Brazilian Journal of Microbiology Brazilian Journal of Microbiology
Braz J Microbiol 2018;49:936-41 - Vol. 49 Num.4 DOI: 10.1016/j.bjm.2018.02.013
Short communication
Shigatoxigenic and atypical enteropathogenic Escherichia coli in fish for human consumption
Marita Vedovelli Cardozoa,, , Clarissa Araújo Borgesa, Lívia Gerbasi Beraldoa, Renato Pariz Malutab, Andressa Souza Polloa, Mariana Monezi Borzia, Luis Fernando dos Santosc, Subhashinie Kariyawasamd, Fernando Antônio de Ávilaa
a Universidade Estadual Paulista (UNESP), Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal, SP, Brazil
b Universidade Estadual de Campinas (UNICAMP), Instituto de Biologia, Campinas, SP, Brazil
c Instituto Adolfo Lutz, Centro de Bacteriologia, São Paulo, SP, Brazil
d Pennsylvania State University, College of Agricultural, State College, PA, United States
Received 29 September 2017, Accepted 28 February 2018
Abstract

Shigatoxigenic and enteropathogenic Escherichia coli with virulence and multidrug resistance profile were isolated from Nile tilapia. This study finding is of great importance to public health because they help understand this pathogen epidemiology in fish and demonstrate how these animals can transmit E. coli related diseases to humans.

Keywords
EPEC, Fish, MLST, STEC, Virulence genes

Escherichia coli (E. coli) is not a natural inhabitant of the fish microbiota, nevertheless, it can be isolated from these animals gut due to its presence in contaminated aquatic environments.1 It is worth noticing that this microorganism have pathogenic strains standing out as emerging zoonotic potential, as well as shigatoxigenic (STEC) and enteropathogenic (EPEC) E. coli. STEC strains produce the shiga toxin (Stx), which is its main virulence factor. There are two classes of shiga toxin, Stx1 and Stx2, with the last one presenting seven subtypes.2 The EPEC may be either typical or atypical, with the atypical strains do not carrying virulence factor that encodes the bundle-forming pilus (bfp), but it carries the eae gene, that is located at the locus of enterocyte effacement (LEE), which is a pathogenicity island, that promote attaching and effacing lesions (A/E). The ability to induce A/E lesions is mediated by genes located on the LEE, as well as additional ones that are outside of it.3

Several studies have analyzed STEC and EPEC, and their virulence in humans,4 cattle,5 sheep,6 pigs,7 and buffaloes.8 However, only a few studies have analyzed the presence of STEC and EPEC in fish9,10 and, of these, none has detected presence of adhesion and ESBL genes. In addition, none has performed the stx2 subtyping in STEC strains from fish. In this regard, this pioneer study aimed to compare the prevalence of STEC and EPEC strains in intensively farmed fish and free-living fish; as well as to detect their virulence and antibiotic resistant profile and analyze their genetic similarity looking for how these fishes contribute to humans infections.

The Ethics Committee on Animal Use (CEUA) approved this study under the protocol number 04076/14. Primers used are described in Table 1. The samples were collected from the fish species Oreochromis niloticus, from six different fish farms and three ranches located at northeast region of Sao Paulo state. A total of 472 samples were collected. Three hundred and seventy three (373) samples were obtained from fish farm animals and of these, 275 were from stools, 80 from muscles and 18 from the nurseries water. The other 99 samples were obtained from free-living fish, these been 90 from stools and nine from the river water. Samples were transferred to tubes containing BHI broth (Brain Heart Infusion) and after an incubation period, the DNA were extracted by thermal lysis according to Borges.7

Table 1.

Information about the primers used in PCR reactions.

