The problems associated with identification and characterization of non-O157 verotoxin-producing Escherichia coli (VTEC) are discussed. The paradox of VTEC is that most reports of human illnesses are associated with serotypes such as O157:H7, O111:H– (nonmotile), O26:H11, and O113:H21, which are rarely found in domestic animals. However, those VTEC serotypes commonly found in domestic animals, especially ruminants, rarely cause human illnesses. When they cause human illnesses, the symptoms are similar to those caused by the serotypes E. coli O157:H7, O111:H–, O26:H11, and O113:H21. The impact of VTEC on human and animal health is also addressed. The VTEC and their toxicity are considered as a paradigm for emerging pathogens. The question on how such pathogens could arise from a basic commensal population is also addressed.
RileyLW, RemisRS, HelgersonSD, McGeeHB, WellsGJ, DavisBR, HerbertRJ, OlcottES, JohnsonLM, HargrettNT, BlakePA, CohenML. Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med308: 681685, 1983.
2.
Centers for Disease Control, and Prevention. Update: multistate outbreak of Escherichia coli O157 infections in hamburgers: Western United States 1992-1993. Morbid Mortal Wkly Rep42: 258263, 1993.
3.
WatanabeH, WadaA, InagakiY, ItohK, TamuraK. Outbreaks of enterohaemorrhagic Escherichia coli O157:H7 infection by two different genotype strains in Japan. Lancet348: 381382, 1996.
4.
MarchSB, RatnamS. Sorbitol-MacConkey medium for detection of Escherichia coli O157:H7 associated with haemorrhagic colitis. J Clin Microbiol23: 869872, 1986.
5.
BettelheimKA. Reliability of CHROMagar O157 for the detection of enterohaemorrhagic Escherichia coli (EHEC) O157 but not EHEC belonging to other serogroups. J Appl Microbiol85: 425428, 1998.
6.
BettelheimKA. Studies of Escherichia coli cultured on Rainbow agar O157 with particular reference to Enterohaemorrhagic Escherichia coli (EHEC). Microbiol Immunol42: 265269, 1998.
7.
ØrskovF, ØrskovI, VillarJA. Cattle as a reservoir of verotoxin-producing Escherichia coli O157:H7. Lancetii: 276, 1987.
8.
FengP, LampelKA, KarchH, WhittamTS. Genotypic and phenotypic changes in the emergence of Escherichia coli O157:H7. J Infect Dis177: 17501753, 1998.
9.
KonowalchukJ, SpeirsJL, StavricS. Vero response to a cytotoxin of Escherichia coli.Infect Immun18: 775779, 1977.
BettelheimKA, WilsonMW. The enterotoxigenicity of strains of Escherichia coli isolated from the faeces of healthy people and cattle. J Hyg (Camb)88: 121123, 1982.
13.
BelnapWD, O'donnellJJ. Epidemic gastroenteritis due to Escherichia coli O-111. J Pediatr47: 178193, 1955.
14.
KarmaliMA. Infection by verocytotoxin-producing Escherichia coli.Clin Microbiol Rev2: 1538, 1989.
15.
ConradiH. Ueber lösliche, durch aseptische autolyse erhaltene Gift-stoffe von Ruhr- und Typhus-Bazillen. Dtsche Med Wchschr29: 2628, 1903.
16.
NeisserM, ShigaK. Ueber freie Receptoren von Typhus- und Dysenteriebazillen und über das Dysenterietoxin. Dtsche Med Wchschr29: 6162, 1903.
17.
O'brienAD, LaVeckGD, ThompsonMR, FormalSB. Production of Shigella dysenteriae type 1-like cytotoxin by Escherichia coli.J Infect Dis146: 763769, 1982.
18.
StrockbineNA, MarquesLRM, NewlandJW, SmithHW, HolmesRK, O'brienAD. Two toxin-converting phages from Escherichia coli O157:H7 strain 933 encode antigenically distinct toxins with similar biological activities. Infect Immun53: 135140, 1986.
19.
O'brienAD, HolmesRK. Shiga and Shiga-like toxins. Microbiol Rev51: 206220, 1987.
20.
von GasserC, GautierE, SteckA, SiebenmannRE, OechslinR. Härnolytisch-urämischessyndrome: beilaterale nierenrindennekrosen bei akuten erworbenen hämolytischen anämien. Schweiz Med Wchschr85: 905909, 1955.
21.
TziporiS, WachsmuthKI, SmithersJ, JacksonC. Studies in gnotobiotic piglets on non-O157:H7 Escherichia coli serotypes isolated from patients with hemorrhagic colitis. Gastroenterology94: 590597, 1988.
ScotlandSM, RoweB, SmithHR, WillshawGA, GrossRJ. Vero cytotoxin-producing strains of Escherichia coli from children with haemolytic uraemic syndrome and their detection by specific DNA probes. J Med Microbiol25: 237243, 1988.
24.
DornCR, ScotlandSM, SmithHR, WillshawGA, RoweB. Properties of verocytotoxin-producing Escherichia coli of human and animal origin belonging to serogroups other than O157:H7. Epidemiol Infect103: 8395, 1989.
