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Master of Science in Biomedical Sciences / Department of Diagnostic Medicine/Pathobiology / Natalia Cernicchiaro / David G. Renter / Cattle shed Shiga toxin-producing Escherichia coli (STEC) in their feces. Therefore, cattle pose a risk to contaminate produce, water, and beef products intended for human consumption. The United States Department of Agriculture Food Safety and Inspection Service consider seven STEC serogroups (O26, O45, O103, O111, O121, O145, and O157) as adulterants in raw, non-intact beef products. Contrary to O157, the frequency and distribution of non-O157 serogroups and virulence genes have not been well-established in cattle. Therefore, the objectives of my thesis research were: 1) to appraise and synthesize data from peer-reviewed literature on non-O157 serogroup and virulence gene prevalence, and 2) to determine the prevalence of seven STEC in feedlot cattle feces across seasons. A systematic review and meta-analysis of published literature were conducted to gather, summarize, and interpret the existent data regarding non-O157 serogroup and virulence gene prevalence in cattle. Random-effects meta-analyses were used to obtain pooled non-O157 fecal prevalence estimates for continents worldwide and meta-regression analyses were conducted to evaluate effects of specific factors on between-study heterogeneity. Results indicated that non-O157 serogroup and virulence gene fecal prevalence significantly differed (P < 0.05) by geographic region, with North America yielding the highest pooled prevalence estimate worldwide. While previous research has demonstrated a strong seasonal shedding pattern of STEC O157, data regarding the seasonality of non-O157 STEC shedding in cattle is very limited. A repeated cross-sectional study was conducted to obtain serogroup and virulence gene prevalence data for the seven STEC in pre-harvest cattle feces, in summer and winter. We found that non-O157 serogroups were recovered in fecal samples collected in both seasons but virulence genes, thus STEC, were rarely detected in summer and undetected in winter. In conclusion, non-O157 STEC are present in cattle feces at very low frequencies, but STEC O103 and O157 significantly differed (P < 0.05) between seasons. Overall, the research described in this thesis greatly contributes to the limited body of data regarding non-O157 serogroup and virulence gene distribution in cattle and provides a better understanding of two major risk factors, season and geographic distribution, associated with STEC fecal shedding in cattle.

Shiga toxin-producing enterohemorrhagic Escherichia coli (EHEC) is an emerging food- and water-borne pathogen, causing approximately 73,000 annual infections in the United States and an estimated 1.5 million infections globally. E. coli O157:H7, the most frequently associated EHEC strain, is primarily transmitted through consumption of contaminated ground beef and produce and leads to hemorrhagic colitis in humans. In 5% to 15% of infected patients, circulating Shiga toxins (Stx1, Stx2) cause hemolytic uremic syndrome (HUS), characterized by the presence of thrombocytopenia, hemolytic anemia, and thrombotic microangiopathy, contributing to acute kidney injury (AKI). Current treatment is supportive and antibiotic therapy is contraindicative as it increases toxin production. Therapeutics for EHEC-induced HUS need to be identified to minimize kidney injury and uncontrolled coagulopathy. Well-characterized animal models of HUS and EHEC infection are available and provide avenues for potential therapeutic discovery. Baboons (Papio) challenged with endotoxin-free Shiga toxins develop full spectrum HUS, and mice infected with Stx2-producing Citrobacter rodentium (Cr Stx2+), a genetically modified enteric mouse pathogen, develop severe Stx2-mediated kidney injury. Initial studies have shown that soluble thrombomodulin (sTM), an anti-coagulant, is a promising therapeutic in preventing severe kidney injury in pediatric patients. In these studies, we determined whether complement was activated in baboons challenged with Shiga toxins, and evaluated whether intraperitoneal injection of sTM would reduce disease severity from mice infected with Cr Stx2+. D-dimer and cell injury markers (HMGB1, histones) confirmed the presence of coagulopathy and cell injury in Stx challenged baboons. Studies revealed that complement activation is not required for the development of thrombotic microangiopathy and HUS induced by EHEC Shiga toxins in these pre-clinical models. Soluble thrombomodulin treatment in Cr Stx2+ infected mice significantly decreased colonization but did not alter mortality. However, gene expression of kidney injury markers (NGAL, KIM-1) decreased significantly compared to no treatment indicating sTM-associated cytoprotectivity. The C. rodentium mouse model does not develop the coagulopathy seen in HUS patients and sTM treatment may be more effective in the baboon toxemia model. Soluble thrombomodulin is a promising therapeutic for EHEC-induced HUS and should be further evaluated in Stx challenged baboons.

