Molecular epidemiology, clinical features and significance of Shiga toxin detection from routine testing of gastroenteritis specimens

Authors:

• Kiss, Christopher
• Kotsanas, Despina
• Francis, Michelle J.
• Sait, Michelle
• Valcanis, Mary
• Lacey, Jake
• Connelly, Kathryn
• Rogers, Benjamin
• Ballard, Susan A.
• Howden, Benjamin P.
• Graham, Maryza

Details:

Pathology, Volume 55, Issue 5, 2023-08-31

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After introduction of faecal multiplex PCR that includes targets for stx1 and stx2 genes, we found stx genes were detected in 120 specimens from 111 patients over a 31-month period from 2018–2020 from a total of 14,179 separate tests performed. The proportion of stx1 only vs stx2 only vs stx1 and stx2 was 35%, 22% and 42%, respectively. There were 54 specimens which were culture positive, with 33 different serotypes identified, the predominant serotype being O157:H7 (19%). Eighty-two patients had clinical data available; we found a high rate of fever (35%), bloody diarrhoea (34%), acute kidney injury (27%), hospital admission (80%) and detection of faecal co-pathogens (23%). Only one patient developed haemolytic uraemic syndrome. We found no significant association with stx genotype and any particular symptom or complication. We found a significant association of serotypes O157:H7 and O26:H11 with bloody stool, but no significant association with any other symptom or complication.