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Journal of Clinical Microbiology, March 1999, p. 497-503, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Associations between Virulence Factors of Shiga Toxin-Producing Escherichia coli and Disease in Humans

Patrick Boerlin,1,2,3,* Scott A. McEwen,1 Franziska Boerlin-Petzold,2 Jeffrey B. Wilson,1 Roger P. Johnson,2,4 and Carlton L. Gyles2

Department of Population Medicine1 and Department of Pathobiology,2 Ontario Veterinary College, University of Guelph, and Health of Animals Laboratory, Health Canada,4 Guelph, Ontario, Canada, and Institute for Veterinary Bacteriology, University of Bern, Bern, Switzerland3

Received 13 July 1998/Returned for modification 9 October 1998/Accepted 19 November 1998

Associations between known or putative virulence factors of Shiga toxin-producing Escherichia coli and disease in humans were investigated. Univariate analysis and multivariate logistic regression analysis of a set of 237 isolates from 118 serotypes showed significant associations between the presence of genes for intimin (eae) and Shiga toxin 2 (stx2) and isolates from serotypes reported in humans. Similar associations were found with isolates from serotypes reported in hemorrhagic colitis and hemolytic-uremic syndrome. The enterohemorrhagic E. coli (EHEC) hemolysin gene was significantly associated with isolates from serotypes found in severe diseases in univariate analysis but not in multivariate logistic regression models. A strong association between the intimin and EHEC-hemolysin genes may explain the lack of statistical significance of EHEC hemolysin in these multivariate models, but a true lack of biological significance of the hemolysin in humans or in disease cannot be excluded. This result warrants further investigations of this topic. Multivariate analysis revealed an interaction between the eae and stx2 genes, thus supporting the hypothesis of the synergism between the adhesin intimin and Shiga toxin 2. A strong statistical association was observed between the stx2 gene and severity of disease for a set of 112 human isolates from eight major serotypes. A comparison of 77 isolates of bovine origin and 91 human isolates belonging to six major serotypes showed significant associations of the genes for Shiga toxin 1 and EspP protease with bovine isolates and an increased adherence on HEp-2 cell cultures for human isolates, particularly from diarrheic patients and healthy persons.

* Corresponding author. Mailing address: Institut für Veterinär-Bakteriologie der Universität Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland. Phone: (41) 31-631 2368. Fax: (41) 31-631 2634. E-mail: patrick.boerlin{at}vbi.unibe.ch.

Journal of Clinical Microbiology, March 1999, p. 497-503, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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