1. A large outbreak of hemolytic uremic syndrome caused by an unusual sorbitol-fermenting strain of Escherichia coli O157:H-.
- Author
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Ammon A, Petersen LR, and Karch H
- Subjects
- Case-Control Studies, Child, Child, Preschool, Escherichia coli Infections microbiology, Escherichia coli O157 classification, Fermentation, Food Microbiology, Germany epidemiology, Hemodialysis Units, Hospital, Hemolytic-Uremic Syndrome microbiology, Hospital Records, Humans, Infant, Meat Products microbiology, Disease Outbreaks, Escherichia coli Infections epidemiology, Escherichia coli O157 isolation & purification, Escherichia coli O157 metabolism, Hemolytic-Uremic Syndrome epidemiology, Sorbitol metabolism
- Abstract
Escherichia coli O157:H7 does not ferment sorbitol, a factor used to differentiate it from other E. coli. From December 1995 to March 1996, 28 children with hemolytic uremic syndrome in Bavaria, Germany, were identified; many had a sorbitol-fermenting (sf) E. coli O157:H- cultured. A case-control study showed a dose-response relationship between sausage consumption and illness. A second case-control study showed a relationship between mortadella and teewurst consumption and illness, particularly during December (mortadella odds ratio [OR], 10.5, P=.004; teewurst OR, 6.2, P=.02). Twelve sf O157:H- were characterized to determine clonality and virulence traits. The strains possessed the Stx2, eae, and EHEC-hlyA genes but were nonhemolytic on blood agar plates. The O157:H- isolates belonged to phage type 88 and had identical pulsed-field gel electrophoresis patterns. This outbreak was caused by sf E. coli O157:H-, which is not detectable by culture on sorbitol MacConkey's agar. Consumption of two sausages, including a raw beef-containing sausage, was statistically related to illness.
- Published
- 1999
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