the tellurite resistance gene was not detected in all saa-positive STEC isolates, suggesting that the standard isolation method using tellurite might lead to an underestimation of the prevalence of saa-positive STEC. A multivariate logistic regression model using epidemiological information revealed a significantly (P < 0·01) high odds ratio on STEC fecal shedding in tie-stall housing and a low odds ratio in flat feed box and mechanical ventilation. Information on isolate characteristics of the two major pathotypes and risk factors in rearing practices will facilitate the development of preventative measures for STEC fecal shedding from cattle.

Shiga Toxin (Verotoxin)-Producing Escherichia coli in Japan

A series of outbreaks of infection with Shiga toxin (verocytotoxin)-producing Escherichia coli or enterohemorrhagic E. coli (EHEC) O157:H7 occurred in Japan in 1996, the largest outbreak occurring in primary schools in Sakai City, Osaka Prefecture, where more than 7,500 cases were reported. Although the reason for the sudden increase in the number of reports of EHEC isolates in 1996 is not known, the number of reports has grown to more than 3,000 cases per year since 1996, from an average of 105 reports each year during the previous 5-year period (1991-1995). Despite control measures instituted since 1996, including designating Shiga toxin-producing E. coli infection as a notifiable disease, and nationwide surveillance effectively monitoring the disease, the number of reports remains high, around 3,800 cases per year. Serogroup O157 predominates over other EHEC serogroups, but isolation frequency of non-O157 EHEC has gone up slightly over the past few years. Non-O157 EHEC has recently caused outbreaks where consumption of a raw beef dish was the source of the infection, and some fatal cases occurred. Laboratory surveillance comprised prefectural and municipal public health institutes, and the National Institute of Infectious Diseases has contributed to finding not only multiprefectural outbreaks but recognizing sporadic cases that could have been missed as an outbreak without the aid of molecular subtyping of EHEC isolates. This short overview presents recent information on the surveillance of EHEC infections in Japan.

Prevalence and characterization of Escherichia coli and Salmonella strains isolated from stray dog and coyote feces in a major leafy greens production region at the United States-Mexico border

In 2010, Romaine lettuce grown in southern Arizona was implicated in a multi-state outbreak of Escherichia coli O145:H28 infections. This was the first known Shiga toxin-producing E. coli (STEC) outbreak traced to the southwest desert leafy green vegetable production region along the United States-Mexico border. Limited information exists on sources of STEC and other enteric zoonotic pathogens in domestic and wild animals in this region. According to local vegetable growers, unleashed or stray domestic dogs and free-roaming coyotes are a significant problem due to intrusions into their crop fields. During the 2010-2011 leafy greens growing season, we conducted a prevalence survey of STEC and Salmonella presence in stray dog and coyote feces. Fresh fecal samples from impounded dogs and coyotes from lands near produce fields were collected and cultured using extended enrichment and serogroup-specific immunomagnetic separation (IMS) followed by serotyping, pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibility testing. A total of 461 fecal samples were analyzed including 358 domestic dog and 103 coyote fecals. STEC was not detected, but atypical enteropathogenic E. coli (aEPEC) strains comprising 14 different serotypes were isolated from 13 (3.6%) dog and 5 (4.9%) coyote samples. Salmonella was cultured from 33 (9.2%) dog and 33 (32%) coyote samples comprising 29 serovars with 58% from dogs belonging to Senftenberg or Typhimurium. PFGE analysis revealed 17 aEPEC and 27 Salmonella distinct pulsotypes. Four (22.2%) of 18 aEPEC and 4 (6.1%) of 66 Salmonella isolates were resistant to two or more antibiotic classes. Our findings suggest that stray dogs and coyotes in the desert southwest may not be significant sources of STEC, but are potential reservoirs of other pathogenic E. coli and Salmonella. These results underscore the importance of good agriculture practices relating to mitigation of microbial risks from animal fecal deposits in the produce production area.