CameronS, WalkerC, BeersM, RoseN, AnearE. Enterohaemorrhagic Escherichia coli outbreak in South Australia associated with consumption of mettwurst. Comm Dis Intell19: 7071, 1995.
27.
PatonAW, RatcliffRM, DoyleMR, Seymour-MurrayJ, DavosD, LancerJA, PatonJC. Molecular microbiological investigation of an outbreak of hemolytic-uremic syndrome caused by dry fermented sausage contaminated with Shiga-like toxin-producing Escherichia coli, J Clin Microbiol34: 16221627, 1996.
28.
MorabitoS, KarchH, Mariani-KurkdjianP, SchmidtH, MinelliF, BingenE, CaprioliA. Enteroaggregative, Shiga toxin-producing Escherichia coli O111:H2 associated with an outbreak of hemolyticuremic syndrome. J Clin Microbiol36: 840842, 1998.
29.
Mariani-KurkdjianP, DenamurE, MilonA, PicardB, CaveH, Lambert-ZechovskyN, LoiratC, GoulletP, SansonettiP, ElionJ. Identification of a clone of Escherichia coli O103:H2 as a potential agent of hemolytic uremic syndrome in France. J Clin Microbiol31: 296301, 1993.
30.
TarrPI, FouserLS, StapletonAE, WilsonRA, KimHH, VaryJC, ClausenCR. Hemolytic-uremic syndrome in a six-year-old girl after a urinary tract infection with Shiga-toxin-producing Escherichia coli O103:H2. N Engl J Med335: 635638, 1996.
31.
KarchH, GeitzC, SchmidtH. Increased Incidence of Infections with EHEC O103:H2. Notiziaro dell'Istituto Superiore di Sanita10(3):2, 1997.
32.
KudohY, KaiA, ObataH, KusunokiJ, MonmaC, ShingakiM, YanagawaY, YamadaS, MtsushitaS, ItohT, OhtaK. Epidemiological Surveys on Verocytotoxin-Producing Escherichia coli Infections in Japan. In: KarmaliMA, GoglioAG, Eds. Recent Advances in Verocytotoxin-Producing Escherichia coli Infections (Excerpta Medica International Congress Series 1072). Amsterdam, The Netherlands: Elsevier Science, pp 5356, 1994.
33.
Centers for Disease Control and Prevention.Outbreak of acute gastroenteritis attributable to Escherichia coli serotype O104:H21: Helena, Montana, 1994. Morbid Mortal Wkly Rep44: 501503, 1995.
WielerLH, BusseB, SteinruckH, BeutinL, WeberA, KarchH, BaljerG. Enterohemorrhagic Escherichia coli (EHEC) strains of serogroup O118 display three distinctive clonal groups of EHEC pathogens. J Clin Microbiol38: 21622169, 2000.
36.
BettelheimKA. Biochemical studies on enterohaemorrhagic Escherichia coli (EHEC). In: KayD, FrickerC, Eds. Coliforms and E. coli Problem or Solution. Gateshead, Tyne, and Wear, UK: Royal Society of Chemistry, Atheneum Press, pp 243248, 1997.
37.
BeutinL, MontenegroMA, ØrskovI, ØrskovF, PradaJ, ZimmermannS, StephanR. Close association of verocytotoxin (Shiga-like toxin) production with enterohemolysin production in strains of Escherichia coli.J Clin Microbiol27: 25592564, 1989.
38.
BettelheimKA. Identification of enterohaemorrhagic Escherichia coli by means of their production of enterohaemolysin. J Appl Bacteriol79: 178180, 1995.
39.
BettelheimKA. A spectrum of verocytotoxigenic Escherichia coli.J Med Microbiol47: 10371038, 1998.
40.
BettelheimKA. Enterohaemorrhagic Escherichia coli O157:H7: a red herring?J Med Microbiol50: 201202, 2001.
41.
LehmacherA, MeierH, AleksicS, BockemühlJ. Detection of hemolysin variants of Shiga toxin-producing Escherichia coli by PCR and culture on vancomycin-cefixime-cefsulodin blood agar. Appl Environ Microbiol64: 24492453, 1998.
42.
HornitzkyMA, BettelheimKA, DjordjevicSP. The detection of Shiga toxin-producing Escherichia coli in diagnostic bovine faecal samples using vancomycin-cefixime-cefsulodin blood agar and PCR. FEMS Microbiol Lett198: 1722, 2001.
AchesonDWK, KeuschGT, LightowlersM, Donohue-RolfeA. Enzyme-linked immunosorbent assay for Shiga toxin and Shiga-like toxin II using P1 glycoprotein from hydatid cysts. J Infect Dis161: 134137, 1990.
45.
ChartH, WillshawGA, CheastyT. Evaluation of a reversed passive latex agglutination test for the detection of verocytotoxin (VT) expressed by strains of VT-producing Escherichia coli.Lett Appl Microbiol32: 370374, 2001.
