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Fruth A, Lang C, Größl T, Garn T, Flieger A. Genomic surveillance of STEC/EHEC infections in Germany 2020 to 2022 permits insight into virulence gene profiles and novel O-antigen gene clusters. Int J Med Microbiol 2024; 314:151610. [PMID: 38310676 DOI: 10.1016/j.ijmm.2024.151610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/06/2024] Open
Abstract
Shiga toxin-producing E. coli (STEC), including the subgroup of enterohemorrhagic E. coli (EHEC), are important bacterial pathogens which cause diarrhea and the severe clinical manifestation hemolytic uremic syndrome (HUS). Genomic surveillance of STEC/EHEC is a state-of-the-art tool to identify infection clusters and to extract markers of circulating clinical strains, such as their virulence and resistance profile for risk assessment and implementation of infection prevention measures. The aim of the study was characterization of the clinical STEC population in Germany for establishment of a reference data set. To that end, from 2020 to 2022 1257 STEC isolates, including 39 of known HUS association, were analyzed and lead to a classification of 30.4 % into 129 infection clusters. Major serogroups in all clinical STEC analyzed were O26, O146, O91, O157, O103, and O145; and in HUS-associated strains were O26, O145, O157, O111, and O80. stx1 was less frequently and stx2 or a combination of stx, eaeA and ehxA were more frequently found in HUS-associated strains. Predominant stx gene subtypes in all STEC strains were stx1a (24 %) and stx2a (21 %) and in HUS-associated strains were mainly stx2a (69 %) and the combination of stx1a and stx2a (12.8 %). Furthermore, two novel O-antigen gene clusters (RKI6 and RKI7) and strains of serovars O45:H2 and O80:H2 showing multidrug resistance were detected. In conclusion, the implemented surveillance tools now allow to comprehensively define the population of clinical STEC strains including those associated with the severe disease manifestation HUS reaching a new surveillance level in Germany.
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Affiliation(s)
- Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella (FG11) and National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Christina Lang
- Division of Enteropathogenic Bacteria and Legionella (FG11) and National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Tobias Größl
- Division of Enteropathogenic Bacteria and Legionella (FG11) and National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Thomas Garn
- Division of Enteropathogenic Bacteria and Legionella (FG11) and National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Antje Flieger
- Division of Enteropathogenic Bacteria and Legionella (FG11) and National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany.
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Lang C, Fruth A, Campbell IW, Jenkins C, Smith P, Strockbine N, Weill FX, Nübel U, Grad YH, Waldor MK, Flieger A. O-Antigen Diversification Masks Identification of Highly Pathogenic Shiga Toxin-Producing Escherichia coli O104:H4-Like Strains. Microbiol Spectr 2023; 11:e0098723. [PMID: 37212677 PMCID: PMC10269612 DOI: 10.1128/spectrum.00987-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/27/2023] [Indexed: 05/23/2023] Open
Abstract
Shiga toxin-producing Escherichia coli (STEC) can give rise to a range of clinical outcomes from diarrhea to the life-threatening systemic condition hemolytic-uremic syndrome (HUS). Although STEC O157:H7 is the serotype most frequently associated with HUS, a major outbreak of HUS occurred in 2011 in Germany and was caused by a rare serotype, STEC O104:H4. Prior to 2011 and since the outbreak, STEC O104:H4 strains have only rarely been associated with human infections. From 2012 to 2020, intensified STEC surveillance was performed in Germany where the subtyping of ~8,000 clinical isolates by molecular methods, including whole-genome sequencing, was carried out. A rare STEC serotype, O181:H4, associated with HUS was identified, and like the STEC O104:H4 outbreak strain, this strain belongs to sequence type 678 (ST678). Genomic and virulence comparisons revealed that the two strains are phylogenetically related and differ principally in the gene cluster encoding their respective lipopolysaccharide O-antigens but exhibit similar virulence phenotypes. In addition, five other serotypes belonging to ST678 from human clinical infection, such as OX13:H4, O127:H4, OgN-RKI9:H4, O131:H4, and O69:H4, were identified from diverse locations worldwide. IMPORTANCE Our data suggest that the high-virulence ensemble of the STEC O104:H4 outbreak strain remains a global threat because genomically similar strains cause disease worldwide but that the horizontal acquisition of O-antigen gene clusters has diversified the O-antigens of strains belonging to ST678. Thus, the identification of these highly pathogenic strains is masked by diverse and rare O-antigens, thereby confounding the interpretation of their potential risk.
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Affiliation(s)
- Christina Lang
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Bacterial Pathogens, Robert Koch Institut, Wernigerode, Germany
| | - Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Bacterial Pathogens, Robert Koch Institut, Wernigerode, Germany
| | - Ian W. Campbell
- Department of Microbiology, Division of Infectious Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Claire Jenkins
- Gastro and Food Safety (One Health) Division, Health Security Agency, London, United Kingdom
| | - Peyton Smith
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nancy Strockbine
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - François-Xavier Weill
- Institut Pasteur, Université Paris Cité, Unité des Bactéries Pathogènes Entériques, Paris, France
| | - Ulrich Nübel
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
- German Center for Infection Research (DZIF), Partner Site Braunschweig-Hannover, Hannover, Germany
- Braunschweig Integrated Center of Systems Biology (BRICS), Technical University, Braunschweig, Germany
| | - Yonatan H. Grad
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Matthew K. Waldor
- Department of Microbiology, Division of Infectious Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Howard Hughes Medical Institute, Boston, Massachusetts, USA
| | - Antje Flieger
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Bacterial Pathogens, Robert Koch Institut, Wernigerode, Germany
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Tiwari SK, van der Putten BCL, Fuchs TM, Vinh TN, Bootsma M, Oldenkamp R, La Ragione R, Matamoros S, Hoa NT, Berens C, Leng J, Álvarez J, Ferrandis-Vila M, Ritchie JM, Fruth A, Schwarz S, Domínguez L, Ugarte-Ruiz M, Bethe A, Huber C, Johanns V, Stamm I, Wieler LH, Ewers C, Fivian-Hughes A, Schmidt H, Menge C, Semmler T, Schultsz C. Genome-wide association reveals host-specific genomic traits in Escherichia coli. BMC Biol 2023; 21:76. [PMID: 37038177 PMCID: PMC10088187 DOI: 10.1186/s12915-023-01562-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/10/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Escherichia coli is an opportunistic pathogen which colonizes various host species. However, to what extent genetic lineages of E. coli are adapted or restricted to specific hosts and the genomic determinants of such adaptation or restriction is poorly understood. RESULTS We randomly sampled E. coli isolates from four countries (Germany, UK, Spain, and Vietnam), obtained from five host species (human, pig, cattle, chicken, and wild boar) over 16 years, from both healthy and diseased hosts, to construct a collection of 1198 whole-genome sequenced E. coli isolates. We identified associations between specific E. coli lineages and the host from which they were isolated. A genome-wide association study (GWAS) identified several E. coli genes that were associated with human, cattle, or chicken hosts, whereas no genes associated with the pig host could be found. In silico characterization of nine contiguous genes (collectively designated as nan-9) associated with the human host indicated that these genes are involved in the metabolism of sialic acids (Sia). In contrast, the previously described sialic acid regulon known as sialoregulon (i.e. nanRATEK-yhcH, nanXY, and nanCMS) was not associated with any host species. In vitro growth experiments with a Δnan-9 E. coli mutant strain, using the sialic acids 5-N-acetylneuraminic acid (Neu5Ac) and N-glycolylneuraminic acid (Neu5Gc) as sole carbon source, showed impaired growth behaviour compared to the wild-type. CONCLUSIONS This study provides an extensive analysis of genetic determinants which may contribute to host specificity in E. coli. Our findings should inform risk analysis and epidemiological monitoring of (antimicrobial resistant) E. coli.
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Affiliation(s)
- Sumeet K Tiwari
- Robert Koch Institute, Genome Sequencing and Genomic Epidemiology, Berlin, Germany
- Quadram Institute Bioscience, Gut Microbes and Health Institute Strategic Program, Norwich Research Park, Norwich, UK
| | - Boas C L van der Putten
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Thilo M Fuchs
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Trung N Vinh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Faculty of Veterinary Medicine, College of Agriculture, Can Tho University, Can Tho, Vietnam
| | | | - Rik Oldenkamp
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Institute for Life and Environment, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Roberto La Ragione
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
- Department of Microbial Sciences, School of Biosciences, University of Surrey, Guildford, UK
| | - Sebastien Matamoros
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ngo T Hoa
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Tropical medicine and global health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
- Microbiology- Parasitology Unit, Biomedical Research Center and Microbiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Christian Berens
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Joy Leng
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
| | - Julio Álvarez
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | | | - Jenny M Ritchie
- Department of Microbial Sciences, School of Biosciences, University of Surrey, Guildford, UK
| | - Angelika Fruth
- Robert Koch Institute, Enteropathogenic Bacteria and Legionella, Wernigerode, Germany
| | - Stefan Schwarz
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, Berlin, Germany
| | - Lucas Domínguez
- Tropical medicine and global health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
- Microbiology- Parasitology Unit, Biomedical Research Center and Microbiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - María Ugarte-Ruiz
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain
| | - Astrid Bethe
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, Berlin, Germany
| | - Charlotte Huber
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Vanessa Johanns
- Robert Koch Institute, Advanced Light and Electron Microscopy, Berlin, Germany
| | - Ivonne Stamm
- Vet Med Labor GmbH, Division of IDEXX Laboratories, Kornwestheim, Germany
| | | | - Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Giessen, Germany
| | - Amanda Fivian-Hughes
- Department of Microbial Sciences, School of Biosciences, University of Surrey, Guildford, UK
| | - Herbert Schmidt
- Institute of Food Science and Biotechnology, Department of Food Microbiology and Hygiene, University of Hohenheim, Stuttgart, Germany
| | - Christian Menge
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Torsten Semmler
- Robert Koch Institute, Genome Sequencing and Genomic Epidemiology, Berlin, Germany.
| | - Constance Schultsz
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
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Richter A, Pietsch M, Harmsen D, Juraschek K, Lang C, Mellmann A, Middendorf-Bauchart B, Pulz M, Roth S, Schuh E, Fruth A, Flieger A. [Assessment of available and currently applied typing methods of zoonotic pathogens using the example of Shiga toxin-producing and enterohemorrhagic Escherichia coli (STEC/EHEC)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:84-91. [PMID: 36525034 PMCID: PMC9756714 DOI: 10.1007/s00103-022-03628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION In order to improve patient care and to increase food safety within the framework of One Health, the project "Integrated Genomic Surveillance of Zoonotic Agents (IGS-Zoo)" aims to develop concepts for a genomic surveillance of Shiga toxin(Stx)-producing and enterohemorrhagic Escherichia coli (STEC/EHEC) in Germany. METHODS An online survey was conducted to assess the currently available and applied STEC/EHEC typing methods in the federal laboratories of veterinary regulation, food control, and public health service. RESULTS Twenty-six questionnaires from 33 participants were evaluated with regard to STEC/EHEC. The number of STEC/EHEC-suspected samples that the laboratories process per year ranges between 10 and 3500, and out of these they obtain between 3 and 1000 pathogenic isolates. Currently the most frequently used typing method is the determination of Stx- and intimin-coding genes using polymerase chain reaction (PCR). Whole genome sequencing (WGS) is currently used by eight federal state laboratories, and nine are planning to implement it in the future. The most common obstacle for further typing of STEC/EHEC is that isolation from sample material is often unsuccessful despite apparent PCR detection of the stx genes. DISCUSSION The results of the survey should facilitate the integration of the analysis methods developed in the project and emphasize the target groups' individual needs for corresponding training concepts.
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Affiliation(s)
- Anne Richter
- Fachgebiet 11: Bakterielle darmpathogene Erreger und Legionellen, Robert Koch-Institut (RKI), Burgstr. 37, 38855, Wernigerode, Deutschland
| | - Michael Pietsch
- Fachgebiet 11: Bakterielle darmpathogene Erreger und Legionellen, Robert Koch-Institut (RKI), Burgstr. 37, 38855, Wernigerode, Deutschland
| | - Dag Harmsen
- Poliklinik für Parodontologie und Zahnerhaltung, Universitätsklinikum Münster, Münster, Deutschland
| | - Katharina Juraschek
- Abteilung Biologische Sicherheit, Bundesinstitut für Risikobewertung (BfR), Berlin, Deutschland
| | - Christina Lang
- Fachgebiet 11: Bakterielle darmpathogene Erreger und Legionellen, Robert Koch-Institut (RKI), Burgstr. 37, 38855, Wernigerode, Deutschland
| | - Alexander Mellmann
- Institut für Hygiene, Universitätsklinikum Münster, Münster, Deutschland
| | | | - Matthias Pulz
- Niedersächsisches Landesgesundheitsamt, Hannover, Deutschland
| | - Sarah Roth
- Niedersächsisches Landesgesundheitsamt, Hannover, Deutschland
| | - Elisabeth Schuh
- Abteilung Biologische Sicherheit, Bundesinstitut für Risikobewertung (BfR), Berlin, Deutschland
| | - Angelika Fruth
- Fachgebiet 11: Bakterielle darmpathogene Erreger und Legionellen, Robert Koch-Institut (RKI), Burgstr. 37, 38855, Wernigerode, Deutschland
| | - Antje Flieger
- Fachgebiet 11: Bakterielle darmpathogene Erreger und Legionellen, Robert Koch-Institut (RKI), Burgstr. 37, 38855, Wernigerode, Deutschland.
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Coipan CE, Friesema IH, van den Beld MJC, Bosch T, Schlager S, van der Voort M, Frank C, Lang C, Fruth A, Franz E. Sporadic Occurrence of Enteroaggregative Shiga Toxin-Producing Escherichia coli O104:H4 Similar to 2011 Outbreak Strain. Emerg Infect Dis 2022; 28:1890-1894. [PMID: 35997633 PMCID: PMC9423916 DOI: 10.3201/eid2809.220037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe the recent detection of 3 Shiga toxin-producing enteroaggregative Escherichia coli O104:H4 isolates from patients and 1 from pork in the Netherlands that were genetically highly similar to isolates from the 2011 large-scale outbreak in Europe. Our findings stress the importance of safeguarding food supply production chains to prevent future outbreaks.