Shiga toxin (Stx) is a bacteriophage (phage)-encoded virulence factor of the Enterohaemorrhagic Escherichia coli (EHEC) O157:H7 implicated in the pathogenesis of renal tissue damage and bloody diarrhoea in human. Cattle are the main asymptomatic reservoir for EHEC O157:H7 with the lymphoid-follicle rich areas of the terminal rectum identified as the primary colonisation site. However, the significance of Stx during bovine intestinal colonisation by EHEC O157:H7 remains unclear with mixed findings described in published studies. The objective of this study was to investigate if Stx and the Stx-encoding phage significantly contribute to EHEC O157:H7 colonisation particularly at the bovine terminal rectum. The expression of Stx receptor, Globotrioasylceramide (Gb3) at the bovine terminal rectum was analysed by fluorescence microscopy, revealing a similar pattern of Gb3 detection in the bovine colon with scattered positive detections limited to sub-epithelial, mesenchymal-associated cells. Purified Stx2 treatment of Gb3+ and Gb3- epithelial cell lines for 6 to 18 hours produced no effect on the cell cycle and proliferation. CD3+/CD8+, CD3+/γδ+ and CD21+ cells were significantly different between calves infected with EHEC O157:H7 Strain 9000 (Stx2a+/Stx2c+) and the uninfected calves, but not in calves with Strain 10671 (Stx2c+). Stx did not interfere with IFN-gamma (IFN-γ)-activation of the JAK/STAT1 pathway in epithelial cells. Bovine EHEC O157:H7 strains isolated from Scottish cattle farms in the IPRAVE study (Phage type 21/28 and 32) were used for a series of bacterial phenotypic characterisation assays. Total Stx production, Verocytotoxicity, growth in a competitive environment, epithelial cell adherence and Galleria mellonella virulence assay were performed to compare the IPRAVE EHEC O157:H7 strains (PT21/28 and PT32) and the isogenic Stx-phage mutants. Stx levels produced by the bovine-originated EHEC O157:H7 strains were significantly lower than that of the human isolated strains. The absence of Gb3 on the bovine terminal rectal epithelium, the non-significant changes in the cell cycle along with the uninterrupted IFN-γ activation of the JAK/STAT1 pathway in intestinal epithelial cells and the minute quantities of Stx generated by EHEC O157:H7 bovine strains suggest that the toxin is not involved in colonisation directly, at least at the intestinal epithelial level. Although future work is required to explain the mechanisms underlying the observed EHEC O157:H7 phenotypic changes particularly in the Stx-phage mutant strains, the work done has proven that the Stx-encoding phage indeed has the ability to exert changes in the bacterial cell leading to changes in bacterial phenotypes, which in turn, might affect the colonisation of the bovine intestine.

