A new health threat in Europe: Shiga toxin-producing Escherichia coli O104:H4 infections

Journal of Microbiology, Immunology and Infection

Volumn 44, Issue 5, 2011, Pages 390-393

  Wu, Chi Jung ^a,b   Hsueh, Po Ren ^c   Ko, Wen Chien ^b  

^a NATIONAL HEALTH RESEARCH INSTITUTES   (Taiwan)

^b NATIONAL CHENG KUNG UNIVERSITY HOSPITAL   (Taiwan)

^c NATIONAL TAIWAN UNIVERSITY HOSPITAL   (Taiwan)

Author keywords

Escherichia coli O104:H4; Hemolytic uremic syndrome; Shiga toxin

Indexed keywords

CIPROFLOXACIN; COTRIMOXAZOLE; GENTAMICIN; TOBRAMYCIN;

ANTIBIOTIC RESISTANCE; ANTIBIOTIC SENSITIVITY; ESCHERICHIA COLI INFECTION; ESCHERICHIA COLI O104; GASTROENTERITIS; GERMANY; HEMOLYTIC UREMIC SYNDROME; PUBLIC HEALTH; REVIEW; SHIGA TOXIN PRODUCING ESCHERICHIA COLI;

DISEASE OUTBREAKS; ESCHERICHIA COLI INFECTIONS; GASTROENTERITIS; GERMANY; HEMOLYTIC-UREMIC SYNDROME; HUMANS; SEROTYPING; SHIGA-TOXIGENIC ESCHERICHIA COLI;

EID: 80053645340     PISSN: 16841182     EISSN: 19959133     Source Type: Journal    
DOI: 10.1016/j.jmii.2011.07.001     Document Type: Review

References (17)

1. Askar M., Faber M., Frank C., Bernard H., Gilsdorf A., Fruth A., et al. Update on the ongoing outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli (STEC) serotype O104, Germany, May 2011. Euro Surveill 2011, 16. pii=19883. Available from:, [accessed 01.07.11]. http://www.eurosurveillance.org/viewarticle.aspx%3Farticleid=19883.
2. World Health Organization Outbreaks of E. coli O104:H4 infection: update 28 Published online July 1, 2011. Available from:, [accessed 04.07.11]. http://www.euro.who.int/en/what-we-do/health-topics/emergencies/international-health-regulations/news/news/2011/07/outbreaks-of-e.-coli-o104h4-infection-update-28.
3. Frank C., Werber D., Cramer J.P., Askar M., Faber M., Heiden M.A., et al. Epidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany-preliminary report. N Engl J Med 2011, doi:10.1056/NEJMoa1106483.
4. Bielaszewska M., Mellmann A., Zhang W., Kock R., Fruth A., Bauwens A., et al. Characterisation of the Escherichia coli strain associated with an outbreak of haemolytic uraemic syndrome in Germany, 2011: a microbiological study. Lancet Infect Dis 2011, doi:10.1016/S1473-3099(11)70165-7.
5. Scheutz F., Nielsen E.M., Frimodt-Moller J., Boisen N., Morabito S., Tozzoli R., et al. Characteristics of the enteroaggregative Shiga toxin/verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011 pii=19889. Available from:, [accessed 01.07.11]. http://www.eurosurveillance.org/ViewArticle.aspx%3FArticleId=19889.
6. Kon M., Kurazono T., Ohshima M., Yamaguchi M., Morita K., Watanabe N., et al. Cefotaxime-resistant Shiga toxin-producing Escherichia coli O26: H11 isolated from a patient with diarrhea. Kansenshogaku Zasshi 2005, 79:161-168. [in Japanese].
7. Ishii Y., Kimura S., Alba J., Shiroto K., Otsuka M., Hashizume N., et al. Extended-spectrum beta-lactamase-producing Shiga toxin gene (Stx1)-positive Escherichia coli O26:H11: a new concern. J Clin Microbiol 2005, 43:1072-1075.
8. Tarr P.I., Gordon C.A., Chandler W.L. Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome. Lancet 2005, 365:1073-1086.
9. Center for Disease Control and Prevention Escherichia coli O157:H7 and other Shiga toxin-producing Escherichia coli (STEC) Available from:, [accessed 01.07.11]. http://www.cdc.gov/nczved/divisions/dfbmd/diseases/ecoli_o157h7/%23what.
10. Gould L.H., Bopp C., Strockbine N., Atkinson R., Baselski V., Body B., et al. Recommendations for diagnosis of Shiga toxin-producing Escherichia coli infections by clinical laboratories. MMWR Morb Mortal Wkly Rep 2009, 58:1-14.
11. Bae W.K., Lee Y.K., Cho M.S., Ma S.K., Kim S.W., Kim N.H., et al. A case of hemolytic uremic syndrome caused by Escherichia coli O104:H4. Yonsei Med J 2006, 47:437-439.
12. Dundas S., Todd W.T., Stewart A.I., Murdoch P.S., Chaudhuri A.K., Hutchinson S.J., et al. The central Scotland Escherichia coli O157:H7 outbreak: risk factors for the hemolytic uremic syndrome and death among hospitalized patients. Clin Infect Dis 2001, 33:923-931.
13. Wong C.S., Jelacic S., Habeeb R.L., Watkins S.L., Tarr P.I. The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. N Engl J Med 2000, 342:1930-1936.
14. Bell B.P., Griffin P.M., Lozano P., Christie D.L., Kobayashi J.M., Tarr P.I. Predictors of hemolytic uremic syndrome in children during a large outbreak of Escherichia coli O157:H7 infections. Pediatrics 1997, 100:E12.
15. Murray M.D., Brater D.C. Renal toxicity of the nonsteroidal anti-inflammatory drugs. Annu Rev Pharmacol Toxicol 1993, 33:435-465.
16. Rober Kock Institute Information update on EHEC outbreak Available from:, [accessed 01.07.11]. http://www.rki.de/cln_109/nn_217400/EN/Home/PM082011.html.
17. Lin Y.L., Chou C.C., Pan T.M. Screening procedure from cattle feces and the prevalence of Escherichia coli O157:H7 in Taiwan dairy cattle. J Microbiol Immunol Infect 2001, 34:17-24.