Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-14T22:15:49.720Z Has data issue: false hasContentIssue false
  • English
  • Français

Verotoxinogenic Citrobacter freundii associated with severe gastroenteritis and cases of haemolytic uraemic syndrome in a nursery school: green butter as the infection source

Published online by Cambridge University Press:  15 May 2009

H. Tschäpe ,
R. Prager ,
W. Streckel ,
A. Fruth ,
E. Tietze  and
G. Böhme
H. Tschäpe
Affiliation:
Robert Koch Instiut, Bereich Wernigerode; Burgstrasse 37, 38855 Wernigerode, Germany
R. Prager
Affiliation:
Robert Koch Instiut, Bereich Wernigerode; Burgstrasse 37, 38855 Wernigerode, Germany
W. Streckel
Affiliation:
Robert Koch Instiut, Bereich Wernigerode; Burgstrasse 37, 38855 Wernigerode, Germany
A. Fruth
Affiliation:
Robert Koch Instiut, Bereich Wernigerode; Burgstrasse 37, 38855 Wernigerode, Germany
E. Tietze
Affiliation:
Robert Koch Instiut, Bereich Wernigerode; Burgstrasse 37, 38855 Wernigerode, Germany
G. Böhme
Affiliation:
Microbiological Laboratory, Ernst-Pörner-Strasse 6, 38855 Wernigerode, Germany
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A summer outbreak of severe gastroenteritis followed by haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura in a nursery school and kindergarten is described. Sandwiches prepared with green butter made with contaminated parsley were the likely vehicle of infection. The parsley originated from an organic garden in which manure of pig origin was used instead of artificial fertilizers, Cornally identical Verotoxinogenic Citrobacter freundii were found as causative agents of HUS and gastroenteritis and were also detected on the parsley.

Type
Research Article
Information
Epidemiology & Infection , Volume 114 , Issue 3 , June 1995 , pp. 441 - 450
Copyright
Copyright © Cambridge University Press 1995