46.
BettelheimKA. Development of a rapid method for the detection of verocytotoxin-producing Escherichia coli (VTEC). Lett Appl Microbiol33: 3135, 2001.
47.
BastianSN, Carle1, GrimontF. Comparison of 14 PCR systems for the detection and subtyping of stx genes in Shiga-toxin-producing Escherichia coli.Res Microbiol149: 457472, 1998.
48.
PatonAW, PatonJC, GoldwaterPN, ManningPA. Direct detection of Escherichia coli Shiga-like toxin genes in primary fecal cultures by polymerase chain reaction. J Clin Microbiol31: 30633067, 1993.
49.
FaganPK, HornitzkyMA, BettelheimKA, DjordjevicSP. Detection of Shiga-like toxin (stx1 and stx2), intimin (eaeA), and enterohemorhagic Escherichia coli (EHEC) hemolysin EHEC hlyA) genes in animal feces by multiplex PCR. Appl Environ Microbiol65: 868872, 1999.
50.
BeutinL, GeierD, SteinrückH, ZimmermannS, ScheutzF. Prevalence and some properties of verotoxin (Shiga-like toxin)-producing Escherichia coli in seven different species of healthy domestic animals. J Clin Microbiol31: 24832488, 1993.
51.
KudvaIT, HatfieldPG, HovdeCJ. Characterization of Escherichia coli O157:H7 and other Shiga toxin-producing E. coli serotypes isolated from sheep. J Clin Microbiol35: 892899, 1997.
52.
Sidjabat-TambunanH, BensinkJ. Verotoxin-producing Escherichia coli from faeces of sheep, calves and pigs. Aust Vet J75: 292293, 1997.
53.
KobayashiH, ShimadaJ, NakazawaM, MorozumiT, PohjanvirtaT, PelkonenS, YamamotoK. Prevalence and characteristics of Shiga toxin-producing Escherichia coli from healthy cattle in Japan. Appl Environ Microbiol67: 484489, 2001.
54.
StephanR, HoelzleLE. Characterization of Shiga toxin type 2 variant B-subunit in Escherichia coli strains from asymptomatic human carriers by PCR-RFLP. Lett Appl Microbiol31: 139142, 2000.
55.
StephanR, RagettliS, UntermannF. Prevalence and characteristics of verotoxin-producing Escherichia coli (VTEC) in stool samples from asymptomatic human carriers working in the meat processing industry in Switzerland. J Appl Microbiol88: 335341, 2000.
56.
DjordjevicSP, HornitzkyMA, BaileyG, GillP, VanselowB, WalkerK, BettelheimKA. Virulence properties and serotypes of Shiga toxin-producing Escherichia coli from healthy Australian slaughter-age sheep. J Clin Microbiol39: 20172021, 2001.
57.
PradelN, BoukhorsK, BertinY, ForestierC, MartinC, LivrelliV. Heterogeneity of Shiga toxin-producing Escherichia coli strains isolated from hemolytic-uremic syndrome patients, cattle, and food samples in central France. Appl Environ Microbiol67: 24602468, 2001.
58.
RamachandranV, HornitzkyMA, BettelheimKA, WalkerMJ, DjordjevicSP. The common ovine Shiga toxin 2-containing Escherichia coli serotypes and human isolates of the same serotypes possess a Stx2d toxin type. J Clin Microbiol39: 19321937, 2001.
59.
PiérardD, StevensD, MoriauL, LiorH, LauwersS. Isolation and virulence factors of verocytotoxin-producing Escherichia coli in human stools. Clin Microbiol Infect3: 531540, 1997.
60.
SperandioV, KaperJB, BortoliniMR, NevesBC, KellerR. Trabulsi LR. Characterization of the locus of enterocyte effacement (LEE) in different enteropathogenic Escherichia coli (EPEC) and Shiga-toxin producing Escherichia coli (STEC) serotypes. FEMS Microbiol Lett164: 133139, 1998.
61.
PatonAW, SrimanoteP. Woodrow MC, Paton JC. Characterization of Saa, a novel autoagglutinating adhesin produced by locus of enterocyte effacement-negative Shiga-toxigenic Escherichia coli strains that are virulent for humans. Infect Immun69: 69997009, 2001.
62.
MitsuokaT, HayakawaK. Die Faecalflora bei Menschen. I. Mitteilung: Die Zusammensetzung der Faecalflora der verschiedenen Altersgruppen. Zb1 Bakt Parasit Hyg I Abt Orig A223: 333342, 1972.
63.
BettelheimKA, Lennox-KingSMJ. The acquisition of Escherichia coli by newborn babies. Infection4: 174179, 1976.
64.
ShooterRA, BettelheimKA, Lennox-KingSMJ, O'farrellS. Escherichia coli serotypes in the faeces of healthy adults over a period of several months. J Hyg (Camb)78: 9598, 1977.
65.
BettelheimKA, FaiersM, ShooterRA. Serotypes of Escherichia coli in normal stools. Lancetii: 12241226, 1972.
