Skip to main content
SpringerLink
Log in

Infection by shiga toxin-producing Escherichia coli

An overview

  • Research
  • Published:
Molecular Biotechnology Aims and scope Submit manuscript

Abstract

Shiga toxin-producing Escherichia coli (STEC), especially of serotype O157:H7, cause a zoonotic food or waterborne enteric illness that is often associated with large epidemic outbreaks as well as the hemolytic uremic syndrome (HUS), the leading cause of acute renal failure in children. After ingestion, STEC colonize enterocytes of the large bowel with a characteristic attaching and effacing pathology, which is mediated by components of a type III secretion apparatus encoded by the LEE pathogenicity island. Shiga toxins are translocated from the bowel to the circularoty system and transported by leukocytes to capillary endothelial cells in renal glomeruli and other organs. After binding to the receptor globotriaosylceramide on target cells, the toxin is internalized by receptor-mediated endocytosis and interacts with the subcellular machinery to inhibit protein synthesis. This leads to pathophysiological changes that result in HUS. Specific therapeutic or preventive strategies are presently not available. The recent sequencing of genomes of two epidemic E. coli O157 strains has revealed novel pathogenicity islands which will likely provide new insights into the virulence of these bacteria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Konowalchuk, J., Speirs, J.I., Stavric, S. (1977) Vero response to a cytotoxin of Escherichia coli. Inect. Immun. 18, 775–779.

    CAS  Google Scholar 

  2. Griffin, P.M. (1995) Escherichia coli O157:H7 and other enterohemorrhagic Escherichia coli. In: Blaser, M.J., Smith, P.D., Ravdin, J.I., et al., (eds.) Infections of the Gastrointestinal Tract. New York: Raven Press, Ltd, pp. 739–761.

    Google Scholar 

  3. Karmali, M.A., Steele, B.T., Petric, M., and Lim, C. (1983) Sporadic cases of hemolytic uremic syndrome associated with fecal cytotoxin and cytotoxin-producing Escherichia coli. Lancet I, 619–620.

    Article  Google Scholar 

  4. Karmali, M.A., Petric, M., Lim, C., et al. (1985) The association between hemolytic uremic syndrome and infection by Verotoxin-producing Escherichia coli. J. Infect. Dis. 151, 775–782.

    PubMed  CAS  Google Scholar 

  5. Nataro, J.P., Kaper, J.B. (1998) Diarrheagenic Escherichia coli. Clin.Microbiol.Rev. 11, 142–201.

    PubMed  CAS  Google Scholar 

  6. Riley, L.W., Remis, R.S., Helgerson, S.D., et al. (1983) Hemorrhagic colitis associated with a rare Escherichia coli serotype. New Engl.J.Med. 308, 681–685.

    Article  PubMed  CAS  Google Scholar 

  7. Ahmed, S. and Donaghy, M. (1998) An outbreak of Escherichia coli O157:H7 in Central Scotland. In: Kaper, J.B. and O’Brien, A.D., (eds.) Escherichia coli O157:H7 and Other Shiga Toxin-Producing E. coli strains. Washington, D.C., ASM Press; pp. 59–65.

    Google Scholar 

  8. CCDR. (2000) Waterborne outbreak of gastroenteritis associated with a contaminated municipal water supply, Walkerton, Ontario, May–June 2000. Can. Commun. Dis. Rep. 26, 170–173.

    Google Scholar 

  9. Karmali, M.A. (1989) Infection by Verocytotoxin-producing Escherichia coli. Clin.Microbiol.Rev. 2, 15–38.

    PubMed  CAS  Google Scholar 

  10. Michino, H., Araki, K., Minami, S., et al. (1998) Recent outbreaks of infection caused by Escherichia coli O157:H7 in Japan. In: Kaper, J.B. and O’Brien, A.D., (eds.), Escherichia coli O157:H7 and other Shiga toxin-producing E. coli strains. Washington, D.C., ASM Press, pp. 73–81.

    Google Scholar 

  11. Fitzpatrick, M.M., Shah, V., Trompeter, R.S., et al. (1991) Long term renal outcome of childhood haemolytic uraemic syndrome. Brit.Med.J. 303, 489–492.

    PubMed  CAS  Google Scholar 

  12. Loirat, C., Sonsino, E., Moreno, A.V., et al. Hemolytic uremic syndrome: An analysis of the natural history and prognostic features. Acta Pediatr Scand 73, 505–514.

  13. Siegler, R.L., Milligan, M.K., Burningham, T.H., et al. (1991) Long-term outcome and prognostic indicators in the hemolytic uremic syndrome. J.Pediatr. 118, 195–200.

