Bacteriology, Department of Infectious Diseases, Faculty of Veterinary Medicine, University of Liège, B-4000 Liège, Belgium.
Vet Res. 2012 Feb 13;43(1):13. doi: 10.1186/1297-9716-43-13.
An enteroaggregative Verotoxin (Vtx)-producing Escherichia coli strain of serotype O104:H4 has recently been associated with an outbreak of haemolytic-uremic syndrome and bloody diarrhoea in humans mainly in Germany, but also in 14 other European countries, USA and Canada. This O104:H4 E. coli strain has often been described as an enterohaemorrhagic E. coli (EHEC), i.e. a Vtx-producing E. coli with attaching and effacing properties. Although both EHEC and the German O104:H4 E. coli strains indeed produce Vtx, they nevertheless differ in several other virulence traits, as well as in epidemiological characteristics. For instance, the primary sources and vehicles of typical EHEC infections in humans are ruminants, whereas no animal reservoir has been identified for enteroaggregative E. coli (EAggEC). The present article is introduced by a brief overview of the main characteristics of Vtx-producing E. coli and EAggEC. Thereafter, the O104:H4 E. coli outbreak is compared to typical EHEC outbreaks and the virulence factors and host specificity of EHEC and EAggEC are discussed. Finally, a renewed nomenclature of Vtx-producing E. coli is proposed to avoid more confusion in communication during future outbreaks and to replace the acronym EHEC that only refers to a clinical condition.
一种产肠聚集性志贺样毒素（Vtx）的 O104:H4 血清型大肠杆菌菌株最近与人类溶血性尿毒综合征和血性腹泻的爆发有关，主要发生在德国，但也发生在其他 14 个欧洲国家、美国和加拿大。这种 O104:H4 大肠杆菌菌株通常被描述为产志贺样毒素的大肠杆菌（EHEC），即一种具有黏附和破坏性质的 Vtx 产生的大肠杆菌。尽管 EHEC 和德国 O104:H4 大肠杆菌菌株确实产生 Vtx，但它们在其他一些毒力特征以及流行病学特征上有所不同。例如，人类典型 EHEC 感染的主要来源和载体是反刍动物，而肠聚集性大肠杆菌（EAggEC）则没有动物储存库。本文首先简要概述了产 Vtx 大肠杆菌和 EAggEC 的主要特征。然后，将 O104:H4 大肠杆菌疫情与典型 EHEC 疫情进行了比较，并讨论了 EHEC 和 EAggEC 的毒力因子和宿主特异性。最后，提出了一种新的产 Vtx 大肠杆菌命名法，以避免在未来的疫情爆发中在沟通时造成更多的混乱，并取代仅指临床情况的缩写 EHEC。