66.
NiemiRM, NiemiJS. Bacterial pollution of waters in pristine and agricultural lands. J Environ Qual20: 620627, 1991.
67.
BrayJ. Isolation of antigenically homogeneous strains of Bact. coli neapolitanum from summer diarrhea of infants. J Pathol Bacteriol63: 239247, 1945.
68.
RoweB, TaylorJ, BettelheimKA. An investigation of travelers' diarrhea. Lanceti: 15, 1970.
69.
CaprioliA, FalboV, RuggeriFM, BisichiaR, CasalinoM, DonelliG. Comparison among enterotoxigenic strains of Escherichia coli isolated in Italy and Somalia. Eur J Epidemiol4: 251255, 1988.
70.
BettelheimKA, CookeEM, O'farrellSM, ShooterRA. The effect of diet on intestinal Escherichia coli.J Hyg (Camb)79: 4345, 1977.
71.
MajedNI, BettelheimKA, ShooterRA, MoorhouseE. The effect of travel on faecal Escherichia coli serotypes. J Hyg (Camb)8: 481487, 1978.
72.
BettelheimKA. The isolation of Escherichia coli from a sheep slaughtering line in an abattoir. Comp Immun Microbiol Infect Dis4: 93100, 1981.
73.
GoldwaterPN, BettelheimKA. Escherichia coli O group serology of an haemolytic uraemic syndrome (HUS) epidemic. Scand J Infect Dis32: 385394, 2000.
74.
TeshVL, BurrisJA, OwensJW, GordonVM, WadolkowskiEA, O'brienAD, SamuelJE. Comparison of the relative toxicities of Shiga-like toxin type I and type II for mice. Infect Immun61: 33923402, 1993.
75.
BettelheimKA. Ecology of verotoxigenic Escherichia coli.Aust Vet J75: 912, 1997.
76.
BielaszewskaM, JandaJ, BlahovaK, FeberJ, PotuzníkV, SouckovaA. Verocytotoxin-producing Escherichia coli in children with hemolytic uremic syndrome in the Czech Republic. Clin Nephrol46: 4244, 1996.
77.
BockemühlJ, AleksicS, KarchH. Serological and biochemical properties of Shiga-like toxin (Verotoxin)-producing strains of Escherichia coli, other than O-group 157, from patients in Germany. Zbl Bakt276: 189195, 1992.
78.
BielaszewskaM, JandaJ, BlahovaK, SrámkovaL, HavlíkJ, PotuzníkV. Verocytotoxin-producing Escherichia coli in children with hemolytic uremic syndrome and diarrhea in the Czech Republic. In: KarmaliMA, GoglioAG, Eds. Recent Advances in Verocytotoxin-Producing Escherichia coli Infections (Excerpta Medica International Congress Series 1072). Amsterdam, The Netherlands: Elsevier Science, pp 3740, 1994.
79.
BlancoM, BlancoJE, BlancoJ, MoraA, PradoC, AlonsoMP, MourinoM. Madrid C, Balsalobre C, Juarez AV. Distribution and characterization of faecal verotoxin-producing Escherichia coli (VTEC) isolated from healthy cattle. Vet Microbiol54: 309319, 1997.
80.
BoketeTN, WhittamTS, WilsonRA, ClausenCR, OcallahanCM, MoseleySL, FritscheTR, TarrPI. Genetic and phenotypic analysis of Escherichia coli with enteropathogenic characteristics isolated from Seattle children. J Infect Dis175: 13821389, 1997.
81.
BrooksHJL. Bettelheim KA, Todd B, Holdaway MD. Non-O157 vero cytotoxin producing Escherichia coli: aetiological agents of diarrhoea in children in Dunedin. New Zealand Comp Immun Microbiol Infect Dis20: 163170, 1997.
82.
BeutinL, ZimmermannS, GleierK. Human infections with Shiga toxin-producing Escherichia coli other than serogroup O157 in Germany. Emerg Infect Dis4: 635639, 1998.
83.
ClarkeRC, WilsonJB, ReadSC, RenwickS, RahnK, JohnsonRP, AlvesD, KarmaliMA, LiorH, McEwenSA, SpikaJ, GylesCL. Verocytotoxin-producing Escherichia coli (VTEC) in the food chain: preharvest and processing perspectives. In: KarmaliMA, GoglioAG, Eds. Recent Advances in Verocytotoxin-Producing Escherichia coli Infections (Excerpta Medica International Congress Series 1072). Amsterdam, The Netherlands: Elsevier Science, pp 1724, 1994.
84.
CaprioliA, LuzziI. VT2-producing E. coli O26:H11. Notiziaro dell'Istituto Superiore di Sanita8: 4, 1995.
85.
CzirokE, HerpayM. National surveillance of VTEC infection (Hungary). Notiziaro dell'Istituto Superiore di Sanita8: 2, 1995.
86.
CobboldR, DesmarchelierP. A longitudinal study of Shiga-toxigenic Escherichia coli (STEC) prevalence in three Australian dairy. Vet Microbiol71: 125137, 2000.
