Shiga toxin producing Escherichia coli: identification of non-O157:H7-Super-Shedding cows and related risk factors

<p>Abstract</p> <p>Background</p> <p>Shiga toxin producing <it>Escherichia coli </it>(STEC) are an important cause of human gastro-enteritis and extraintestinal sequelae, with ruminants, especially cattle, as the major source of infection and reservoir. In this study, the fecal STEC shedding of 133 dairy cows was analyzed over a period of twelve months by monthly sampling with the aim to investigate shedding patterns and risk factors.</p> <p>Results</p> <p>Overall, 24.7% (in total 407) of 1,646 fecal samples were tested positive for <it>stx </it>by PCR with inner-herd prevalences on the different farms of 11.1% to 32.3%. At individual levels, cows were <it>stx</it>-positive on zero to eight consecutive samplings. According to a strictly longitudinal definition of Super-Shedding, in the present study 14 cows were identified as Super-Shedders of non-O157 serotypes.</p> <p>Significant risk factors for the shedding of STEC were the month of sampling, the number of lactations and days in lactation, the nutritional condition, the somatic cell count and the content of protein in milk. Most notably, the presence of STEC Super-Shedding cows in the herd was a significant risk factor, revealing that STEC Super-Shedding is not restricted to STEC O157:H7 alone.</p> <p>Conclusions</p> <p>These data have implications for possible interventions, as removing single non-O157:H7 STEC Super-Shedding cattle from farms would significantly reduce STEC burden.</p

From Stable to Lab—Investigating Key Factors for Sudden Deaths Caused by Streptococcus suis

Swine stocks are endemically infected with the major porcine pathogen Streptococcus (S.) suis. The factors governing the transition from colonizing S. suis residing in the tonsils and the exacerbation of disease have not yet been elucidated. We analyzed the sudden death of fattening pigs kept under extensive husbandry conditions in a zoo. The animals died suddenly of septic shock and showed disseminated intravascular coagulopathy. Genotypic and phenotypic characterizations of the isolated S. suis strains, a tonsillar isolate and an invasive cps type 2 strain, were conducted. Isolated S. suis from dead pigs belonged to cps type 2 strain ST28, whereas one tonsillar S. suis isolate harvested from a healthy animal belonged to ST1173. Neither S. suis growth, induction of neutrophil extracellular traps, nor survival in blood could explain the sudden deaths. Reconstituted blood assays with serum samples from pigs of different age groups from the zoo stock suggested varying protection of individuals against pathogenic cps type 2 strains especially in younger pigs. These findings highlight the benefit of further characterization of the causative strains in each case by sequence typing before autologous vaccine candidate selection

Separated by a Common Language: Awareness of Term Usage Differences Between Languages and Disciplines in Biopreparedness

Preparedness for bioterrorism is based on communication between people in organizations who are educated and trained in several disciplines, including law enforcement, health, and science. Various backgrounds, cultures, and vocabularies generate difficulties in understanding and interpretating terms and concepts, which may impair communication. This is especially true in emergency situations, in which the need for clarity and consistency is vital. The EU project AniBio- Threat initiated methods and made a rough estimate of the terms and concepts that are crucial for an incident, and a pilot database with key terms and definitions has been constructed. Analysis of collected terms and sources has shown that many of the participating organizations use various international standards in their area of expertise. The same term often represents different concepts in the standards from different sectors, or, alternatively, different terms were used to represent the same or similar concepts. The use of conflicting terminology can be problematic for decision makers and communicators in planning and prevention or when handling an incident. Since the CBRN area has roots in multiple disciplines, each with its own evolving terminology, it may not be realistic to achieve unequivocal communication through a standardized vocabulary and joint definitions for words from common language. We suggest that a communication strategy should include awareness of alternative definitions and ontologies and the ability to talk and write without relying on the implicit knowledge underlying specialized jargon. Consequently, cross-disciplinary communication skills should be part of training of personnel in the CBRN field. In addition, a searchable repository of terms and definitions from relevant organizations and authorities would be a valuable addition to existing glossaries for improving awareness concerning bioterrorism prevention planning