Molecular characterization of enterohemorrhagic E. coli O157 isolated from animal fecal and food samples in Eastern China

Objective. To elucidate the extent of food contamination by enterohemorrhagic Escherichia coli (EHEC) O157 in Eastern China. Methods. A total of 1100 food and animal fecal samples were screened for EHEC O157. Then, molecular characterization of each isolate was determined. Results. EHEC O157 was isolated as follows: pig feces, 4% (20/500); cattle feces, 3.3% (2/60); chicken feces, 1.43% (2/140); pork, 2.14% (3/140), milk, 1.67% (1/60); and chicken meat, 1.67% (1/60). The stx1, stx2, eae, and hlyA genes were present in 26.7% (8/30), 40% (12/30), 63.3% (19/30), and 50% (15/30) of the O157 isolates, respectively. Molecular typing showed that strains from fecal and food samples were clustered into the same molecular typing group. Furthermore, the isolates from pork and pig feces possessed the same characterization as the clinical strains ATCC35150 and ATCC43889. Biofilm formation assays showed that 53.3% of the EHEC O157 isolates could produce biofilm. However, composite analyses showed that biofilm formation of EHEC O157 was independent of genetic background. Conclusions. Animal feces, especially from pigs, serve as reservoirs for food contamination by EHEC O157. Thus, it is important to control contamination by EHEC O157 on farms and in abattoirs to reduce the incidence of foodborne infections in humans.

Relative sensitivity of Escherichia coli O157 detection from bovine feces and rectoanal mucosal swabs

The need to quantify the potential human health risk posed by the bovine reservoir of Escherichia coli O157 has led to a wealth of prevalence studies and improvements in detection methods over the last two decades. Rectoanal mucosal swabs have been used for the detection of E. coli O157 fecal shedding, colonized animals, and those predisposed to super shedding. We conducted a longitudinal study to compare the detection of E. coli O157 from feces and rectoanal mucosal swabs (RAMS) from a cohort of dairy heifers. We collected 820 samples that were tested by immunomagnetic separation of both feces and RAMS. Of these, 132 were detected as positive for E. coli O157 from both samples, 66 were detected as positive from RAMS only, and 117 were detected as positive from feces only. The difference in results between the two sample types was statistically significant (P < 0.001). The relative sensitivities of detection by immunomagnetic separation were 53% (confidence interval, 46.6 to 59.3) from RAMS and 67% (confidence interval, 59.6 to 73.1) from fecal samples. No association between long-term shedding (P = 0.685) or super shedding (P = 0.526) and detection by RAMS only was observed.

Regional variation in the prevalence of E. coli O157 in cattle: a meta-analysis and meta-regression

BACKGROUND

Escherichia coli O157 (EcO157) infection has been recognized as an important global public health concern. But information on the prevalence of EcO157 in cattle at the global and at the wider geographical levels is limited, if not absent. This is the first meta-analysis to investigate the point prevalence of EcO157 in cattle at the global level and to explore the factors contributing to variation in prevalence estimates.

METHODS

Seven electronic databases- CAB Abstracts, PubMed, Biosis Citation Index, Medline, Web of Knowledge, Scirus and Scopus were searched for relevant publications from 1980 to 2012. A random effect meta-analysis model was used to produce the pooled estimates. The potential sources of between study heterogeneity were identified using meta-regression.

PRINCIPAL FINDINGS

A total of 140 studies consisting 220,427 cattle were included in the meta-analysis. The prevalence estimate of EcO157 in cattle at the global level was 5.68% (95% CI, 5.16-6.20). The random effects pooled prevalence estimates in Africa, Northern America, Oceania, Europe, Asia and Latin America-Caribbean were 31.20% (95% CI, 12.35-50.04), 7.35% (95% CI, 6.44-8.26), 6.85% (95% CI, 2.41-11.29), 5.15% (95% CI, 4.21-6.09), 4.69% (95% CI, 3.05-6.33) and 1.65% (95% CI, 0.77-2.53), respectively. Between studies heterogeneity was evidenced in most regions. World region (p<0.001), type of cattle (p<0.001) and to some extent, specimens (p = 0.074) as well as method of pre-enrichment (p = 0.110), were identified as factors for variation in the prevalence estimates of EcO157 in cattle.

