RESUMEN
We describe the epidemiology, clinical features, and molecular characterization of enterohemorrhagic Escherichia coli (EHEC) infections caused by the singular hybrid pathotype O80:H2, and we examine the influence of antibiotics on Shiga toxin production. In France, during 2005-2014, a total of 54 patients were infected with EHEC O80:H2; 91% had hemolytic uremic syndrome. Two patients had invasive infections, and 2 died. All strains carried stx2 (variants stx2a, 2c, or 2d); the rare intimin gene (eae-ξ); and at least 4 genes characteristic of pS88, a plasmid associated with extraintestinal virulence. Similar strains were found in Spain. All isolates belonged to the same clonal group. At subinhibitory concentrations, azithromycin decreased Shiga toxin production significantly, ciprofloxacin increased it substantially, and ceftriaxone had no major effect. Antibiotic combinations that included azithromycin also were tested. EHEC O80:H2, which can induce hemolytic uremic syndrome complicated by bacteremia, is emerging in France. However, azithromycin might effectively combat these infections.
Asunto(s)
Escherichia coli Enterohemorrágica/clasificación , Escherichia coli Enterohemorrágica/genética , Síndrome Hemolítico-Urémico/epidemiología , Síndrome Hemolítico-Urémico/microbiología , Adolescente , Adulto , Antibacterianos/farmacología , Niño , Preescolar , Brotes de Enfermedades , Farmacorresistencia Bacteriana , Escherichia coli Enterohemorrágica/metabolismo , Escherichia coli Enterohemorrágica/patogenicidad , Femenino , Estudios de Seguimiento , Francia/epidemiología , Genotipo , Geografía Médica , Síndrome Hemolítico-Urémico/diagnóstico , Síndrome Hemolítico-Urémico/tratamiento farmacológico , Humanos , Incidencia , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Serogrupo , Serotipificación , Toxina Shiga/biosíntesis , Toxina Shiga/genética , Virulencia , Factores de Virulencia/genética , Adulto JovenRESUMEN
Non-O157 Shiga toxin producing Escherichia coli (STECs) have become a growing concern to the food industry. Grape seed extract (GSE), a byproduct of wine industry, is abundant in polyphenols that are known to be beneficial to health. The objective of this study was to evaluate the effect of GSE on the growth, quorum sensing, and virulence factors of Centers for Disease Control and Prevention (CDC) "top-six" non-O157 STECs. Minimal inhibitory concentration (MIC) of GSE was 2mg/ml against E. coli O26:H11, and 4mg/ml against the other non-O157 STECs tested. Minimal bactericidal concentration (MBC) was the same as MIC for all six non-O157 STECs tested. At 5×10(5)CFU/ml inoculation level, 4mg/ml GSE effectively inhibited the growth of all tested strains, while 0.25-2mg/ml GSE delayed bacterial growth. At a higher inoculation level (1×10(7)CFU/ml), GSE had less efficacy against the growth of the selected six non-O157 STECs. Its impact on bacterial virulence was then assessed at this inoculation level. Autoinducer-2 (AI-2) is a universal signal molecule mediating quorum sensing (QS). GSE at concentration as low as 0.5mg/ml dramatically reduced AI-2 production of all non-O157 STECs tested, with the inhibitory effect proportional to GSE levels. Consistent with diminished QS, GSE at concentration of 0.125mg/ml caused marked reduction of swimming motility of all motile non-O157 STECs tested. In agreement, GSE treatment reduced the production of flagella protein FliC and its regulator FliA in E. coli O103:H2 and E. coli O111:H2. Furthermore, 4mg/ml GSE inhibited the production of Shiga toxin, a major virulence factor, in E. coli O103:H2 and E. coli O111:H2. In summary, GSE inhibits the growth of "top-six" non-O157 STECs at the population level relevant to food contamination. At higher initial population, GSE suppresses QS with concomitant decrease in motility, flagella protein expression and Shiga toxin production. Thus, GSE has the potential to be used in food industry to control non-O157 STEC.