analysis of risk factors and shedding pattern

Die Relevanz von Shiga-Toxin bildenden Escherichia coli (STEC) bei humanen Infektionen bedingt die sehr niedrige Infektionsdosis in Kombination mit den möglichen extraintestinalen Komplikationen, besonders bei Kindern. Wiederkäuer, und hier in besonderem Maße Rinder, sind die natürliche Ansteckungsquelle der STEC. Shiga-Toxin bildende Escherichia coli- ausscheidende Rinder zeigen keine Krankheitssymptome; von ihnen stammende Lebensmittel können kontaminiert sein. Verschiedene Faktoren hinsichtlich der Haltung, der Fütterung und des Herdenmanagements von Rindern wurden als Risiken identifiziert. Große Bedeutung besitzen allerdings auch individuelle Eigenschaften des einzelnen Tieres. Ziel dieser Studie war es, die fäkale Ausscheidung von STEC durch Milchkühe über den Lauf eines Jahres zu untersuchen und verschiedene Einflussfaktoren zu bewerten. Die Probennahme erfolgte monatlich auf sechs Milchvieh-haltenden Betrieben in Schleswig- Holstein. Dabei wurden 1.646 Kotproben von 140 Kühen genommen. Durch Screening der angereicherten Proben mittels stx-PCR wurden positive Tiere identifiziert, STEC isoliert und diese durch PCR-gestützte Analyse weiterer Virulenzfaktoren und zum Teil durch Serotypisierung charakterisiert. Zur Auswertung wurden darüber hinaus Informationen zum Herdenmanagement, dem Ernährungs- und Gesundheitszustand, der Milchleistung und der Milchinhaltsstoffe, der Anzahl der absolvierten Laktationen und dem Laktationstag herangezogen. Die Daten wurden mit der Prozedur „Logistic“ (SAS®) statistisch ausgewertet. Insgesamt waren 24,7% (407) aller Proben stx-positiv in der Screening-PCR. Von 140 Kühen wurden 122 (87,1%) Tiere mindestens einmal als stx-positiv detektiert. Vierzehn Kühe (10,0%) wurden in mehr als der Hälfte ihrer Kotproben und bei mindestens vier aufeinander folgenden Beprobungen als stx-positiv nachgewiesen. Diese Tiere wurden als kontinuierliche Ausscheider definiert. Die dominierenden Virulenzprofile der 1.105 isolierten STEC waren stx2 EHEC- hlyA (434 Isolate, 39,3%) und stx1 stx2 EHEC-hlyA (311 Isolate, 28,1%). Bei der Serotypisierung von 61 STEC zeigte sich, dass einige der 24 nachgewiesenen nonO157:H7-Serovare an zwei bis zu fünf aufeinanderfolgenden Beprobungsterminen beim Einzeltier nachweisbar waren. Ein signifikanter Einfluss auf die STEC-Ausscheidung wurde für mehrere Faktoren nachgewiesen. Hierzu zählten die Jahreszeiten (Odds Ratio (OR) Sommer = 1.64, OR Herbst =2.35, OR Winter = 1.60 alle vs. Frühjahr), die Anzahl der absolvierten Laktationen (OR Erstkalbinnen vs. >3 absolvierte Laktationen = 1.74) und der Laktationstag (OR 51.-100. d = 1.73, OR 101.-150.. d = 1.93, OR>350. d = 2.06, OR trocken stehende Kuh = 1.67 alle vs. Kühe im ersten bis 50. Laktationstag), der Ernährungszustand (OR BCS > 3.5 vs. <3.5 = 1.92), die somatische Zellzahl (SSC) in der Milch pro Mililiter (OR SSC 100,000 = 1.57), der Proteingehalt der Milch in Prozent (OR 3.00-3.80 vs. 3.80 vs. <3.00 = 2.30) und die Anwesenheit eines als kontinuierlich ausscheidend definierten Tieres in der Herde (OR Tier in Herde vs. kein Tier = 2.63). Mit dieser Studie wurde die Bedeutung kontinuierlich nonO157-STEC-ausscheidender Tiere für den Infektionszyklus innerhalb des Bestands aufgezeigt.Shiga-Toxin producing Escherichia coli (STEC) are an emerging human health issue with special regard to their low infectious dose combined with serious sequelae of disease especially in children. Cattle are often infected, but without clinical signs of disease; hence, cattle derived foods could be contaminated. Different factors like the kind of husbandry, the diet and the herd management of cattle were identified as risk for shedding of STEC. However, the individual characteristics of the single animal seem to have a major impact. The aim of this study was to investigate the faecal excretion of STEC by dairy cattle over the course of one year. The design of the study was longitudinal to follow selected dairy cows over a period of twelve months to reveal their shedding patterns. Furthermore, the data was analyzed at herd level to detect and evaluate different risk factors. Additional information about herd management, nutritional and health status were available as well as data about the amount and contents of milk, the number of passed lactations and the days in milk. The data was statistically analyzed using the procedure ‘logistic’ in ‘SAS®’. On six dairy farms in Northern Germany, 1,646 faecal samples from 140 cows in different lactation numbers were examined once per month. Following cultural isolation, stx-positive cows were identified by PCR. STEC of these cows were isolated by colony-hybridization and characterized by PCR. Furthermore, selected STEC-isolates were serotyped. In 24.7% (407) of all samples, stx were detected by the screening-PCR. Within the herds, prevalence varied between 11.1% and 32.3%. Most of the 140 investigated animals excreted stx at least once (87.1% 122 cows. Cows with at least four consecutive positive samplings (10.0%, 14 cows) were classified as continuously shedding cows. Isolated Shiga-toxin producing E. coli from these cows were selected (n=61). They belonged to 24 Sorbitol-fermenting non-O157:H7-STEC-serovares, some of them were detected from single cows on two to five consecutive samplingl. In this study, 1,105 STEC were isolated. Dominating combinations of virulence genes were stx2 and EHEC-hlyA (434 isolates, 39.3%), and stx1, stx2 and EHEC-hlyA (311 isolates, 28.1%). Significant risk factors for the shedding of STEC were the month of sampling (Odds Ratio (OR) summer vs. spring = 1.64, OR autumn vs. spring = 2.35, OR winter vs. spring = 1.60), the number of lactations (OR first calvers vs. >3 completed lactations = 1.74) and days in lactation (OR 51.-100.d vs. 1.-50.d = 1.73, OR 101.-150.d vs. 1.-50.d = 1.93, OR >350.d vs. 1.-50.d = 2.06, ORdry cow vs. 1.-50.d = 1.67, the nutritional condition (OR BCS >3.5 vs. <3.5 = 1.92), the somatic cell count (OR SSC 100,000 = 1.57) and the content of protein in milk (OR 3.00-3.80% vs. 3.80% vs. <3.00% = 2.30). Most notably, the presence of STEC Super-shedding cows in the herd (OR Super-Shedder present vs. no Super-Shedder = 2.63) was a significant risk factor. This study confirms the importance of continuously shedding cows as a major source of STEC. These cows maintain the infectious cycle of STEC in the herd; therefore, interventions on individual animal might serve as the base for an effective pathogen control