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Göttling J, Heckel JO, Hotzel H, Fruth A, Pfeifer Y, Henning K, Kopp P, Mertens-Scholz K, Rietschel W, Pfeffer M. Zoonotic bacteria in clinically healthy goats in petting zoo settings of zoological gardens in Germany. Zoonoses Public Health 2022; 69:333-343. [PMID: 35229466 DOI: 10.1111/zph.12922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/23/2021] [Accepted: 01/27/2022] [Indexed: 12/28/2022]
Abstract
Goats and other small ruminants are frequently used as contact animals in petting zoo settings of zoological gardens. However, they are capable to carry a broad spectrum of zoonotic pathogens without clinical signs. In this study, we analysed the presence of different zoonotic pathogens in 300 clinically healthy goats from 14 zoological gardens in Germany. Rectal and nasal swabs were investigated with a series of cultural and molecular techniques. In addition, vaginal swabs of the 230 female goats were investigated for the presence of Coxiella burnetii by real-time PCR. Antibodies against C. burnetii were tested in milk and serum by ELISA. Campylobacter spp. were found in 22.7%, Shiga-toxigenic Escherichia coli in 20.0% and Arcobacter spp. were found in 1.7% of the tested 300 goats after culture from rectal swabs and subsequent PCR. One sample contained an Escherichia fergusonii isolate with a blaCTX-M-1 -encoded extended-spectrum beta-lactamase phenotype. Neither Yersinia spp. nor Salmonella spp. were found. Nasal swabs of 20.7% of the goats yielded Staphylococcus aureus including one mecC-positive methicillin-resistant isolate. Neither Yersinia spp. nor Salmonella spp. were found, and none of the 230 vaginal swabs was positive for C. burnetii. Attempts to detect dermatophytes failed. In conclusion, a possible risk of transmission of zoonotic bacteria from goats in petting zoos to visitors should be considered. Appropriate information and facilities for hand washing and disinfection should be provided in all zoological gardens using goats as contact animals due to the regular presence of zoonotic bacteria in the collection.
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Affiliation(s)
| | | | - Helmut Hotzel
- Institute for Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Angelika Fruth
- Robert Koch Institute, National Reference Centre for Salmonella and other Bacterial Enterics, Wernigerode, Germany
| | - Yvonne Pfeifer
- Robert Koch Institute, Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
| | - Klaus Henning
- Institute for Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Peter Kopp
- IDEXX Vet Med Labor GmbH, Kornwestheim, Germany
| | - Katja Mertens-Scholz
- Institute for Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Wolfram Rietschel
- Tierärztliches Zentrum für Pferde in Kirchheim Altano GmbH, Kirchheim unter Teck, Germany
| | - Martin Pfeffer
- Institute for Animal Hygiene and Veterinary Public Health, University Leipzig, Germany
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Projahn M, Lamparter MC, Ganas P, Goehler A, Lorenz-Wright SC, Maede D, Fruth A, Lang C, Schuh E. Genetic diversity and pathogenic potential of Shiga toxin-producing Escherichia coli (STEC) derived from German flour. Int J Food Microbiol 2021; 347:109197. [PMID: 33895597 DOI: 10.1016/j.ijfoodmicro.2021.109197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022]
Abstract
Shiga toxin-producing Escherichia coli (STEC) can cause severe human illness, which are frequently linked to the consumption of contaminated beef or dairy products. However, recent outbreaks associated with contaminated flour and undercooked dough in the United States and Canada, highlight the potential of plant based food as transmission routes for STEC. In Germany STEC has been isolated from flour, but no cases of illness have been linked to flour. In this study, we characterized 123 STEC strains isolated from flour and flour products collected between 2015 and 2019 across Germany. In addition to determination of serotype and Shiga toxin subtype, whole genome sequencing (WGS) was used for isolates collected in 2018 to determine phylogenetic relationships, sequence type (ST), and virulence-associated genes (VAGs). We found a high diversity of serotypes including those frequently associated with human illness and outbreaks, such as O157:H7 (stx2c/d, eae), O145:H28 (stx2a, eae), O146:H28 (stx2b), and O103:H2 (stx1a, eae). Serotypes O187:H28 (ST200, stx2g) and O154:H31 (ST1892, stx1d) were most prevalent, but are rarely linked to human cases. However, WGS analysis revealed that these strains, as well as, O156:H25 (ST300, stx1a) harbour high numbers of VAGs, including eae, nleB and est1a/sta1. Although STEC-contaminated flour products have yet not been epidemiologically linked to human clinical cases in Germany, this study revealed that flour can serve as a vector for STEC strains with a high pathogenic potential. Further investigation is needed to determine the sources of STEC contamination in flour and flour products particularly in regards to these rare serotypes.
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Affiliation(s)
- Michaela Projahn
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Escherichia coli including VTEC, Berlin, Germany
| | - Marina C Lamparter
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Escherichia coli including VTEC, Berlin, Germany
| | - Petra Ganas
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Escherichia coli including VTEC, Berlin, Germany
| | - André Goehler
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Escherichia coli including VTEC, Berlin, Germany
| | - Sandra C Lorenz-Wright
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Escherichia coli including VTEC, Berlin, Germany
| | - Dietrich Maede
- Institute for Consumer Protection Saxony-Anhalt, Halle, Germany
| | - Angelika Fruth
- Robert Koch Institute, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enterics, Wernigerode, Germany
| | - Christina Lang
- Robert Koch Institute, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enterics, Wernigerode, Germany
| | - Elisabeth Schuh
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Escherichia coli including VTEC, Berlin, Germany.
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Fischer MA, Wamp S, Fruth A, Allerberger F, Flieger A, Halbedel S. Population structure-guided profiling of antibiotic resistance patterns in clinical Listeria monocytogenes isolates from Germany identifies pbpB3 alleles associated with low levels of cephalosporin resistance. Emerg Microbes Infect 2021; 9:1804-1813. [PMID: 32691687 PMCID: PMC7473133 DOI: 10.1080/22221751.2020.1799722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Numbers of listeriosis illnesses have been increasing in Germany and the European Union during the last decade. In addition, reports on the occurrence of antibiotic resistance in Listeria monocytogenes in clinical and environmental isolates are accumulating. The susceptibility towards 14 antibiotics was tested in a selection of clinical L. monocytogenes isolates to get a more precise picture of the development and manifestation of antibiotic resistance in the L. monocytogenes population. Based on the population structure determined by core genome multi locus sequence typing (cgMLST) 544 out of 1220 sequenced strains collected in Germany between 2009 and 2019 were selected to cover the phylogenetic diversity observed in the clinical L. monocytogenes population. All isolates tested were susceptible towards ampicillin, penicillin and co-trimoxazole – the most relevant antibiotics in the treatment of listeriosis. Resistance to daptomycin and ciprofloxacin was observed in 493 (91%) and in 71 (13%) of 544 isolates, respectively. While all tested strains showed resistance towards ceftriaxone, their resistance levels varied widely between 4 mg/L and >128 mg/L. An allelic variation of the penicillin binding protein gene pbpB3 was identified as the cause of this difference in ceftriaxone resistance levels. This study is the first population structure-guided analysis of antimicrobial resistance in recent clinical isolates and confirms the importance of penicillin binding protein B3 (PBP B3) for the high level of intrinsic cephalosporin resistance of L. monocytogenes on a population-wide scale.
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Affiliation(s)
- Martin A Fischer
- FG11 Division of Enteropathogenic bacteria and Legionella, Robert Koch Institute, Wernigerode, Germany
| | - Sabrina Wamp
- FG11 Division of Enteropathogenic bacteria and Legionella, Robert Koch Institute, Wernigerode, Germany
| | - Angelika Fruth
- FG11 Division of Enteropathogenic bacteria and Legionella, Robert Koch Institute, Wernigerode, Germany
| | | | - Antje Flieger
- FG11 Division of Enteropathogenic bacteria and Legionella, Robert Koch Institute, Wernigerode, Germany.,German Consultant Laboratory for Listeria, Robert Koch Institute, Wernigerode, Germany
| | - Sven Halbedel
- FG11 Division of Enteropathogenic bacteria and Legionella, Robert Koch Institute, Wernigerode, Germany.,German Consultant Laboratory for Listeria, Robert Koch Institute, Wernigerode, Germany
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Schiller P, Knödler M, Berger P, Greune L, Fruth A, Mellmann A, Dersch P, Berger M, Dobrindt U. The Superior Adherence Phenotype of E. coli O104:H4 is Directly Mediated by the Aggregative Adherence Fimbriae Type I. Virulence 2021; 12:346-359. [PMID: 33356871 PMCID: PMC7834096 DOI: 10.1080/21505594.2020.1868841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Whereas the O104:H4 enterohemorrhagic Escherichia coli (EHEC) outbreak strain from 2011 expresses aggregative adherence fimbriae of subtype I (AAF/I), its close relative, the O104:H4 enteroaggregative Escherichia coli (EAEC) strain 55989, encodes AAF of subtype III. Tight adherence mediated by AAF/I in combination with Shiga toxin 2 production has been suggested to result in the outbreak strain’s exceptional pathogenicity. Furthermore, the O104:H4 outbreak strain adheres significantly better to cultured epithelial cells than archetypal EAEC strains expressing different AAF subtypes. To test whether AAF/I expression is associated with the different virulence phenotypes of the outbreak strain, we heterologously expressed AAF subtypes I, III, IV, and V in an AAF-negative EAEC 55989 mutant and compared AAF-mediated phenotypes, incl. autoaggregation, biofilm formation, as well as bacterial adherence to HEp-2 cells. We observed that the expression of all four AAF subtypes promoted bacterial autoaggregation, though with different kinetics. Disturbance of AAF interaction on the bacterial surface via addition of α-AAF antibodies impeded autoaggregation. Biofilm formation was enhanced upon heterologous expression of AAF variants and inversely correlated with the autoaggregation phenotype. Co-cultivation of bacteria expressing different AAF subtypes resulted in mixed bacterial aggregates. Interestingly, bacteria expressing AAF/I formed the largest bacterial clusters on HEp-2 cells, indicating a stronger host cell adherence similar to the EHEC O104:H4 outbreak strain. Our findings show that, compared to the closely related O104:H4 EAEC strain 55989, not only the acquisition of the Shiga toxin phage, but also the acquisition of the AAF/I subtype might have contributed to the increased EHEC O104:H4 pathogenicity.
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Affiliation(s)
| | - Michael Knödler
- Institute of Hygiene, University of Münster , Münster, Germany
| | - Petya Berger
- Institute of Hygiene, University of Münster , Münster, Germany
| | - Lilo Greune
- Institute for Infectiology, University of Münster , Münster, Germany
| | - Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella, Robert Koch Institute , Wernigerode, Germany
| | | | - Petra Dersch
- Institute for Infectiology, University of Münster , Münster, Germany
| | - Michael Berger
- Institute of Hygiene, University of Münster , Münster, Germany
| | - Ulrich Dobrindt
- Institute of Hygiene, University of Münster , Münster, Germany
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10
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Korf IHE, Kittler S, Bierbrodt A, Mengden R, Rohde C, Rohde M, Kroj A, Lehnherr T, Fruth A, Flieger A, Lehnherr H, Wittmann J. In Vitro Evaluation of a Phage Cocktail Controlling Infections with Escherichia coli. Viruses 2020; 12:v12121470. [PMID: 33352791 PMCID: PMC7768485 DOI: 10.3390/v12121470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022] Open
Abstract
Worldwide, poultry industry suffers from infections caused by avian pathogenic Escherichia coli. Therapeutic failure due to resistant bacteria is of increasing concern and poses a threat to human and animal health. This causes a high demand to find alternatives to fight bacterial infections in animal farming. Bacteriophages are being especially considered for the control of multi-drug resistant bacteria due to their high specificity and lack of serious side effects. Therefore, the study aimed on characterizing phages and composing a phage cocktail suitable for the prevention of infections with E. coli. Six phages were isolated or selected from our collections and characterized individually and in combination with regard to host range, stability, reproduction, and efficacy in vitro. The cocktail consisting of six phages was able to inhibit formation of biofilms by some E. coli strains but not by all. Phage-resistant variants arose when bacterial cells were challenged with a single phage but not when challenged by a combination of four or six phages. Resistant variants arising showed changes in carbon metabolism and/or motility. Genomic comparison of wild type and phage-resistant mutant E28.G28R3 revealed a deletion of several genes putatively involved in phage adsorption and infection.
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Affiliation(s)
- Imke H. E. Korf
- Leibniz Institute DSMZ—German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany; (C.R.); (J.W.)
- Correspondence:
| | - Sophie Kittler
- Institute for Food Quality and Food Safety, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173 Hannover, Germany;
| | | | - Ruth Mengden
- Food Inspection, Animal Welfare and Veterinary Service of the Land of Bremen, Border Control Post Bremerhaven, Senator-Borttscheller-Straße 8, 27568 Bremerhaven, Germany;
| | - Christine Rohde
- Leibniz Institute DSMZ—German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany; (C.R.); (J.W.)
| | - Manfred Rohde
- Central Facility for Microscopy, Helmholtz-Centre for Infection Research (HZI), Inhoffenstraße 7, 38124 Braunschweig, Germany;
| | - Andrea Kroj
- PTC Phage Technology Center GmbH, Siemensstraße 42, 59199 Bönen, Germany; (A.K.); (T.L.); (H.L.)
| | - Tatiana Lehnherr
- PTC Phage Technology Center GmbH, Siemensstraße 42, 59199 Bönen, Germany; (A.K.); (T.L.); (H.L.)
| | - Angelika Fruth
- Robert Koch Institute, Burgstraße 37, 38855 Wernigerode, Germany; (A.F.); (A.F.)
| | - Antje Flieger
- Robert Koch Institute, Burgstraße 37, 38855 Wernigerode, Germany; (A.F.); (A.F.)
| | - Hansjörg Lehnherr
- PTC Phage Technology Center GmbH, Siemensstraße 42, 59199 Bönen, Germany; (A.K.); (T.L.); (H.L.)
| | - Johannes Wittmann
- Leibniz Institute DSMZ—German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany; (C.R.); (J.W.)
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11
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Renfert K, Rabsch W, Fruth A, Marschang RE, Speck S, Pees M. Influence of Salmonella specific bacteriophages (O1; S16) on the shedding of naturally occurring Salmonella and an orally applied Salmonella Eastbourne strain in bearded dragons (Pogona vitticeps). Vet Med Sci 2020; 7:534-547. [PMID: 33161646 PMCID: PMC8025629 DOI: 10.1002/vms3.388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/02/2020] [Accepted: 10/09/2020] [Indexed: 01/21/2023] Open
Abstract
This study determined the passage time and phage propagation time of salmonella specific phages, Felix O1 and S16, in 10 bearded dragons, based on re‐isolation from cloacal swabs and faecal samples following oral administration, as a possible tool for reducing salmonella shedding. In Study 1, Felix O1 was administered orally for 12 consecutive days. Over 60 days, swabs were taken from the oral cavity and cloaca and qualitative Salmonella detection as well as salmonella quantification from faecal samples were performed. In Study 2, a phage cocktail (Felix O1 and S16) was administered to half of the tested animals. Salmonella (S.) Eastbourne was also given orally to all animals. Oral and cloacal swabs were tested as in Study 1, and faecal samples were collected for phage quantification. Various Salmonella serovars were detectable at the beginning of the study. The numbers of serovars detected declined over the course of the study. S. Kisarawe was most commonly detected. Salmonella titres ranged from 102 to 107 cfu/g faeces. The phages (Felix O1 and S16) were detectable for up to 20 days after the last administration. The initial phage titres ranged from 103 to 107 pfu/ml. The study shows that the phages were able to replicate in the intestine, and were shed for a prolonged period and therefore could contribute to a reduction of Salmonella shedding.