The Shiga-like toxins have DNA sequence homology to the toxins accountable for the dysentery brought about by the Shigella species. <i>Escherichia coli</i> which encode and produce shiga-like toxins are referred to as shiga toxin-producing E. coli (STEC). Upon infection with STEC, humans may develop a variety of clinical symptoms ranging in severity from bloody diarrhea to life threatening hemolytic uremic syndrome (HUS). Hemolytic uremic syndrome is the most fatal disease manifestation upon STEC infection for humans and has been documented to occur in up to 20% of patients upon STEC infection [29]. The Shiga toxins (Shiga toxin 1 and 2) are regarded as the principal virulence factor of STEC and are responsible for the clinical manifestations during HUS in humans [49].<p> Cattle are the primary non-human reservoir for STEC and therefore represent an attractive target for pre-slaughter intervention as a means to reduce human infections. To date, vaccination with secreted proteins including Shiga toxin 2 (Stx2), has reduced the numbers of bacteria shed in feces [3]. Even though published data exists supporting vaccination in cattle as a means to reduce STEC, commercially available vaccines are not being used by farms and STEC remain a significant zoonotic pathogen of humans causing disease and death. To further our knowledge about STEC pathogenesis in cattle, we examined the effect of Shiga toxin 2 on bovine immune responses. Bovine lymphocyte function was determined in the presence of Shiga toxin 2 and the magnitude of bovine immunological responses was measure after immunization with Shiga toxin 2. In general, results suggest that Shiga toxin 2 downregulates bovine immune responses suggesting vaccination with effector molecules that exclude Shiga toxin 2 may induce a better immunological response and improve vaccine efficacy.<p> To examine the possibility that Stx2 modulates bovine immune responses, we investigated lymphocyte function in the presence of Stx2. Menge et al [70] have reported that bovine lymphocytes express the Stx receptor and that Shiga toxin 1 inhibits lymphocyte proliferation in vitro. We isolated two populations of lymphocytes, peripheral blood mononuclear cells (PBMCs) and ileal Peyers patch lymphocytes (IPPL) and compared lymphocyte function in the presence and absence of Stx2. We found that Stx2 did not affect IPPL viability in vitro but did inhibit IPPL proliferation after 12 hours of incubation <i>in vitro</i>. In contrast, no altered PBMC function could be observed in the presence of Stx2. These results suggest that receptor-bound Stx2 may inhibit IPPL proliferation and that the two populations of lymphocytes isolated are unique and distinct from each other in their response to Stx2.<p> To determine the effect of Stx2 on bovine immune responses during STEC infection, a bovine ileal ligated loop model was employed. Ligated loops were inoculated with either a Stx2+ STEC strain or an isogenic Stx2- STEC strain. After 24 hours, IPPL populations were isolated from each ligated loop and immunophenotyped. The results indicated a significantly reduced CD4+ T cell population in the presence of Stx2. No differences in the levels of IFNá, TNFá, IL12 or IFNã could be detected between groups. These results suggest that Stx2 modulates bovine immune responses but not as a result of increased production of these cytokines. To extend this finding, we determined the effect of Stx2 on bovine immune responses during active immunization by using ELISA to measure serological responses in the presence and absence of Stx2. Serological responses to secreted proteins, as well as a co-administered antigen (hen egg lysozyme), were significantly reduced in the groups of cattle that were immunized with either purified Stx2 or secreted protein preparations isolated from STEC compared to groups vaccinated with antigens which did not contain the toxin. Bovine proliferative responses were also measured and the results indicated significantly reduced proliferation in the groups vaccinated with the formulations containing Stx2. Therefore, based on these results, we conclude that Stx2 downregulates bovine immune responses and thus may contribute to the colonization and persistence of cattle by STEC.

