Shiga-toxigenic E. coli: A Fully Emerged, Still-Underappreciated Pathogen

Shiga-toxigenic E. coli (STEC) is an enteric pathogen associated with several foodborne infections throughout the world every year. The major virulence determinant that defines STEC is the Shiga-like toxin, which is capable of transmission between various gram-negative organisms. STEC causes significant morbidity during acute outbreaks and can cause mortality associated with the development of hemolytic uremic syndrome. Until recently, testing for STEC in the clinical laboratory was inadequate, relying solely on selective, serogroup-biased culture methods. Recent advancements have been made that allow for toxin detection or molecular detection of toxin genes from stool specimens, removing the culture-bias problem. With these improvements in screening, the cases of STEC reported have increased significantly, revealing a pathogen that may have eluded the laboratory for decades. The 2011 STEC outbreak in Germany will be discussed in detail as an example of the emerging nature of this enigmatic pathogen.

Originally published on May 2, 2016, in Salt Lake City, Utah.

Lecture Presenter
Marc Roger Couturier, PhD, D(ABMM)
Marc R. Couturier, PhD, D(ABMM)
Medical Director, Microbial Immunology, ARUP Laboratories
Medical Director, Parasitology and Fecal Testing, ARUP Laboratories
Medical Director, Infectious Disease Rapid Testing, ARUP Laboratories
Assistant Professor of Pathology, University of Utah School of Medicine

Dr. Couturier is an assistant professor of pathology at the University Of Utah School of Medicine. He received his PhD in medical microbiology and immunology with a specialty in bacteriology from the University of Alberta in Edmonton, Alberta, Canada. Dr. Couturier served as a research associate/post-doctoral fellow at the Alberta Provincial Laboratory for Public Health and completed a medical microbiology fellowship (ABMM) at the University of Utah. His research interests include Helicobacter pylori diagnostics and population prevalence, in particular identifying populations with increased risk of infection and reduced access to medical care. Dr. Couturier also has a research focus aimed at developing improved diagnostics for emerging agents of infectious gastroenteritis. He is board certified in medical microbiology, and a member of the American Society for Microbiology and Infectious Disease Society of America.

Objectives

After this presentation, participants will be able to:

Summarize the key features of STEC and the illnesses associated with infection.
Evaluate their laboratory methods to determine if their current practice meets the guidelines and recommendations for testing.
Evaluate their laboratory’s ability to detect emerging strains of STEC.