BACKGROUND: Escherichia coli O157:H7 is a leading cause of diarrhea and the hemolytic-uremic syndrome. Current public health surveillance for E. coli O157:H7 requires considerable resources; traditional methods lack the sensitivity and specificity to detect outbreaks effectively. METHODS: During 1994 and 1995, the Minnesota Department of Health requested that all clinical isolates of E. coli O157:H7 be submitted to our laboratory. Isolates were subtyped by pulsed-field gel electrophoresis (PFGE), and patients were interviewed about potential sources of infection. RESULTS: In 1994 and 1995, 344 cases of E. coli O157:H7 infection were reported to the Minnesota Department of Health; 317 (92 percent) were subtyped by PFGE, and 143 distinct PFGE patterns were identified. Ten outbreaks of E. coli O157:H7 were identified; these accounted for 56 (18 percent) of the 317 subtyped cases. Four outbreaks were detected solely as a result of subtype-specific surveillance. In 11 two-week periods, the number of reported cases of E. coli O157:H7 doubled from the previous two weeks. In eight of these instances, the patterns identified were dissimilar and there were no outbreaks. Two of the remaining three increases resulted from multiple simultaneous outbreaks. CONCLUSIONS: Subtype-specific surveillance for E. coli O157:H7 can identify outbreaks that are not detected by traditional methods and can ascertain whether sudden increases in reported cases are due to sporadic isolated cases or to one or more outbreaks.
BACKGROUND:Escherichia coli O157:H7 is a leading cause of diarrhea and the hemolytic-uremic syndrome. Current public health surveillance for E. coli O157:H7 requires considerable resources; traditional methods lack the sensitivity and specificity to detect outbreaks effectively. METHODS: During 1994 and 1995, the Minnesota Department of Health requested that all clinical isolates of E. coli O157:H7 be submitted to our laboratory. Isolates were subtyped by pulsed-field gel electrophoresis (PFGE), and patients were interviewed about potential sources of infection. RESULTS: In 1994 and 1995, 344 cases of E. coli O157:H7infection were reported to the Minnesota Department of Health; 317 (92 percent) were subtyped by PFGE, and 143 distinct PFGE patterns were identified. Ten outbreaks of E. coli O157:H7 were identified; these accounted for 56 (18 percent) of the 317 subtyped cases. Four outbreaks were detected solely as a result of subtype-specific surveillance. In 11 two-week periods, the number of reported cases of E. coli O157:H7 doubled from the previous two weeks. In eight of these instances, the patterns identified were dissimilar and there were no outbreaks. Two of the remaining three increases resulted from multiple simultaneous outbreaks. CONCLUSIONS: Subtype-specific surveillance for E. coli O157:H7 can identify outbreaks that are not detected by traditional methods and can ascertain whether sudden increases in reported cases are due to sporadic isolated cases or to one or more outbreaks.
Authors: G A Barkocy-Gallagher; T M Arthur; G R Siragusa; J E Keen; R O Elder; W W Laegreid; M Koohmaraie Journal: Appl Environ Microbiol Date: 2001-09 Impact factor: 4.792
Authors: Susan B Hunter; Paul Vauterin; Mary Ann Lambert-Fair; M Susan Van Duyne; Kristy Kubota; Lewis Graves; Donna Wrigley; Timothy Barrett; Efrain Ribot Journal: J Clin Microbiol Date: 2005-03 Impact factor: 5.948
Authors: D L Pearl; M Louie; L Chui; K Doré; K M Grimsrud; D Leedell; S W Martin; P Michel; L W Svenson; S A McEwen Journal: Epidemiol Infect Date: 2006-01-03 Impact factor: 2.451
Authors: D L Pearl; M Louie; L Chui; K Doré; K M Grimsrud; S W Martin; P Michel; L W Svenson; S A McEwen Journal: Epidemiol Infect Date: 2006-06-02 Impact factor: 2.451
Authors: Anna C Noller; M Catherine McEllistrem; O Colin Stine; J Glenn Morris; David J Boxrud; Bruce Dixon; Lee H Harrison Journal: J Clin Microbiol Date: 2003-02 Impact factor: 5.948
Authors: Anna C Noller; M Catherine McEllistrem; Antonio G F Pacheco; David J Boxrud; Lee H Harrison Journal: J Clin Microbiol Date: 2003-12 Impact factor: 5.948