Emerg Infect Dis. 2018 Dec;24(12):2219-2227. doi: 10.3201/eid2412.180404.
Among Shiga toxin (Stx)-producing Escherichia coli (STEC) O157:H7 strains, those producing Stx2a cause more severe diseases. Atypical STEC O157:H7 strains showing a β-glucuronidase-positive phenotype (GP STEC O157:H7) have rarely been isolated from humans, mostly from persons with asymptomatic or mild infections; Stx2a-producing strains have not been reported. We isolated, from a patient with bloody diarrhea, a GP STEC O157:H7 strain (PV15-279) that produces Stx2a in addition to Stx1a and Stx2c. Genomic comparison with other STEC O157 strains revealed that PV15-279 recently emerged from the stx1a/stx2c-positive GP STEC O157:H7 clone circulating in Japan. Major virulence genes are shared between typical (β-glucuronidase-negative) and GP STEC O157:H7 strains, and the Stx2-producing ability of PV15-279 is comparable to that of typical STEC O157:H7 strains; therefore, PV15-279 presents a virulence potential similar to that of typical STEC O157:H7. This study reveals the importance of GP O157:H7 as a source of highly pathogenic STEC clones.
产志贺毒素(Stx)大肠杆菌(STEC)O157:H7 菌株中,产生 Stx2a 的菌株引起更严重的疾病。具有β-葡萄糖醛酸酶阳性表型(GP STEC O157:H7)的非典型 STEC O157:H7 菌株很少从人类中分离出来,主要从无症状或轻度感染的人群中分离出来;尚未报道产生 Stx2a 的菌株。我们从一名患有血性腹泻的患者中分离出一株 GP STEC O157:H7 菌株(PV15-279),该菌株除了产生 Stx1a 和 Stx2c 之外,还产生 Stx2a。与其他 STEC O157 菌株的基因组比较表明,PV15-279 是从日本流行的 stx1a/stx2c 阳性 GP STEC O157:H7 克隆中最近出现的。典型(β-葡萄糖醛酸酶阴性)和 GP STEC O157:H7 菌株之间共享主要毒力基因,PV15-279 的 Stx 产生能力与典型 STEC O157:H7 菌株相当;因此,PV15-279 具有与典型 STEC O157:H7 相似的毒力潜力。本研究揭示了 GP O157:H7 作为高致病性 STEC 克隆来源的重要性。