Chapter 12 : Enterohemorrhagic

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Gastrointestinal pathogenic includes enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroinvasive (EIEC), enteroaggregative (EAEC), and enterohemorrhagic (EHEC). This chapter focuses largely on the EHEC group, which among the strains that cause foodborne illness, is the most significant group based on the frequency of foodborne illness in the United States and the severity of illness. Some types of EPEC are referred to as enteroadherent (EAEC), based on specific patterns of adherence. The chapter next discusses the characteristics of O157:H7, first identified as a foodborne pathogen in 1982. The serious nature of the symptoms of hemorrhagic colitis and hemolytic-uremic syndrome (HUS) caused by O157:H7 places this pathogen in a category apart from other foodborne pathogens, which typically cause only mild symptoms. 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. Cattle are a major reservoir of O157:H7. O157:H7 is still by far the most important serotype of Shiga toxins (Stx)-producing (STEC) in North America. The increased availability in clinical laboratories of techniques such as testing for Stxs or their genes and identification of other virulence markers unique for EHEC will continue to enhance the detection of disease attributable to non-O157 EHEC.

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Figure 12.1

Number of Stx-producing O157:H7 cases in the United States by year, 2000 to 2010. doi:10.1128/9781555818463.ch12f1

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Figure 12.2

Schematic illustration of A/E lesion formation in EHEC, modified from reference . (A) A/E translocation of effector proteins through T3SS 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, G, 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. doi:10.1128/9781555818463.ch12f2

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Figure 12.3

Genetic organization of the EHEC LEE and EHEC prophages CP-933U, CP-933K, and CP-933P, reproduced from reference . doi:10.1128/9781555818463.ch12f3

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Figure 12.4

T3SS apparatus of EHEC. The basal body of the T3SS is composed of the secretin EscC, the inner membrane proteins EscR, EscS, EscT, EscU, and EscV, and the EscJ lipoprotein, 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 T3SS. (Reproduced from reference .) doi:10.1128/9781555818463.ch12f4

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Table 12.1

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

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Table 12.2

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

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Table 12.3

Vehicles of foodborne outbreaks and associated cases of O157 infections in the United States between 2000 and 2010

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
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Table 12.4

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

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12
Generic image for table
Table 12.5

Nomenclature and biological characteristics of Stxs

Citation: Meng J, LeJeune J, Zhao T, Doyle M. 2013. Enterohemorrhagic , p 287-309. In Doyle M, Buchanan R (ed), Food Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555818463.ch12

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