The Shiga-like toxins have DNA sequence homology to the toxins accountable for the dysentery brought about by the Shigella species. <i>Escherichia coli</i> which encode and produce shiga-like toxins are referred to as shiga toxin-producing E. coli (STEC). Upon infection with STEC, humans may develop a variety of clinical symptoms ranging in severity from bloody diarrhea to life threatening hemolytic uremic syndrome (HUS). Hemolytic uremic syndrome is the most fatal disease manifestation upon STEC infection for humans and has been documented to occur in up to 20% of patients upon STEC infection [29]. The Shiga toxins (Shiga toxin 1 and 2) are regarded as the principal virulence factor of STEC and are responsible for the clinical manifestations during HUS in humans [49].<p> Cattle are the primary non-human reservoir for STEC and therefore represent an attractive target for pre-slaughter intervention as a means to reduce human infections. To date, vaccination with secreted proteins including Shiga toxin 2 (Stx2), has reduced the numbers of bacteria shed in feces [3]. Even though published data exists supporting vaccination in cattle as a means to reduce STEC, commercially available vaccines are not being used by farms and STEC remain a significant zoonotic pathogen of humans causing disease and death. To further our knowledge about STEC pathogenesis in cattle, we examined the effect of Shiga toxin 2 on bovine immune responses. Bovine lymphocyte function was determined in the presence of Shiga toxin 2 and the magnitude of bovine immunological responses was measure after immunization with Shiga toxin 2. In general, results suggest that Shiga toxin 2 downregulates bovine immune responses suggesting vaccination with effector molecules that exclude Shiga toxin 2 may induce a better immunological response and improve vaccine efficacy.<p> To examine the possibility that Stx2 modulates bovine immune responses, we investigated lymphocyte function in the presence of Stx2. Menge et al [70] have reported that bovine lymphocytes express the Stx receptor and that Shiga toxin 1 inhibits lymphocyte proliferation in vitro. We isolated two populations of lymphocytes, peripheral blood mononuclear cells (PBMCs) and ileal Peyers patch lymphocytes (IPPL) and compared lymphocyte function in the presence and absence of Stx2. We found that Stx2 did not affect IPPL viability in vitro but did inhibit IPPL proliferation after 12 hours of incubation <i>in vitro</i>. In contrast, no altered PBMC function could be observed in the presence of Stx2. These results suggest that receptor-bound Stx2 may inhibit IPPL proliferation and that the two populations of lymphocytes isolated are unique and distinct from each other in their response to Stx2.<p> To determine the effect of Stx2 on bovine immune responses during STEC infection, a bovine ileal ligated loop model was employed. Ligated loops were inoculated with either a Stx2+ STEC strain or an isogenic Stx2- STEC strain. After 24 hours, IPPL populations were isolated from each ligated loop and immunophenotyped. The results indicated a significantly reduced CD4+ T cell population in the presence of Stx2. No differences in the levels of IFNá, TNFá, IL12 or IFNã could be detected between groups. These results suggest that Stx2 modulates bovine immune responses but not as a result of increased production of these cytokines. To extend this finding, we determined the effect of Stx2 on bovine immune responses during active immunization by using ELISA to measure serological responses in the presence and absence of Stx2. Serological responses to secreted proteins, as well as a co-administered antigen (hen egg lysozyme), were significantly reduced in the groups of cattle that were immunized with either purified Stx2 or secreted protein preparations isolated from STEC compared to groups vaccinated with antigens which did not contain the toxin. Bovine proliferative responses were also measured and the results indicated significantly reduced proliferation in the groups vaccinated with the formulations containing Stx2. Therefore, based on these results, we conclude that Stx2 downregulates bovine immune responses and thus may contribute to the colonization and persistence of cattle by STEC.

