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Short review: molecular diagnosis of Escherichia coli O104H4

Malecki, Monikaa; Mattner, Fraukeb; Schildgen, Olivera

Reviews in Medical Microbiology: March 2012 - Volume 23 - Issue 2 - p 14–17
doi: 10.1097/MRM.0b013e3283530839
Original Articles

In May 2011 an increasing number of cases with gastroenteric symptoms were reported in German hospitals. The patients showed mainly an onset of vomiting and bloody diarrhoea. Because high numbers of these patients suffered from haemolytic uraemic syndrome (HUS), immediately HUS-inducing Shigatoxin-producing Escherichia coli were suspected of causing the outbreak. Shigatoxin-producing E. coli serotype O157:H7 is associated with HUS with a high prevalence worldwide, but also non-O157 serotypes are known to initiate HUS. Characterization of the responsible enteropathogenic E. coli identified it as a novel serotype, which possesses virulence factors combining those from enterohaemorrhagic E. coli and enteroaggregative E. coli. Hitherto available microbiological methods were unsuitable to accurately identify the outbreak. Rapid screening diagnostic methods were essential to ensure timely and appropriate patient management. This short review summarizes the molecular methods to detect E. coli O104:H4 and novel diarrhoeagenic E. coli strains appearing during the outbreak in Germany in 2011.

aKliniken der Stadt Köln gGmbH, Institut für Pathologie

bKliniken der Stadt Köln gGmbH, Institut für Hygiene, Klinikum der Privaten Universität Witten/Herdecke, Cologne, Germany.

Correspondence to Priv.-Doz. Dr rer. nat. Oliver Schildgen, Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Institut für Pathologie, Klinikum der Privaten Universität Witten/Herdecke, Ostmerheimer Street 200, D-51109 Köln (Cologne), Germany. Tel: +49 0 221 8907 13467; fax: +49 0 221 8907 3542; e-mail:

Received 30 January, 2012

Accepted 27 February, 2012

© 2012 Lippincott Williams & Wilkins, Inc.