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Affiliation(s)
- Kevin Renfert
- Department for Birds and Reptiles, Veterinary teaching hospital, University of Leipzig, Leipzig, Germany
| | - Wolfgang Rabsch
- National Reference Centre for Salmonella and other bacterial Enterics, Robert Koch Institute, Wernigerode, Germany
| | - Angelika Fruth
- National Reference Centre for Salmonella and other bacterial Enterics, Robert Koch Institute, Wernigerode, Germany
| | | | - Stephanie Speck
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - Michael Pees
- Department for Birds and Reptiles, Veterinary teaching hospital, University of Leipzig, Leipzig, Germany
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12
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Rödel J, Edel B, Braun SD, Ehricht R, Simon S, Fruth A, Löffler B. Simple differentiation of Salmonella Typhi, Paratyphi and Choleraesuis from Salmonella species using the eazyplex TyphiTyper LAMP assay. J Med Microbiol 2020; 69:817-823. [DOI: 10.1099/jmm.0.001201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Identification of typhoidal
Salmonella
(TS) serovars and their discrimination from non-typhoidal
Salmonella
(NTS) is conventionally performed by seroagglutination. This method is labour-intensive, requires technical experience and can be inconclusive in some cases. Molecular assays may be reliable alternative diagnostic tools.
Aim. This study was designed to evaluate the eazyplex TyphiTyper based on loop-mediated isothermal amplification (LAMP) for fast identification of TS and S. Choleraesuis in culture.
Methodology. A total of 121
Salmonella
strains and 33 isolates of other
Enterobacterales
species were tested by the eazyplex TyphiTyper. Simulated and clinical blood cultures (BCs) were used to examine the performance of the assay for diagnosis of systemic infection. Sample preparation took about 5 min and the test running time was 20 min. Amplification was measured by real-time fluorescence detection.
Results. All TS and S. Choleraesuis strains were correctly identified. The most common NTS S. Typhimurium (n=34) and S. Enteritidis (n=15) were detected as
Salmonella
species without any false positive result for TS targets. Cross-reactions of NTS with TS were only rarely observed. Direct testing of positive BCs gave correct results. Sensitivities and specificities of the assay were as follows: 100 and 99.3 % for S. Typhi, 100 and 98.7 % for S. Paratyphi A, 100 and 97.3 % for S. Paratyphi B, 100 and 100 % for S. Paratyphi C, 100 and 100 % for S. Choleraesuis, and 100 and 100 % for
Salmonella
species, respectively.
Conclusion. The eazyplex TyphiTyper is very easy to perform and allows the rapid identification of TS and S. Choleraesuis isolates.
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Affiliation(s)
- Jürgen Rödel
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
| | - Birgit Edel
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
| | - Sascha D. Braun
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Ralf Ehricht
- Institute of Physical Chemistry, Friedrich Schiller University of Jena, Jena, Germany
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Sandra Simon
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
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13
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Renfert K, Rabsch W, Fruth A, Speck S, Pees M. The use of a salmonella bacteriophage in bearded dragons: application, passage time and reisolation. Tierarztl Prax Ausg K Kleintiere Heimtiere 2019; 47:247-256. [PMID: 31434125 DOI: 10.1055/a-0959-5528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study determined the passage time and phage propagation time of a salmonella specific phage, Felix O1, in bearded dragons, based on reisolation from cloacal swabs and faecal samples following oral administration, as a possible tool for reducing the zoonotic risk of salmonella from pet reptiles. An application scheme for this phage in bearded dragons was developed. MATERIAL AND METHODS Ten healthy bearded dragons (Pogona vitticeps) were used in the study. The pH tolerance of the phage was tested and drugs were used to evaluate their influence on the gastric pH of the reptiles. After pH adjustment, the phage was administered orally for 12 consecutive days. Over 60 days, swabs were taken from the cloaca and examined for the presence of phages using culture and PCR. Furthermore, faecal samples were collected for phage quantification. RESULTS Felix O1 displayed no activity at pH below 2.8. A calcium- and magnesium carbonate buffer induced an appropriate gastric pH increase for 30 minutes. Phages were reisolated for up to 24 days (mean shedding: 19 days) after last administration. Titres between 105 and 107 plaque forming units/g faeces were detected. The animals did not show any clinical signs related to phage application. CONCLUSION AND CLINICAL RELEVANCE The study provides first results on oral administration, passage time, and reisolation of a phage in reptiles. It could be shown that the phage was able to replicate in the intestine, and was shed for a prolonged period and therefore could potentially contribute to a reduction of salmonella shedding.
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Affiliation(s)
- Kevin Renfert
- Clinic for Birds and Reptiles, University of Leipzig
| | - Wolfgang Rabsch
- National Reference Centre for salmonella and other bacterial enterics, Robert Koch Institute
| | - Angelika Fruth
- National Reference Centre for salmonella and other bacterial enterics, Robert Koch Institute
| | - Stephanie Speck
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig
| | - Michael Pees
- Clinic for Birds and Reptiles, University of Leipzig
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14
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Lang C, Fruth A, Holland G, Laue M, Mühlen S, Dersch P, Flieger A. Novel type of pilus associated with a Shiga-toxigenic E. coli hybrid pathovar conveys aggregative adherence and bacterial virulence. Emerg Microbes Infect 2018; 7:203. [PMID: 30514915 PMCID: PMC6279748 DOI: 10.1038/s41426-018-0209-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/09/2018] [Accepted: 11/11/2018] [Indexed: 01/31/2023]
Abstract
A large German outbreak in 2011 was caused by a locus of enterocyte effacement (LEE)-negative enterohemorrhagic E. coli (EHEC) strain of the serotype O104:H4. This strain harbors markers that are characteristic of both EHEC and enteroaggregative E. coli (EAEC), including aggregative adhesion fimbriae (AAF) genes. Such rare EHEC/EAEC hybrids are highly pathogenic due to their possession of a combination of genes promoting severe toxicity and aggregative adhesion. We previously identified novel EHEC/EAEC hybrids and observed that one strain exhibited aggregative adherence but had no AAF genes. In this study, a genome sequence analysis showed that this strain belongs to the genoserotype O23:H8, MLST ST26, and harbors a 5.2 Mb chromosome and three plasmids. One plasmid carries some EAEC marker genes, such as aatA and genes with limited protein homology (11–61%) to those encoding the bundle-forming pilus (BFP) of enteropathogenic E. coli. Due to significant protein homology distance to known pili, we designated these as aggregate-forming pili (AFP)-encoding genes and the respective plasmid as pAFP. The afp operon was arranged similarly to the operon of BFP genes but contained an additional gene, afpA2, which is homologous to afpA. The deletion of the afp operon, afpA, or a nearby gene (afpR) encoding an AraC-like regulator, but not afpA2, led to a loss of pilin production, piliation, bacterial autoaggregation, and importantly, a >80% reduction in adhesion and cytotoxicity toward epithelial cells. Gene sets similar to the afp operon were identified in a variety of aatA-positive but AAF-negative intestinal pathogenic E. coli. In summary, we characterized widely distributed and novel fimbriae that are essential for aggregative adherence and cytotoxicity in a LEE-negative Shiga-toxigenic hybrid.
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Affiliation(s)
- Christina Lang
- Division of Enteropathogenic Bacteria and Legionella, Robert Koch Institut, Wernigerode, Saxony-Anhalt, 38855, Germany
| | - Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella, Robert Koch Institut, Wernigerode, Saxony-Anhalt, 38855, Germany
| | - Gudrun Holland
- Division of Advanced Light and Electron Microscopy, Robert Koch Institut, Berlin, 13353, Germany
| | - Michael Laue
- Division of Advanced Light and Electron Microscopy, Robert Koch Institut, Berlin, 13353, Germany
| | - Sabrina Mühlen
- Department of Molecular Infection Biology, Helmholtz Centre for Infection Research, Braunschweig, Lower Saxony, 38124, Germany
| | - Petra Dersch
- Department of Molecular Infection Biology, Helmholtz Centre for Infection Research, Braunschweig, Lower Saxony, 38124, Germany
| | - Antje Flieger
- Division of Enteropathogenic Bacteria and Legionella, Robert Koch Institut, Wernigerode, Saxony-Anhalt, 38855, Germany.
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15
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Pradella F, Leimer B, Fruth A, Queißer A, van Ewijk R. Health effects of in utero exposure to Ramadan: A survey study among pregnant Muslim women in Germany. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Pradella
- Johannes Gutenberg University Mainz, Mainz, Germany
| | - B Leimer
- Johannes Gutenberg University Mainz, Mainz, Germany
| | - A Fruth
- University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - A Queißer
- University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - R van Ewijk
- Johannes Gutenberg University Mainz, Mainz, Germany
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16
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Karnisova L, Marejkova M, Hrbackova H, Mellmann A, Karch H, Fruth A, Drevinek P, Blahova K, Bielaszewska M, Nunvar J. Attack of the clones: whole genome-based characterization of two closely related enterohemorrhagic Escherichia coli O26 epidemic lineages. BMC Genomics 2018; 19:647. [PMID: 30170539 PMCID: PMC6119250 DOI: 10.1186/s12864-018-5045-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/27/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Enterohemorrhagic Escherichia coli (EHEC) O26:H11/H-, the most common non-O157 serotype causing hemolytic uremic syndrome worldwide, are evolutionarily highly dynamic with new pathogenic clones emerging rapidly. Here, we investigated the population structure of EHEC O26 isolated from patients in several European countries using whole genome sequencing, with emphasis on a detailed analysis of strains of the highly virulent new European clone (nEC) which has spread since 1990s. RESULTS Genome-wide single nucleotide polymorphism (SNP)-based analysis of 32 EHEC O26 isolated in the Czech Republic, Germany, Austria and Italy demonstrated a split of the nEC (ST29C2 clonal group) into two distinct lineages, which we termed, based on their temporal emergence, as "early" nEC and "late" nEC. The evolutionary divergence of the early nEC and late nEC is marked by the presence of 59 and 70 lineage-specific SNPs (synapomorphic mutations) in the genomes of the respective lineages. In silico analyses of publicly available E. coli O26 genomic sequences identified the late nEC lineage worldwide. Using a PCR designed to target the late nEC synapomorphic mutation in the sen/ent gene, we identified the early nEC decline accompanied by the late nEC rise in Germany and the Czech Republic since 2004 and 2013, respectively. Most of the late nEC strains harbor one of two major types of Shiga toxin 2a (Stx2a)-encoding prophages. The type I stx2a-phage is virtually identical to stx2a-phage of EHEC O104:H4 outbreak strain, whereas the type II stx2a-phage is a hybrid of EHEC O104:H4 and EHEC O157:H7 stx2a-phages and carries a novel mutation in Stx2a. Strains harboring these two phage types do not differ by the amounts and biological activities of Stx2a produced. CONCLUSIONS Using SNP-level analyses, we provide the evidence of the evolutionary split of EHEC O26:H11/H- nEC into two distinct lineages, and a recent replacement of the early nEC by the late nEC in Germany and the Czech Republic. PCR targeting the late nEC synapomorphic mutation in ent/sen enables the discrimination of early nEC strains and late nEC strains in clinical and environmental samples, thereby facilitating further investigations of their geographic distribution, prevalence, clinical significance and epidemiology.
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Affiliation(s)
- Lucia Karnisova
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Monika Marejkova
- National Reference Laboratory for E. coli and Shigella, National Institute of Public Health, Prague, Czech Republic
| | - Hana Hrbackova
- Laboratory for Tissue Cultures, National Institute of Public Health, Prague, Czech Republic
| | - Alexander Mellmann
- Institute for Hygiene and the National Consulting Laboratory on Hemolytic Uremic Syndrome, University of Münster, Münster, Germany
| | - Helge Karch
- Institute for Hygiene and the National Consulting Laboratory on Hemolytic Uremic Syndrome, University of Münster, Münster, Germany
| | - Angelika Fruth
- National Reference Center for Salmonella and Other Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Pavel Drevinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kveta Blahova
- Department of Paediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Martina Bielaszewska
- National Reference Laboratory for E. coli and Shigella, National Institute of Public Health, Prague, Czech Republic
| | - Jaroslav Nunvar
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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17
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Kunstmann S, Scheidt T, Buchwald S, Helm A, Mulard LA, Fruth A, Barbirz S. Bacteriophage Sf6 Tailspike Protein for Detection of Shigella flexneri Pathogens. Viruses 2018; 10:E431. [PMID: 30111705 PMCID: PMC6116271 DOI: 10.3390/v10080431] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/26/2018] [Accepted: 08/09/2018] [Indexed: 12/30/2022] Open
Abstract
Bacteriophage research is gaining more importance due to increasing antibiotic resistance. However, for treatment with bacteriophages, diagnostics have to be improved. Bacteriophages carry adhesion proteins, which bind to the bacterial cell surface, for example tailspike proteins (TSP) for specific recognition of bacterial O-antigen polysaccharide. TSP are highly stable proteins and thus might be suitable components for the integration into diagnostic tools. We used the TSP of bacteriophage Sf6 to establish two applications for detecting Shigella flexneri (S. flexneri), a highly contagious pathogen causing dysentery. We found that Sf6TSP not only bound O-antigen of S. flexneri serotype Y, but also the glucosylated O-antigen of serotype 2a. Moreover, mass spectrometry glycan analyses showed that Sf6TSP tolerated various O-acetyl modifications on these O-antigens. We established a microtiter plate-based ELISA like tailspike adsorption assay (ELITA) using a Strep-tag®II modified Sf6TSP. As sensitive screening alternative we produced a fluorescently labeled Sf6TSP via coupling to an environment sensitive dye. Binding of this probe to the S. flexneri O-antigen Y elicited a fluorescence intensity increase of 80% with an emission maximum in the visible light range. The Sf6TSP probes thus offer a promising route to a highly specific and sensitive bacteriophage TSP-based Shigella detection system.
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Affiliation(s)
- Sonja Kunstmann
- Physical Biochemistry, University of Potsdam, 14476 Potsdam, Germany.
| | - Tom Scheidt
- Physical Biochemistry, University of Potsdam, 14476 Potsdam, Germany.
| | - Saskia Buchwald
- Physical Biochemistry, University of Potsdam, 14476 Potsdam, Germany.
| | - Alexandra Helm
- Physical Biochemistry, University of Potsdam, 14476 Potsdam, Germany.
| | - Laurence A Mulard
- Institut Pasteur, Unité de Chimie des Biomolécules, 28 rue du Roux, 75015 Paris, France.
- CNRS UMR 3523, Institut Pasteur, 75015 Paris, France.
| | - Angelika Fruth
- National Reference Centre for Salmonella and other Bacterial Enterics, Robert Koch Institute, 38855 Wernigerode, Germany.
| | - Stefanie Barbirz
- Physical Biochemistry, University of Potsdam, 14476 Potsdam, Germany.
