Enterohaemorrhagic and other Shiga toxin-producing Escherichia coli (STEC): Where are we now regarding diagnostics and control strategies?
Enterohaemorrhagic and other Shiga toxin-producing Escherichia coli (STEC): Where are we now regarding diagnostics and control strategies?
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DOI：
10.1111/tbed.12789
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发表时间：
2018-05-01
影响因子：
4.3
通讯作者：
La Ragione, R. M.
中科院分区：
文献类型：
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作者：
Newell, D. G.;La Ragione, R. M.
大肠埃希菌由一组高度多样化的革兰氏阴性细菌组成，是人类和动物肠道微生物区系中的常见成员。一般来说，这种定植是无症状的；然而，一些大肠杆菌菌株已经进化成致病性，从而在易感宿主中引起临床疾病。志贺产毒大肠杆菌(STEC)是一种重要的食源性致病菌，它由表达志贺样毒素的菌株组成。STEC的一个亚型是肠出血性大肠杆菌(EHEC)，它可以导致严重的人类疾病，包括溶血性尿毒症综合征(HUS)。肠出血性大肠杆菌感染的诊断以及食物链和环境中的STEC监测需要准确、成本效益高和及时的检测。在这篇综述中，我们描述和评价了目前常规使用的测试，以及即将到来的病原体检测测试技术，包括环介导的等温扩增(LAMP)和全基因组测序(WGS)。我们考虑了在控制和预防人类、食物链和环境中的这些病原体的现行战略中需要改进诊断工具。我们的结论是，尽管已经取得了重大进展，但STEC仍然是一个重要的全球人畜共患病问题。要大幅减少这种感染造成的公共卫生负担，将需要采取多管齐下的方法，包括目前正在开发的高分辨率诊断技术的持续监测，并将其纳入公共卫生实验室的常规调查。然而，可能需要更多的研究要求，才能使用这种高分辨率诊断工具来开发适当的干预措施，如疫苗和去污战略。
Escherichia coli comprises a highly diverse group of Gram-negative bacteria and is a common member of the intestinal microflora of humans and animals. Generally, such colonization is asymptomatic; however, some E. coli strains have evolved to become pathogenic and thus cause clinical disease in susceptible hosts. One pathotype, the Shiga toxigenic E. coli (STEC) comprising strains expressing a Shiga-like toxin is an important foodborne pathogen. A subset of STEC are the enterohaemorrhagic E. coli (EHEC), which can cause serious human disease, including haemolytic uraemic syndrome (HUS). The diagnosis of EHEC infections and the surveillance of STEC in the food chain and the environment require accurate, cost-effective and timely tests. In this review, we describe and evaluate tests now in routine use, as well as upcoming test technologies for pathogen detection, including loop-mediated isothermal amplification (LAMP) and whole-genome sequencing (WGS). We have considered the need for improved diagnostic tools in current strategies for the control and prevention of these pathogens in humans, the food chain and the environment. We conclude that although significant progress has been made, STEC still remains an important zoonotic issue worldwide. Substantial reductions in the public health burden due to this infection will require a multipronged approach, including ongoing surveillance with high-resolution diagnostic techniques currently being developed and integrated into the routine investigations of public health laboratories. However, additional research requirements may be needed before such high-resolution diagnostic tools can be used to enable the development of appropriate interventions, such as vaccines and decontamination strategies.