Association between Shiga Toxin-Producing Escherichia coli O157:H7 stx Gene Subtype and Disease Severity, England, 2009-2019

Lisa Byrne, Natalie Adams, Claire Jenkins*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Signs and symptoms of Shiga toxin-producing Escherichia coli (STEC) serogroup O157:H7 infection range from mild gastrointestinal to bloody diarrhea and hemolytic uremic syndrome (HUS). We assessed the association between Shiga toxin gene (stx) subtype and disease severity for ≈3,000 patients with STEC O157:H7 in England during 2009-2019. Odds of bloody diarrhea, HUS, or both, were significantly higher for patients infected with STEC O157:H7 possessing stx2a only or stx2a combined with other stx subtypes. Odds of severe signs/symptoms were significantly higher for isolates encoding stx2a only and belonging to sublineage Ic and lineage I/II than for those encoding stx2a only and belonging to sublineage IIb, indicating that stx2a is not the only driver causing HUS. Strains of STEC O157:H7 that had stx1a were also significantly more associated with severe disease than strains with stx2c only. This finding confounds public health risk assessment algorithms based on detection of stx2 as a predictor of severe disease.

Original languageEnglish
Pages (from-to)2394-2400
Number of pages7
JournalEmerging Infectious Diseases
Volume26
Issue number10
DOIs
Publication statusPublished - Oct 2020

Bibliographical note

Publisher Copyright:
© 2020 Centers for Disease Control and Prevention (CDC). All rights reserved.

Fingerprint

Dive into the research topics of 'Association between Shiga Toxin-Producing Escherichia coli O157:H7 stx Gene Subtype and Disease Severity, England, 2009-2019'. Together they form a unique fingerprint.

Cite this