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18
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Eichhorn I, Heidemanns K, Ulrich RG, Schmidt H, Semmler T, Fruth A, Bethe A, Goulding D, Pickard D, Karch H, Wieler LH. Lysogenic conversion of atypical enteropathogenic Escherichia coli (aEPEC) from human, murine, and bovine origin with bacteriophage Φ3538 Δstx 2::cat proves their enterohemorrhagic E. coli (EHEC) progeny. Int J Med Microbiol 2018; 308:890-898. [PMID: 29937391 DOI: 10.1016/j.ijmm.2018.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/04/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022] Open
Abstract
Bacteriophages play an important role in the evolution of bacterial pathogens. A phage-mediated transfer of stx-genes to atypical enteropathogenic E. coli (aEPEC) which are prevalent in different hosts, would convert them to enterohemorrhagic E. coli (EHEC). We decided to confirm this hypothesis experimentally to provide conclusive evidence that aEPEC isolated from different mammalian hosts are indeed progenitors of typical EHEC which gain the ability to produce Shiga-Toxin by lysogeny with stx-converting bacteriophages, utilizing the model phage Φ3538 Δstx2::cat. We applied a modified in vitro plaque-assay, using a high titer of a bacteriophage carrying a deletion in the stx2 gene (Φ3538 Δstx2::cat) to increase the detection of lysogenic conversion events. Three wild-type aEPEC strains were chosen as acceptor strains: the murine aEPEC-strain IMT14505 (sequence type (ST)28, serotype Ont:H6), isolated from a striped field mouse (Apodemus agrarius) in the surrounding of a cattle shed, and the human aEPEC-strain 910#00 (ST28, Ont:H6). The close genomic relationship of both strains implies a high zoonotic potential. A third strain, the bovine aEPEC IMT19981, was of serotype O26:H11 and ST21 (STC29). All three aEPEC were successfully lysogenized with phage Φ3538 Δstx2::cat. Integration of the bacteriophage DNA into the aEPEC host genomes was confirmed by amplification of chloramphenicol transferase (cat) marker gene and by Southern-Blot hybridization. Analysis of the whole genome sequence of each of the three lysogens showed that the bacteriophage was integrated into the known tRNA integration site argW, which is highly variable among E. coli. In conclusion, the successful lysogenic conversion of aEPEC with a stx-phage in vitro underlines the important role of aEPEC as progenitors of EHEC. Given the high prevalence and the wide host range of aEPEC acceptors, their high risk of zoonotic transmission should be recognized in infection control measures.
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Affiliation(s)
- Inga Eichhorn
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Katrin Heidemanns
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Rainer G Ulrich
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Insel Riems, Germany
| | - Herbert Schmidt
- Institute of Food Science and Biotechnology, University of Hohenheim, Hohenheim, Germany
| | | | | | - Astrid Bethe
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - David Goulding
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Derek Pickard
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Helge Karch
- Institute for Hygiene, University Münster, Münster, Germany
| | - Lothar H Wieler
- Institute for Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany; Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Insel Riems, Germany.
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Mylius M, Dreesman J, Pulz M, Pallasch G, Beyrer K, Claußen K, Allerberger F, Fruth A, Lang C, Prager R, Flieger A, Schlager S, Kalhöfer D, Mertens E. Shiga toxin-producing Escherichia coli O103:H2 outbreak in Germany after school trip to Austria due to raw cow milk, 2017 - The important role of international collaboration for outbreak investigations. Int J Med Microbiol 2018; 308:539-544. [PMID: 29884330 DOI: 10.1016/j.ijmm.2018.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/18/2018] [Accepted: 05/28/2018] [Indexed: 11/17/2022] Open
Abstract
Following a school ski-trip to Austria from 10 to 18/02/2017, nine of 25 participants of the group from Lower Saxony (Germany) developed gastroenteritis. The students and teachers (17-41 years) shared meals in a hotel. Active case finding revealed further cases among German school groups from North Rhine-Westphalia and Schleswig-Holstein, staying at the same hotel in February 2017. We conducted two retrospective cohort studies using self-administered questionnaires on clinical symptoms and food consumption. We defined a case as a trip participant in February 2017, staying at the aforementioned hotel and developing diarrhoea, vomiting or abdominal pain during or within ten days after the trip and/or who had a stool sample tested positive for STEC within four weeks after the trip. During the outbreak investigation, Austrian authorities detected that unlabeled raw cow milk delivered by a dairy farm had been offered at the hotel for breakfast during January and February 2017. Stool samples of participants, samples of milk served in the hotel and fecal samples of various animals kept at the milk-delivering farm were examined by culture and polymerase chain reaction. STEC isolates were typed using Pulsed-field Gel Electrophoresis (PFGE) and Whole-Genome Sequencing (WGS). All 25 participants from Lower Saxony completed the questionnaire on symptoms and milk consumption; 14 were cases (56%). Thirteen of 20 participants who had consumed cold milk fell ill (risk ratio (RR): 3.25; 95%-confidence interval (CI): 0.55-19.32). Of 159 trip participants from North Rhine-Westphalia, 81 completed the questionnaire (51%), 25 were cases (31%); RR for cold milk was 2.11 (CI: 0.89-5.03). The combined RR for cold milk in both groups was 2.49 (CI: 1.16-5.35). Shiga toxin 1a-gene and eaeA-gene positive STEC O103:H2 were detected in nine of 32 patients' stool samples and in two of 18 dairy farm cattle. Nine isolates from human stool samples and two isolates from cattle fecal samples yielded the same strain with an almost identical PFGE-pattern and WGS-profile. Microbiological and epidemiological evidence identified raw cow milk as the vehicle. Results may have been compromised by misclassification of cases due to a recall bias and mild symptoms. As a result of this outbreak investigation, the Austrian authorities enforced Austrian law in the hotel, to provide milk only when pasteurized. We recommend re-emphasizing the risk of raw milk consumption to providers.
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Affiliation(s)
- Maren Mylius
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany; Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany; affiliated with the European Programme for Intervention Epidemiology Training, ECDC, Sweden.
| | - Johannes Dreesman
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | - Matthias Pulz
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | | | - Konrad Beyrer
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | - Katja Claußen
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
| | | | - Angelika Fruth
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany.
| | - Christina Lang
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany
| | - Rita Prager
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany
| | - Antje Flieger
- National Reference Centre for Salmonella and other Bacterial Enteritic Pathogens, Division of Enteropathogenic Bacteria and Legionella (FG11), Robert Koch Institute, Wernigerode, Germany
| | - Sabine Schlager
- Austrian Agency for Health and Food Safety (AGES), Graz, Austria.
| | | | - Elke Mertens
- Governmental Institute of Public Health of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA), Hanover, Germany.
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20
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Mylius M, Pallasch G, Beyrer K, Allerberger F, Claußen K, Schlager S, Fruth A, Lang C, Prager R, Dreesman J, Mertens E. Enterohämorrhagische Escherichia coli (EHEC)-Erkrankungen in Schulklassen nach Rohmilch-Konsum bei Skifreizeit in Österreich, 2017 – Der ÖGD verhindert weitere Ausbrüche. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1639295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Mylius
- Robert Koch-Institut/NLGA Infektionsepidemiologie, Berlin, Germany
| | - G Pallasch
- Gesundheitsamt Landkreis Stade, Amtsleitung, Stade, Germany
| | - K Beyrer
- Niedersächsisches Landesgesundheitsamt (NLGA), Infektionsepidemiologie, Hannover, Germany
| | - F Allerberger
- Österreichische Agentur für Gesundheit und Ernährungssicherheit, Öffentliche Gesundheit, Graz, Österreich
| | - K Claußen
- Niedersächsisches Landesgesundheitsamt (NLGA), Bakteriologie, Hannover, Germany
| | - S Schlager
- Österreichische Agentur für Gesundheit und Ernährungssicherheit, Bakteriologie, Graz, Österreich
| | - A Fruth
- Robert Koch-Institut NRZ Salmonellen und andere bakterielle Enteritiserreger, Wernigerode, Germany
| | - C Lang
- Robert Koch-Institut NRZ Salmonellen und andere bakterielle Enteritiserreger, Wernigerode, Germany
| | - R Prager
- Robert Koch-Institut NRZ Salmonellen und andere bakterielle Enteritiserreger, Wernigerode, Germany
| | - J Dreesman
- Niedersächsisches Landesgesundheitsamt (NLGA), Infektionsepidemiologie, Hannover, Germany
| | - E Mertens
- Niedersächsisches Landesgesundheitsamt (NLGA), Infektionsepidemiologie, Hannover, Germany
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21
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Vygen-Bonnet S, Rosner B, Wilking H, Fruth A, Prager R, Kossow A, Lang C, Simon S, Seidel J, Faber M, Schielke A, Michaelis K, Holzer A, Kamphausen R, Kalhöfer D, Thole S, Mellmann A, Flieger A, Stark K. Ongoing haemolytic uraemic syndrome (HUS) outbreak caused by sorbitol-fermenting (SF) Shiga toxin-producing Escherichia coli (STEC) O157, Germany, December 2016 to May 2017. ACTA ACUST UNITED AC 2018; 22:30541. [PMID: 28597831 PMCID: PMC5479985 DOI: 10.2807/1560-7917.es.2017.22.21.30541] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 05/24/2017] [Indexed: 11/20/2022]
Abstract
We report an ongoing, protracted and geographically dispersed outbreak of haemolytic uraemic syndrome (HUS) and gastroenteritis in Germany, involving 30 cases since December 2016. The outbreak was caused by the sorbitol-fermenting immotile variant of Shiga toxin-producing (STEC) Escherichia coli O157. Molecular typing revealed close relatedness between isolates from 14 cases. One HUS patient died. Results of a case–control study suggest packaged minced meat as the most likely food vehicle. Food safety investigations are ongoing.
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Affiliation(s)
- Sabine Vygen-Bonnet
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
| | - Bettina Rosner
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
| | - Hendrik Wilking
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
| | - Angelika Fruth
- Robert Koch-Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Rita Prager
- Robert Koch-Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Annelene Kossow
- University Hospital of Münster, Consultant Laboratory for HUS, Münster, Germany
| | - Christina Lang
- Robert Koch-Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Sandra Simon
- Robert Koch-Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Juliane Seidel
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany.,Postgraduate Training for Applied Epidemiology, Robert Koch Institute, Berlin, Germany.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Mirko Faber
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
| | - Anika Schielke
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
| | - Kai Michaelis
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
| | - Alexandra Holzer
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
| | - Rolf Kamphausen
- Ministry of Climate Protection, Environment, Agriculture, Nature Conservation and Consumer Protection of the state of North Rhine-Westphalia, Düsseldorf, Germany
| | - Daniela Kalhöfer
- North Rhine-Westphalia, Centre for Health, Department of Infectiology and Hygiene, Münster, Germany
| | - Sebastian Thole
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,North Rhine-Westphalia, Centre for Health, Department of Infectiology and Hygiene, Münster, Germany
| | - Alexander Mellmann
- University Hospital of Münster, Consultant Laboratory for HUS, Münster, Germany
| | - Antje Flieger
- Robert Koch-Institute, Department of Infectious Diseases, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode, Germany
| | - Klaus Stark
- Robert Koch-Institute, Department of Infectious Diseases Epidemiology, Berlin, Germany
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22
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Schielke A, Rabsch W, Prager R, Simon S, Fruth A, Helling R, Schnabel M, Siffczyk C, Wieczorek S, Schroeder S, Ahrens B, Oppermann H, Pfeiffer S, Merbecks SS, Rosner B, Frank C, Weiser AA, Luber P, Gilsdorf A, Stark K, Werber D. Two consecutive large outbreaks of Salmonella Muenchen linked to pig farming in Germany, 2013 to 2014: Is something missing in our regulatory framework? ACTA ACUST UNITED AC 2017; 22:30528. [PMID: 28494842 PMCID: PMC5434879 DOI: 10.2807/1560-7917.es.2017.22.18.30528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/15/2016] [Indexed: 11/20/2022]
Abstract
In 2013, raw pork was the suspected vehicle of a large outbreak (n = 203 cases) of Salmonella Muenchen in the German federal state of Saxony. In 2014, we investigated an outbreak (n = 247 cases) caused by the same serovar affecting Saxony and three further federal states in the eastern part of Germany. Evidence from epidemiological, microbiological and trace-back investigations strongly implicated different raw pork products as outbreak vehicles. Trace-back analysis of S. Muenchen-contaminated raw pork sausages narrowed the possible source down to 54 pig farms, and S. Muenchen was detected in three of them, which traded animals with each other. One of these farms had already been the suspected source of the 2013 outbreak. S. Muenchen isolates from stool of patients in 2013 and 2014 as well as from food and environmental surface swabs of the three pig farms shared indistinguishable pulsed-field gel electrophoresis patterns. Our results indicate a common source of both outbreaks in the primary production of pigs. Current European regulations do not make provisions for Salmonella control measures on pig farms that have been involved in human disease outbreaks. In order to prevent future outbreaks, legislators should consider tightening regulations for Salmonella control in causative primary production settings.
