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Chapter 12 : Enterohemorrhagic

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Abstract:

Diarrheagenic isolates are categorized into specific groups (pathotypes) based on virulence properties, mechanisms of pathogenicity, clinical syndromes, and distinct O:H serotypes. This chapter focuses on enterohemorrhagic (EHEC), which among the strains that cause foodborne illness in the United States, is the most significant group based on frequency and severity of illness. Since O157:H7 is the most common serotype of the EHEC and because more is known about this serotype than other serotypes of EHEC, the chapter focuses on O157:H7. O157:H7 strains isolated from humans, animals, and food have developed resistance to multiple antibiotics, with streptomycin-sulfisoxazoletetracycline being the most common resistance profile. Details of many reported foodborne and waterborne outbreaks of EHEC infections are provided in the chapter. The nomenclature of the Shiga toxins (Stx) family and their important characteristics are listed. Stx and Stx1 production is negatively regulated at the transcriptional level by an iron-Fur protein corepressor complex which binds at the promoter but is unaffected by temperature. The severity of the illness it causes combined with its apparent low infectious dose qualifies O157:H7 to be among the most serious of known foodborne pathogens. O157: H7 is still by far the most important serotype of Shiga toxin-producing (STEC) in North America. Isolation of non-O157:H7 STEC requires techniques not generally used in clinical laboratories; hence, these bacteria are infrequently sought or detected in routine practice.

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12

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Outer Membrane Protein A
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Figures

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Figure 12.1

Number of O157:H7 outbreaks in the United States by year, 1982–2002 ( = 350), reproduced from reference .

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
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Figure 12.2

Transmission routes of O157:H7 outbreaks in the United States by year, 1982–2002, reproduced from reference .

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
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Figure 12.3

Vehicles of foodborne O157:H7 outbreaks in the United States by year, 1982–2002, reproduced from reference .

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
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Image of Figure 12.4
Figure 12.4

Schematic illustration of A/E lesion formation in EHEC, modified based on references and . (A) A/E translocation of effector proteins through TTSS that forms a pore through the membranes of EHEC. EHEC translocate a number of proteins: EspB and EspD, which form a translocon in the plasma membrane; the cytoplasmic proteins EspF, EspG, and Map; the translocated intimin receptor Tir, which inserts into the plasma membrane; and other unidentified effectors. (B) Formation of EHEC pedestal. EHEC intimately attaches to the host cell through intimin-Tir binding. The binding triggers the formation of actin-rich pedestals beneath adherent bacteria after Wiskott-Aldrich syndrome protein (WASP) and the heptameric actin-related protein Arp2/3 are recruited to the pedestal tip.

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
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Figure 12.5

Genetic organization of the EHEC LEE and EHEC prophages CP-933U, CP-933K, and CP-933P, reproduced from reference .

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
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Figure 12.6

TTSS apparatus of EHEC. The basal body of the TTSS is composed of the secretin EscC, the inner membrane proteins EscR, EscS, EscT, EscU, and EscV, and the EscJ lipo-protein, which connects the inner and outer membrane ring structures. EscF constitutes the needle structure, whereas EspA subunits polymerize to form the EspA filament. EspB and EspD form the translocation pore in the host cell plasma membrane, connecting the bacteria with the eukaryotic cell via EspA filaments. The cytoplasmic ATPase EscN provides the energy to the system by hydrolyzing ATP molecules into ADP. SepD and SepL have been represented as cytoplasmic components of the TTSS. (Reproduced from reference .)

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
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References

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Tables

Generic image for table
Table 12.1

Serotypes of non-O157 Shiga toxin-producing recovered from patients with hemorrhagic colitis and/or HUS

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
Generic image for table
Table 12.2

Comparison of values for O157:H7 and spp. in ground beef

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
Generic image for table
Table 12.3

Outbreaks and cases of O157 infection by transmission route, 1982–2002

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
Generic image for table
Table 12.4

Representative foodborne and waterborne outbreaks of O157:H7 and other EHEC infections

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
Generic image for table
Table 12.5

List of effector proteins of EHEC

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12
Generic image for table
Table 12.6

Nomenclature and biological characteristics of Shiga toxins (Stx)

Citation: Meng J, Doyle M, Zhao T, Zhao S. 2007. Enterohemorrhagic , p 249-269. In Doyle M, Beuchat L (ed), Food Microbiology: Fundamentals and Frontiers, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815912.ch12

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