Shiga toxin 2-producing Escherichia coli O26:H11 in southern Italy

E.coli O26:H11 strains lacking the stx genes were isolated from bulk milk and curd samples.

In summer 2013, an excess of pediatric cases of hemolytic uremic syndrome (HUS) in a southern region of Italy prompted the investigation of a community-wide outbreak of Shiga toxin 2-producing Escherichia coli (STEC) O26:H11 infections.

Case finding was based on testing patients with HUS or bloody diarrhea for STEC infection by microbiological and serological methods.

A case–control study was conducted to identify the source of the outbreak. STEC O26 infection was identified in 20 children (median age 17 months) with HUS, two of whom reported severe neurological sequel.

No cases in adults were detected. Molecular typing showed that two distinct STEC O26:H11 strains were involved.

The case–control study showed an association between STEC O26 infection and consumption of dairy products from two local plants, but not with specific ready-to-eat products. E.coli O26:H11 strains lacking the stx genes were isolated from bulk milk and curd samples, but their PFGE profiles did not match those of the outbreak isolates.

This outbreak supports the view that infections with Stx2-producing E. coli O26 in children have a high probability of progressing to HUS and represent an emerging public health problem in Europe.

Source: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22583