The Shiga-like toxins have DNA sequence homology to the toxins accountable for the dysentery brought about by the Shigella species. Escherichia coli which encode and produce shiga-like toxins are referred to as shiga toxin-producing E. coli (STEC). Upon infection with STEC, humans may develop a variety of clinical symptoms ranging in severity from bloody diarrhea to life threatening hemolytic uremic syndrome (HUS). Hemolytic uremic syndrome is the most fatal disease manifestation upon STEC infection for humans and has been documented to occur in up to 20% of patients upon STEC infection [29]. The Shiga toxins (Shiga toxin 1 and 2) are regarded as the principal virulence factor of STEC and are responsible for the clinical manifestations during HUS in humans [49]. Cattle are the primary non-human reservoir for STEC and therefore represent an attractive target for pre-slaughter intervention as a means to reduce human infections. To date, vaccination with secreted proteins including Shiga toxin 2 (Stx2), has reduced the numbers of bacteria shed in feces [3]. Even though published data exists supporting vaccination in cattle as a means to reduce STEC, commercially available vaccines are not being used by farms and STEC remain a significant zoonotic pathogen of humans causing disease and death. To further our knowledge about STEC pathogenesis in cattle, we examined the effect of Shiga toxin 2 on bovine immune responses. Bovine lymphocyte function was determined in the presence of Shiga toxin 2 and the magnitude of bovine immunological responses was measure after immunization with Shiga toxin 2. In general, results suggest that Shiga toxin 2 downregulates bovine immune responses suggesting vaccination with effector molecules that exclude Shiga toxin 2 may induce a better immunological response and improve vaccine efficacy. To examine the possibility that Stx2 modulates bovine immune responses, we investigated lymphocyte function in the presence of Stx2. Menge et al [70] have reported that bovine lymphocytes express the Stx receptor and that Shiga toxin 1 inhibits lymphocyte proliferation in vitro. We isolated two populations of lymphocytes, peripheral blood mononuclear cells (PBMCs) and ileal Peyer’s patch lymphocytes (IPPL) and compared lymphocyte function in the presence and absence of Stx2. We found that Stx2 did not affect IPPL viability in vitro but did inhibit IPPL proliferation after 12 hours of incubation in vitro. In contrast, no altered PBMC function could be observed in the presence of Stx2. These results suggest that receptor-bound Stx2 may inhibit IPPL proliferation and that the two populations of lymphocytes isolated are unique and distinct from each other in their response to Stx2. To determine the effect of Stx2 on bovine immune responses during STEC infection, a bovine ileal ligated loop model was employed. Ligated loops were inoculated with either a Stx2+ STEC strain or an isogenic Stx2- STEC strain. After 24 hours, IPPL populations were isolated from each ligated loop and immunophenotyped. The results indicated a significantly reduced CD4+ T cell population in the presence of Stx2. No differences in the levels of IFNá, TNFá, IL12 or IFNã could be detected between groups. These results suggest that Stx2 modulates bovine immune responses but not as a result of increased production of these cytokines. To extend this finding, we determined the effect of Stx2 on bovine immune responses during active immunization by using ELISA to measure serological responses in the presence and absence of Stx2. Serological responses to secreted proteins, as well as a co-administered antigen (hen egg lysozyme), were significantly reduced in the groups of cattle that were immunized with either purified Stx2 or secreted protein preparations isolated from STEC compared to groups vaccinated with antigens which did not contain the toxin. Bovine proliferative responses were also measured and the results indicated significantly reduced proliferation in the groups vaccinated with the formulations containing Stx2. Therefore, based on these results, we conclude that Stx2 downregulates bovine immune responses and thus may contribute to the colonization and persistence of cattle by STEC.