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Affiliation(s)
- Anika Schielke
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany.,Postgraduate Training for Applied Epidemiology (PAE, German Field Epidemiology Training Programme), Robert Koch Institute, Berlin, Germany.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Wolfgang Rabsch
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany
| | - Rita Prager
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany
| | - Sandra Simon
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany
| | - Angelika Fruth
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany
| | - Rüdiger Helling
- Saxon State Ministry of Social Affairs and Consumer Protection, Dresden, Germany
| | - Martin Schnabel
- Saxon State Ministry of Social Affairs and Consumer Protection, Dresden, Germany
| | - Claudia Siffczyk
- Brandenburg State Office of Occupational Safety, Consumer Protection and Health, Potsdam, Germany
| | - Sina Wieczorek
- Brandenburg State Office of Occupational Safety, Consumer Protection and Health, Potsdam, Germany
| | - Sabine Schroeder
- Thuringian State Authority for Consumer Protection, Bad Langensalza, Germany
| | - Beate Ahrens
- Thuringian State Authority for Consumer Protection, Bad Langensalza, Germany
| | - Hanna Oppermann
- Agency for Consumer Protection of the Federal State of Saxony-Anhalt, Magdeburg, Germany
| | - Stefan Pfeiffer
- Ministry of Labour and Social Affairs Saxony-Anhalt, Magdeburg, Germany
| | | | - Bettina Rosner
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany
| | - Christina Frank
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany
| | - Armin A Weiser
- The Federal Institute for Risk Assessment, Berlin, Germany
| | - Petra Luber
- Federal Office of Consumer Protection and Food Safety, Berlin, Germany
| | | | - Klaus Stark
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany
| | - Dirk Werber
- Robert Koch Institute (RKI), Berlin and Wernigerode, Germany.,State Office for Health and Social Affairs, Berlin, Germany
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23
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Pradella F, Leimer B, Fruth A, Queißer A, van Ewijk R. Pränatale Exposition zu Ramadan in Deutschland: Eine Umfragestudie in Mainz. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F Pradella
- Johannes Gutenberg-Universität Mainz, Lehrstuhl für Statistik und Ökonometrie, Mainz
| | - B Leimer
- Johannes Gutenberg-Universität Mainz, Lehrstuhl für Statistik und Ökonometrie, Mainz
- Goethe Universität Frankfurt, Graduate School of Economics, Finance, and Management, Frankfurt (Main)
| | - A Fruth
- Universitätsmedizin der JGU Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz
| | - A Queißer
- Universitätsmedizin der JGU Mainz, Zentrum für Kinder- und Jugendmedizin, Mainz
| | - R van Ewijk
- Johannes Gutenberg-Universität Mainz, Lehrstuhl für Statistik und Ökonometrie, Mainz
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Seidmann L, Kamyshanskiy Y, Martin SZ, Fruth A, Roth W. Immaturity for gestational age of microvasculature and placental barrier in term placentas with high weight. Eur J Obstet Gynecol Reprod Biol 2017. [PMID: 28624691 DOI: 10.1016/j.ejogrb.2017.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Villous immaturity for gestational age is a multifactorial developmental deviation associated with unexpected placental insufficiency, fetal hypoxia and term fetal death. In our previous work we have shown that immature CD15+/CD31+/CD34+ endothelial cells were an important indicator of placental villous immaturity and chronic insufficiency. The aim of this study was to perform a comparative analysis of CD15-marked immaturity in the vessel walls between normal and pathological term placentas of clinically and structurally heterogenous groups with normal, low and high weight. STUDY DESIGN 165 clinically normal and pathological placentas of gestational age 39-42 with normal weight (25-75 percentile), low weight (<10 percentile) and high weight (>90 percentile) were structurally and immunohistochemically analyzed. Excluded were placentas with a severe form of placental insufficiency associated with intrauterine fetal death, low APGAR-score, genetic and chromosomal diseases or placental inflammations. The distribution patterns of CD15, CD31 and CD34 were assessed separately in the macrovasculature, microvasculature and placental barrier (PB) - associated capillaries. RESULTS All placental groups with normal weight, low weight and high weight include normal, accelerated villous maturation or villous immaturity independent of their weight. However, a significant increase of immature CD15+/CD31+/CD34+ endothelial cells was detected in microvasculature and PB -associated capillaries in high weight-placentas (63.5%/52.2%), compared to those of normal weight (13.8%/8.2%) and low weight (16.1%/17.8%). The distribution of macrovascular immature CD15+/CD31+/CD34+ endothelial cells did not show such marked differences. CONCLUSION We have identified the immaturity of microvasculature and PB -associated capillaries with a pathological persistency of immature CD15+/CD31+/CD34+ endothelial cells and a reduction of terminally differentiated CD15-/CD31+/CD34+ endothelial cells in a structurally and clinically heterogeneous group of high weight-placentas. We assume that immaturity of placental vessels are part of prenatal adaptational processes that can be recruited in different emergency situations and may provide potential targets of therapeutic correction of placental growth and chronic insufficiency. We therefore recommend the use of CD15-based immunophenotyping as a method to identify latent unfavorable conditions of fetal development in the intrauterine life and individual risk of disease in the postnatal period.
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Affiliation(s)
- L Seidmann
- Institute of Pathology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.
| | - Y Kamyshanskiy
- Institute of Pathology, Karaganda State Medical University, Kazakhstan
| | - S Z Martin
- Institute of Pathology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - A Fruth
- Department of Obstetrics and Gynecology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - W Roth
- Institute of Pathology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
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Liebsch C, Rödiger S, Böhm A, Nitschke J, Weinreich J, Fruth A, Roggenbuck D, Lehmann W, Schedler U, Juretzek T, Schierack P. Solid-phase microbead array for multiplex O-serotyping of Escherichia coli. Mikrochim Acta 2017. [DOI: 10.1007/s00604-017-2088-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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26
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Bielaszewska M, Rüter C, Bauwens A, Greune L, Jarosch KA, Steil D, Zhang W, He X, Lloubes R, Fruth A, Kim KS, Schmidt MA, Dobrindt U, Mellmann A, Karch H. Host cell interactions of outer membrane vesicle-associated virulence factors of enterohemorrhagic Escherichia coli O157: Intracellular delivery, trafficking and mechanisms of cell injury. PLoS Pathog 2017; 13:e1006159. [PMID: 28158302 PMCID: PMC5310930 DOI: 10.1371/journal.ppat.1006159] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 02/15/2017] [Accepted: 12/30/2016] [Indexed: 01/15/2023] Open
Abstract
Outer membrane vesicles (OMVs) are important tools in bacterial virulence but their role in the pathogenesis of infections caused by enterohemorrhagic Escherichia coli (EHEC) O157, the leading cause of life-threatening hemolytic uremic syndrome, is poorly understood. Using proteomics, electron and confocal laser scanning microscopy, immunoblotting, and bioassays, we investigated OMVs secreted by EHEC O157 clinical isolates for virulence factors cargoes, interactions with pathogenetically relevant human cells, and mechanisms of cell injury. We demonstrate that O157 OMVs carry a cocktail of key virulence factors of EHEC O157 including Shiga toxin 2a (Stx2a), cytolethal distending toxin V (CdtV), EHEC hemolysin, and flagellin. The toxins are internalized by cells via dynamin-dependent endocytosis of OMVs and differentially separate from vesicles during intracellular trafficking. Stx2a and CdtV-B, the DNase-like CdtV subunit, separate from OMVs in early endosomes. Stx2a is trafficked, in association with its receptor globotriaosylceramide within detergent-resistant membranes, to the Golgi complex and the endoplasmic reticulum from where the catalytic Stx2a A1 fragment is translocated to the cytosol. CdtV-B is, after its retrograde transport to the endoplasmic reticulum, translocated to the nucleus to reach DNA. CdtV-A and CdtV-C subunits remain OMV-associated and are sorted with OMVs to lysosomes. EHEC hemolysin separates from OMVs in lysosomes and targets mitochondria. The OMV-delivered CdtV-B causes cellular DNA damage, which activates DNA damage responses leading to G2 cell cycle arrest. The arrested cells ultimately die of apoptosis induced by Stx2a and CdtV via caspase-9 activation. By demonstrating that naturally secreted EHEC O157 OMVs carry and deliver into cells a cocktail of biologically active virulence factors, thereby causing cell death, and by performing first comprehensive analysis of intracellular trafficking of OMVs and OMV-delivered virulence factors, we provide new insights into the pathogenesis of EHEC O157 infections. Our data have implications for considering O157 OMVs as vaccine candidates. Enterohemorrhagic Escherichia coli (EHEC) O157, the leading EHEC group causing diarrhea and the life-threatening hemolytic uremic syndrome in humans, produce several virulence factors which play distinct roles in the pathogenesis of these diseases. However, the mechanisms of their secretion and host cell injury are poorly understood. We show here that EHEC O157 strains isolated from patients shed nanostructures termed outer membrane vesicles (OMVs) which contain major EHEC O157 virulence factors including Shiga toxin 2a (Stx2a), cytolethal distending toxin V (CdtV), EHEC hemolysin, and flagellin. The OMVs are taken up by human intestinal epithelial and renal and brain microvascular endothelial cells, which are the major targets during EHEC O157 infections, and deliver the virulence factors intracellularly. Inside cells the virulence factors separate from OMVs and are transported via different pathways to their target compartments including the cytosol (Stx2a), nucleus (CdtV-B subunit), and mitochondria (EHEC hemolysin). Cells exposed to EHEC O157 OMVs develop G2 cell cycle arrest induced by CdtV-B-mediated DNA damage. This is followed by apoptotic cell death triggered by Stx2a and CdtV via caspase-9 activation. OMVs thus serve as novel tools of EHEC O157-mediated host injury and are quite likely involved in the pathogenesis of human diseases.
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Affiliation(s)
| | - Christian Rüter
- Institute of Infectiology, Center for Molecular Biology of Inflammation (ZMBE), University of Münster, Münster, Germany
| | - Andreas Bauwens
- Institute of Hygiene, University of Münster, Münster, Germany
| | - Lilo Greune
- Institute of Infectiology, Center for Molecular Biology of Inflammation (ZMBE), University of Münster, Münster, Germany
| | | | - Daniel Steil
- Institute of Hygiene, University of Münster, Münster, Germany
| | - Wenlan Zhang
- Institute of Hygiene, University of Münster, Münster, Germany
| | - Xiaohua He
- Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture (USDA), Albany, California, United States of America
| | - Roland Lloubes
- Laboratoire d'Ingenierie des Systemes Macromoleculaires UMR7255, CNRS-Aix-Marseille Université, Marseille, France
| | - Angelika Fruth
- National Reference Center for Salmonella and Other Enteric Pathogens, Robert Koch Institute, Branch Wernigerode, Wernigerode, Germany
| | - Kwang Sik Kim
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - M. Alexander Schmidt
- Institute of Infectiology, Center for Molecular Biology of Inflammation (ZMBE), University of Münster, Münster, Germany
| | - Ulrich Dobrindt
- Institute of Hygiene, University of Münster, Münster, Germany
| | - Alexander Mellmann
- Institute of Hygiene, University of Münster, Münster, Germany
- Interdisciplinary Center for Clinical Research (IZKF), University of Münster, Münster, Germany
| | - Helge Karch
- Institute of Hygiene, University of Münster, Münster, Germany
- Interdisciplinary Center for Clinical Research (IZKF), University of Münster, Münster, Germany
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Pietsch M, Eller C, Wendt C, Holfelder M, Falgenhauer L, Fruth A, Grössl T, Leistner R, Valenza G, Werner G, Pfeifer Y. Molecular characterisation of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolates from hospital and ambulatory patients in Germany. Vet Microbiol 2017; 200:130-137. [DOI: 10.1016/j.vetmic.2015.11.028] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
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Schneider M, Schmeh I, Fruth A, Whybra-Trümpler C, Mildenberger E. [Female Preterm Monozygotic Twins Discordant for Fetal Megacystis due to Cloacal Dysgenesis After Conception by Intracytoplasmatic Sperm Injection - Case Report and Review of Literature]. Z Geburtshilfe Neonatol 2016; 220:223-227. [PMID: 27764886 DOI: 10.1055/s-0042-110324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Monozygotic twins were previously regarded as "identical". By now an increasing number of case reports of monozygotic but discordant twins have been reported, and therefore discordance between monozygotic twins is being investigated intensively. We report a case of female preterm monozygotic twins who were discordant for fetal megacystis due to cloacal dysgenesis. Pregnancy was achieved after intracytoplasmatic sperm injection and transfer of 2 embryos. By the first trimester fetal megacystis with consecutive oligohydramnios and hypoplasia of the lungs was diagnosed. Both foetuses had normal karyotypes. After delivery at 25+3 weeks of gestation due to premature labour, the affected child was treated palliatively and died within 2 hours. In the postmortem physical examination, a cloacal dysgenesis was detected. In the male foetus, megacystis is typically caused by obstructive uropathy. In the rarely affected female foetus, it usually results from complex urogenital malformations like cloacal dysgenesis which originates from disruption during gastrulation. We identified 10 case series of mono- or dizygotic twins who were discordant either for fetal megacystis or for cloacal dysgenesis. Issues like conception, zygosity, sex, karyotype and aetiology of fetal megacystis were not reported in all cases. Discordance between monozygotic twins for structural birth defects is closely linked to the twinning process itself. Assisted reproduction is said to generate a higher rate of monozygotic twin pregnancies and to be responsible for a higher prevalence of chromosomal aberrations or congenital malformations. With regard to conception, zygosity, sex, karyotype and combination of malformations, our case is unique.
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Affiliation(s)
- M Schneider
- Neonatologie, Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin der Johannes Gutenberg-Universitat Mainz
| | - I Schmeh
- Neonatologie, Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin der Johannes Gutenberg-Universitat Mainz
| | - A Fruth
- Klinik und Poliklinik für Geburtshilfe und Frauenkrankheiten, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - C Whybra-Trümpler
- Neonatologie, Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin der Johannes Gutenberg-Universitat Mainz
| | - E Mildenberger
- Neonatologie, Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin der Johannes Gutenberg-Universitat Mainz
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29
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Fruth A, Conradi R, Auer CV. Management TTP in der Schwangerschaft – ein Fallbericht mit ungünstigem Ausgang. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Njamkepo E, Fawal N, Tran-Dien A, Hawkey J, Strockbine N, Jenkins C, Talukder KA, Bercion R, Kuleshov K, Kolínská R, Russell JE, Kaftyreva L, Accou-Demartin M, Karas A, Vandenberg O, Mather AE, Mason CJ, Page AJ, Ramamurthy T, Bizet C, Gamian A, Carle I, Sow AG, Bouchier C, Wester AL, Lejay-Collin M, Fonkoua MC, Le Hello S, Blaser MJ, Jernberg C, Ruckly C, Mérens A, Page AL, Aslett M, Roggentin P, Fruth A, Denamur E, Venkatesan M, Bercovier H, Bodhidatta L, Chiou CS, Clermont D, Colonna B, Egorova S, Pazhani GP, Ezernitchi AV, Guigon G, Harris SR, Izumiya H, Korzeniowska-Kowal A, Lutyńska A, Gouali M, Grimont F, Langendorf C, Marejková M, Peterson LAM, Perez-Perez G, Ngandjio A, Podkolzin A, Souche E, Makarova M, Shipulin GA, Ye C, Žemličková H, Herpay M, Grimont PAD, Parkhill J, Sansonetti P, Holt KE, Brisse S, Thomson NR, Weill FX. Erratum: Global phylogeography and evolutionary history of Shigella dysenteriae type 1. Nat Microbiol 2016; 1:16209. [PMID: 27694821 DOI: 10.1038/nmicrobiol.2016.209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Niemann JK, Alter T, Gölz G, Tietze E, Fruth A, Rabsch W, von Münchhausen C, Merle R, Kreienbrock L. Simultaneous occurrence of Salmonella enterica, Campylobacter spp. and Yersinia enterocolitica along the pork production chain from farm to meat processing in five conventional fattening pig herds in Lower Saxony. Berl Munch Tierarztl Wochenschr 2016; 129:296-303. [PMID: 27529991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The objectives of this study were to gather data on the occurrence of Salmonella (S.) enterica, Campylobacter spp. and Yersinia (Y.) enterocolitica along the pork production chain and to further analyze detected Salmonella isolates by additionally applying MLVA (multiple-locus variable-number tandem repeat analysis). In total, 336 samples were collected at primary production, slaughter and meat processing from five conventional fattening pig farms and one common slaughterhouse. At farm level, S. enterica, Campylobacter spp. and Y. enterocolitica were detected in 19.4%, 38.9% and 11.1% of pooled fecal samples of fattening pigs. At slaughter, more than two-thirds of examined carcasses, 24% of carcass surfaces samples and about 60% of cecal content samples were positive for at least one of the examined pathogens. An amount of 4% of meat samples were positive for non-human pathogenic Y. enterocolitica. Identical MLVA patterns of Salmonella isolates from farm- and associated slaughterhouse samples demonstrated transmission across both production stages. Other MLVA patterns found at slaughter indicated possible colonization of pigs during transport or lairage and/or cross-contamination during slaughter. Identical MLVA patterns from risk tissues and the nearby carcass surface evidenced a direct contamination of carcasses as well. Overall, our data showed wide distribution ranges for all three examined pathogens within the pig production chain and underline the need for appropriate intervention strategies at pre- and postharvest.
