Epidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany.

@article{Frank2011EpidemicPO,
  title={Epidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany.},
  author={Christina Frank and Dirk Werber and Jakob P Cramer and Mona Askar and Mirko Faber and Matthias an der Heiden and Helen Bernard and Angelika Fruth and Rita Prager and Anke Spode and Maria Wadl and Alexander Zoufaly and Sabine Jordan and Markus J. Kemper and Per Follin and Luise M{\"u}ller and Lisa A. King and Bettina M Rosner and Udo Buchholz and Klaus Stark and G{\'e}rard Krause},
  journal={The New England journal of medicine},
  year={2011},
  volume={365 19},
  pages={
          1771-80
        }
}
BACKGROUND We describe an outbreak of gastroenteritis and the hemolytic-uremic syndrome caused by Shiga-toxin-producing Escherichia coli in Germany in May, June, and July, 2011. The consumption of sprouts was identified as the most likely vehicle of infection. METHODS We analyzed data from reports in Germany of Shiga-toxin-producing E. coli gastroenteritis and the hemolytic-uremic syndrome and clinical information on patients presenting to Hamburg University Medical Center (HUMC). An outbreak… 

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The findings suggest that horizontal genetic exchange allowed for the emergence of the highly virulent Shiga-toxin-producing enteroaggregative E. coli O104:H4 strain that caused the German outbreak, and highlight the way in which the plasticity of bacterial genomes facilitates the emerged of new pathogens.
Similarity of Shiga Toxin–producing Escherichia coli O104:H4 Strains from Italy and Germany
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It is found that an STEC strain (ED-703) from a case-patient with HUS in 2009 in Italy had the same combination of virulence factors as the strain from Germany: Stx2 production and enteroaggregative adhesion genetic markers.
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