Primers  Sequences  Size  Reference 
stx1-F  AGAGCGATGTTACGGTTTG  388  32 
stx1-R  TTGCCCCCAGAGTGGATG     
stx2-F  TGGGTTTTTCTTCGGTATC  807  32 
stx2-R  GACATTCTGGTTGACTCTCTT     
eae -F  AGGCTTCGTCACAGTTG  570  32 
eae -R  CCATCGTCACCAGAGGA     
bfpA -GGAAGTCAAATTCATGGGGGTAT  300  33 
bfpA -R  GGAATCAGACGCAGACTGGTAGT     
ehxA -F  GGTGCAGCAGAAAAAGTTGTA G  340  34 
ehxA -R  TCTCGCCTGATAGTGTTTGGT A     
saa-CGTGATGAACAGGCTATTGC  119  17 
saa -R  ATGGACATGCCTGTGGCAAC     
iha -F  CAGTTCAGTTTCGCATTCACC  1305  35 
iha -R  GTATGGCTCTGATGCGATG     
toxB -F  ATACCTACCTGCTCTGGATTGA  602  36 
toxB -R  TTCTTACCTGATCTGATGCAGC     
efa1- F  GAGACTGCCAGAGAAAG  479  37 
efa1-R  GGTATTGTTGCATGTTCAG     
lpfAO113- F  ATGAAGCGTAATATTATAG  573  38 
lpfAO113- R  TTATTTCTTATATTCGAC     
lpfAO157/OI-141-F  CTGCGCATTGCCGTAAC  412  39 
lpfAO157/OI-141-R  ATTTACAGGCGAGATCGTG     
lpfAO157/OI-154-GCAGGTCACCTACAGGCGGC  525  34 
lpfAO157/OI-154-CTGCGAGTCGGCGTTAGCTG     
astA -TCGGATGCCATCAACACAGT  125  24 
astA-R  GTCGCGAGTGACGGCTTTGTAG     
paa -F  ATGAGGAACATAATGGCAGG  360  23 
paa-R  TCTGGTCAGGTCGTCAATAC     
CTX-M group 1- F  TTAGGAARTGTGCCGCTGYA  668  11 
CTX-M group 1- R  CGATATCGTTGGTGGTRCCAT     
CTX-M group 2 - F  CGTTAACGGCACGATGAC  404  11 
CTX-M group 2 - R  CGATATCGTTGGTGGTRCCAT     
CTX-M group 8/25 F  AACRCRCAGACGCTCTAC  326  11 
CTX-M group 8/25R  TCGAGCCGGAASGTGTYAT     
CTX-M group 9 - F  TCAAGCCTGCCGATCTGGT  561  11 
CTX-M group 9 - R  TGATTCTCGCCGCTGAAG     
TEM - F  CATTTCCGTGTCGCCCTTATTC  800  11 
TEM - R  CATTTCCGTGTCGCCCTTATTC     
SHV - F  AGCCGCTTGAGCAAATTAAAC  713  11 
SHV - R  ATCCCGCAGATAAATCACCAC     
stx2a-F  GCGATACTGRGBACTGTGGCC  347  2 
stx2a-R  GCCACCTTCACTGTGAATGTG     
stx2b-F  AAATATGAAGAAGATATTTGTAGCGGC  251  2 
stx2b-R  CAGCAAATCCTGAACCTGACG     
stx2c-F  GAAAGTCACAGTTTTTATATACAACGGGTA  177  2 
stx2c-R  CCGGCCACYTTTACTGTGAATGTA     
stx2d-F  AAARTCACAGTCTTTATATACAACGGGTG  179  2 
stx2d-R  TTYCCGGCCACTTTTACTGTG     
stx2e-F  CGGAGTTACGGGGAGAGGC  411  2 
stx2e-R  CTTCCTGACACCTTCACAGTAAAGGT     
stx2f-F  TGGGCGTCATTCACTGGTTG  424  2 
stx2f-R  TAATGGCCGCCCTGTCTCC     
stx2g-F  CACCGGGTAGTTATATTTCTGTGGATATC  573  2 
stx2g-R  GATGGCAATTCAGAATAACCGCT     
adk-F  ATTCTGCTTGGCGCTCCGGG  583  a 
adk-R  CCGTCAACTTTCGCGTATTT     
fumC-F  TCACAGGTCGCCAGCGCTTC  806  a 
fumC-R  GTACGCAGCGAAAAAGATTC     
gyrB-F  TCGGCGACACGGATGACGGC  911  a 
gyrB-R  ATCAGGCCTTCACGCGCATC     
icd-F  ATGGAAAGTAAAGTAGTTGTTCCGGCACA  878  a 
icd-R  GGACGCAGCAGGATCTGTT     
mdh-F  ATGAAAGTCGCAGTCCTCGGCGCTGCTGGCGG  932  a 
mdh-R  TTAACGAACTCCTGCCCCAGAGCGATATCTTTCTT     
purA-F  CGCGCTGATGAAAGAGATGA  816  a 
purA-R  CATACGGTAAGCCACGCAGA     
recA  CGCATTCGCTTTACCCTGACC  780  a 
recA  AGCGTGAAGGTAAAACCTGTG     