    Article  PubMed  CAS  Google Scholar 

  14. Trompeter, R.S., Schwartz, R., Chantler, C., et al. (1983) Haemolytic uraemic syndrome: An analysis of prognostic features. Arch Dis Child 58, 101–105.

    PubMed  CAS  Google Scholar 

  15. Advisory Committee on the Microbiological Safety of Food. (1995) Report on verocytotoxin-producing Escherichia coli. (1995) Her Majesty’s Stationary Office, London.

    Google Scholar 

  16. USDA:APHIS:VS. Escherichia coli O157:H7 issues and ramifications. 1994. Centers for Epidemiology and Animal Health, 555 South Howes, Fort Collins, Colorado, 80521.

  17. World Health Organization. (1999) Zoonotic non-O157 Shiga toxin-producing Escherichia coli (STEC). Report of a WHO Scientific Working Group Meeting, Berlin, Germany, 22–23 June, 1998. WHO/CSR/APH/98.8. World Health Organization, pp. 1–30.

  18. Lopez, E.L., Contrini, M.M., and Rosa, M.F. (1998) Epidemiology of shiga toxin-producing Escherichia coli in South America. In: Kaper, J.B and O’Brien, A.D. (eds). Escherichia coli O157:H7 and Other Shiga Toxin-Producing E. coli strains. ASM Press, Washington, D.C, pp.30–37.

    Google Scholar 

  19. Gerber A, Karch H, Allerberger F, et al. (2002) Clinical course and the role of shiga toxin-producing Escherichia coli infection in the hemolytic-uremic syndrome in pediatric patients, 1997–2000, in Germany and Austria: A prospective study. J.Infect.Dis. 186,493–500.

    Article  PubMed  Google Scholar 

  20. Tozzi, A.E., Caprioli, A., Minelli, F., et al. (2003) Shiga toxin-producing Escherichia coli infections associated with hemolytic uremic syndrome, Italy, 1988–2000. Emerg.Infect.Dis. 9, 106–108.

    PubMed  Google Scholar 

  21. Banatvala, N., Griffin, P.M., Greene, K.D et al. The United States National Prospective Hemolytic Uremic Syndrome Study: Microbiologic, serologic, clinical, and epidemiologic findings.

  22. Centers for Disease Control and Prevention (1993). Update: Multistate outbreak of Escherichia coli O157:H7 infections from hamburgers—western United States, 1992–1993. J.Amer.Med.Assoc. 269, 2194–2196.

    Article  Google Scholar 

  23. Griffin, P.M. (1998) Epidemiology of shiga toxin-producing Escherichia coli infections in humans in the United States. In: Kaper, J.B. and O’Brien, A.D. (eds.). Escherichia coli O157:H7 and other shiga toxin-producing E. coli strains. ASM Press, Washington, D.C, pp. 15–22.

    Google Scholar 

  24. Carter, A.O., Borczyk, A.A., Carlson, J.A.K. et al. (1987) A severe outbreak of Escherichia coli O157:H7-associated hemorrhagic colitis in a nursing home. N.Engl.J.Med. 317, 1496–1500.

    Article  PubMed  CAS  Google Scholar 

  25. Kibel, M.A. and Barnard, P.J. (1968) The hemolytic uremic syndrome: A survey in Southern Africa. S.Afr.Med.J. 42, 692–698.

    PubMed  CAS  Google Scholar 

  26. Jernigan, S.M. and Waldo, F.B. (1994) Racial incidence of hemolytic uremic syndrome. Pediatr.Nephrol. 8 545–547.

    Article  PubMed  CAS  Google Scholar 

  27. Gianantonio, C., Vitacco, M., Mendilaharzu, F., et al. (1964) The hemolytic-uremic syndrome. J.Pediatr. 64, 478–491.

    Article  PubMed  CAS  Google Scholar 

  28. Gianantonio, C., Vitacco, M., Mendilaharzu, F., et al. (1973) The hemolytic uremic syndrome. Nephron 11, 174–192.

    PubMed  CAS  Google Scholar 

  29. Tarr, P.I., Fouser, L.S., Stapleton, A.E., et al. (1996) Hemolytic-uremic syndrome in a six-year old girl after a urinary tract infection with shiga-toxin-producing Escherichia coli O103:H2. N.Engl.J.Med. 335, 635–660.

    Article  PubMed  CAS  Google Scholar 

  30. McLaine, P.N., Orrbine, E., Rowe, P.C. (1992) Childhood Hemolytic Uremic Syndrome in Canada: A multicenter study. In: Kaplan, B.S. (ed.). Hemolytic Uremic Syndrome and Thrombotic Thrombocytopenic Purpura. Marcel Dekker Inc., New York, pp. 61–69.