References

REFERENCES

1.Karmali, MA. Infections by verotoxin producing E. coli. Clin Microbiol Rev 1989; 12: 15–38.Google Scholar
2.Chart, H, van der Kar, CA, Tolboom, JJM, Monnens, LMH, Rowe, B. Serological detection of verocytotoxin producing E. coli in patients with haemolytic uraemic syndrome in Western Europe. Eur J Clin Microbiol Infect Dis 1993; 12: 707–9.Google Scholar
3.Milley, DG, Sekla, LH. An enzyme-linked immunosorbent assay-based isolation procedure for verotoxinogenic E. coli. Appl Environ Microbiol 1993; 59: 4223–9.CrossRefGoogle Scholar
4.Ritchie, M, Partington, S, Jessop, J, Kelly, MT. Comparison of a direct fecal Shiga like toxin assay and Sorbitol MacConkey agar culture for laboratory diagnosis of enteroheniorrhagic E. coli infection. J Clin Microbiol 1992; 30: 461–4.CrossRefGoogle Scholar
5.Schmidt, H, Montag, M, Bockemühl, J, Heesemann, J, Karch, H. Shiga like toxin II related cytotoxins in Citrobacter freundii strains from human and beef samples. Infect Immun 1993; 61: 534–43.Google Scholar
6.Willshaw, GA, Smith, HR, Scotland, SM, Field, AM, Rowe, B. Heterogeneity of E. coli phages encoding verotoxins. Comparison of cloned sequences determining VT1 and VT2 and development of specific gene probes. J Gen Microbiol 1987: 133: 1309–17.Google Scholar
7.Willshaw, GA, Scotland, SM, Smith, HR, Rowe, B. Properties of vero-cytotoxin-producing E. coli of human origin of O serogroups other than O157. J Infect Dis 1992; 166: 797–802.CrossRefGoogle Scholar
8.Borczyk, A, Karmali, MA, Lior, H, Duncan, LMC. Bovine reservoir for verotoxin producing E. coli O157: H7. Lancet 1987; i: 98.CrossRefGoogle Scholar
9.Martin, ML, Shipmann, LD, Wells, JG et al. , Isolation of E. coli O157: H7 from dairy cattle associated with two cases of haemolytic-uraemic syndrome. Lancet 1986: ii: 1043.CrossRefGoogle Scholar
10.Mohammad, A, Peiris, JS, Wijewanta, EA. Serotypes of verotoxigenic E. coli isolated from cattle and buffalo calf diarrhea. FEMS Microbiol Lett 1986; 35: 261–5.Google Scholar
11.O'Brien, AD, Holmes, RK. Shiga and Shiga-like toxins. Microbiol Rev 1987; 51: 206–20.CrossRefGoogle ScholarPubMed
12.Ørskov, F, Ørskov, I, Villar, F. Cattle as reservoir of verotoxin producing E. coli O157: H7. Lancet 1987; ii: 276.CrossRefGoogle Scholar
13.Rasmussen, MA, Cray, WC, Casey, TA, Whipp, SC. Rumen contents as a reservoir of enterohaemorrhagic E. coli. FEMS Microbiol Lett 1993; 114: 79–84.Google Scholar
14.Smith, HR, Scotland, SM, Willshaw, GA et al. , Verocytotoxin production and presence of VT genes in Escherichia coli strains of animal origin. J Gen Microbiol 1988; 134: 829–34.Google ScholarPubMed
15.Willshaw, GA, Smith, HR, Roberts, D, Thirewell, J, Cheasty, T, Rowe, B. Examination of raw beef products for the presence of verocytotoxin producing E. coli. particularly those of serogroup O157. J Appl Bacteriol 1993; 75: 420–26.CrossRefGoogle ScholarPubMed
16.Besser, RE, Lett, SM, Weber, JR et al. . An outbreak of diarrhea and hemolytic uremic syndrome from E. coli O157: H7 in fresh pressed apple cider. JAMA 1993; 269: 2217–20.Google Scholar
17.Cieslak, PR, Barrett, TJ, Griffin, PM et al. , E. coli O157: H7 infection from a manured garden. Lancet 1993: 342: 367.CrossRefGoogle ScholarPubMed
18.Rice, EW, Johnson, CH, Wild, DK, Reasoner, DJ. Survival of E. coli O157: H7 in drinking water associated with a waterborne disease outbreak of hemorrhagie colitis. Lett Appl Microbiol 1992; 15: 38–40.Google Scholar
19.Tschäpe, H, Bohme, G. Die hämorrhagisehe Colitis und das hämolytiseh-urämische Syndrom - E. coli als ätiologisches Agens. Teil I Bakteriologie und Pathogenese. KIPRAM 1991; 59: 161–5.Google Scholar
20.Farmer, JJ III. The genus Citrobacter. In: Staar, P, Stolp, H, Trüper, HG, Balows, A, Schlegel, HG. eds. The procaryotes. Heidelberg: Springer Verlag. 1981: 1140–4.Google Scholar
21.Sakazaki, R, Genus, IV. Citrobacter Werkmann and Gillen. In: Krieg, NR, Hold, JG. eds. Bergey's manual of systematic bacteriology. Baltimore: Williams and Wilkins. 1984: 1: 458–61.Google Scholar
22.Sedlak, J. Present knowledge and aspects of Citrobacter. Curr Top Microbiol Immunol 1973; 62: 41–59.Google Scholar
23.Maniatis, T, Fritsch, EF, Sambrook, J. Molecular cloning. New York: Cold Spring Harbor Lab. 1982.Google Scholar
24.Tietze, E, Tschäpe, H. Plasmid pattern analysis of natural bacterial isolates and its epidemiological implication. J Hyg 1983; 90: 475–88.Google Scholar
25.Tschäpe, H, Bender, L, Ott, M, Wittig, W, Hacker, J. Restriction fragment length polymorphism and virulence pattern of the veterinary pathogen Escherichia coli O139:K82:H1. Zbl Bakt 1992; 276: 264–72.CrossRefGoogle ScholarPubMed
26.Karch, H, Mayer, T, Rüssmann, H, Heesemann, J. Frequent loss of shiga-like toxin genes in clinical isolates of E. coli upon subcultivation. Infect Immun 1992: 60: 3464–7.Google Scholar
27.Dickie, N, Speirs, JL, Akhtar, M, Johnson, WM, Szabo, RA. Purification of an E. coli serogroup O157: H7 verotoxin and its detection in North American hemorrhagie colitis isolates. J Clin Microbiol 1989; 27: 1973–8.Google Scholar
28.Bettelheim, K, Evangelidis, H, Pearce, JL, Sowers, E, Strockbine, NA. Isolation of a Citrobacter freundii strain which carries the E. coli O157 antigen. J Clin Microbiol 1993; 31: 760–1.Google Scholar
29.Lipsky, AE, Hook, AA III, Plorde, JJ. Citrobacter infections in humans. Experience at the Seatle Veterans Administration Medical Center and a review of the literature. Rev Infect Dis 1989; 2: 746–60.Google Scholar