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    See discussions, stats, and author profiles for this publication at: http://www.researchgate.net/publication/6663508

    Screening food raw materials for the presenceof the world's most frequent clinical cases of Shiga toxin-encoding Escherichia coli O26,O103, O111, O145 and O157

     ARTICLE  in  INTERNATIONAL JOURNAL OF FOOD MICROBIOLOGY · MARCH 2007

    Impact Factor: 3.08 · DOI: 10.1016/j.ijfoodmicro.2006.08.014 · Source: PubMed

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    http://www.researchgate.net/profile/Sylvie_Perelle?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_4http://www.researchgate.net/?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_1http://www.researchgate.net/profile/Patrick_Fach?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_7http://www.researchgate.net/institution/Agence_Nationale_de_Securite_Sanitaire_de_lAlimentation_de_lEnvironnement_et_du_Travail?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_6http://www.researchgate.net/profile/Patrick_Fach?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_5http://www.researchgate.net/profile/Patrick_Fach?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_4http://www.researchgate.net/profile/Sylvie_Perelle?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_7http://www.researchgate.net/institution/Agence_Nationale_de_Securite_Sanitaire_de_lAlimentation_de_lEnvironnement_et_du_Travail?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_6http://www.researchgate.net/profile/Sylvie_Perelle?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_5http://www.researchgate.net/profile/Sylvie_Perelle?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_4http://www.researchgate.net/?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_1http://www.researchgate.net/publication/6663508_Screening_food_raw_materials_for_the_presence_of_the_world%27s_most_frequent_clinical_cases_of_Shiga_toxin-encoding_Escherichia_coli_O26_O103_O111_O145_and_O157?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_3http://www.researchgate.net/publication/6663508_Screening_food_raw_materials_for_the_presence_of_the_world%27s_most_frequent_clinical_cases_of_Shiga_toxin-encoding_Escherichia_coli_O26_O103_O111_O145_and_O157?enrichId=rgreq-ed7325ec-5800-49ac-8eab-0cbe20f668eb&enrichSource=Y292ZXJQYWdlOzY2NjM1MDg7QVM6MTAyMDQ1MDQ2NTQyMzQwQDE0MDEzNDA4NDM0NDE%3D&el=1_x_2

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    Screening food raw materials for the presence of the world's most frequent 

    clinical cases of Shiga toxin-encoding  Escherichia coli

    O26, O103, O111, O145 and O157

    Sylvie Perelle, Françoise Dilasser, Joël Grout, Patrick Fach ⁎

     AFSSA, Agence Française de Sécurité Sanitaire des Aliments (French Agency for Food Safety),

     Laboratoire d'Etudes et de Recherches sur la Qualité des Aliments et sur les Procédés Agroalimentaires (LERQAP),

    Unité EBA: Etude moléculaire des contaminants biologiques alimentaires, 23 avenue du Général de Gaulle, 94700 Maisons-Alfort, France

    Received 3 November 2005; received in revised form 28 April 2006; accepted 12 August 2006

    Abstract

    This work aims to provide a strategy for rapidly screening food raw materials of bovine origin for the presence of the most frequent O-

    serogroups of Shiga toxin-encoding   Escherichia coli   (STEC) involved in food poisoning outbreaks. The prevalence of highly pathogenic

    serogroups of STEC was surveyed in 25 g portions of minced meat and raw milk using PCR-ELISA and multiplex real-time PCR assays. The

     prevalence of STEC in raw milk (n =205) and meat samples (n =300) was 21% and 15%, respectively. Contamination by the main pathogenic

     E. coli O-serogroups representing a major public health concern, including O26, O103, O111, O145, and O157, was potentially around 2.6% in

    minced meat and 4.8% in raw milk. The MPN values showed an overall contamination ranging from 1 to 2 MPN cells from highly pathogenic

    serogroups/kg. This survey would indicate that the human pathogenic potential of STEC present in these samples probably remains limited. No

    conclusion can be drawn at the moment concerning a potential risk for consumers. This rapid screening approach for evaluating the potential

     presence of highly pathogenic serogroups of STEC in food raw materials should help to improve risk assessment of food poisoning outbreaks.© 2006 Elsevier B.V. All rights reserved.

