Case study: Shiga Toxin-producing Escherichia coli …Case study: Shiga Toxin-producing Escherichia...
Transcript of Case study: Shiga Toxin-producing Escherichia coli …Case study: Shiga Toxin-producing Escherichia...
Case study: Shiga Toxin-producing
Escherichia coli (STEC), insight on hybrid types
Parma Summer School 2020
“One Health”
Date: 9-10 June 2020
Meeting venue: Virtual event
Pathogenic Escherichia coli
STEC
Meningitis
Septicemia
EIEC
ExPEC
DEC
Emorrhagic Diarrhea
Adehsion/colonization
90%
Recovery
5-7 days
10%
HUS
Action of Stx on the kidney’s
endothelium
STEC: Pathogenesis of infections
2-4 days
Ingestion
1-2 days
Abdominal Cramps, diarrhea Stx in blood– Action on the colonic endothelium
Toxins
E-hly
Adhesion
toxB
Pathogenic E. coli: Genomic Complexity
toxins
AB BB A
B BB
Mobile genetic Elements:
• Bacteriophages
•Genomic Islands (PAI)
• Plasmids
LEE
OI-122
OI-57
AB BB
Gene pool
AEEC
aEPEC
tEPEC
STECsptAB
LEE; Ehly
LEE
LEE
Stx
Ehly
LEE
pEAF
STECsptC StxSubAB; tia, saa
EhlyespP
STECOD
cfa; elt, est
Stx
f4; elt, est
ETEC
Stx-ETEC
Stx
EA-ETECaggR; elt
EAECaggR; aaf; aaiC; aatA
Stx-EAEC
Stx
ExPEC
Stx-ExPEC
Stx
pap; iroN; iss
EIECpic; sepA, sigA
pINV
pINV
Stx
Shigella
Hybrid E. coli types can emerge from the E. coli Continuum
Stx-producing EAEC: The first cross patotypepathogenic E. coli
3,842 cases
2987
non-HUS STEC
18 deaths
(0.6%)
855
HUS
35 deaths
(4.1%)
Of HUS cases,- 68% women
- Median age 42 years (0-91 years)- Bloody diarrhoea in 79%
Stx-producing EAEC O104:H4, Germany 2011
ST-EAEC O111:H108 HUS
1992France
2012
Northern IrelandST-EAEC O111:H21
1 HUS
ST-EAEC O104:H4850 HUS
2011Germany, France
2009ST-EAEC O104:H41 HUS Italy
2010Finland
ST-EAEC O104:H41 HUS
ST-EAEC O104:H41 HUS
2001Germany
Stx-producing Enteroaggregative E. coli (ST-EAEC)
2013Italy
ST-EAEC O127:H44 HUS
ST-EAEC O86:NM1 HUS
2000Japan
STEC Hybrid Pathogroups in the NGS era
E. coli Infection: Epidemiology
✓ Entero-toxigenic E. coli (ETEC)
✓ Eentero-invasive E. coli (EIEC)
✓ Entero-aggregative E. coli (EAEC)
✓ Entero-patogenic E.coli (EPEC)
✓ Extra-intestinal Pathogenic E. coli (ExPEC)
inter–human Cycle
Oral–fecal Transmission
But foodborne transmission
is also suspected/ascertained
✓ Shiga-toxin-producing E.coli (STEC)
Zoonotic Cycle
Food-borne Transmission
Person to person also
reported
Food of animal origin
STEC a zoonotic pathogen
For hybrid types of pathogenic E. coli to emerge, contacts between strains from human and animal source is necessary
Soil Surface waters
Environmental lead
How does the overlapping between human and zoonotic bacteria occur?
• Municipal sewage sludge: Sewage sludge refers to the residual, semi-solid material that is produced as a by-product during sewage treatment of industrial or municipal wastewater. Increasingly used in agriculture as TSI
• Reclaimed water: Used in agriculture
• Contamination of recreational waters
• Urbanization of water streams
• Lack of safe water (increases the gene pool)
Human and zoonotic E.coli
The CogWheel
Crops production management
Social disparity
Clean water availability
Animal farming
Patient’s treatment
Prevention
Food security
Wastes management
Thank you for your attention