Screening for the detection of STEC and EPEC strain were based on the, stx1, stx2 and eae genes detection by multiplex PCR.7 When one of these genes were detected, individual colonies from each sample were tested by PCR to isolate STEC and EPEC strains according to the protocol available at www.apzec.ca/en/APZEC/Protocols/pdfs/ECL_PCR_Protocol.pdf. This methodology is in accordance to the OIE Reference Laboratory for Escherichia coli (EcL – Faculté de Médecine Véterinaire, Université de Montréal). Isolates were further submitted to another PCR to detect others virulence genes as follow: bfpA, ehxA, saa, iha, toxB, efa1, lpfAO113, lpfAO157/OI-141, lpfAO157/OI-154, astA and paa genes. The Stx2 variants analysis was performed by stx2 subtyping according to Scheutz.2

The antimicrobial susceptibility test was performed using the disc diffusion method.30 The antimicrobials chosen were the ones most used in fish farming and which are important for the detection of resistance genes dissemination. In this regard, drugs tested were ampicillin (10μg), cephalothin (30μg), streptomycin (10μg), gentamicin (10μg), ciprofloxacin (5μg), chloramphenicol (30μg), tetracycline (30μg), nitrofurantoin (300μg), nalidixic acid (30μg), sulfamethoxazole and trimethoprim (25μg), ceftriaxone (30μg), cefoxitin (30μg), kanamycin (30μg), norfloxacin (10μg), enrofloxacin (5μg) (Oxoid). In addition, E. coli isolates were screened for extended-spectrum beta-lactamase (ESBL) genes for the blaCTX-M genotype groups 1, 2, 8, 9 and 25, the blaTEM, and the blaSHV.11

Phylogenetic E. coli groups’ classification was performed according to the methodology proposed by Clermont.12 Serotyping was performed at the E. coli Reference Center (EcRc) at Pennsylvania State University. The O somatic antigen were determinate by agglutination plates, also the PCR-RFLP of fliC gene, which encodes flagella, were performed to determine the H flagella antigen. Somatic antigens used were O1 to O187, with the exception of O31, O47, O67, O72, O94, O122 and the flagellar antigens used were H1 to H49, except H17, since these serogroups still not have been designated.

The isolates were also characterized by PFGE pattern of the PulseNet protocol as described by Ribot.13 Briefly, the chromosomal DNA was digested with Xba1 and the electrophoresis conditions were an initial time of 2.2s and an end time of 54.2s in a gradient of 6V and the gels were electrophoresed for 21h. The fragment similarities were compared using the Dice coefficient and the dendrogram was constructed by neighbor-joining grouping using BioNumerics software (Applied Maths, Sint-Martens-Latem, Belgium). MLST was performed following the Achtmans's scheme (http://mlst.ucc.ie/mlst/dbs/Ecoli), through the sequencing of the PCR amplification products of the adk, fumC, gyrB, icd, mdh, purA, and recA genes. The generated sequences were trimmed and analyzed by the Phred/Phrap/Consed software package.

All the results are shown in Fig. 1. Of the 373 analyzed samples from the fish farm, one (0.2%), from stools, tested positive for a STEC related gene (isolate 125F5). Of the 99 free-living fish analyzed samples, six (6%), also from stools, were positive for at least one of the STEC or EPEC related genes (isolates 6F8, 9F8, 10F8, 12F8, 24F8 and 30F8). In addition, all six isolates were collected from the same location, and the stx1, stx2 and eae genes were detected. None of the muscle or water samples tested were positive for the STEC or EPEC markers investigated. Isolates from the fish farms were positive for ehxA, lpfAO113 and saa virulence genes. Also, strains from the free-living fish presented astA, ehxA, lpfAO113, saa, efa1 and paa genes. Regarding Stx2 toxin variants, the subtypes stx2a, stx2c and stx2d were observed at the same isolate.

Fig. 1.
(0.26MB).

