Vtec Flashcards

1
Q

Intro

A

> 400 e.coli serotypes that harbour stx genes
Classed on O,H,K antigens
Virulence differs between strains
Stx2 is 1000 times stronger then stx1
Foodborne illness - cattle
Bloody diarrhea, hus, haemorrhagic colitis

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2
Q

Common strains

A

O157:H7
O26
O104:H4

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3
Q

Emergence of o157:h7

A

Initial outbreak of o157:h7 in 1982 in undercooked burgers

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4
Q

Evolution

A

First in an
Acquired stx toxin first
Then the o157 plasmid encoding a haemolysin
Lost ability to ferment b glucuronidase and sorbitol

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5
Q

Super shedders

A

Greater than 10^4 cfu/g
Colonised at recto anal junction

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6
Q

Sources

A

Both o157 and non o157 found in ruminants

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7
Q

Virulence factors

A

Locus of enterocyte effacement
Plasmid o157
Shigatoxins

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8
Q

Lee

A

A pathogenicity island
41 different genes responsible for attaching and effacing lesions
Encodes a type iii secretion system
Associated with disease but not essential

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9
Q

Types iii secretion system, what does it eject

A

Injects effector molecules across host cell membrane
Needs contact with membrane though
Secretes TIR receptors into host cell

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10
Q

TIR receptors

A

When in host cell - injected by TTSS - they undergo a tyrosine phosphorylation event

This modification allows the tirs to be inserted into the host membrane

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11
Q

What follows tir insertion into mrmbrane

A

Sn adhesion intimin (eae) can then bin to tir which attaches the bacteria to the host cell

We then get other secreted protein (EPS)

Polymerisation of actin molecules forms a pedestal

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12
Q

Po157 plasmid

A

An F like non conjugative plasmid
19 genes e.g
ehxA - Encode haemolysin A -> lysis of rbcs
TTSS - secretary system apparatus
KatP - encodes catalase peroxidase- protects damage from oxidative damage
esp1 -> serine protease -> micro vascular damage

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13
Q

What carries stx

A

Lambdoid prophages

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14
Q

Trends/mortality of hus

A

HUS most common in <5yrs old (15%) compared to 1.2% in adults

In one irish study 90% were in <15yr olds

Highest mortality in >60

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15
Q

What strain predominates in hus in ireland

A

50% we’re o157
33% o26

5/6 ‘big 6’ non o157s involved

Majority were stx2 only

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16
Q

How much more likely is hus to developing, stx2 vs stx2

A

Stx2 is x4 times more likely

17
Q

Resistance in 0157

A

Sulfonamide and tetracycline common in o157

Esbls TEM/CTXM in Denmark

18
Q

0104 resistance

A

Ampicillin, cefotaxime, ceftazidime, streptomycin and tetracycline resistance

19
Q

Toxin binding

A

A/b toxin
B subunit binds Gb3 receptors on host cells
Internalised by endocytosis
Complex transported through golgi

A subunit cleaved into A1 and A2

20
Q

How does A2 work

A

Targets 28s rRNA of 60s ribodomal subunit

Results in inhibition of protein synthesis and inhibition of elongation factor 1 which can lead to cell death

21
Q

Why is stx2 a worse prognosis

A

More frequently associated with hus and haemorrhagic colitis

Aldo cause thrombosis microangiopathy -> thrombocytopenia and haemolytic anaemia

22
Q

How does o104 virulence factors differ

A

Missing o157 plasmid
Missing LEE

Has AAF instead -> better adhesion
Stx transfered via phage
Biofilm production
Esbl production

23
Q

What % progress to hus

A

90% recover, hus progress

About 5% of hus result in death, 60% recover

Only about 2% of non0157 progress to hus

24
Q

EAHEC stands for? What strain does it refer to? What was the original outbreak?

A

Enteroadherant haemorrhagic e.coli

O104:H4

Sprouts in Germany
- 4000 cases and 53 deaths

25
EAHEC has AAF instead of normal virulence factors, what does this stand for? How does it work?
Aggregation adherence factor AAF pili encodes hy aagR results in aggregation and adherence fimbria Stacked brick adherence Unusual tight binding to epithelium allowing quicker delivery of toxin
26
EAHEC epedimiology
Emerging pathogen but spreading globally Caused sporadic infections first in Asia and across Europe Endemic to central Africa Not zoonotic - human transmission, possible water contamination
27
Hus rate in 0104
22%
28
What antibiotic is dangerous for vtec
Ciprofoxacin triggers continuous transcription of bacteripjage toxin