    Google Scholar 

  31. Upadhyaya, K., Barwick, K., Fishaut, M., et al. (1980). The importance of nonrenal involvement in hemolytic uremic syndrome. Pediatrics 65, 115–120.

    PubMed  CAS  Google Scholar 

  32. Frankel, G., Phillips, A.D., Rosenshine, I., et al. (1998) Enteropathogenic and enterohaemorrhagic Escherichia coli: more subversive elements. Mol. Microbiol. 30, 911–921.

    Article  PubMed  CAS  Google Scholar 

  33. Goosney, D.L., DeVinney, R., Finlay, B.B. (2001) Recruitment of cytoskeletal and signaling proteins to enteropathogenic and enterohemorrhagic Escherichia coli pedestals. Infect.Immun. 69, 3315–3322.

    Article  PubMed  CAS  Google Scholar 

  34. Mellies, J.L., Elliott, S.J., Sperandio, V., et al. The Per regulon of enteropathogenic Escherichia coli: Identification of a regulatory cascade and a novel transcriptional activator, the locus of enterocyte effacement (LEE)-encoded regulator (Ler). Mol.Microbiol. 33, 296–306.

  35. Sperandio, V., Mellies, J.L., Nguyen, W., et al. (1999) Quorum sensing controls expression of the type III secretion gene transcription and protein secretion in enterohemorrhagic and enteropathogenic Escherichia coli. Proc.Natl.Acad.Sci.USA 96, 15,196–15,201.

    Article  CAS  Google Scholar 

  36. Friedrich, A.W., Bielaszewska, M., Zhang, W.L., et al. (2002) Escherichia coli harboring shiga toxin 2 gene variants: frequency and association with clinical symptoms. J.Infect.Dis. 185, 74–84.

    Article  PubMed  CAS  Google Scholar 

  37. O’Brien, A.D., Tesh, V.L., Donohue-Rolfe, A., et al. (1992) Shiga toxin: Biochemistry, genetics, mode of Action. and role in pathogenesis. Curr.Topics Microbiol. Immunol. 180, 65–94.

    CAS  Google Scholar 

  38. Lingwood, C.A., Law, H., Richardson, S.E., et al. (1987) Glycolipid binding of natural and recombinant Escherichia coli produced verotoxin in vitro. J. Biol. Chem. 262, 8834–8839.

    PubMed  CAS  Google Scholar 

  39. Lingwood, C.A., Mylvaganam, M., Arab, S., Set al. (1998) Shiga toxin (verotoxin) binding to its receptor glycolipid. In: Kaper, J.B. and O’Brien, A.D. (eds.). Escherichia coli O157:H7 and other Shiga toxin-producing E. coli strains. ASM Press, Washington, D.C. pp. 129–139.

    Google Scholar 

  40. te Loo, D.M., Hinsbergh, V.W., Heuvel, L.P., and Monnens, L.A. (2001) Detection of verocytotoxin bound to circulating polymorphonuclear leukocytes of patients with hemolytic uremic syndrome. J. Am. Soc. Nephrol. 12, 800–806.

    PubMed  CAS  Google Scholar 

  41. Fong, J.S.C., de Chadarevian, J.P., Kaplan, B. (1982) Hemolytic uremic syndrome. Current concepts and management. Pediatr. Clin. North Amer. 29, 835–856.

    CAS  Google Scholar 

  42. Richardson, S.E., Karmali, M.A., Becker, L.E., and Smith CR. (1988) The histopathology of the hemolytic uremic syndrome associated with verocytotoxin-producing Escherichia coli Infections. Hum. Pathol. 19, 1102–1108.

    Article  PubMed  CAS  Google Scholar 

  43. Vitsky, B.H., Suzuki, Y., Strauss, L., and Churg, J. (1969) The hemolytic uremic syndrome: A study of renal pathologic alternations. Am. J. Pathol. 57, 627.

    PubMed  CAS  Google Scholar 

  44. Obrig, T. (1998) Interaction of shiga toxins with endothelial cells. In: Kaper, J.B. and O’Brien, A.D., (eds.). Escherichia coli O157:H7 and other shiga toxin-producing E. coli strains. ASM Press, Washington, D.C, pp. 303–311.

    Google Scholar 

  45. te Loo, D.M., Monnens, L.A., van den Heuvel, L.P., et al. (2001) Detection of apoptosis in kidney biopsies of patients with d+ hemolytic ure mic syndrome. Pediatr. Res. 49, 413–416.

    Article  PubMed  CAS  Google Scholar 

  46. Monnens, L., Savage, C.O., Taylor, C.M. (1998) Pathophysiology of hemolytic-uremic syndrome. In: Kaper, J.B. and O’Brien, A.D. (eds.). Escherichia coli O157:H7 and other shiga toxin-producing E. coli strains. ASM Press, Washington, D.C, pp. 287–292.