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Mazick A, Toikkanen S, Claußen K, Fruth A, Prager R, Messelhäußer U, Konrad R, Dreesman J, Mertens E, Scharlach M. Könnte es der Sand sein? Ein Ausbruch von Sorbitol-fermentierenden enterohämorrhagischen Escherichia coli O157: H- in Norddeutschland, 2015. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Njamkepo E, Fawal N, Tran-Dien A, Hawkey J, Strockbine N, Jenkins C, Talukder KA, Bercion R, Kuleshov K, Kolínská R, Russell JE, Kaftyreva L, Accou-Demartin M, Karas A, Vandenberg O, Mather AE, Mason CJ, Page AJ, Ramamurthy T, Bizet C, Gamian A, Carle I, Sow AG, Bouchier C, Wester AL, Lejay-Collin M, Fonkoua MC, Le Hello S, Blaser MJ, Jernberg C, Ruckly C, Mérens A, Page AL, Aslett M, Roggentin P, Fruth A, Denamur E, Venkatesan M, Bercovier H, Bodhidatta L, Chiou CS, Clermont D, Colonna B, Egorova S, Pazhani GP, Ezernitchi AV, Guigon G, Harris SR, Izumiya H, Korzeniowska-Kowal A, Lutyńska A, Gouali M, Grimont F, Langendorf C, Marejková M, Peterson LAM, Perez-Perez G, Ngandjio A, Podkolzin A, Souche E, Makarova M, Shipulin GA, Ye C, Žemličková H, Herpay M, Grimont PAD, Parkhill J, Sansonetti P, Holt KE, Brisse S, Thomson NR, Weill FX. Global phylogeography and evolutionary history of Shigella dysenteriae type 1. Nat Microbiol 2016; 1:16027. [PMID: 27572446 DOI: 10.1038/nmicrobiol.2016.27] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 02/03/2016] [Indexed: 11/09/2022]
Abstract
Together with plague, smallpox and typhus, epidemics of dysentery have been a major scourge of human populations for centuries(1). A previous genomic study concluded that Shigella dysenteriae type 1 (Sd1), the epidemic dysentery bacillus, emerged and spread worldwide after the First World War, with no clear pattern of transmission(2). This is not consistent with the massive cyclic dysentery epidemics reported in Europe during the eighteenth and nineteenth centuries(1,3,4) and the first isolation of Sd1 in Japan in 1897(5). Here, we report a whole-genome analysis of 331 Sd1 isolates from around the world, collected between 1915 and 2011, providing us with unprecedented insight into the historical spread of this pathogen. We show here that Sd1 has existed since at least the eighteenth century and that it swept the globe at the end of the nineteenth century, diversifying into distinct lineages associated with the First World War, Second World War and various conflicts or natural disasters across Africa, Asia and Central America. We also provide a unique historical perspective on the evolution of antibiotic resistance over a 100-year period, beginning decades before the antibiotic era, and identify a prevalent multiple antibiotic-resistant lineage in South Asia that was transmitted in several waves to Africa, where it caused severe outbreaks of disease.
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Affiliation(s)
- Elisabeth Njamkepo
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Nizar Fawal
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Alicia Tran-Dien
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Jane Hawkey
- Centre for Systems Genomics, University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Victoria 3010, Australia.,School of Agriculture and Veterinary Science, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Nancy Strockbine
- Centers for Disease Control and Prevention, Escherichia and Shigella Reference Unit, Atlanta, Georgia 30333, USA
| | - Claire Jenkins
- Public Health England, Gastrointestinal Bacteria Reference Unit, Colindale NW9 5HT, UK
| | - Kaisar A Talukder
- icddr,b, Enteric and Food Microbiology Laboratory, Dhaka 1212, Bangladesh
| | - Raymond Bercion
- Institut Pasteur de Bangui, BP 923, Bangui, République Centrafricaine.,Institut Pasteur de Dakar, BP 220, Dakar, Senegal
| | - Konstantin Kuleshov
- Federal Budget Institute of Science, Central Research Institute for Epidemiology, Moscow 111123, Russia
| | - Renáta Kolínská
- Czech National Collection of Type Cultures (CNCTC), National Institute of Public Health, Prague 10, Czech Republic
| | - Julie E Russell
- Public Health England, National Collection of Type Cultures, Porton Down SP4 0JG, UK
| | - Lidia Kaftyreva
- Pasteur Institute of St Petersburg, St Petersburg 197101, Russia
| | - Marie Accou-Demartin
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Andreas Karas
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Olivier Vandenberg
- Department of Microbiology, LHUB-ULB, Brussels University Hospitals Laboratory, 1000 Brussels, Belgium.,Environmental Health Research Centre, Public Health School, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Alison E Mather
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK.,Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Carl J Mason
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand
| | - Andrew J Page
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
| | | | - Chantal Bizet
- Institut Pasteur, Collection de l'Institut Pasteur (CIP), 75724 Paris Cedex 15, France
| | - Andrzej Gamian
- Polish Collection of Microorganisms, Institute of Immunology and Experimental Therapy, 53-114 Wroclaw, Poland
| | - Isabelle Carle
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | | | - Astrid Louise Wester
- Department of Foodborne Infections, Norwegian Institute of Public Health, Nydalen 0403, Oslo, Norway
| | - Monique Lejay-Collin
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | - Simon Le Hello
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Martin J Blaser
- Departments of Medicine and Microbiology, New York University Langone Medical Center, New York, New York 10016, USA
| | | | - Corinne Ruckly
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Audrey Mérens
- Biology Department and Infection Control Unit, Bégin Military Hospital, 94160 Saint-Mandé, France
| | | | - Martin Aslett
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
| | | | - Angelika Fruth
- Divison of Enteropathogenic Bacteria and Legionella, Robert Koch Institut, 38855 Wernigerode, Germany
| | - Erick Denamur
- INSERM, IAME, UMR 1137, Univ. Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, 75018 Paris, France
| | - Malabi Venkatesan
- Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910, USA
| | - Hervé Bercovier
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Ladaporn Bodhidatta
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand
| | - Chien-Shun Chiou
- Center of Research and Diagnostics, Centers for Disease Control, Taichung 40855, Taiwan
| | - Dominique Clermont
- Institut Pasteur, Collection de l'Institut Pasteur (CIP), 75724 Paris Cedex 15, France
| | - Bianca Colonna
- Istituto Pasteur-Fondazione Cenci Bolognetti, Dipartimento di Biologia e Biotecnologie C Darwin, Sapienza Università di Roma, 00185, Roma, Italy
| | - Svetlana Egorova
- Pasteur Institute of St Petersburg, St Petersburg 197101, Russia
| | - Gururaja P Pazhani
- National Institute of Cholera and Enteric Diseases (NICED), Kolkata, West Bengal 700010, India
| | | | - Ghislaine Guigon
- Institut Pasteur, Genotyping of Pathogens and Public Health Platform, 75724 Paris Cedex 15, France
| | | | - Hidemasa Izumiya
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, 162-8640, Japan
| | | | - Anna Lutyńska
- Department of Sera and Vaccines Evaluation, National Institute of Public Health-National Institute of Hygiene, 00-791 Warsaw, Poland
| | - Malika Gouali
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | - Francine Grimont
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | - Monika Marejková
- National Reference Laboratory for E. coli and Shigella, National Institute of Public Health, Prague 10, Czech Republic
| | - Lorea A M Peterson
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Guillermo Perez-Perez
- Departments of Medicine and Microbiology, New York University Langone Medical Center, New York, New York 10016, USA
| | | | - Alexander Podkolzin
- Federal Budget Institute of Science, Central Research Institute for Epidemiology, Moscow 111123, Russia
| | - Erika Souche
- Institut Pasteur, Bioinformatics platform, 75724 Paris Cedex 15, France
| | - Mariia Makarova
- Pasteur Institute of St Petersburg, St Petersburg 197101, Russia
| | - German A Shipulin
- Federal Budget Institute of Science, Central Research Institute for Epidemiology, Moscow 111123, Russia
| | - Changyun Ye
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, China CDC, Beijing 102206, China
| | - Helena Žemličková
- Czech National Collection of Type Cultures (CNCTC), National Institute of Public Health, Prague 10, Czech Republic.,Department of Clinical Microbiology, Faculty of Medicine and University Hospital, Charles University, 500 05, Hradec Kralove, Czech Republic
| | - Mária Herpay
- Hungarian National Collection of Medical Bacteria, National Center for Epidemiology, H-1097 Budapest, Hungary
| | - Patrick A D Grimont
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France
| | | | - Philippe Sansonetti
- Institut Pasteur, Unité de Pathogénie Microbienne Moléculaire, 75724 Paris Cedex 15, France
| | - Kathryn E Holt
- Centre for Systems Genomics, University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Sylvain Brisse
- Institut Pasteur, Genotyping of Pathogens and Public Health Platform, 75724 Paris Cedex 15, France.,Institut Pasteur, Microbial Evolutionary Genomics Unit, 75724 Paris Cedex 15, France.,CNRS, UMR 3525, 75015 Paris, France
| | - Nicholas R Thomson
- Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK.,London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - François-Xavier Weill
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, 75724 Paris Cedex 15, France.,Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
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Poppel MT, Skiebe E, Laue M, Bergmann H, Ebersberger I, Garn T, Fruth A, Baumgardt S, Busse HJ, Wilharm G. Acinetobacter equi sp. nov., isolated from horse faeces. Int J Syst Evol Microbiol 2016; 66:881-888. [DOI: 10.1099/ijsem.0.000806] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Marie T. Poppel
- Robert Koch Institute, Wernigerode Branch, Burgstr. 37, D-38855 Wernigerode, Germany
| | - Evelyn Skiebe
- Robert Koch Institute, Wernigerode Branch, Burgstr. 37, D-38855 Wernigerode, Germany
| | - Michael Laue
- Robert Koch Institute, Advanced Light and Electron Microscopy (ZBS 4), Seestr. 11, D-13353 Berlin, Germany
| | - Holger Bergmann
- Institute for Cell Biology and Neuroscience, Goethe University Frankfurt, Max-von-Laue-Str. 13, D-60438 Frankfurt am Main, Germany
| | - Ingo Ebersberger
- Institute for Cell Biology and Neuroscience, Goethe University Frankfurt, Max-von-Laue-Str. 13, D-60438 Frankfurt am Main, Germany
| | - Thomas Garn
- Robert Koch Institute, Wernigerode Branch, Burgstr. 37, D-38855 Wernigerode, Germany
| | - Angelika Fruth
- Robert Koch Institute, Wernigerode Branch, Burgstr. 37, D-38855 Wernigerode, Germany
| | - Sandra Baumgardt
- Division of Clinical Microbiology and Infection Biology, Institute of Bacteriology, Mycology and Hygiene, University of Veterinary Medicine, A-1210 Vienna, Austria
| | - Hans-Jürgen Busse
- Division of Clinical Microbiology and Infection Biology, Institute of Bacteriology, Mycology and Hygiene, University of Veterinary Medicine, A-1210 Vienna, Austria
| | - Gottfried Wilharm
- Robert Koch Institute, Wernigerode Branch, Burgstr. 37, D-38855 Wernigerode, Germany
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Schaufler K, Semmler T, Wieler LH, Wöhrmann M, Baddam R, Ahmed N, Müller K, Kola A, Fruth A, Ewers C, Guenther S. Clonal spread and interspecies transmission of clinically relevant ESBL-producing Escherichia coli of ST410--another successful pandemic clone? FEMS Microbiol Ecol 2015; 92:fiv155. [PMID: 26656065 DOI: 10.1093/femsec/fiv155] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 12/23/2022] Open
Abstract
Clinically relevant extended-spectrum beta-lactamase (ESBL)-producing multi-resistant Escherichia coli have been on the rise for years. Initially restricted to mostly a clinical context, recent findings prove their prevalence in extraclinical settings independent of the original occurrence of antimicrobial resistance in the environment. To get further insights into the complex ecology of potentially clinically relevant ESBL-producing E. coli, 24 isolates from wild birds in Berlin, Germany, and 40 ESBL-producing human clinical E. coli isolates were comparatively analyzed. Isolates of ST410 occurred in both sample groups (six). In addition, three ESBL-producing E. coli isolates of ST410 from environmental dog feces and one clinical dog isolate were included. All 10 isolates were clonally analyzed showing almost identical macrorestriction patterns. They were chosen for whole-genome sequencing revealing that the whole-genome content of these 10 E. coli isolates showed a very high genetic similarity, differing by low numbers of single nucleotide polymorphisms only. This study gives initial evidence for a recent interspecies transmission of a new successful clone of ST410 E. coli between wildlife, humans, companion animals and the environment. The results underline the zoonotic potential of clinically relevant multi-resistant bacteria found in the environment as well as the mandatory nature of the 'One Health' approach.
