Molecular epidemiology of a household outbreak of Shiga-toxin-producing Escherichia coli in Poland due to secondary transmission of STEC O104:H4 from Germany

J Med Microbiol. 2012 Apr;61(Pt 4):552-558. doi: 10.1099/jmm.0.039289-0. Epub 2011 Dec 1.

Abstract

We characterized two STEC O104 : H4 clinical isolates collected in Poland from a 7-year-old boy with haemolytic uraemic syndrome (HUS) and his nanny. This household outbreak began on 29 May 2011. Because of its time-frame, the outbreak was assumed to be part of the international STEC O104 : H4 outbreak that arose in Germany in May 2011. The two Polish isolates were Shiga-toxin-producing Escherichia coli (stx2 lpf) with enteroaggregative E. coli pathotype (aggR aap aggA), thereby sharing the unique virulence properties of the epidemic STEC O104 : H4 strain from the international outbreak. The Polish isolates were multi-drug resistant and carried bla(TEM), strA, strB, tetA, sul1 and sul2 markers together with the bla(CTX-M-15) gene for CTX-M-15 extended-spectrum β-lactamase. PFGE patterns and plasmid profiles of the Polish isolates and the epidemic STEC O104 : H4 strain corresponded closely. This finding suggested an epidemiological link between the Polish STEC O104 : H4 isolates and the international outbreak. Retrospective serological investigations proved person-to-person transmission of the epidemic STEC O104 : H4 strain from a father who had visited Dortmund, Germany, to his 7-year-old son in Giżycko, Poland. To the best of our knowledge, this is the first report of household transmission of Shiga-toxin-producing E. coli in Poland.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Antibodies, Bacterial / blood
  • Child
  • DNA, Bacterial / genetics
  • Diabetes Mellitus, Type 1 / complications
  • Disease Outbreaks
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology*
  • Escherichia coli Infections / transmission
  • Family Characteristics
  • Feces / microbiology
  • Female
  • Germany / epidemiology
  • Hemolytic-Uremic Syndrome / epidemiology
  • Hemolytic-Uremic Syndrome / microbiology*
  • Humans
  • Male
  • Molecular Epidemiology
  • Poland / epidemiology
  • Shiga-Toxigenic Escherichia coli / classification
  • Shiga-Toxigenic Escherichia coli / genetics
  • Shiga-Toxigenic Escherichia coli / immunology
  • Shiga-Toxigenic Escherichia coli / isolation & purification*

Substances

  • Antibodies, Bacterial
  • DNA, Bacterial