A dendrogram representing the genetic similarity relationship and virulence indicators in STEC and aEPEC isolates from fish.

From the 15 antimicrobial drugs tested, the isolates originated from the fish farm animals were resistant to 14 of them, while the isolates from the free-living fish were resistant to three antimicrobials and no ESBL genes were found. All of the STEC strains belong to group B1 and the aEPEC strain to group A as in accord with the classification of Clermont.12 From seven isolates analyzed by serotyping, three were nontypeable for the O antigen, and three isolates were nontypeable for the H antigen. Thus, the groups detected were O55, O39, O116, H14, H18 and H36; and their serotype is shown in Fig. 1. Seven isolates possessed a heterogeneous profile, by PFGE analysis, and seven distinct sequence types (STs) with four clonal groups (CCs) detected by the MLST technique.

Although STEC and aEPEC strains isolated from fish are not natural inhabitants of its microbiota, these strains can colonize the fish through a contaminated environment of which they live.1 In both establishments that these positive strains were isolated, presence of cattle were observed around the nurseries and rivers. It is important to notice that bovine is considered the main reservoir of pathogenic E. coli.26

Moreover, in this study, all muscle and water samples were negative for the presence of STEC or EPEC. This result should not be taken lightly, because the samples were collected by dissecting the animal using aseptic conditions so that muscles samples were carefully separated from the intestinal content, which it does not occur at the fishermen or slaughterhouses daily practice. Commonly, a cut is made between the anus and the fish’ head, releasing all of its intestinal contents and, in the process, contaminating the muscle. In this regard, according to Kim,31 pathogenic E. coli can enter the human food chain mainly through food contamination. Moreover, none of the water sample tested positive for STEC or EPEC and this was associated with the large water flow at the nurseries and rivers.

These pathogens have already detected in Brazil4,6–8,14; and in other countries such as United States,15 Argentina,16 Netherlands,26 Iran,18 Tunisia,19 and Australia.20 These studies, as well as the present one, are fundamental to understand these pathogens epidemiology, since they have great importance in animal and public health.

In this study, one STEC strain with eae gene also contained several other genes, efa1, ehxA, lpfAO113 and paa, which have been associated with cases of diarrhea.21,22 The presence of saa gene was shown to be closely related to the presence of the ehxA gene in STEC strains devoid of eae gene, regardless of their serotype.4,23 In an STEC isolated, the presence of astA gene, which is important for pathogenesis of diarrhea and plays a key role in this strain’ virulence,24 was observed. Also, the lpfAO113 gene was shown in previous reports to have a high prevalence in STEC isolated from different animals.4 Regarding Stx2 toxin variants, the stx2a, stx2c and stx2d subtypes were observed in the same isolate; this combination is very unusual and makes this strain fairly unique and with aggravated virulence. The presence of stx2a, stx2c and stx2d subtype are often associated with the hemorrhagic colitis and with hemolytic uremic syndrome.2

The quinolones, tetracyclines, aminoglycosides and amphenicols are the most commonly used antimicrobials in fish farming25 and thus, it may explain the multiresistance observed in the fish farm isolates. All of the tested quinolones, tetracyclines, aminoglycosides and amphenicols were ineffective. Although it was observed multiresistance, no ESBL genes were found. The ESBL would confer an even greater risk for the raw fish consuming population, because these bacteria's can produce an enzyme that are able to hydrolyze the beta lactam ring of penicillins, cephalosporins and aztreonam, thus conferring resistance to these antimicrobials.11 However, this multiresistance profile shows a phenotypic response from the isolates, and due to the selective pressure originated from the abusive use of broad-spectrum cephalosporins, according to data obtained in the present study, ESBL strains can emerge rapidly, as it is already observed in other animal productions.

According to the phylogenetic results of this study, it is confirmed that tropical populations can harbor strains of group A and B1 preferentially, which may be one of the factors that could explain tropical countries higher diarrhea frequency.27 Although much is reported about the O157 strains, non-O157 STEC strains are the most prevalent in animals and food. For this reason, chances of humans becoming infected by these strains are large, indicating the importance of this serogroups to public health.5 Therefore, the O116 serogroup observed in the present study is relevant due to the fact that it is often associated with severe human disease. Furthermore, the strain with the flagelar antigen H18 which contains the stx2 but not the eae gene, has also shown frequent association with infections in animals.28 Moreover, the ONT: H18 serotype in eae negative and saa positive strains, similarly to the ones in this study, has previously been detected in pathogenic E. coli in cattle,29 thus emphasizing the fact that these animals were, likely, the source of this pathogen infection in fish.

