King Grace, Jenkins Claire, Hayden Iain, Rodwell Ella V, Quinn Orlagh, Godbole Gauri, Douglas Amy, Sawyer Clare, Balasegaram Sooria
Field Service - South East and London, UK Health Security Agency, London, UK.
Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, UK.
J Med Microbiol. 2025 Jan;74(1). doi: 10.1099/jmm.0.001947.
Shiga toxin-producing (STEC) infections are of public health concern as STEC can cause large national foodborne outbreaks of severe gastrointestinal disease, particularly in the young and elderly. In recent years, the implementation of PCR by diagnostic microbiology laboratories has improved the detection of STEC, and there has been an increase in notifications of cases of non-O157 STEC. However, the extent this increase in caseload can be attributed to the improved detection by PCR, or a true increase in non-O157 STEC infections, is unknown. Epidemiological and microbiological data and analyses describing the trends in non-O157 STEC in England since the implementation of PCR are limited. Demographic, microbiological and clinical characteristics of non-O157 STEC from 8 years (2016-2023) of laboratory surveillance data were analysed to understand the recent trends in non-O157 serotypes and the incidence of disease in England. All human isolates of STEC non-O157 detected between 2016 and 2023 were extracted from the laboratory surveillance system. Microbiological data were analysed and linked to clinical outcomes. There was an almost 10-fold increase in diagnoses of non-O157 STEC from 2016 (=297) to 2023 (=2341). A total of 9378 isolates of non-O157 STEC were detected, comprising 338 different serotypes, and were linked to 9311 individuals. A higher proportion of non-O157 STEC cases were female (56%) and aged between 20 and 39 years (27%). The most common non-O157 serotypes were O26:H11 (16%), O146:H21 (12%), O91:H14 (11%), O128:H2 (6%), O145:H28 (5%) and O103:H2 (4%). STEC O26:H11 was more frequently reported in under 5s than any other age group (38%), whereas the other common serotypes were more frequently isolated from adults. , which has been associated with greater disease severity, was detected in 18% of cases. Where clinical details were available, 27% of non-O157 cases were admitted to the hospital and 6% developed HUS. Cases of STEC O145:H28 reported a higher rate of hospitalisation than other non-O157 STEC cases. The serotypes most likely to be associated with progression to HUS were O26:H11 (9%) and O145:H28 (7%). STEC harbouring (19%), (11%) and (11%) were most frequently isolated from cases with HUS. The implementation of widespread PCR testing in England has facilitated better surveillance of STEC non-O157, with respect to establishing the true incidence and burden of disease of non-O157 STEC and monitoring the emergence of highly virulent strains.
产志贺毒素大肠杆菌（STEC）感染是公共卫生关注的问题，因为STEC可引发大规模的全国性食源性严重胃肠道疾病疫情，尤其是在年轻人和老年人中。近年来，诊断微生物实验室实施的聚合酶链反应（PCR）提高了STEC的检测率，非O157 STEC病例的报告数量有所增加。然而，病例数量的增加在多大程度上可归因于PCR检测的改善，还是非O157 STEC感染的真正增加，尚不清楚。自实施PCR以来，描述英格兰非O157 STEC趋势的流行病学和微生物学数据及分析有限。分析了8年（2016 - 2023年）实验室监测数据中，非O157 STEC的人口统计学、微生物学和临床特征，以了解英格兰非O157血清型的近期趋势和疾病发病率。2016年至2023年间检测到的所有非O157 STEC人类分离株均从实验室监测系统中提取。分析了微生物学数据并将其与临床结果相关联。从2016年（=297例）到2023年（=2341例），非O157 STEC的诊断数量几乎增加了10倍。共检测到9378株非O157 STEC分离株，包括338种不同血清型，并与9311人相关。非O157 STEC病例中女性比例较高（56%），年龄在20至39岁之间（27%）。最常见的非O157血清型为O26:H11（16%）、O146:H21（12%）、O91:H14（11%）、O128:H2（6%）、O145:H28（5%）和O103:H2（4%）。STEC O26:H11在5岁以下儿童中报告的频率高于其他任何年龄组（38%），而其他常见血清型在成年人中分离得更频繁。在18%的病例中检测到了与更高疾病严重程度相关的[此处原文缺失具体内容]。在可获得临床细节的情况下，27%的非O157病例入院，6%发生溶血尿毒综合征（HUS）。STEC O145:H28病例的住院率高于其他非O157 STEC病例。最有可能与进展为HUS相关的血清型为O26:H11（9%）和O145:H28（7%）。携带[此处原文缺失具体内容]（19%）、[此处原文缺失具体内容]（11%）和[此处原文缺失具体内容]（11%）的STEC最常从HUS病例中分离出来。在英格兰广泛实施PCR检测有助于更好地监测非O157 STEC，包括确定非O157 STEC疾病的真实发病率和负担以及监测高毒力菌株的出现。