87.
DornCR, FrancisDH, AngrickEJ, WilgohsJA, WilsonRA, CollinsJE, JenkeBH, ShawdSJ. Characteristics of verocytotoxin-producing Escherichia coli associated with intestinal colonization and diarrhea in calves. Vet Microbiol36: 149159, 1993.
88.
EnamiM, NakasoneN, HonmaY, KakinohanaS, KudakaJ, IwanagaM. Expression of type I pili is abolished in verotoxin-producing Escherichia coli O157. FEMS Microbiol Lett179: 467472, 1999.
89.
FeyPD, WickertRS, RuppME, SafranekTJ, HinrichsSH. Prevalence of non-O157:H7 Shiga toxin-producing Escherichia coli in diarrheal stool samples from Nebraska. Emerg Infect Dis6: 530533, 2000.
90.
GoldwaterPN, BettelheimKA. The role of enterohaemorrhagic E. coli serotypes other than O157:H7 as causes of disease. In: KarmaliMA, GoglioAG, Eds. Recent Advances in Verocytotoxin-Producing Escherichia coli Infections (Excerpta Medica International Congress Series 1072). Amsterdam, The Netherlands: Elsevier Science, pp 5760, 1994.
91.
GiammancoA, MaggioM, GiammancoG, MorelliR, MinelliF, ScheutzF, CaprioliA. Characteristics of Escherichia coli strains belonging to enteropathogenic E. coli serogroups isolated in Italy from children with diarrhea. J Clin Microbiol34: 689694, 1996.
92.
FarinaC, GoglioA, ConederaG, MinelliF, CaprioliA. Antimicrobial susceptibility of Escherichia coli O157 and other enterohaemorrhagic Escherichia coli isolated in Italy. Eur J Clin Microbiol Infect Dis15: 351353, 1996.
93.
HuppertzHI, RutkowskiS, BuschDH, EisebitR, LissnerR, KarchH. Bovine colostrum ameliorates diarrhea in infection with diarrheagenic Escherichia coli, Shiga toxin-producing E. coli, and E. coli expressing intimin and hemolysin. J Pediatr Gastroenteriol Nutr29: 452456, 1999.
94.
KeskimäkiM, SaariM, HeiskanenT, SiitonenA. Shiga toxin-producing Escherichia coli in Finland from 1990 through 1997: prevalence and characteristics of isolates. J Clin Microbiol36: 36413646, 1998.
95.
LudwigK, PetricM, BlanchetteV, KarmaliM. Isolated thrombocytopenic purpura associated with infection due to verocytotoxin (Shiga toxin)-producing Escherichia coli serotype O26:H11. Clin Infect Dis27: 660661, 1998.
96.
MackenzieAMR, LebelP, OrrbineE. Rowe PC, Hyde L, Chan F, Johnson W, McLaine PN. Sensitivities and specificities of premier E. coli O157 and premier EHEC enzyme immunoassays for diagnosis of infection with verotoxin (Shiga-like toxin)-producing Escherichia coli.J Clin Microbiol36: 16081611, 1998.
97.
MengJH, ZhaoSH, DoyleMP. Virulence genes of Shiga toxin-producing Escherichia coli isolated from food, animals and humans. Int J Food Microbiol45: 229235, 1998.
98.
MiyamotoH. Statistical and Epidemiological Analyses on Food Poisonings and Infections and Applications by Microbiological Analyses, Project Research on Application of DNA and Phage Typing, etc. as Epidemiological Markers and Development of New Rapid Typings in Big Outbreak of Bacterial Food Poisonings. National Reports on “Emerging and Reemerging Infectious Diseases” 1997-1999; Ministry of Health and Welfare, Japan, 2000.
99.
PiérardD, StevensD, MoriauL, LiorH, LauwersS. Three years PCR screening for VTEC in human stools in Brussels. In: KarmaliMA, GoglioAG, Eds. Recent Advances in Verocytotoxin-Producing Escherichia coli Infections (Excerpta Medica International Congress Series 1072). Amsterdam, The Netherlands: Elsevier Science, pp 3336, 1994.
100.
PradelN, LivrelliV, De ChampsC, PalcouxJB, ReynaudA, ScheutzF, SirotJ, JolyB, ForestierC. Prevalence and characterization of Shiga toxin-producing Escherichia coli isolated from cattle, food, and children during a one-year prospective study in France. J Clin Microbiol38: 10231031, 2000.
101.
ReadSC, ClarkeRC, MartinA, De GrandisSA, HiiJ, GylesCL. Polymerase chain reaction for detection of verocytotoxigenic Escherichia coli isolated from animal and food sources. Mol Cell Probes6: 153161, 1992.
102.
SmithHR, ScotlandSM, WillshawGA, WrayC, McLarenIM, CheastyT, RoweB. Verocytotoxin production and the presence of VT genes in Escherichia coli strains of animal origin. J Gen Microbiol134: 829834, 1988.
103.