     Keywords:  STEC; O-serogroup; Real-time PCR; Food testing

    1. Introduction

    Since the early 1980s, Shiga toxin-producing   Escherichia

    coli   (STEC) have emerged as a major cause of food-borne

    infections (Karmali et al., 1983; Riley et al., 1983). STEC can

    cause diarrhea and hemorrhagic colitis (HC) and may lead to

    haemolytic uraemic syndrome (HUS). In Europe, HUS is now believed to be the commonest cause of acute renal failure in

    children, and may be fatal in up to 10% of cases (Padhye and

    Doyle, 1992). Infections may result from direct contact with

    animals or their faeces (Locking et al., 2001) but most human

    infections originate from the consumption of contaminated

    water or raw or undercooked food. A range of different 

    foodstuffs including vegetables, salad bar items, fruit, salami,

    and fresh cheese made of raw goats' and cows' milk have been

    epidemiologically implicated in serotype O157 outbreaks

    (Besser et al., 1993; CDC, 1995; Del Rosario and Beuchat,

    1995; Deschenes et al., 1996). Nevertheless, raw meat, in

     particular beef, has been considered as the principal source of 

    STEC (Karmali, 1989), and ruminants are still considered the

    major STEC reservoir. While numerous outbreaks have been

    attributed to STEC strains of serotype O157:H7, it has beenestablished that STEC strains causing gastrointestinal diseases

    in humans may well belong to more than 100 serotypes

    (Karmali, 1989; Russmann et al., 1995; Paton and Paton, 1998;

     Nataro and Kaper, 1998). However, the value of screening for 

    the presence of the   stx  gene sequences remains controversial,

    since not all STEC prove to be clinically significant in humans.

    A better understanding of the scientific basis for the difference

    in virulence between serotypes would help to identify specific

    targets characterizing strains that pose a significant risk in

    human diseases. However, although certain differences in viru-

    lence between groups of STEC strains have been related to the

    International Journal of Food Microbiology 113 (2007) 284 –288

    www.elsevier.com/locate/ijfoodmicro

    ⁎  Corresponding author. Tel.: +33 1 4977 2813; fax: +33 1 4368 9762.

     E-mail address: [email protected]  (P. Fach).

    0168-1605/$ - see front matter © 2006 Elsevier B.V. All rights reserved.doi:10.1016/j.ijfoodmicro.2006.08.014

    http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-mailto:[email protected]://dx.doi.org/10.1016/j.ijfoodmicro.2006.08.014http://dx.doi.org/10.1016/j.ijfoodmicro.2006.08.014mailto:[email protected]://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-

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     presence of specific pathogenicity islands (PAIs), e.g. the locus

    of enterocyte effacement (LEE), the scientific bases for as-

    sessing the potential virulence of STEC have not yet been

    elucidated (Karmali et al., 2003). Several reports have

    mentioned O26, O103, O111, O145 and O157:H7 as the most 

    frequent O-serogroups involved in food poisoning outbreaks,

    leading STEC strains from these O-serogroups to be consideredas the world's main pathogenic strains with implications for 

     public health. Despite several real-time PCR O-serotyping

    assays are available to rapidly determine certain STEC

    serogroups (Sharma, 2002; Perelle et al., 2004, 2005), surveys

    in foods have rarely focused on these five major serogroups. It is

    extremely important to evaluate natural contamination of raw

    milk and beef meat by STEC O26, STEC O103, STEC O111,

    STEC O145 and STEC O157:H7 for efficient risk assessment of 

    food poisoning outbreaks, but there are still few prevalence data

    available.

    The aim of this study was to evaluate the prevalence of these

    STEC O-serogroups in minced meat and raw milk samplescollected in France. The study method is based on enrichment of 

    samples in a nutrient broth before positive STEC screening

    using a recently developed duplex 5′-nuclease PCR assay

    (Perelle et al., 2004) targeting the   stx   genes, followed by a

    newly developed multiplex 5′-nuclease PCR test specific for 

     E. coli   O26,   E. coli   O103,   E. coli   O111,   E. coli   O145 and

     E. coli O157. The advantages and disadvantages of using such a

    strategy for foods analysis are discussed.

