Characteristics of the enteroaggregative Shiga toxin/verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011

F Scheutz; E Møller Nielsen; J Frimodt-Møller; N Boisen; S Morabito; R Tozzoli; J P Nataro; A Caprioli

doi:10.2807/ese.16.24.19889-en

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Characteristics of the enteroaggregative Shiga toxin/verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011
F Scheutz^1,2 , E Møller Nielsen² , J Frimodt-Møller^1,3 , N Boisen^1,2 , S Morabito⁴ , R Tozzoli⁴ , J P Nataro⁵ , A Caprioli⁴
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Affiliations: ¹ World Health Organization Collaborating Centre for Reference and Research on Escherichia and Klebsiella, Department of Microbiological Surveillance and Research, Copenhagen, Denmark ² Food-borne pathogens and typing, Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark ³ Department of Clinical Microbiology, Hillerød Sygehus, Hillerød, Denmark ⁴ European Union Reference Laboratory for Escherichia coli, Department of veterinary public health and food safety, Istituto Superiore di Sanità, Rome, Italy ⁵ University of Virginia School of Medicine, Charlottesville, United States

Correspondence:
F Scheutz
fsc ssi.dk
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Citation style for this article: Scheutz F, Møller Nielsen E, Frimodt-Møller J, Boisen N, Morabito S, Tozzoli R, Nataro J P, Caprioli A. Characteristics of the enteroaggregative Shiga toxin/verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011. Euro Surveill. 2011;16(24):pii=19889. https://doi.org/10.2807/ese.16.24.19889-en Received: 11 Jun 2011

Abstract

The Escherichia coli strain causing a large outbreak of haemolytic uraemic syndrome and bloody diarrhoea in Germany in May and June 2011 possesses an unusual combination of pathogenic features typical of enteroaggregative E. coli together with the capacity to produce Shiga toxin. Through rapid national and international exchange of information and strains the known occurrence in humans was quickly assessed. We describe simple diagnostic screening tools to detect the outbreak strain in clinical specimens and a novel real-time PCR for its detection in foods.