ScheutzF. VTEC isolated from Danish patients, 1986-1994. Notiziaro dell'Istituto Superiore di Sanita8: 3, 1995.
104.
SandhuKS, ClarkeRC, McFaddenK, BrouwerA, LoouieM, WilsonJ, LiorH, GylesCL. Prevalence of the eaeA gene in verotoxigenic Escherichia coli strains from dairy cattle in Southwest Ontario. Epidemiol Infect116: 17, 1996.
105.
SchmidtH, von MaldeghemJ, FroschM, KarchH. Antibiotic susceptibilities of verocytotoxin-producing Escherichia coli O157 and non-O157 strains isolated from patients and healthy subjects in Germany during 1996. Antimicrob Chemother42: 548550, 1998.
106.
SandhuKS, ClarkeRC, GylesCL. Virulence markers in Shiga toxin-producing Escherichia coli isolated from cattle. Can J Vet Res63: 177184, 1999.
107.
SchmidtH, GeitzC, TarrPI, FroschM, KarchH. Non-O157:H7 pathogenic Shiga toxin-producing Escherichia coli: phenotypic and genetic profiling of virulence traits and evidence for clonality. J Infect Dis179: 115123, 1999.
108.
SchurmanRD, HariharanH, HeaneySB, RahnK. Prevalence and characteristics of Shiga toxin-producing Escherichia coli in beef cattle slaughtered on Prince Edward Island. J Food Protect63: 15831586, 2000.
109.
TamuraK, SakazakiR, MuraseM, KosakoY. Serotyping and categorisation of Escherichia coli strains isolated between 1958 and 1992 from diarrhoeal diseases in Asia. J Med Microbiol45: 353358, 1996.
110.
ThomasA, CheastyT, FrostJA, ChartH, SmithHR, RoweB. Vero cytotoxin producing Escherichia coli, particularly serogroup O157, associated with human infections in England and Wales: 1992-1994. Epidemiol Infect117: 110, 1996.
WellsJG, ShipmanLD, GreeneKD, SowersEG, GreenJH, CameronDN, DownesFP, MartinML, GriffinPM, OstroffSM, PotterME, TauxeRV, WachsmuthIK. Isolation of Escherichia coli O157:H7 and other Shiga-like toxin-producing E. coli from dairy cattle. J Clin Microbiol29: 985989, 1991.
113.
WielerLH, VielerE, ErpensteinC, SchlappT, SteinrückH, BauerfeindR, ByomiA, BaljerG. Shiga toxin-producing Escherichia coli strains from bovines: association of adhesion with carriage of eae and other genes. J Clin Microbiol34: 29802984, 1996.
VerweyenHM, KarchH, AllerbergerF, ZimmerhacklLB. Enterohemorrhagic Escherichia coli (EHEC) in pediatric hemolytic-uremic syndrome: A prospective study in Germany and Austria. Infection27: 341347, 1999.
PiérardD, EtterijckR, van BreynaertJ, MoriauL, LauwersS. Results of screening for verocytotoxin-producing Escherichia coli in faeces in Belgium. Europ J Clin Microbiol Infect Dis9: 198201, 1990.
118.
PryorW, HodsonH, McIntyreP, BettelheimKA. Toxigenic Escherichia coli in uraemic haemolytic syndrome. Med J Aust152: 221222, 1990.
119.
AllerbergerF, RossbothD, DierichMP, AleksicS, SchmidtH, KarchH. Prevalence and clinical manifestations of Shiga toxin-producing Escherichia coli infections in Austrian children. Eur J Clin Microbiol Infect Dis15: 545550, 1996.
120.
BanatvalaN, DebeukelaerMM, GriffinPM, BarrettTJ, GreeneKD, GreenJH, WellsJG. Shiga-like toxin producing Escherichia coli O111 and associated hemolytic-uremic syndrome: a family outbreak. Pediatr Infect Dis J15: 10081011, 1996.
121.
HuppertzHI, BuschD, SchmidtH, AleksicS, KarchH. Diarrhea in young children associated with Escherichia coli non-O157 organisms that produce Shiga-like toxin. J Pediatr128: 341346, 1996.
122.
ParkCH, GatesKM, VandelNM, HixonDL. Isolation of Shiga-like toxin producing Escherichia coli (O157 and non-O157) in a community hospital. Diag Microbiol Infect Dis26: 6972, 1996.
StrockbineN, SowersE, GreeneK, HayesP, GriffinP, WellsJ. Characterization of Shiga toxin-producing non-O157 Escherichia coli from the United States, 1983–1997 [abstract]. VTEC '97 3rd International Symposium and Workshop on Shiga Toxin (Verocytotoxin)-Producing Escherichia coli Infections. Baltimore (MD): Lois Joy Galler Foundation for Hemolytic Uremic Syndrome, Inc.; 1997. p 67. Abstract nr 235/111.
125.
AsakuraH, MakinoS, ShirahataT, TsukamotoT, KurazonoH, IkedaT, TakeshiK. Detection and genetical characterization of Shiga toxin-producing Escherichia coli from wild deer. Microbiol Immun42: 815822, 1998.