    Google Scholar 

  47. Taylor, C.M. and Monnens, L.A. (1998) Advances in haemolytic uraemic syndrome. Arch. Dis. Child 78, 190–193.

    Article  PubMed  CAS  Google Scholar 

  48. van Setten PA, Monnens, L.A., Verstraten, R.G., et al. (1996) Effects of verocytotoxin-1 on nonadherent human monocytes: binding characteristics, protein synthesis, and induction of cytokine release. Blood 88, 174–183.

    PubMed  Google Scholar 

  49. Kar, N.C.A.J., Monnens, L.A.H., Karmali, M.A., and Hinsbergh, V.W.M.. (1992) Tumor necrosis factor and interleukin-1 induce expression of the verocytotoxin receptor globotriaosyl ceramide on human endothelial cells: Implications for the pathogenesis of the hemolytic uremic syndrome. Blood 80, 2755–2764.

    PubMed  Google Scholar 

  50. Perna, N.T., Plunkett, G. III., Burland, V., et al. (2001) Genome sequence of enterohaemorrhagic Escherichia coli O157:H7. Nature 409,529–533.

    Article  PubMed  CAS  Google Scholar 

  51. Hayashi, T., Makino, K., Ohnishi, M., et al. (2001) Complete genome sequence of enterohemorrhagic Escherichia coli O157:H7 and genomic comparison with a laboratory strain K-12. DNA Res. 8, 11–22.

    Article  PubMed  CAS  Google Scholar 

  52. Karmali, M. A., Mascarenhas, M., Shen, S., et al. (2003) Association of genomic O island 122 of Escherichia coli EDL 933 with verocytotoxin-producing Escherichia coli seropathotypes that are linked to epidemic and/or serious disease. J. Clin. Microbiol. 41, 4930–4940.

    Article  PubMed  CAS  Google Scholar 

  53. Neill, M.A. (1998) Treatment of disease due to shiga toxin-producing Escherichia coli: Infectious disease management. In: Kaper, J.B. and O’Brien, A.D. (eds.). Escherichia coli O157:H7 and other Shiga toxin-producing E. coli strains. ASM Press, Washington, D.C, pp. 357–363.

    Google Scholar 

  54. Takeda, T., Yoshino, K., Uchida, H., et al. (1998) Early use of fosfomycin for shiga toxin-producing Escherichia coli O157 infection reduces the risk of hemolytic-uremic syndrome. In: Kaper, J.B. and O’Brien AD, (eds.). Escherichia coli O157:H7 and other shiga toxin-producing E. coli strains. ASM Press, Washington, D.C, pp. 385–387.

    Google Scholar 

  55. Wong, C.S., Jelacic, S., Habeeb, R.L., et al. (2000) The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. N. Engl. J. Med. 342, 1930–1936.

    Article  PubMed  CAS  Google Scholar 

  56. Levine, M.M. (1998) Immunoprophylaxis of shiga toxin-producing Escherichia coli infection and disease: strengths and weaknesses of various strategies. In: Kaper, J.B. and O’Brien, A.D., (eds.). Escherichia coli O157:H7 and other shiga toxin-producing E. coli strains. ASM Press, Washington, D.C, pp. 405–408.

    Google Scholar 

  57. Armstrong, G.D., McLaine, P.N., and Rowe, P.C. (1998) Clinical trials of synsorb Pk in preventing hemolytic uremic syndrome. In: Kaper, J.B. and O’Brien, A.D., (eds.). Escherichia col O157:H7 and other shiga toxin-producing E. coli strains. ASM Press, Washington, D.C., pp. 374–384.

    Google Scholar 

  58. Kitov, P.I., Sadowska, J.M., Mulvey, G., et al. (2000) Shiga-like toxins are neutralized by tailored multivalent carbohydrate ligands. Nature 403, 669–672.

    Article  PubMed  CAS  Google Scholar 

  59. Gyles, C.L. (1998) Vaccines and shiga toxin-producing Escherichia coli in animals. In: Kaper, J.B. and O’Brien, A.D. (eds.). Escherichia coli O157:H7 and other shiga toxin-producing E. coli strains. ASM Press, Washington, D.C., pp. 434–444.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Laboratory for Foodborne Zoonoses, Health Canada, 110 Stone Road West, N1G 3W4, Guelph, Ontario, Canada

    Mohamed A. Karmali

Authors
  1. Mohamed A. Karmali
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohamed A. Karmali.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Karmali, M.A. Infection by shiga toxin-producing Escherichia coli . Mol Biotechnol 26, 117–122 (2004). https://doi.org/10.1385/MB:26:2:117

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1385/MB:26:2:117

Index Entries

Search

Navigation