The genetic diversity analysis showed that, although the isolates belonged to the same bacterial species, they had genetic diversities that were highlighted though the PFGE technique. The same was observed with the MSLT data, indicating that although they had a common ancestral origin, the transference of genetic information, though time, made this isolates very diverse, thus explaining their distinct phylogenetic classification.

Ours results shows that fish can harbor an important combination of Stx2 subtypes and putative adhesions genes. Also, it draws attention to the fact that the indiscriminate use of antibiotics in fish farming has the potential to endanger consumer health through the dissemination of antibiotic resistance genes. And finally, it highlights the role of STEC and aEPEC as foodborne pathogens in fish for human consumption.

Acknowledgments

The authors would like to thank FAPESP for all research support granted (2011/07358-2 and 2011/15050-8).

References
1
M.C. Guzmán,M.A. Bistoni,L.M. Tamagnini
Recovery of Escherichia coli in fresh water fish, Jenynsia multidentata and Bryconamericus iheringi
Water Res, 38 (2004), pp. 2368-2374
2
F. Scheutz,L.D. Teel,L. Beutin
Multicenter evaluation of a sequence-based protocol for subtyping shiga toxins and standardizing Stx nomenclature
J Clin Microbiol, 50 (2012), pp. 2951-2963 http://dx.doi.org/10.1128/JCM.00860-12
3
R.N. Nguyen,L.S. Taylor,M. Tauschek
Atypical enteropathogenic Escherichia coli infection and prolonged diarrhea in children
Emerging Infect Dis, 12 (2006), pp. 597-603 http://dx.doi.org/10.3201/eid1204.051112
4
M.C. Cergole-Novella,L.S. Nishimura,L.F. Dos Santos
Distribution of virulence profiles related to new toxins and putative adhesins in shiga toxin – producing Escherichia coli isolated from diverse sources in Brazil
FEMS Microbiol Lett, 274 (2007), pp. 329-334 http://dx.doi.org/10.1111/j.1574-6968.2007.00856.x
5
V. Brusa,V. Restovich,L. Galli
Isolation and characterization of non-O157 Shiga toxin-producing Escherichia coli from beef carcasses, cuts and trimmings of abattoirs in Argentina
6
R.P. Maluta,J.M. Fairbrother,A.E. Stella
Potentially pathogenic Escherichia coli in healthy, pasture-raised sheep on farms and at the abattoir in Brazil
Vet Microbiol, 169 (2013), pp. 89-95 http://dx.doi.org/10.1016/j.vetmic.2013.12.013
7
C.A. Borges,L.G. Beraldo,R.P. Maluta
Shiga toxigenic and atypical enteropathogenic Escherichia coli in the feces and carcasses of slaughtered pigs
Foodborne Pathog Dis, 9 (2012), pp. 1119-1125 http://dx.doi.org/10.1089/fpd.2012.1206
8
L.G. Beraldo,C.A. Borges,R.P. Maluta
Detection of Shiga toxigenic (STEC) and enteropathogenic (EPEC) Escherichia coli in dairy buffalo
Vet Microbiol, 170 (2014), pp. 162-166 http://dx.doi.org/10.1016/j.vetmic.2014.01.023
9
S.K. Manna,R. Das,C. Manna
Microbiological quality of finfish and shellfish with special reference to shiga toxin-producing Escherichia coli O157
J Food Sci, 73 (2008), pp. 283-286
10
L.F. Ribeiro,M.M.C. Barbosa,F. Rezende Pinto
Shiga toxigenic and enteropathogenic Escherichia coli in water and fish from pay-to-fish ponds
Lett Appl Microbiol, 62 (2016), pp. 216-220 http://dx.doi.org/10.1111/lam.12536
11
C.A. Dallenne,D. Da Costa,C. Decré
Development of a set of multiplex PCR assays for the detection of genes encoding important β-lactamases in Enterobacteriaceae
