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1 Key words: enteropathogenic Escherichia coli, food-borne outbreak, enteroaggregative Escherichia coli, heat-stable enterotoxin-1 gene, agg A gene, eae gene

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3 Table 1 Outline of the outbreak caused by EPEC Date16, Jan PlaceG Town in Minami-Akita Akita Prefecture district, VenhicleUndetermined Persons exposed 39 Patients 25 Attack rate64.0% Main symptomsdiarrhea Abdominal pain Pathogen isolated EPEC (O126: NM) Isolation rate 44.4% (4 EPEC from 9 patients' feces) Table 2 Biochemical characteristics of the EPEC strains Figures in parentheses indicate incubation period (day)

4 八柳 76 さ れ な か っ た.一 方,本 事 例 は 行 政 上,食 中毒事 潤 他 分 離 株3株 O126: 件 と し て の 取 り扱 い が な さ れ な か っ た た め に,原 は い ず れ も運 動 性 を 欠 き,血 NMで あ っ た(Table 清 型 は 1).Table 2に 示 す 因 食 品 の 調 査 は 実 施 さ れ な か っ た. 2.分 離EPEC株 の性 状 Fig. 某 病 院 で 分 離 同 定 さ れ たEPEC4株 の う ち,当 所 で 入 手 し 得 た3株(EC-152株,EC-153株,お びEC-154株)の 性,プ Table 血 清 型,生 よ 化 学 的 性 状,薬 剤感受 1 Plasmid profile of EPEC EC-153 and EC-154 isolated like outbreak. S. Enteritidis from strains EC-152, the food-borne L-156, E. coli K-12 W677 NR-1 and E. coli V-517 represent molecular marker. ラ ス ミ ドプ ロ フ ァ イ ル に つ い て 検 討 し た. 3 Antibiotic susceptibility patterns of the EPEC strains R: resistant S: Sensitive Fig. 2 Detection of eae, EAF, EAST-1 and egg A genes by PCR in EPEC strains EC-152, EC-153 and EC-154 isolated from the food-borne like outbreak. EPEC strain E2348/69 represents positive control for eae and EAF genes. EAggEC strain 17-2 represents positive control for EAST-1 and egg A genes. M represents molecular marker (100bp ladder). eae/eaf EAST-1 agg 感 染 症 学 雑誌 A 第70巻 第1号

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6 1) Knutton S, Lloyd DR & McNeish AS: Adhesion of enteropathogenic Escherichia coli to human intestinal enterocytes and cultured human intestinal mucosa. Infect Immun 1987; 55: ) Jerse AE, Yu J, Tall BD & Kaper JB: A genetic locus of enteropathogenic Escherichia coli necessary for the production of attaching and effacing lesions on tissue culture cells. Proc Natl Acad Sci USA 1990; 87: ) Vial PA, Robins-Browne R, Lior H et al.: Characterization of Enteroadherent- Aggregative Escherichia coli, a putative agent of diarrheal disease. J Infect Dis 1988; 158: ) Savarino S J, Fasano A, Robertson DC & Levine MM: Enteroaggregative Escherichia coli elaborate a heat-stable enterotoxin demonstrable in an in vitro rabbit intestinal model. J Clin Invest 1991; 87: ) Savarino SJ, Fasano A, Watson J et at.: Enteroaggregative Escherichia coliu heat-stable enteroroxin 1 represents another subfamily of E. coli heat-stable toxin. Proc Natl Acad Sci

7 USA 1993; 90: ) Nataro JP, Deng Y, Maneval DR, German AL, Martin WC & Levine MM: Aggregative adherence fimbriae I of enteroaggregative Escherichia coli mediate adherence to HEp-2 cells and hemagglutination of human erythrocytes. Infect Immun 1992; 60: ) Savarino SJ, Fox P, Yikang D & Nataro JP: Identification and characterization of a gene cluster mediating enteroaggregative Escherichia coli aggregative adherence fimbria I biogenesis. J Bacteriol 1994 ; 176: ) Levine MM, Nataro JP, Karch H et al.: The diarrheal response of humans to some classic serotypes of enteropathogenic Escherichia coli is dependent on a plasmid encoding an enteroadhesiveness factor. J Infect Dis 1985; 152: ) Ewing WH: Edwards and Ewing's identification of Enterobacteriaceae 4th ed., Elsevier Science Pub Co, New York, ) Kado CI & Liu ST: Rapid procedure for detection and isolation of large and small plasmids. J Bacteriol 1981; 145: ) Franke J, Franke S, Schmidt H et al.: Nucleotide sequence analysis of enteropathogenic Escherichia coli (EPEC) adherence factor probe and development of PCR for rapid detection of EPEC harboring virulence plasmids. J Clin Microbiol 1994; 32: ) Nataro JP, Baldini MM, Kaper JB, Black RE, Bravo N & Levine MM : Detection of an adherence factor of enteropathogenic Escherichia coli with a DNA probe. J Infect Dis 1985; 152: ) Gomes TAT, Blake PA & Trabulsi LR: Prevalence of Escherichia coli strains with localized, diffuse, and aggregative adherence to HaLa cells in infants with diarrhea and matched controls. J Clin Microbiol 1989; 27: ) Nataro JP, Yikang D, Yingkang D & Walker K: Agg R, a transcriptional activator of aggregative adherence fimbria I Expression in enteroaggregative Escherichia coli. J Bacteriol 1994; 176: Enteropathogenic Escherichia coli Strains Harboring Enteroaggregative Escherichia coli (EAggEC) Heat-stable Enterotoxin-1 Gene Isolated from a Food-borne Like Outbreak Jun YATSUYANAGI, Yu KINOUCHI, Shioko SAITO, Hiroyasu SATO & Morihiro MORITA Akita Prefectural Institute of Public Health A food-poisoning outbreak occurred in G Town in Minami-Akita District, Akita Prefecture on 16 January As the causative agent of the outbreak, Enteropathogenic Escherichia coli (EPEC) O126:NM were isolated. The isolates showed the same plasmid profile and antibiotic susceptibility patterns suggesting that the EPEC strains originated from same infectious source. The isolates lacked eae and EAF genes which were considered to play a significant role in the diarrheagenic mechanism of EPEC. On the otherhand, the isolates possessed Enteroaggregative E. coli (EAggEC) heat-stable enterotoxin-1 (EAST-1) gene, though they did not possess the agg A gene in which the coded structural subunit of Aggregative adherence fimbriae 1 (AAF/ 1) has been demonstrated to be involved in the expression of ability for EAggEC to adhere to cultured cells in aggregative pattern, indicating that the EPEC strains apparently differed from EAggEC. These data suggested that EAST-1 showed its enterotoxic activity to human, and that EPEC represented multiple category of E. coli strains with different diarrheagenic mechanism, in which both eae and EAST-1 might be involved.

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