Decontamination of High-risk Animal and Zoonotic Pathogens

Program obilježavanja Noći muzeja 31. siječnja 2020. na Sveučilištu u Zagrebu

Shiga toxin-producing Escherichia coli strains from bovines: association of adhesion with carriage of eaeA and other

Abstract Background: Shiga toxin producing Escherichia coli (STEC) are an important cause o

Assessing empowerment as multidimensional outcome of a patient education program for adolescents with chronic conditions:A latent differences core model

ObjectivesThe current study aims to examine the construct of empowerment in the context of a transition education program. Patient education programs strive to empower adolescents with chronic conditions to take responsibility for their own health care to manage their transition from pediatric to adult medicine. Our study aimed to identify the core components of patient empowerment and examined whether its components are responsive to a patient education program.MethodsData was collected in two longitudinal studies involving N = 723 adolescents with chronic conditions. We used Latent Difference Score models (LDSm) of: 1) self-efficacy (GSE), 2) transition competence (TCS), and 3) patient activation (PAM) to quantify the latent variable of patient empowerment (PE). Additionally, the LDSm were extended to analyze the effects of group affiliation (intervention vs. control) and participants' age on empowerment.ResultsPE was identifiable by the three components. The intervention group developed significantly higher scores of PE compared to the control group. Age (13-21 years) did not moderate the relation between group affiliation and PE.ConclusionsWe quantified PE successfully using a psychometric modeling of change. Patient empowerment is measureable and utilizable in the specific context of transition of adolescents with chronic conditions

From Stable to Lab—Investigating Key Factors for Sudden Deaths Caused by Streptococcus suis

Swine stocks are endemically infected with the major porcine pathogen Streptococcus (S.) suis. The factors governing the transition from colonizing S. suis residing in the tonsils and the exacerbation of disease have not yet been elucidated. We analyzed the sudden death of fattening pigs kept under extensive husbandry conditions in a zoo. The animals died suddenly of septic shock and showed disseminated intravascular coagulopathy. Genotypic and phenotypic characterizations of the isolated S. suis strains, a tonsillar isolate and an invasive cps type 2 strain, were conducted. Isolated S. suis from dead pigs belonged to cps type 2 strain ST28, whereas one tonsillar S. suis isolate harvested from a healthy animal belonged to ST1173. Neither S. suis growth, induction of neutrophil extracellular traps, nor survival in blood could explain the sudden deaths. Reconstituted blood assays with serum samples from pigs of different age groups from the zoo stock suggested varying protection of individuals against pathogenic cps type 2 strains especially in younger pigs. These findings highlight the benefit of further characterization of the causative strains in each case by sequence typing before autologous vaccine candidate selection

From Stable to Lab—Investigating Key Factors for Sudden Deaths Caused by Streptococcus suis

Swine stocks are endemically infected with the major porcine pathogen Streptococcus (S.) suis. The factors governing the transition from colonizing S. suis residing in the tonsils and the exacerbation of disease have not yet been elucidated. We analyzed the sudden death of fattening pigs kept under extensive husbandry conditions in a zoo. The animals died suddenly of septic shock and showed disseminated intravascular coagulopathy. Genotypic and phenotypic characterizations of the isolated S. suis strains, a tonsillar isolate and an invasive cps type 2 strain, were conducted. Isolated S. suis from dead pigs belonged to cps type 2 strain ST28, whereas one tonsillar S. suis isolate harvested from a healthy animal belonged to ST1173. Neither S. suis growth, induction of neutrophil extracellular traps, nor survival in blood could explain the sudden deaths. Reconstituted blood assays with serum samples from pigs of different age groups from the zoo stock suggested varying protection of individuals against pathogenic cps type 2 strains especially in younger pigs. These findings highlight the benefit of further characterization of the causative strains in each case by sequence typing before autologous vaccine candidate selection