Since the 1920s, the relevance of the bacterium Escherichia coli (E. coli) as a cause of infections has been recognised. In the following years, E. coli was increasingly identified as a trigger of gastrointestinal diseases.

E. coli is classified as a gram-negative, rod-shaped bacteria that belongs to the Enterobacteriaceae family. They occur naturally in the intestine of humans and animals and include apathogenic, facultative pathogenic, and obligate pathogenic strains.

ENTEROPATHOGENIC VARIANTS OF ESCHERICHIA COLI

The two obligate pathogenic strains EHEC (enterohaemorrhagic E. coli) and EPEC (enteropathogenic E. coli) are among the most significant pathogens causing bacterial gastroenteritis, which can range from mild to severe. The symptoms include amongst others bloody diarrhea, abdominal cramps or fever. Furthermore, EHEC has also been associated with severe complications, including hemolytic uremic syndrome, which can result in acute renal failure.

Infection with these pathogenic bacteria occurs primarily through the process of smear infection. The main sources of infection are the consumption of contaminated food such as raw milk, minced meat, or vegetables, as well as contaminated water. Furthermore, an infection through contact with an infected person is also a possibility. Pregnant women, infants, children under five years of age, elderly people, and people with weakened immune systems are particularly at risk.

The prevention of EHEC and EPEC infections is based on the interruption of the chain of transmission by maintaining food, hand, and drinking water hygiene.

Consistent adherence to hygiene standards can significantly reduce the risk of infection. In order to prevent the spread of infection, it is important to maintain strict hand hygiene, particularly following contact with animals or prior preparation of meals. In addition, it is recommended that meat is thoroughly cooked, and that raw milk and raw sausage products are avoided. Fruit and vegetables should be washed thoroughly or peeled, as this reduces the bacterial load.

REPORTING REQUIREMENT UNDER THE INFECTION PROTECTION ACT

In Germany, the majority of EHEC outbreaks are attributable to food contamination. Both EHEC and EPEC infections are subject to mandatory reporting in Germany under Section 7 of the Infection Protection Act (IfSG).

For the rapid detection of the source of infection and for prevention of enteropathogenic Escherichia coli outbreaks, CONGEN has developed the SureFast® EHEC/EPEC 4plex (Art. No. F5128) kit. This kit is a real-time PCR test for the direct, qualitative detection and differentiation of specific DNA sequences of the Escherichia coli virulence factors stx1 (subtype a-d), stx2 (subtype a-g), eae, as well as the E. coli and Shigella spp. virulence factor ipaH in enriched food. The real-time PCR assay can be performed with commonly used real-time PCR instruments, equipped for detection of four fluorescence emissions at the channels FAM, VIC/HEX, ROX and Cy5 at the same time and has a limit of detection of ≤ 5 DNA copies.

For further differentiation of the E. coli strains, CONGEN offers real-time PCR kits that enable direct qualitative detection of specific DNA sequences of E. coli serotypes, such as SureFast® Escherichia coli Serotype I 4plex (Art.No. F5167) and SureFast® Escherichia coli Serotype II 4plex (Art.No. F5168).