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Affiliation(s)
- Katharina Schaufler
- Institute of Microbiology and Epizootics, Veterinary Faculty, Freie Universität Berlin, 14163 Berlin, Germany
| | - Torsten Semmler
- NG 1 - Microbial Genomics, Robert Koch Institute, 13302 Berlin, Germany
| | | | - Michael Wöhrmann
- Institute of Microbiology and Epizootics, Veterinary Faculty, Freie Universität Berlin, 14163 Berlin, Germany
| | - Ramani Baddam
- Institute of Microbiology and Epizootics, Veterinary Faculty, Freie Universität Berlin, 14163 Berlin, Germany Pathogen Biology Laboratory, Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, 500046 Hyderabad, India
| | - Niyaz Ahmed
- Pathogen Biology Laboratory, Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, 500046 Hyderabad, India
| | - Kerstin Müller
- Clinic of Small Animals, Veterinary Faculty, Freie Universität Berlin, 14163 Berlin, Germany
| | - Axel Kola
- Institute of Hygiene and Environmental Medicine, Charité Universitätsklinikum, 12203 Berlin, Germany
| | - Angelika Fruth
- Department for Infectious Diseases, Division of Bacterial Infections and National Reference, Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch Institute, 38855 Wernigerode, Germany
| | - Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Veterinary Faculty, Justus-Liebig-Universität Giessen, 35392 Giessen, Germany
| | - Sebastian Guenther
- Institute of Microbiology and Epizootics, Veterinary Faculty, Freie Universität Berlin, 14163 Berlin, Germany
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36
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Vorwerk H, Huber C, Mohr J, Bunk B, Bhuju S, Wensel O, Spröer C, Fruth A, Flieger A, Schmidt-Hohagen K, Schomburg D, Eisenreich W, Hofreuter D. A transferable plasticity region in Campylobacter coli allows isolates of an otherwise non-glycolytic food-borne pathogen to catabolize glucose. Mol Microbiol 2015; 98:809-30. [PMID: 26259566 DOI: 10.1111/mmi.13159] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 12/31/2022]
Abstract
Thermophilic Campylobacter species colonize the intestine of agricultural and domestic animals commensally but cause severe gastroenteritis in humans. In contrast to other enteropathogenic bacteria, Campylobacter has been considered to be non-glycolytic, a metabolic property originally used for their taxonomic classification. Contrary to this dogma, we demonstrate that several Campylobacter coli strains are able to utilize glucose as a growth substrate. Isotopologue profiling experiments with (13) C-labeled glucose suggested that these strains catabolize glucose via the pentose phosphate and Entner-Doudoroff (ED) pathways and use glucose efficiently for de novo synthesis of amino acids and cell surface carbohydrates. Whole genome sequencing of glycolytic C. coli isolates identified a genomic island located within a ribosomal RNA gene cluster that encodes for all ED pathway enzymes and a glucose permease. We could show in vitro that a non-glycolytic C. coli strain could acquire glycolytic activity through natural transformation with chromosomal DNA of C. coli and C. jejuni subsp. doylei strains possessing the ED pathway encoding plasticity region. These results reveal for the first time the ability of a Campylobacter species to catabolize glucose and provide new insights into how genetic macrodiversity through intra- and interspecies gene transfer expand the metabolic capacity of this food-borne pathogen.
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Affiliation(s)
- Hanne Vorwerk
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Claudia Huber
- Lehrstuhl für Biochemie, Technische Universität München, Garching, Germany
| | - Juliane Mohr
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Boyke Bunk
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany.,German Centre of Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Sabin Bhuju
- Department of Genome Analytics, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Olga Wensel
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Cathrin Spröer
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany.,German Centre of Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella (FG11), German National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institute, Wernigerode, Germany
| | - Antje Flieger
- Division of Enteropathogenic Bacteria and Legionella (FG11), German National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institute, Wernigerode, Germany
| | - Kerstin Schmidt-Hohagen
- Institute for Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Dietmar Schomburg
- Institute for Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Braunschweig, Germany
| | | | - Dirk Hofreuter
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
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Fruth A, Prager R, Tietze E, Rabsch W, Flieger A. Molecular epidemiological view on Shiga toxin-producing Escherichia coli causing human disease in Germany: Diversity, prevalence, and outbreaks. Int J Med Microbiol 2015; 305:697-704. [PMID: 26372529 DOI: 10.1016/j.ijmm.2015.08.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Infections by intestinal pathogenic Escherichia coli (E. coli) are among those causing a high mortality and morbidity due to diarrheal disease and post infection sequelae worldwide. Since introduction of the Infection Protection Act in Germany 2001, these pathogens rank third among bacterial infections of the gastrointestinal tract. As a major pathovar Shiga toxin-producing E. coli (STEC) which include enterohemorrhagic E. coli (EHEC) play a leading role in occurrence of sporadic cases and disease outbreaks. An outstanding example is the large outbreak in spring 2011 caused by EHEC/EAEC O104:H4. To monitor and trace back STEC infections, national surveillance programs have been implemented including activities of the German National Reference Centre for Salmonella and other Enteric Bacterial Pathogens (NRC). This review highlights advances in our understanding of STEC in the last 20 years of STEC surveillance by the NRC. Here important characteristics of STEC strains from human infections and outbreaks in Germany between 1997 and 2013 are summarized.
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Affiliation(s)
- Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany
| | - Rita Prager
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany
| | - Erhard Tietze
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany
| | - Wolfgang Rabsch
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany
| | - Antje Flieger
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode Branch, Burgstr. 37, 38855 Wernigerode, Germany.
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Kunsmann L, Rüter C, Bauwens A, Greune L, Glüder M, Kemper B, Fruth A, Wai SN, He X, Lloubes R, Schmidt MA, Dobrindt U, Mellmann A, Karch H, Bielaszewska M. Virulence from vesicles: Novel mechanisms of host cell injury by Escherichia coli O104:H4 outbreak strain. Sci Rep 2015; 5:13252. [PMID: 26283502 PMCID: PMC4539607 DOI: 10.1038/srep13252] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/22/2015] [Indexed: 12/27/2022] Open
Abstract
The highly virulent Escherichia coli O104:H4 that caused the large 2011 outbreak of diarrhoea and haemolytic uraemic syndrome secretes blended virulence factors of enterohaemorrhagic and enteroaggregative E. coli, but their secretion pathways are unknown. We demonstrate that the outbreak strain releases a cocktail of virulence factors via outer membrane vesicles (OMVs) shed during growth. The OMVs contain Shiga toxin (Stx) 2a, the major virulence factor of the strain, Shigella enterotoxin 1, H4 flagellin, and O104 lipopolysaccharide. The OMVs bind to and are internalised by human intestinal epithelial cells via dynamin-dependent and Stx2a-independent endocytosis, deliver the OMV-associated virulence factors intracellularly and induce caspase-9-mediated apoptosis and interleukin-8 secretion. Stx2a is the key OMV component responsible for the cytotoxicity, whereas flagellin and lipopolysaccharide are the major interleukin-8 inducers. The OMVs represent novel ways for the E. coli O104:H4 outbreak strain to deliver pathogenic cargoes and injure host cells.
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Affiliation(s)
- Lisa Kunsmann
- Institute of Hygiene and the National Consulting Laboratory for Hemolytic Uremic Syndrome, University of Münster, 48149 Münster, Germany
| | - Christian Rüter
- Institute of Infectiology, Center for Molecular Biology of Inflammation (ZMBE), University of Münster, 48149 Münster, Germany
| | - Andreas Bauwens
- Institute of Hygiene and the National Consulting Laboratory for Hemolytic Uremic Syndrome, University of Münster, 48149 Münster, Germany
| | - Lilo Greune
- Institute of Infectiology, Center for Molecular Biology of Inflammation (ZMBE), University of Münster, 48149 Münster, Germany
| | - Malte Glüder
- Institute of Hygiene and the National Consulting Laboratory for Hemolytic Uremic Syndrome, University of Münster, 48149 Münster, Germany
| | - Björn Kemper
- Biomedical Technology Center, University of Muenster, 48149 Münster, Germany
| | - Angelika Fruth
- National Reference Center for Salmonella and Other Enteric Pathogens, Robert Koch Institute, Branch Wernigerode, 38855 Wernigerode, Germany
| | - Sun Nyunt Wai
- Department of Molecular Biology, Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, S-90187 Umeå, Sweden
| | - Xiaohua He
- Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture (USDA), Albany, CA 94710, USA
| | - Roland Lloubes
- Laboratoire d'Ingenierie des Systemes Macromoleculaires UMR7255, CNRS-Aix-Marseille Université, 13402 Marseille cedex 20, France
| | - M Alexander Schmidt
- Institute of Infectiology, Center for Molecular Biology of Inflammation (ZMBE), University of Münster, 48149 Münster, Germany
| | - Ulrich Dobrindt
- Institute of Hygiene and the National Consulting Laboratory for Hemolytic Uremic Syndrome, University of Münster, 48149 Münster, Germany
| | - Alexander Mellmann
- Institute of Hygiene and the National Consulting Laboratory for Hemolytic Uremic Syndrome, University of Münster, 48149 Münster, Germany
| | - Helge Karch
- Institute of Hygiene and the National Consulting Laboratory for Hemolytic Uremic Syndrome, University of Münster, 48149 Münster, Germany
| | - Martina Bielaszewska
- Institute of Hygiene and the National Consulting Laboratory for Hemolytic Uremic Syndrome, University of Münster, 48149 Münster, Germany
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Fruth A, Macchiella D, Schweiger S, Puhl AG. Plazentares Mosaik Trisomie 17 – Fetus immer unauffällig? – Ein Fallbericht. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0034-1375759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tietze E, Dabrowski PW, Prager R, Radonic A, Fruth A, Auraß P, Nitsche A, Mielke M, Flieger A. Comparative genomic analysis of two novel sporadic Shiga toxin-producing Escherichia coli O104:H4 strains isolated 2011 in Germany. PLoS One 2015; 10:e0122074. [PMID: 25836671 PMCID: PMC4383531 DOI: 10.1371/journal.pone.0122074] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/11/2015] [Indexed: 02/02/2023] Open
Abstract
A large outbreak of gastrointestinal disease occurred in 2011 in Germany which resulted in almost 4000 patients with acute gastroenteritis or hemorrhagic colitis, 855 cases of a hemolytic uremic syndrome and 53 deaths. The pathogen was an uncommon, multiresistant Escherichia coli strain of serotype O104:H4 which expressed a Shiga toxin characteristic of enterohemorrhagic E. coli and in addition virulence factors common to enteroaggregative E. coli. During post-epidemic surveillance of Shiga toxin-producing E. coli (STEC) all but two of O104:H4 isolates were indistinguishable from the epidemic strain. Here we describe two novel STEC O104:H4 strains isolated in close spatiotemporal proximity to the outbreak which show a virulence gene panel, a Shiga toxin-mediated cytotoxicity towards Vero cells and aggregative adherence to Hep-2 cells comparable to the outbreak strain. They differ however both from the epidemic strain and from each other, by their antibiotic resistance phenotypes and some other features as determined by routine epidemiological subtyping methods. Whole genome sequencing of these two strains, of ten outbreak strain isolates originating from different time points of the outbreak and of one historical sporadic EHEC O104:H4 isolate was performed. Sequence analysis revealed a clear phylogenetic distance between the two variant strains and the outbreak strain finally identifying them as epidemiologically unrelated isolates from sporadic cases. These findings add to the knowledge about this emerging pathogen, illustrating a certain diversity within the bacterial core genome as well as loss and gain of accessory elements. Our results do also support the view that distinct new variants of STEC O104:H4 repeatedly might originate from yet unknown reservoirs, rather than that there would be a continuous diversification of a single epidemic strain established and circulating in Germany after the large outbreak in 2011.
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Affiliation(s)
- Erhard Tietze
- Department of Infectious Diseases, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode Branch of Robert Koch-Institute, Berlin, Germany
- * E-mail:
| | | | - Rita Prager
- Department of Infectious Diseases, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode Branch of Robert Koch-Institute, Berlin, Germany
| | - Aleksandar Radonic
- Centre for Biological Threats and Special Pathogens, Robert Koch-Institute, Berlin, Germany
| | - Angelika Fruth
- Department of Infectious Diseases, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode Branch of Robert Koch-Institute, Berlin, Germany
| | - Philipp Auraß
- Department of Infectious Diseases, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode Branch of Robert Koch-Institute, Berlin, Germany
| | - Andreas Nitsche
- Centre for Biological Threats and Special Pathogens, Robert Koch-Institute, Berlin, Germany
| | - Martin Mielke
- Department of Infectious Diseases, Robert Koch-Institute, Berlin, Germany
| | - Antje Flieger
- Department of Infectious Diseases, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Wernigerode Branch of Robert Koch-Institute, Berlin, Germany
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Arvand M, Bettge-Weller G, Fruth A, Uphoff H, Pfeifer Y. Extended-spectrum beta-lactamase-producing Shiga toxin gene (stx1)-positive Escherichia coli O91:H14 carrying blaCTX-M-15 on an IncI1-ST31 plasmid isolated from a human patient in Germany. Int J Med Microbiol 2015; 305:404-7. [PMID: 25801683 DOI: 10.1016/j.ijmm.2015.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 03/02/2015] [Accepted: 03/03/2015] [Indexed: 12/15/2022] Open
Abstract
In 2011, the Shiga toxin- and extended-spectrum β-lactamase (ESBL)-producing Escherichia coli O104:H4 caused a serious outbreak of gastroenteritis in Germany. This strain carried bla(CTX-M-15) and bla(TEM-1) on an IncI1-ST31 plasmid. During screening of individuals at risk for acquisition of the epidemic E. coli O104:H4, we isolated another ESBL-producing and Shiga toxin-positive E. coli belonging to serotype O91:H14 from feces of a human patient. Interestingly, the patient also carried a further ESBL-producing but Shiga toxin-negative E. coli. Both strains harbored bla(CTX-M-15) and bla(TEM-1) on an IncI1-ST31 plasmid, which was indistinguishable regarding size and plasmid restriction pattern from the plasmid of the epidemic E. coli O104:H4 strain. The patient had traveled to India 6 months prior to the isolation of the E. coli strains. This is the first report of an ESBL-producing, Shiga toxin-positive E. coli of serogroup O91. Our data suggest a high propensity of the IncI1-ST31 plasmid to spread in the human and/or animal population.
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Affiliation(s)
- Mardjan Arvand
- Hesse State Health Office, Centre for Health Protection, Dillenburg, Germany.
| | | | - Angelika Fruth
- Robert Koch Institute, National Reference Centre for Salmonella and other Bacterial Enterics, Wernigerode, Germany
| | - Helmut Uphoff
- Hesse State Health Office, Centre for Health Protection, Dillenburg, Germany
| | - Yvonne Pfeifer
- Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
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Niemann J, Tietze E, Ruddat I, Fruth A, Prager R, Rabsch W, Blaha T, Münchhausen C, Merle R, Kreienbrock L. Epidemiological analysis of the dynamic and diversity of Salmonella spp. in five German pig production clusters using pheno- and genotyping methods: An exploratory study. Vet Microbiol 2015; 176:190-5. [DOI: 10.1016/j.vetmic.2014.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 12/09/2014] [Accepted: 12/10/2014] [Indexed: 10/24/2022]
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Ewers C, Dematheis F, Singamaneni HD, Nandanwar N, Fruth A, Diehl I, Semmler T, Wieler LH. Correlation between the genomic o454-nlpD region polymorphisms, virulence gene equipment and phylogenetic group of extraintestinal Escherichia coli (ExPEC) enables pathotyping irrespective of host, disease and source of isolation. Gut Pathog 2014; 6:37. [PMID: 25349632 PMCID: PMC4209514 DOI: 10.1186/s13099-014-0037-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 09/01/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The mutS-rpoS intergenic region in E. coli displays a mosaic structure which revealed pathotype specific patterns. To assess the importance of this region as a surrogate marker for the identification of highly virulent extraintestinal pathogenic E. coli (ExPEC) strains we aimed to: (i) characterize the genetic diversity of the mutS gene and the o454-nlpD genomic region among 510 E. coli strains from animals and humans; (ii) delineate associations between the polymorphism of this region and features such as phylogenetic background of E. coli, pathotype, host species, clinical condition, serogroup and virulence associated genes (VAG)s; and (iii) identify the most important VAGs for classification of the o454-nlpD region. METHODS Size variation in the o454-nlpD region was investigated by PCR amplification and sequencing. Phylogenetic relationships were assessed by Ecor- and Multilocus sequence- typing (MLST), and a comparative analysis between mutS gene phylogenetic tree obtained with RAxML and the MLST grouping method was performed. Correlation between o454-nlpD patterns and the features described above were analysed. In addition, the importance of 47 PCR-amplified ExPEC-related VAGs for classification of o454-nlpD patterns was investigated by means of Random Forest algorithm. RESULTS Four main structures (patterns I-IV) of the o454-nlpD region among ExPEC and commensal E. coli strains were identified. Statistical analysis showed a positive and exclusive association between pattern III and the ExPEC strains. A strong association between pattern III and either the Ecor group B2 or the sequence type complexes known to represent the phylogenetic background of highly virulent ExPEC strains (such as STC95, STC73 and STC131) was found as well. RF analyses determined five genes (csgA, malX, chuA, sit, and vat) to be suitable to predict pattern III strains. CONCLUSION The significant association between pattern III and group B2 strains suggested the o454-nlpD region to be of great value in identifying highly virulent strains among the mixed population of E. coli promising to be the basis of a future typing tool for ExPEC and their gut reservoir. Furthermore, top-ranked VAGs for classification and prediction of pattern III were identified. These data are most valuable for defining ExPEC pathotype in future in vivo assays.