126.
GallienP, KarchH, MuchC, SteinruckH, LehmannS, TimmM, RichterH, PerlbergKW, ProtzD. Subtyped eae-genes in Shiga toxin-producing Escherichia coli (STEC): occurrence in raw or undercooked food samples and comparison of isolates from faecal samples and stool samples. Fleischwirtschaft80: 8489, 2000.
127.
HornitzkyMA, BettelheimKA, DjordjevicSP. The isolation of enterohaemorrhagic Escherichia coli O111:H− from Australian cattle. Aust Vet J78: 636637, 2000.
128.
HallGA, ChanterN, BlandAP. Comparison in gnotobiotic pigs in lesions caused by verotoxigenic and non-verotoxigenic Escherichia coli.Vet Pathol25: 205210, 1985.
129.
WillshawGA, ScotlandSM, SmithHR, RoweB. Properties of verocytotoxin-producing Escherichia coli of human origin of O groups other than O157. J Infect Dis166: 797802, 1992.
130.
WillshawGA, SmithHR, RobertsD, ThirlwellJ, CheastyT, RoweB. Examination of raw beef products for the presence of verocytotoxin-producing Escherichia coli, particularly those of serogroup O157. J Appl Bacteriol. 75: 420426, 1993.
131.
WilsonJB, ClarkeRC, RenwickSA, RahnK, JohnsonD, AlvesD, KarmaliMA, LiorH, McEwenSA, SpikaJ. Verocytotoxigenic Escherichia coli infection on dairy farms in Southern Ontario. In: KarmaliMA, GoglioAG, Eds. Recent Advances in Verocytotoxin-Producing Escherichia coli Infections (Excerpta Medica International Congress Series 1072). Amsterdam, The Netherlands: Elsevier Science, pp 6164, 1994.
132.
Sidjabat-TambunanH, BensinkJ, BettelheimKA. Isolation of verocytotoxin-producing Escherichia coli from mutton carcasses. Aust Vet J76: 364365, 1998.
133.
StarrM, Bennett-WoodV, BighamAK, Dekoning-WardTP, BordunAM, LightfootD, BettelheimKA, JonesCL, Robins-BrowneRM. Hemolytic-uremic syndrome following urinary tract infection with enterohemorrhagic Escherichia coli: case report and review. Clin Infect Dis27: 310315, 1998.
134.
ToddECD, SzaboRA, MacKenzieJM, MartinA, RahnK, GylesC, GaoA, AlvesD, YeeAJ. Application of a DNA hybridizationhydrophobic-grid membrane filter method for detection and isolation of verotoxigenic Escherichia coli.Appl Environ Microbiol65: 47754780, 1999.
PiérardD, Van DammeL, StevensD, MoriauL, LauwersS. Detection of verocytotoxin-producing Escherichia coli in meat in Belgium. In: KarmaliMA, GoglioAG, Eds. Recent Advances in Verocytotoxin-Producing Escherichia coli Infections (Excerpta Medica International Congress Series 1072). Amsterdam, The Netherlands: Elsevier Science, pp 7780, 1994.
137.
BeutinL, GeierD, ZimmermannS, AleksicS, GillespieHA, WhittamTS. Epidemiological relatedness and clonal types of natural populations of Escherichia coli strains producing Shiga toxins in separate populations of cattle and sheep. Appl Environ Microbiol63: 21752180, 1997.
138.
BlancoM, BlancoJE, GonzalezEA, MoraA, JansenW, GomesTAT, ZerbiniLF, YanoT, DecastroAFP, BlancoJ. Genes coding for enterotoxins and verotoxins in porcine Escherichia coli strains belonging to different O:K:H serotypes: relationship with toxic phenotypes. J Clin Microbiol35: 29582963, 1997.
139.
GallienP, RichterH, KlieH, TimmM, KarchH, PerlbergKW, SteinrückH, RiemerS, DjurenM, ProtzD. Detection of STEC and epidemiological investigations in surrounding of a HUS patient. Berlin Münch Tierarzt Wchscht110: 342346, 1997.
140.
RichterH, KlieH, TimmM, GallienP, SteinruckH, PerlbergKW, ProtzD. Verotoxin-producing E. coli (VTEC) in faeces from cattle slaughtered in Germany. Berlin München Tierarzt Wchsch110: 121127, 1997.
BakerM, BennettJ, NicolC. Emergence of verotoxigenic Escherichia coli (VTEC) in New Zealand. New Zealand Publ Hlth Rpt6: 912, 1999.
143.
GallienP, MuchC, PerlbergKW, ProtzD. Subtyping of stx-genes in Shiga toxin-producing Escherichia coli (STEC): presence in raw foods and correlation to other factors. Fleischwirtschaft79: 99103, 1999.
144.
McCluskeyBJ, RiceDH, HancockDD, HovdeCJ, BesserTE, GrayS, JohnsonRP. Prevalence of Escherichia coli O157 and other Shiga toxin-producing E. coli in lambs at slaughter. J Vet Diag Invest11: 563565, 1999.