abstract: In the United States, Escherichia coli O157:H7 (E. coli O157:H7) is the most frequent cause of hemolytic uremic syndrome (HUS) and it is also the primary cause of acute renal failure in children. The most common route of the infection is ingestion of contaminated meat or dairy product originating from cattle or vegetables contaminated with bovine manure. Since cattle are the main reservoir for human infection with E. coli O157:H7, the reduction of intestinal colonization by these bacteria in cattle is the best approach to prevent human infections. Intimin is an outer membrane protein of E. coli O157:H7 that plays an important role in adhesion of the bacteria to the host cell. Hence, I proposed to express intimin protein in tomato plants to use it as a vaccine candidate to reduce or prevent intestinal colonization of cattle with E. coli O157:H7. I expressed His-tagged intimin protein in tomato plants and tested the purified plant-derived intimin as a vaccine candidate in animal trials. I demonstrated that mice immunized intranasally with purified tomato-derived intimin produced intimin-specific serum IgG1and IgG2a, as well as mucosal IgA. I further demonstrated that mice immunized with intimin significantly reduced time of the E. coli O157:H7 shedding in their feces after the challenge with these bacteria, as compared to unimmunized mice. Shiga toxin is the major virulence factor that contributes to HUS. Since Shiga toxin B subunit has an important role in the attachment of the toxin to its receptor, I fused intimin to Shiga toxin B subunit to create multivalent subunit vaccine and tested the effects upon immunization of mice with the B subunit when combined with intimin. His-tagged intimin, Shiga toxin B subunit, and Shiga toxin-intimin fusion proteins were expressed in E. coli and purified. I demonstrated that this multivalent fusion protein vaccine candidate elicited intimin- and Shiga toxin B-specific IgG1, IgG2a, and IgA antibodies in mice. I also showed a reduction in the duration of the bacterial shedding after the challenge compared to the control sham-immunized groups. / Dissertation/Thesis / Ph.D. Plant Biology 2010

Made available in DSpace on 2015-12-06T22:55:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Programa de Apoio a Núcleos de Excelência (PRONEX) / O perfil de resistência a antimicrobianos e análise da diversidade genética foi analisado em 32 amostras de Escherichia coli produtoras de toxina Shiga (STEC) isoladas de infecção humana (n = 21) e das fezes de bovinos saudáveis (n = 11) e em 12 amostras de E. coli de origem humana isoladas de sítios extraintestinais, exceto uma delas isolada de diarréia. As amostras foram isoladas no Estado de São Paulo. Multiresistência (resistência a ≥3 grupos de antimicrobianos) foi observada tanto nas amostras de STEC (21/32 - 65,6%) como nas demais E. coli estudadas (8/12 - 66.7%). As amostras de STEC foram resistentes à tetraciclina (100%), seguida à estreptomicina (78,1%) e trimetoprim-sulfametoxazol (56,2%). Onze amostras de STEC resistentes a ampicilina carreavam a enzima β-lactamase TEM (blaTEM) e foram sensíveis a todas as cefalosporinas e quinolonas analisadas. As amostras de E. coli associadas a infecções intestinais e extraintestinais foram resistentes a um maior número de grupos de antimicrobianos. Foi observado resistência à estreptomicina (91,7%), tetraciclina (75%) e trimetoprim-sulfametoxazol (66,7%). Resistência à ampicilina (58,3%) foi também identificada. Três amostras de E. coli mostraram resistência a cefalosporinas de terceira geração, uma delas isolada de infecção intestinal carreava blaCTX-M-14 e blaTEM-1 e outra amostra isolada de secreção traqueal carreava blaCTX-M-15 e blaOXA-1. Cinco das 12 amostras de E. coli mostraram resistência à quinolonas. O gene da integrase associada ao integron classe 1 (intI1) foi encontrado em 6 (28,6%) das 21 amostras de STEC isoladas de humanos pertencentes ao sorogrupo O111 e em uma amostra isolada de bovino (9,1%) pertencente ao sorogrupo O118. Oito das 12 amostras de E. coli associadas a infecções intestinais e extraintestinais apresentaram intI1 e pertenciam a vários sorotipos. As amostras intI1 positivas carreavam plasmídeos com uma diversidade de tamanho, mas perfil plasmidial similar foi observado em algumas delas. O ensaio de hibridização indicou que