CONCLUSION

The prevalence of the organism seems to be higher in the African and Northern American regions. The important factors that might have influence in the estimates of EcO157 are type of cattle and kind of screening specimen. Their roles need to be determined and they should be properly handled in any survey to estimate the true prevalence of EcO157.

Molecular approach for tracing dissemination routes of Shiga toxin-producing Escherichia coli O157 in bovine offal at slaughter

Bovine offal is currently recognized as one of the sources of human Shiga toxin-producing Escherichia coli (STEC) infection in Japan. Here, the prevalence and genetic characterization of STEC O157 in bovine feces, offal, and carcasses at slaughtering were examined between July and October in 2006. STEC O157 was detected in 31 of 301 cattle feces (10.3%) delivered from 120 farms. Simultaneously, 60 bovine-originated offal (tongue, liver, and omasum) and carcasses were randomly selected and the detection of O157 STEC was examined as well. STEC O157 was isolated from 4 tongues (6.7%), 1 liver (1.7%), 3 omasa (5.0%), and 2 carcasses (3.3%), respectively. All the O157 isolates were positive for eae and hlyA genes, and 37 of 41 isolates (90.2%) exhibited stx2c genotype. PFGE analysis revealed the identical macrogenotypes of 4-tongue- and 1-liver-originated isolates and among 2 fecal isolates from animals slaughtered consecutively. Considering their continuous detection according to the slaughtering order, we concluded that these distributions of O157 in bovine offal and feces might be due to cross-contamination at (pre)slaughter. Our data thus reposes implication of better sanitary control in diapedesis from both upper and lower sites to prevent spread of this pathogen to bovine offal at slaughtering.

Longitudinal follow-up of the persistence and dissemination of EHEC on cattle farms in Belgium

A longitudinal survey was performed on three cattle herds known to be positive for, respectively, Enterohemorrhagic Eschericia coli (EHEC) O157, O26/O103, and O26 in a slaughterhouse study. This study aimed to investigate the persistence and dissemination of EHEC in beef cattle and beef cattle farms. At each farm, a cohort of 10 animals was sampled, seven times on farm B and eight times on farms A and C, at intervals of approximately 4-6 weeks. In addition, incoming cattle and environmental samples were also examined for the presence of EHEC at each sampling occasion. In 65 (18.8%) out of 345 samples, EHEC was detected, of which 41 were from cohort animals, four from incoming cattle and 20 from environmental samples (cats 3/23; dogs 2/7; feed 4/23, water 2/23, and dust 9/23). On two farms, non-EHEC strains harboring either vtx or eae genes were detected in 21 samples. EHEC was detected at least once in 23 of the cohort animals, with a maximum of four positive sampling occasions. Genetic typing by pulsed-field gel electrophoresis (PFGE) demonstrated that a same strain occurred for several months (up to 11 months) in two of three cattle farms. Among the environmental samples, dust harbored EHEC most frequently. In conclusion, transmission and dissemination of EHEC might have occurred not only in the bovine reservoir but also in the farm environment and in other farm animals.

Comparison of the prevalence of shiga toxin-producing Escherichia coli strains O157 and O26 between beef and dairy cattle in Japan

With the aim of comparing the prevalence of Shiga toxin-producing Escherichia coli (STEC) O157 and O26 between beef and dairy cattle, we collected rectal content samples from 250 beef cattle on 25 beef farms and 250 dairy cows on 25 dairy farms from July through September 2011. STEC O157 was isolated from 16 beef cattle on 7 beef farms, while no STEC O157 was isolated from any dairy farms. This result suggests that the prevalence of STEC O157 is higher in beef cattle than in dairy cattle. STEC O26 was isolated from 1 animal each from beef and dairy cattle herds, and therefore, it was not possible to compare statistically the prevalence of STEC O26 in beef and dairy cattle.