145.
TimmM, KlieH, RichterH, GallienP, PerlbergKW, LehmannS, ProtzD. Detection and prevalence of verotoxin-producing Escherichia coli (VTEC) in raw sausages. Berlin Münch Tierarzt Wchscht112: 385389, 1999.
146.
TokhiAM, PeirisJSM, ScotlandSM, WillshawGA, SmithHR, RobertsD, CheastyT. A longitudinal study of verocytotoxin-producing Escherichia coli cattle calves in Sri Lanka. Epidemiol Infect110: 197208, 1993.
147.
AsakuraH, MakinoS, ShirahataT, TsukamotoT, KurazonoH, IkedaT, TakeshiK. Detection and long-term existence of Shiga toxin (Stx)-producing Escherichia coli in sheep. Microbiol Immun42: 683688, 1998.
148.
MiyaoY, KataokaT, NomotoT, KaiA, ItohT, ItohK. Prevalence of verotoxin-producing Escherichia coli harbored in the intestine of cattle in Japan. Vet Microbiol61: 137143, 1998.
149.
HeuvelinkAE, WernarsK, de BoerE. Occurrence of Escherichia coli O157 and other verocytotoxin-producing E. coli in retail raw meats in The Netherlands. J Food Protect59: 12671272, 1996.
150.
StephanR, KühnK. Prevalence of verotoxin-producing Escherichia coli (VTEC) in bovine coli mastitis and their antibiotic resistance patterns. Zbl Veterinärm B46: 423427, 1999.
151.
BettelheimKA, BowdenDS, DoultreeJC, CattonMG, ChiboD, RyanNJP, WrightPJ, GunesekereIC, GriffithJM, LightfootD, HoggGG, Bennett-WoodV, MarshallJA. Combined infection of Norwalk-like virus and verotoxin-producing bacteria associated with a gastroenteritis outbreak. J Diarrh Dis Res17: 3436, 1999.
152.
BettelheimKA, BrownJE, LolokhaS, EcheverriaP. Serotypes of Escherichia coli that hybridized with DNA probes for genes encoding Shiga-like Toxin I, Shiga-like Toxin II and serogroup O157 enterohemorrhagic E. coli fimbriae isolated from adults with diarrhea in Thailand. J Clin Microbiol28: 293295, 1990.
153.
SuthienkulO, BrownJE, SeriwatanaJ, TienthongdeeS, SastravahaS, EcheverriaP. Shiga-like-toxin producing Escherichia coli in retail meats and cattle in Thailand. Appl Environ Microbiol56: 11351139, 1990.
154.
ThomasA, ChartH, CheastyT, SmithHR, FrostJA, RoweB. Verocytotoxin-producing Escherichia coli particularly serogroup O157 associated with human infections in the United Kingdom. Epidemiol Infect110: 591600, 1993.
155.
CerqueiraAMF, TibanaA, GuthBEC. High occurrence of Shiga-like toxin-producing Escherichia coli isolated from raw beef products in Rio de Janeiro City. Brazil J Food Protect60: 177180, 1997.
156.
KlieH, TimmM, RichterH, GallienP, PerlbergKW, SteinrückH. Detection and occurrence of verotoxin-forming and/or Shiga toxinforming Escherichia coli (VTEC and/or STEC) in milk. Berlin Münch Tierarzt Wchscht110: 337341, 1997.
157.
BeutinL, MüllerW. Cattle and verotoxigenic Escherichia coli (VTEC), an old relationship. Vet Rec142: 283284, 1998.
158.
GoldwaterPN, GilesN, BettelheimKA. An unusual case of microangiopathic haemolytic anaemia associated with enterohaemorrhagic Escherichia coli O113:H21 infection, a verocytotoxin-2/Shiga toxin-2 producing serotype. J Infect37: 302304, 1998.
159.
RahnK, RenwickSA, JohnsonRP, WilsonJB, ClarkeRC, AlvesD, McEwenSA, LiorH, SpikaJ. Follow-up study of verocytotoxigenic Escherichia coli infection in dairy farm families. J Infect Dis177: 11391140, 1998.
160.
HashimotoH, MizukoshiK, NishiM, KawakitaT, HasuiS, KatoY, UenoY, TakeyaR, OkudaN, TakedaT. Epidemic of gastrointestinal tract infection including hemorrhagic colitis attributable to Shiga toxin 1-producing Escherichia coli O118:H2 at a junior high school in Japan. Pediatrics103: E21E25, 1999.
161.
PatonAW, WoodrowMC, DoyleMR, LanserJA, PatonJC. Molecular characterization of a Shiga toxigenic Escherichia coli O113:H21 strain lacking eae responsible for a cluster of cases of hemolytic-uremic syndrome. J Clin Microbiol37: 33573361, 1999.
162.
StephanR, UntermannF. Virulence factors and phenotypical traits of verotoxin-producing Escherichia coli strains isolated from asymptomatic human carriers. J Clin Microbiol37: 15701572, 1999.
