Healthcare

In 2008, there were a large outbreak in Oklahoma related to the serotype Escherichia coli (E. coli) 0111 that leads to serious illness of hemolytic-uremic syndrome (HUS) in a substantial number of patients. However recent findings said that in a pattern, E. coli 0111 less common than E.coli o157.

Before that time, the E. coli 0157 is the most common serotype linked with gastrointestinal infections in the U.S. after E. coli 026. However, since the outbreak of E.coli 0111 in Oklahoma, the researchers could characterize the illness and HUS attack rate of any serotype other than 0157.

Also, the age distribution from E. coli 0111 cases with HUS was strikingly different than with E.coli 0157, although the proportion of both of cases was similar (17%).

Published on October 11th of the Archives of Internal Medicine, the authors of study that led by Dr. Emily Piercefield from the US Centers for Disease Control and Prevention, and colleagues recommend public health officials to urge that O111 and other non-O157 serotypes be included in the differential diagnosis when bacterial diarrhea is suspected because “E. coli 0111 is capable of causing serious disease among humans and might be emerging in the United States or at least is present to a greater extent than was previously appreciated.”

The study results from 156 people infected by E. coli o111 at a country buffet restaurant in Oklahoma in the largest known 0111 outbreak in the U.S. There were 72 hospitalized and 26 (16.7%) developed HUS.

According to Dr. Piercefield, the test to detect E. coli o111 and other non-0157 serotypes are available and they should be used along with the 0157 tests to make sure all possible types of E. coli involved diarrheal illnesses founded.

This is because its capacity to cause serious illness wasn’t recognize until now, and most laboratories don’t screen for 0111 and other non-0157 serotypes in patients with suspected bacterial diarrhea.

Dr. Percefield add that by knowing patients have infections with these serotypes allows health care providers to be vigilant for early signs of hemolytic-uremic syndrome and to treat patients more aggressively to head off worse complications later.

That recommendation aligns with CDC guidelines that urge testing not just for 0157, but also for shiga toxins to detect non-0157 serotypes.

In 2006, compared with 73,000 reported illness by 0157 serotypes, Non-0157 serotypes accounted for 37,000 reported in the U.S.
An Australian study found that 0111 serotypes accounted for half of the HUS cases linked to non-0157 serotypes.