intl1 estava localizado em plasmídeos em 5 das 7 amostras de STEC e em 6 das 8 demais amostras de E. coli. Análise dos integrons por PCR-RFLP revelou perfil idêntico em 4 amostras de STEC e em uma E. coli extraintestinal. Esses integrons tinham tamanho uniforme e continham o cassete gênico aadA1. O agrupamento filogenético mostrou que a maioria das amostras de STEC pertencia ao grupo B1, enquanto os grupos A, B2 e D foram observados entre as demais amostras de E. coli em 33,3%, respectivamente. Quatro amostras de E. coli isoladas de infecções extraintestinais foram denominadas como típicas E. coli patogênicas extraintestinais (ExPEC). Entre as 44 amostras de E. coli estudadas 54,5% apresentaram serino-proteases autotransportadoras (SPATE). A toxina vacuolizante Vat foi identificada somente em 3 das 12 E. coli associadas a infecções intestinais e extraintestinais, e essas amostras apresentaram fímbria tipo 1, fator necrosante citotóxico, Alfa hemolisina e a adesina de membrana externa, Iha (100%, 8,3%, 8,3% e 25%, respectivamente). A tipagem por PFGE das amostras de STEC O111 e O118 mostrou uma diversidade de perfis, mas a maioria das amostras foi agrupada em um mesmo grupo (80% a 97% de similaridade). Por outro lado, a tipagem molecular confirmou que a maioria das amostras de E. coli associadas a infecções intestinais e extraintestinais era epidemiologicamente não relacionada (similaridade genética ≥80%), exceto 2 amostras de E. coli isoladas do mesmo paciente, no mesmo dia, e que apresentaram padrões de PFGE com similaridade de 93,3%. Os plasmídeos das amostras de E. coli associadas a infecções intestinais e extraintestinais carreando genes de resistência e/ou virulência, acarretaram um custo biológico de pequeno a neutro por geração, quando inseridos às amostras laboratoriais de E. coli. Em conclusão, apesar da aquisição de genes ter interferido pouco na capacidade das amostras de E. coli laboratoriais em se multiplicarem e consequentemente se disseminarem, a presença de integrons e de outros elementos genéticos móveis tanto em amostras de STEC como entre as amostras de E. coli extraintestinais é preocupante, principalmente em relação as amostras de E. coli extraintestinais considerando a provável aquisição de resistência a outros antimicrobianos, como recentemente descrito aos carbapenens. / Phenotypic and genotypic characterization of resistance to antimicrobials and genetic diversity were analyzed in 32 Shiga Toxin-Producing Escherichia coli (STEC) strains isolated from human infections (n = 21) and cattle feces (n = 11), and 12 human extraintestinal E. coli strains, except one isolated from diarrhea. The E. coli strains were isolated in Sao Paulo State. Multiresistance (resistance to ≥3 antimicrobial groups) was observed in both STEC (21/32 – 65.6%) and ExPEC strains (8/12 - 66.7%). The STEC strains were resistant to tetracycline (100%) followed by streptomycin (78.1%) and trimethoprimsulfamethoxazole (56.2%). The eleven STEC strains resistant to ampicilin possessed β-lactamase TEM (blaTEM) enzyme and all strains were susceptible to third-generation cephalosporins, and also to quinolones. On the other hand, E. coli strains associated with intestinal and extraintestinal infections were resistant to a larger number of antimicrobial groups than STEC. Resistance was observed to streptomycin (91.7%), tetracycline (75%) and trimethoprimsulfamethoxazole (66.7%). Resistance to ampicillin (58.3%) was also identified. Three E. coli strains were non-susceptible to third-generation cephalosporins, one isolated from diarrhea carried blaCTX-M-14 and blaTEM-1 whereas other, isolated from tracheal secretion, carried blaCTX-M-15 and blaOXA-1. Five of the 12 E. coli strains showed resistance to quinolones. Integrase associated with class 1 integron (intI1) was detected in six (28.6%) of the 21 human STEC strains belonging to O111 serogroup and in one (9.1%) bovine strain belonging to O118 serogroup. Eight of the 12 E. coli strains associated with intestinal and extraintestinal infections presented intI1 and belonged to various serotypes. The intI1-positive isolates carried plasmids showing a diversity of sizes, but similar plasmid profiles were observed in some strains. Southern blot hybridization assay with intI1-specific probe indicated that intl1 was located on plasmids in five out of the seven