J Antimicrob Chemother, 65 (2010), pp. 490-495 http://dx.doi.org/10.1093/jac/dkp498
12
O. Clermont,J.K. Christenson,E. Denamur
The Clermont Escherichia coli phylo-typing method revisited: improvement of specificity and detection of new phylo-groups
Environ Microbiol Rep, 5 (2013), pp. 58-65 http://dx.doi.org/10.1111/1758-2229.12019
13
E.M. Ribot,M.A. Fair,R. Gautom
Standardization of pulsed-field gel electrophoresis protocols for the subtyping of Escherichia coli O157:H7, Salmonella, and Shigella for PulseNet
Foodborne Pathog Dis, 3 (2006), pp. 59-67 http://dx.doi.org/10.1089/fpd.2006.3.59
14
K.M. Lascowski,B.E. Guth,F.H. Martins
Shiga toxin-producing Escherichia coli in drinking water supplies of north Paraná State, Brazil
J Appl Microbiol, 114 (2013), pp. 1230-1239 http://dx.doi.org/10.1111/jam.12113
15
K.M. Herman,A.J. Hall,L.H. Gould
Outbreaks attributed to fresh leafy vegetables, United States, 1973–2012
Epidemiol Infect, 143 (2015), pp. 3011-3021 http://dx.doi.org/10.1017/S0950268815000047
16
F.A. Bessone,G. Bessone,S. Marini
Presence and characterization of Escherichia coli virulence genes isolated from diseased pigs in the central region of Argentina
17
A.W. Paton,J.C. Paton
Multiplex PCR for direct detection of Shiga toxigenic Escherichia coli strains producing the novel subtilase cytotoxin
J Clin Microbiol, 43 (2005), pp. 2944-2947 http://dx.doi.org/10.1128/JCM.43.6.2944-2947.2005
18
S.T. Miri,A. Dashti,S. Mostaan
Identification of different Escherichia coli pathotypes in north and north-west provinces of Iran
Iran J Microbiol, 9 (2017), pp. 33-37
19
S. Bessalah,J.M. Fairbrother,I. Salhi
Antimicrobial resistance and molecular characterization of virulence genes, phylogenetic groups of Escherichia coli isolated from diarrheic and healthy camel-calves in Tunisia
Comp Immunol Microbiol Infect Dis, 49 (2016), pp. 1-7 http://dx.doi.org/10.1016/j.cimid.2016.08.008
20
M. McPherson,M.D. Kirk,J. Raupach
Economic costs of Shiga toxin-producing Escherichia coli infection in Australia
Foodborne Pathog Dis, 8 (2011), pp. 55-62 http://dx.doi.org/10.1089/fpd.2010.0608
21
J. Afset,G. Bruant,R. Brousseau
Identification of virulence genes linked with diarrhea due to atypical Enteropathogenic Escherichia coli by DNA microarray analysis and PCR
J Clin Microbiol, 44 (2006), pp. 3703-3711 http://dx.doi.org/10.1128/JCM.00429-06
22
H. Narimatsu,K. Ogata,Y. Makino
Distribution of non-locus of enterocyte effacement pathogenic island-related genes in Escherichia coli carrying eae from patients with diarrhea and healthy indi-viduals in Japan
J Clin Microbiol, 48 (2010), pp. 4107-4114 http://dx.doi.org/10.1128/JCM.00677-10
23
S.J. Savarino,A. Fasano,J. Watson
Enteroaggregative Escherichia coli heat-stable enterotoxin 1 represents another subfamily of E. coli heat-stable toxin
Proc Natl Acad Sci U S A, 90 (1993), pp. 3093-3097
24
M. Ngeleka,J. Pritchard,G. Appleyard
Isolation and association of Escherichia coli AIDA-I/STb, rather than EAST1 pathotype, with diarrhea in piglets and antibiotic sensitivity of isolates
J Vet Diagn Invest, 15 (2003), pp. 242-252 http://dx.doi.org/10.1177/104063870301500305
25
G. Rigos,G.M. Troisi
Antibacterial agents in Maditerranean finfish farming: a sinopsis of drug pharmacokinetics in important euryhaline fish species and possible environmental implications
Rev Fish Biol Fish, 15 (2005), pp. 53-55
26
L. Mughini-Gras,W. van Pelt,M. van der Voort