    2. Materials and methods

    2.1. Food samples

    More than five hundred samples of bovine origin were

    collected in France from different geographical areas across

    the country during a period of 12 months. They arrived at the

    laboratory by rapid cold road transport and were processed on

    arrival. The samples of food raw materials were raw milk 

    (n =205) collected in several dairies and minced meat (n =300)

    collected in different abattoirs. Beef meat was cut using sterile

    instruments, placed in individual plastic bags, homogenized

    in a stomacher blender for 120 s, and then stored at  −20 °C

    until use. Raw milk samples were stored at 4 °C. The sample

    quantities prepared were approximately 25 g for each sam-

     ple. The samples were stored not longer than 48 h beforeinvestigation.

    2.2. Enrichment procedure and DNA extraction

    Samples of 25 g of raw material were diluted tenfold (wt/vol)

    in 225 ml of modified EC medium containing 20 mg l− 1 of 

    novobiocin (mEC+n broth), and incubated at 37 °C overnight.

    After incubation, a 1 ml aliquot of the enrichment broth was

    collected for DNA extraction. This aliquot was centrifuged for 

    5 min at 9000  g , and the supernatant was discarded. The cell

     pellets were then DNA-extracted using InstaGene Matrix™

    (Bio-Rad Laboratories, Marnes-La-Coquette, France) and the

    DNA was stored at  −20 °C until PCR testing.

    2.3. Food PCR detection

    To detect STEC in food samples, we used the PCR-ELISA

    described previously (Fach et al., 2001). Briefly, four 

    degenerated oligonucleotides targeting the most well-con-

    served sequences in the  stx  genes were designed for screening

     stx1   and   stx2   gene sequences in food products (Fach et al.,2001). Two oligonucleotides were designed as primers to

    amplify approximately 500 bp fragments from  stx  genes, while

    the two others were used as capture and detection probes in a

    sandwich hybridization assay. The capture probe was labelled

    with biotin and bound to streptavidin-coated microtiter plates,

    while the detection probe was labelled with digoxigenin. After 

    alkaline denaturation of the PCR products, hybridization oc-

    curred with the two probes in the streptavidin-coated microtiter 

     plates. In a similar way to ELISA technology, hybrids were

    detected using a peroxidase anti-digoxigenin conjugate, and

    the final enzymatic reaction of the test gave a colorimetric

    signal measured with a microtiter plate reader. To identify possible PCR inhibitors derived from the food samples, an

    internal amplification control (IAC) was included which co-

    amplified with stx  target genes. PCR products derived from the

    IAC were detected with a specific set of capture and detection

     probes (Fach et al., 2001). The PCR-ELISA positive samples

    were further tested in a newly developed multiplex real-time

    PCR assay screening for   E. coli   O26,   E. coli   O103,   E. coli

    O111, E. coli O145 and E. coli O157. This multiplex PCR test 

    is based on primers and probes targeting the O-antigen gene

    clusters of  E. coli O26, E. coli O111 and E. coli O157, the eae

    gene of  E. coli O103, and the O-island 29 of  E. coli  O145, as

    described in a previous study (Perelle et al., 2004). Multiplex

    amplifications were performed using 20  μl of reaction mixturecontaining 1× concentration of a LightCycler-Faststart DNA

    master hybridization probes mix (Roche Diagnostics, Meylan,

    France), 5 mM MgCl2, 500 nM of each primer, 200 nM of each

    FAM-TAMRA labelled probe, and 2  μl of the template DNA.

    Positive controls using appropriate purified plasmid DNA

    (Perelle et al., 2004) and two negative controls containing

    all the reagents except the DNA template were included

    with each amplification set. Cycling was carried out in the

    LightCycler instrument (Roche Diagnostics). The amplifica-

    tion started with an initial denaturing step at 95 °C for 10 min,

    followed by 40 cycles at 95 °C for 10 s with a temperature

    transition rate of 20 °C/s, and 60 °C for 30 s with a temperaturetransition rate of 10 °C/s, and then a cooling step at 40 °C for 

    30 s. The generation of fluorescence for each sample was

    monitored at the end of the elongation steps in the F1/F2

    channel (530 nm). A fluorescent signal 10-fold higher than the

    standard deviation of the mean baseline emission indicated a

     positive detection. Ct was defined as the PCR cycle at which

    the fluorescent intensity exceeds the threshold. Finally,

    samples tested positive by the multiplex real-time PCR assay

    were further tested in simplex real-time PCR assays to identify

    the exact pathogenic   E. coli   O-serogroups concerned, as

    well as in an  stx-typing 5′-nuclease PCR assay (Perelle et al.,

    2004). The method proposed in our study is summarized

    in Fig. 1.

