Shiga Toxin–Producing Escherichia coli in Montana: Bacterial Genotypes and Clinical Profiles

Authors

Jill K. Jelacic, University of Washington
Todd Damrow, Montana Department of Public Health and Human Services
Gilbert S. Chen, University of WashingtonFollow
Srdjan Jelacic, Children's Hospital and Regional Medical Center, Seattle, Washington
Martina Bielaszewska, Universitätsklinikum Münster
Marcia Ciol, Children's Hospital and Regional Medical Center, Seattle, Washington
Humberto M. Carvalho, Uniformed Services University of the Health Sciences
Angela R. Melton-Celsa, Uniformed Services University of the Health SciencesFollow
Alison D. O'Brien, Uniformed Services University of the Health SciencesFollow
Phillip I. Tarr, University of WashingtonFollow

Date of this Version

2003

Citation

The Journal of Infectious Diseases (2003); 188:719–29

Abstract

The diseases and virulence genes associated with Shiga toxin–producing Escherichia coli (STEC) are characterized incompletely. We analyzed, by polymerase chain reaction, 82 STEC isolates collected prospectively in Montana and profiled associated illnesses by patient chart review. All E. coli O157:H7 contained stx₂-group genes, as well as eae, iha, espA, and ehxA; 84% contained stx₁. Non-O157:H7 STEC less frequently contained stx₁( P = .046 ), stx₂ (P < .001), iha (P < .001), eae, and espA (P = .039 for both), were isolated less often from patients treated in emergency departments (P = .022), and tended to be associated less frequently with bloody diarrhea (P = .061). There were no significant associations between stx genotype and bloody diarrhea, but isolates containing stx_2c or stx_{2d-activatable} were recovered more often from patients who underwent diagnostic or therapeutic procedures (P = .033). Non-O157:H7 STEC are more heterogeneous and cause bloody diarrhea less frequently than do E. coli O157:H7. Bloody diarrhea cannot be attributed simply to the stx genotype of the infecting organism.