Attribution of Human Infections with Shiga Toxin-Producing Escherichia coli (STEC) to Livestock Sources and Identification of Source-Specific Risk Factors, The Netherlands (2010–2014)
Zoonoses Public Health, (2017)
27
P. Escobar-Páramo,K. Grenet,A.L. Menac’h
Large-scale population structure of human commensal Escherichia coli isolates
Appl Environ Microbiol, 70 (2004), pp. 5698-5700 http://dx.doi.org/10.1128/AEM.70.9.5698-5700.2004
28
M. Eklund,F. Scheutz,A. Siitonen
Clinical isolates of non-O157 shiga toxin-producing Escherichia coli: serotypes, virulence characteristics, and molecular profiles of strains of the same serotype
J Clin Microbiol, 39 (2001), pp. 2829-2834 http://dx.doi.org/10.1128/JCM.39.8.2829-2834.2001
29
L. Aidar-Ugrinovkch,J. Blanco,M. Blanco
Serotypes, virulence genes, and intimin types of Shiga toxin-producing Escherichia coli (STEC) and enteropathogenic E. coli (EPEC) isolated from calves in São Paulo, Brazil
Int J Food Microbiol, 115 (2007), pp. 297-306 http://dx.doi.org/10.1016/j.ijfoodmicro.2006.10.046
30
CLSI Clinical and Laboratory Standard Institute
Performance Standards for Antimicrobial Disk Susceptibility Tests. CLSI Document MO2-A10
CLSI, (2009)
31
N.H. Kim,T.J. Cho,M.S. Rhee
Current interventions for controlling pathogenic Escherichia coli
Adv Appl Microbiol, 100 (2017), pp. 1-47 http://dx.doi.org/10.1016/bs.aambs.2017.02.001
32
B. China,V. Pirson,J. Mainil
Typing of bovine attaching and effacing Escherichia coli by multiplex in vitro amplification of virulence-associated genes
Appl Environ Microbiol, 62 (1996), pp. 3462-3465
33
R. Vidal,M. Vidal,R. Lagos
Multiplex PCR for diagnosis of enteric infections associated with diarrheagenic Escherichia coli
J Clin Microbiol, 42 (2004), pp. 1787-1789
34
C. Toma,E. Martinez Espinosa,T. Song
Distribution of putative adhesins in different seropathotypes of shiga toxin-producing Escherichia coli
J Clin Microbiol, 42 (2004), pp. 4937-4946 http://dx.doi.org/10.1128/JCM.42.11.4937-4946.2004
35
H. Schmidt,W.L. Zhang,U. Hemmrich
Identification and characterization of a novel genomic island integrated at selC in Locus of Enterocyte Effacement-negative, Shiga toxin-producing Escherichia coli
Infect Immun, 69 (2001), pp. 6863-6873 http://dx.doi.org/10.1128/IAI.69.11.6863-6873.2001
36
C.L. Tarr,T.M. Large,C.L. Moeller
Molecular characterization of a serotype O121:H19 clone, a distinct Shiga toxin-producing clone of pathogenic Escherichia coli
Infect Immun, 70 (2001), pp. 6853-6859
37
L. Nicholls,T. Grant,R. Robins-Browne
Identification of a novel genetic locus that is required for in vitro adhesion of a clinical isolate of enterohaemorrhagic Escherichia coli to epithelial cells
Mol Microbiol, 35 (2000), pp. 275-288
38
S. Doughty,J. Sloan,V. Bennett-Wood
Identification of a novel fimbrial gene cluster related to long polar fimbriae in locus of enterocyte effacement-negative strains of enterohemorrhagic Escherichia coli
Infect Immun, 70 (2001), pp. 6761-6769
39
I.M. Szalo,F. Goffaux,V. Pirson
Presence in bovine enteropathogenic (EPEC) and enterohaemorrhagic (EHEC) Escherichia coli of genes encoding for putative adhesins of human EHEC strains
Res Microbiol, 153 (2002), pp. 653-658
Corresponding author. (Marita Vedovelli Cardozo maritavedovelli@yahoo.com.br)
Copyright © 2018. Sociedade Brasileira de Microbiologia
Braz J Microbiol 2018;49:936-41 - Vol. 49 Num.4 DOI: 10.1016/j.bjm.2018.02.013