Prevalence and characterization of foodborne pathogens in dairy cattle in the eastern part of Japan

To investigate the prevalence and characterization of foodborne pathogens [Campylobacter spp., Shiga toxin-producing Escherichia coli (STEC), Listeria monocytogenes and Salmonella spp.] in dairy cows, rectal content grab samples were collected from 250 dairy cows reared on 25 dairy farms in eastern Japan from December 2010 through February 2011. Campylobacter jejuni was isolated from 106 (42%) cows on 23 (92%) farms, STEC O157 from three cows on one farm, L. monocytogenes from three cows on another three farms and Salmonella enterica subsp. enterica serovar Typhimurium from eight cows on another farm. STEC O26 was not isolated from any of the dairy farms investigated. The results suggest that C. jejuni is widespread in dairy farms in eastern Japan.

Pet animals and foreign travel are risk factors for colonisation with extended-spectrum β-lactamase-producing Escherichia coli

OBJECTIVE

The purpose of this study was to determine the prevalence of extended-spectrum β-lactamase (ESBL) and vancomycin-resistant enterococci (VRE) colonisation among healthy infection control personnel and to determine risk factors for ESBL or VRE colonisation within this group.

METHODS

Participants were recruited at an infection control symposium in 2011. Volunteers were asked to perform a rectal swab and to fill in questionnaires on risk factors of ESBL or VRE carriage (report on diet, contact with domestic or production animals, travel, hospital stay and antibiotic use all within the last 12 months). Rectal swabs were inoculated onto ESBL and VRE chromogenic agar; species identification and susceptibility testing was done by using a VITEK 2 system. In the multivariable analysis, a logistic regression with stepwise forward variable selection was performed.

RESULTS

Two hundred and thirty people participated in the study, i.e. 36 % of the symposium attendees (231/639). No VRE faecium or faecalis were isolated, whereas ESBL were isolated from 8 out of 231 individuals, i.e. 3.5 % (95 % confidence interval 1.5-6.7). In the multivariable analysis, travel to Greece or Africa and contact with pets were independently associated with ESBL positivity. The odds ratios were as follows: travel to Greece 15.2, travel to Africa 14.8 and for having a pet animal 6.7.

CONCLUSION

This is the first report showing that contact with pets increases by almost seven-fold the chance to be colonised with ESBL Escherichia coli. A colonisation rate of 3.5 % with ESBL-producing enterobacteriaceae among infection control personnel is of concern and reflects probably less an occupational health risk but the reservoir of and the expansion into the community, especially in persons with pet animals and travel history to high-endemicity countries.

Mainstreams of horizontal gene exchange in enterobacteria: consideration of the outbreak of enterohemorrhagic E. coli O104:H4 in Germany in 2011

BACKGROUND

Escherichia coli O104:H4 caused a severe outbreak in Europe in 2011. The strain TY-2482 sequenced from this outbreak allowed the discovery of its closest relatives but failed to resolve ways in which it originated and evolved. On account of the previous statement, may we expect similar upcoming outbreaks to occur recurrently or spontaneously in the future? The inability to answer these questions shows limitations of the current comparative and evolutionary genomics methods.

PRINCIPAL FINDINGS

The study revealed oscillations of gene exchange in enterobacteria, which originated from marine γ-Proteobacteria. These mobile genetic elements have become recombination hotspots and effective 'vehicles' ensuring a wide distribution of successful combinations of fitness and virulence genes among enterobacteria. Two remarkable peculiarities of the strain TY-2482 and its relatives were observed: i) retaining the genetic primitiveness by these strains as they somehow avoided the main fluxes of horizontal gene transfer which effectively penetrated other enetrobacteria; ii) acquisition of antibiotic resistance genes in a plasmid genomic island of β-Proteobacteria origin which ontologically is unrelated to the predominant genomic islands of enterobacteria.

CONCLUSIONS

Oscillations of horizontal gene exchange activity were reported which result from a counterbalance between the acquired resistance of bacteria towards existing mobile vectors and the generation of new vectors in the environmental microflora. We hypothesized that TY-2482 may originate from a genetically primitive lineage of E. coli that has evolved in confined geographical areas and brought by human migration or cattle trade onto an intersection of several independent streams of horizontal gene exchange. Development of a system for monitoring the new and most active gene exchange events was proposed.