STEC strains and in six out of the eight E. coli strains. Analysis of integrons by PCR-RFLP revealed identical profiles in 4 STEC strains and in one extraintestinal E. coli strain. These integrons had a uniform size and contained a single gene cassette aadA1. The phylogenetic grouping showed that most of the STEC strains belonged to B1 group, while groups A, B2 and D (33.3%), respectively were observed among the other E. coli isolates. Four E. coli strains isolated from extraintestinal infection were classified as typical extraintestinal pathogenic E. coli (ExPEC). Among 44 E. coli strains studied, 54.5% presented the Spate protease autotransporter. The Vat vacuolating toxin was identified only in 3 of the 12 E. coli strains associated with intestinal and extraintestinal infections, and these strains presented type-1 fimbriae, cytotoxic nectrotizing factor, alpha-hemolysin and the IrgA homologue adhesin, Iha (100%, 8.3%, 8.3% e 25%, respectively). PFGE analysis of O111 and O118 STEC strains showed a diversity of profiles, but most of the strains were grouped in the same cluster (80% to 97% of similarity). On the other hand, PFGE analysis revealed that most E. coli strains associated with intestinal and extraintestinal infections were epidemiologically unrelated, and were not grouped in any cluster with significant similarity (≥80%), except 2 E. coli strains, isolated at the same day from the same patient, and that presented PFGE patterns with similarity of 93.3%. The plasmids of the E. coli strains associated with intestinal and extraintestinal infections carrying resistance and/or virulence genes, resulted in a low or neutral biological cost per generation, when inserted into laboratory E. coli strains. In conclusion, despite the acquisition of genes has shown a low interference in the ability of laboratory E. coli strains to grow and consequently to spread, the presence of integrons and other mobile genetic elements in both STEC and E. coli associated with extraintestinal infections is worrisome, mainly in relation to extraintestinal E. coli strains considering the probable acquisition of resistance to other antimicrobials, as recently reported to carbapenems. / BV UNIFESP: Teses e dissertações

Master of Public Health / Department of Diagnostic Medicine and Pathobiology / Robert Larson / Among animal products consumed by humans, ground beef has been reported as one of the most common vehicles for STEC outbreaks in humans. In the United States, cull dairy cattle contribute as one of the primary sources for ground beef. The objective of this study was to determine the prevalence and concentration of 7 Shiga toxin-producing Escherichia coli serogroups (STEC-7; O26, O103, O111, O121, O45, O145, and O157) and associated virulence genes (Shiga toxin 1 and 2 (stx1, stx2), intimin (eae), and enterohomolysin (ehxA)) in the feces of cull dairy cattle processed in commercial slaughter plants during summer months. Fecal swab samples (n=183) were collected from three processing plants, one in California and two in Pennsylvania. At each plant at least 60 to 65 cattle were selected, and the samples were obtained by swabbing the mucosal surface of the recto-anal junction using a sterile cotton-tipped applicator. To determine prevalence, all samples were subjected to culture-based detection methods that included enrichment, serogroup-specific immunomagnetic separation and plating on selective media, followed by polymerase chain reaction for serogroup confirmation and virulence gene detection. Pre-enriched fecal samples were subjected to spiral plating to determine the concentration of STEC-7. A sample was considered STEC positive if a recovered isolate harbored one of the 7 target O genes, stx1, and/or stx2. Of the 183 fecal swab samples collected, 23 (12.6%) harbored at least one O157, O26, O103, or O111 serogroup, with their associated virulence genes. However, none of the fecal samples from this cattle population carried STEC at high-levels (>10⁴ CFU/g). This study has provided important information on STEC-7 prevalence from dairy cattle that enter the ground beef processing system. However, there is still a need to determine prevalence and concentration of STEC in cull dairy cattle during winter months as well as in other sources of ground beef production (e.g., imported lean beef, cull beef).