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Affiliation(s)
- Christa Ewers
- Institute for Hygiene and Infectious Diseases of Animals, Justus-Liebig-Universität Giessen, Frankfurter Str. 85-89, Giessen, 35392, Germany
| | - Flavia Dematheis
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, Berlin, 14163, Germany
| | - Haritha Devi Singamaneni
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, Berlin, 14163, Germany
| | - Nishant Nandanwar
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, Berlin, 14163, Germany ; Pathogen Biology Laboratory, Department of Biotechnology and Bioinformatics, University of Hyderabad, Hyderabad 500046, Gachibowli, India
| | - Angelika Fruth
- National Reference Centre for Salmonella and Other Enteric Pathogens, Robert Koch Institute, Burgstr. 37, Wernigerode, 38855, Germany
| | - Ines Diehl
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, Berlin, 14163, Germany
| | - Torsten Semmler
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, Berlin, 14163, Germany
| | - Lothar H Wieler
- Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, Berlin, 14163, Germany
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Heimes AS, Fruth A, Albrich S, Selgert L, Hornung R, Schmidt M, Hoffmann G. Konservative Behandlung einer Cervixgravidität mit Methotrexat. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Prager R, Lang C, Aurass P, Fruth A, Tietze E, Flieger A. Two novel EHEC/EAEC hybrid strains isolated from human infections. PLoS One 2014; 9:e95379. [PMID: 24752200 PMCID: PMC3994036 DOI: 10.1371/journal.pone.0095379] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 03/26/2014] [Indexed: 12/14/2022] Open
Abstract
The so far highest number of life-threatening hemolytic uremic syndrome was associated with a food-borne outbreak in 2011 in Germany which was caused by an enterohemorrhagic Escherichia coli (EHEC) of the rare serotype O104:H4. Most importantly, the outbreak strain harbored genes characteristic of both EHEC and enteroaggregative E. coli (EAEC). Such strains have been described seldom but due to the combination of virulence genes show a high pathogenicity potential. To evaluate the importance of EHEC/EAEC hybrid strains in human disease, we analyzed the EHEC strain collection of the German National Reference Centre for Salmonella and other Bacterial Enteric Pathogens (NRC). After exclusion of O104:H4 EHEC/EAEC strains, out of about 2400 EHEC strains sent to NRC between 2008 and 2012, two strains exhibited both EHEC and EAEC marker genes, specifically were stx2 and aatA positive. Like the 2011 outbreak strain, one of the novel EHEC/EAEC harbored the Shiga toxin gene type stx2a. The strain was isolated from a patient with bloody diarrhea in 2010, was serotyped as O59:H−, belonged to MLST ST1136, and exhibited genes for type IV aggregative adherence fimbriae (AAF). The second strain was isolated from a patient with diarrhea in 2012, harbored stx2b, was typed as Orough:H−, and belonged to MLST ST26. Although the strain conferred the aggregative adherence phenotype, no known AAF genes corresponding to fimbrial types I to V were detected. In summary, EHEC/EAEC hybrid strains are currently rarely isolated from human disease cases in Germany and two novel EHEC/EAEC of rare serovars/MLST sequence types were characterized.
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Affiliation(s)
- Rita Prager
- Divison of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institut, Wernigerode, Germany
| | - Christina Lang
- Divison of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institut, Wernigerode, Germany
| | - Philipp Aurass
- Divison of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institut, Wernigerode, Germany
| | - Angelika Fruth
- Divison of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institut, Wernigerode, Germany
| | - Erhard Tietze
- Divison of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institut, Wernigerode, Germany
| | - Antje Flieger
- Divison of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and other Bacterial Enteric Pathogens, Robert Koch-Institut, Wernigerode, Germany
- * E-mail:
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Fruth A, Prager R, Friedrich A, Kuczius T, Roggentin P, Karch H, Ammon A, Bockemühl J, Tschäpe H. [Not Available]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 45:715-21. [PMID: 24728121 DOI: 10.1007/s00103-002-0458-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Intestinal infections in Germany due to enterohemorrhagic E. coli bacteria (EHEC) between 1998 and 2001 reveal a large scale of biological diversity of their pathogens. However, no dramatic increase of their clinical importance and public health implications has been observed. As strains of serovar O157:H7 have continuously declined as causative agents, other serovars such as O26:H11 and O103:H2 have replaced them. The great diversity of the EHEC pathogens might point to a great number of various infection routes and sources. Since recently new pathogenic factors of EHEC bacteria have been detected (especially by the sequencing of the genome of EHEC), it is currently not possible to define a clear-cut difference between human pathogens and nonhuman pathogens. The enhanced surveillance of EHEC pathogens with respect to their biological diversity and dynamics, their epidemic spread, and their infection routes and sources remain an essential task of the public health authorities.
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Affiliation(s)
- A Fruth
- Robert Koch-Institut, Bereich Wernigerode, Wernigerode, Germany
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Ewers C, Stamm I, Stolle I, Guenther S, Kopp PA, Fruth A, Wieler LH, Scheufen S, Bauerfeind R, Bethe A, Prenger-Berninghoff E. Detection of Shiga toxin- and extended-spectrum β-lactamase-producing Escherichia coli O145:NM and Ont:NM from calves with diarrhoea. J Antimicrob Chemother 2014; 69:2005-7. [PMID: 24595804 DOI: 10.1093/jac/dku042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig University Giessen, Giessen, Germany
| | - Ivonne Stamm
- Vet Med Labor GmbH, Division of IDEXX Laboratories, Ludwigsburg, Germany
| | - Inka Stolle
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig University Giessen, Giessen, Germany
| | - Sebastian Guenther
- Institute of Microbiology and Epizootics, Free University Berlin, Berlin, Germany
| | - Peter A Kopp
- Vet Med Labor GmbH, Division of IDEXX Laboratories, Ludwigsburg, Germany
| | | | - Lothar H Wieler
- Institute of Microbiology and Epizootics, Free University Berlin, Berlin, Germany
| | - Sandra Scheufen
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig University Giessen, Giessen, Germany
| | - Rolf Bauerfeind
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig University Giessen, Giessen, Germany
| | - Astrid Bethe
- Institute of Microbiology and Epizootics, Free University Berlin, Berlin, Germany
| | - Ellen Prenger-Berninghoff
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig University Giessen, Giessen, Germany
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Toboldt A, Tietze E, Helmuth R, Junker E, Fruth A, Malorny B. Molecular epidemiology of Salmonella enterica serovar Kottbus isolated in Germany from humans, food and animals. Vet Microbiol 2014; 170:97-108. [PMID: 24559660 DOI: 10.1016/j.vetmic.2014.01.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/15/2014] [Accepted: 01/23/2014] [Indexed: 11/18/2022]
Abstract
Salmonella enterica serovar Kottbus has been continuously isolated from poultry and poultry meat, especially from turkey. We investigated by comparative molecular typing 95 S. Kottbus isolates obtained in Germany between 2000 and 2011 from poultry/poultry meat, pig/pork, cattle, reptiles, the environment as well as from human cases to identify potential infection sources for humans, especially the role of poultry and poultry products as vehicle in transmission of S. Kottbus isolates to humans. Multilocus sequence typing analysis detected three main genetic lineages. Most human isolates belonged to lineage 1 represented by sequence types ST212 and ST808. Part of the isolates isolated from cattle and pork were also linked to this lineage. Nevertheless, human isolates and especially isolates from poultry/poultry meat, and with less extend from other livestock, grouped in lineage 2 represented by ST582. Four additional isolates from reptiles and humans belonging to ST1669 represented the third lineage. The three lineages were also reflected by pulsed-field gel electrophoresis typing data and DNA microarray analysis of 102 pathogenicity genes. Antimicrobial resistance especially to nalidixic acid and ciprofloxacin was predominantly observed in isolates assigned to lineage 2, which contains predominantly resistant isolates compared to lineage 1 and 3. Sequencing of the quinolone resistance-determining region of gyrA revealed a point mutation in codon 83 or 87 responsible for nalidixic acid resistance and MIC values for ciprofloxacin between 0.125 and 0.25mg/l. Overall, this study showed that in Germany a specific S. Kottbus lineage (ST582), which is well-established in poultry, can be transmitted to humans by poultry meat and, consequently, poses a risk for human health.
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Affiliation(s)
- Anne Toboldt
- Federal Institute for Risk Assessment, National Reference Laboratory for Salmonella, Max-Dohrn-Str. 8-10, D-10589 Berlin, Germany; Free University Berlin, Department of Biology, Chemistry and Pharmacy, Takustr. 3, 14195 Berlin, Germany
| | - Erhard Tietze
- Robert Koch Institute, Wernigerode Branch, Division Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonellae and other Bacterial Enteric Pathogens, Burgstr. 37, 38855 Wernigerode, Germany
| | - Reiner Helmuth
- Federal Institute for Risk Assessment, National Reference Laboratory for Salmonella, Max-Dohrn-Str. 8-10, D-10589 Berlin, Germany
| | - Ernst Junker
- Federal Institute for Risk Assessment, National Reference Laboratory for Salmonella, Max-Dohrn-Str. 8-10, D-10589 Berlin, Germany
| | - Angelika Fruth
- Robert Koch Institute, Wernigerode Branch, Division Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonellae and other Bacterial Enteric Pathogens, Burgstr. 37, 38855 Wernigerode, Germany
| | - Burkhard Malorny
- Federal Institute for Risk Assessment, National Reference Laboratory for Salmonella, Max-Dohrn-Str. 8-10, D-10589 Berlin, Germany.
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Bielaszewska M, Schiller R, Lammers L, Bauwens A, Fruth A, Middendorf B, Schmidt MA, Tarr PI, Dobrindt U, Karch H, Mellmann A. Heteropathogenic virulence and phylogeny reveal phased pathogenic metamorphosis in Escherichia coli O2:H6. EMBO Mol Med 2014; 6:347-57. [PMID: 24413188 PMCID: PMC3958309 DOI: 10.1002/emmm.201303133] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Extraintestinal pathogenic and intestinal pathogenic (diarrheagenic) Escherichia coli differ phylogenetically and by virulence profiles. Classic theory teaches simple linear descent in this species, where non-pathogens acquire virulence traits and emerge as pathogens. However, diarrheagenic Shiga toxin-producing E. coli (STEC) O2:H6 not only possess and express virulence factors associated with diarrheagenic and uropathogenic E. coli but also cause diarrhea and urinary tract infections. These organisms are phylogenetically positioned between members of an intestinal pathogenic group (STEC) and extraintestinal pathogenic E. coli. STEC O2:H6 is, therefore, a 'heteropathogen,' and the first such hybrid virulent E. coli identified. The phylogeny of these E. coli and the repertoire of virulence traits they possess compel consideration of an alternate view of pathogen emergence, whereby one pathogroup of E. coli undergoes phased metamorphosis into another. By understanding the evolutionary mechanisms of bacterial pathogens, rational strategies for counteracting their detrimental effects on humans can be developed.
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50
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Ewers C, Bethe A, Stamm I, Grobbel M, Kopp PA, Guerra B, Stubbe M, Doi Y, Zong Z, Kola A, Schaufler K, Semmler T, Fruth A, Wieler LH, Guenther S. CTX-M-15-D-ST648 Escherichia coli from companion animals and horses: another pandemic clone combining multiresistance and extraintestinal virulence? J Antimicrob Chemother 2014; 69:1224-30. [PMID: 24398338 DOI: 10.1093/jac/dkt516] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To discern the relevance of ST648 extended-spectrum β-lactamase (ESBL)-producing Escherichia coli as a putative new group of multiresistant and extraintestinal pathogenic strains in animals, its frequency, ESBL types, antimicrobial resistance patterns and virulence gene (VG) profiles should be determined and compared with ST131 strains from the same collection of strains. METHODS ESBL-producing E. coli isolates (n = 1152), consecutively sampled from predominantly dogs, cats and horses between 2008 and 2011, were assigned to a phylogenetic group by PCR. Partial multilocus sequence typing was performed for group D and B2 strains and strains presumed to be D-ST648 and B2-ST131 were fully typed. ESBL genes and extraintestinal pathogenic E. coli (ExPEC)-like VGs were characterized by PCR and sequence analysis and antimicrobial resistance was determined by broth dilution. Clonal analysis was done by PFGE. RESULTS Forty (3.5%) ESBL-producing E. coli were determined as D-ST648, whereas B2-ST131 isolates occurred less frequently (2.8%). Although the predominant ESBL type in both groups was CTX-M-15 (72.5% versus 46.9%), ST648 strains from companion animals and horses displayed a lower variety of ESBL types (CTX-M-1, -3, -14, -15 and -61 versus CTX-M-1,-2,-14,-15,-27 and -55 and SHV-12). In contrast to ST131 strains, a higher proportion of ST648 strains showed resistance to most non-β-lactam antibiotics. Overall, VGs were less abundant in ST648 strains, although some strains had VG profiles comparable to those of ST131 strains. ExPEC-associated serotype O1:H6 was predominant (46.8%) among the ST648 strains. Some PFGE clusters comprised ST648 isolates from pets, horses and wild birds and humans included from previous studies. CONCLUSIONS Our findings demonstrate that certain subgroups of E. coli D-ST648-CTX-M may represent a novel genotype that combines multiresistance, extraintestinal virulence and zoonotic potential.
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Affiliation(s)
- Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Justus-Liebig-Universität Giessen, Frankfurter Str. 85-89, 35392 Giessen, Germany
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