Shiga-like toxin-producing Escherichia coli O111 and associated hemolytic-uremic syndrome: a family outbreak

Abstract

Objective: To describe a family cluster of Shiga toxin-producing Escherichia coli O111ac:NM infection.

Study design: The index case was identified as part of a United States prospective study of hemolytic-uremic syndrome. Epidemiologic investigation was conducted through interviews. E. coli O111:NM infection was characterized through culture and serology. Shiga toxin 1 and 2 gene sequences were determined with oligonucleotide DNA probes.

Results: All three children and both parents had nonbloody diarrhea, vomiting and abdominal cramps, and one child developed hemolytic-uremic syndrome. Shiga toxin 1- and 2-producing E. coli O111ac:NM was isolated from two children. IgG antibodies to E. coli O111 were detected in all three children.

Conclusions: To our knowledge this is the first reported cluster of O111 infection and only the second caused by non-O157 Shiga toxin-producing E. coli in North America.