    285S. Perelle et al. / International Journal of Food Microbiology 113 (2007) 284 – 288

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    2.4. Determination of MPN counts

    The survey data were converted to MPN counts as

     previously proposed (Halvorson and Ziegler, 1933). MPNs

    were calculated using the following formula: MPN=Ln(n / q),

    where  n   is the number of samples tested and  q  the number of 

    negative samples.

    3. Results and discussion

    A total of 505 food raw materials of bovine origin were

    screened by PCR for the presence of the most frequent O-

    serogroups of STEC involved in food poisoning outbreaks.

    Screening of STEC was performed by PCR-ELISA with an IAC

    to monitor false negative results due to sample PCR inhibitors

    (Fach et al., 2001). STEC-positive samples were further tested

    in the newly developed multiplex real-time PCR assay for 

     E. coli   O26,   E. coli   O103,   E. coli   O111,   E. coli   O145 and

     E. coli  O157. Finally, samples tested positive by the multiplex

    real-time PCR assay were further tested in simplex real-time

    PCR assays to identify the exact pathogenic   E. coli   O-

    serogroups concerned, as well as in an   stx-typing 5′-nucleasePCR assay (Perelle et al., 2004).

    The prevalence of STEC-positive samples as determined by

    PCR-ELISA was 17.4% (Table 1). Forty-five (15%) of the 300

    samples of beef meat and 43 (21%) of the 205 samples of raw

    milk were positive for STEC in PCR-ELISA. Seventy-four 

    (84%) of the 88 positive samples were confirmed positive by

     stx-typing with 5′-nuclease PCR assay. This difference between

    the PCR-ELISA and 5′-nuclease PCR may be due either to the

    Table 1

    Evaluation of the prevalence of STEC O26, O103, O111, O145 and O157 in food raw materials of bovine origin

    Sample type Number 

    tested

     Number of positive samples Most 

     probable

    number/ 

    kg a 

    PCR-ELISA Typing of the stx  genes by 5′-nuclease PCR Specific O-serogroup identification of STEC-positive samples

     Number 

    (%)

     Number 

    (%)

    (Number of samples)

    Minced meat 

    (beef)

    300 45 (15%) 2  stx1 (4.6%), 28  stx2  (65%),

    and 13  stx1+ stx2  (30.2%)

    O145 (4), O157 (1), O145+O157 (1), O145+O103 (1),

    and O157+O103 (1)

    1

    (Total=8)

    Raw milk 205 43 (21%) 12  stx1  (38.7%), 10  stx2  (32.2%),

    and 9  stx1+ stx2 (29%)

    O145 (4), O103 (1), O145+O157 (3), O145+O103 (1),

    and O145+O26 (1)

    2

    (Total=10)

    Total 505 88 (17.4%) 14  stx1  (18.9%), 38  stx2  (51.3%),

    and 22  stx1+ stx2  (29.7%)

    O145 (8), O157 (1), O103 (1), O145+O157 (4),

    O145+O103 (2), O145+O26 (1), and O157+O103 (1)

    1–2

    (Total = 74) (Total = 18)

    a  According to Halvorson and Ziegler (1933).

    Fig. 1. Flow diagram illustrating the preparation of food samples and the different screening steps for evaluating the presence of STEC serogroups of major public

    health concern.

    286   S. Perelle et al. / International Journal of Food Microbiology 113 (2007) 284 – 288

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    different quantities of DNA tested in the two PCR tests (10 μl in

    PCR-ELISA against 2  μl in real-time PCR), to the presence of 

    PCR inhibitors in the samples which may have affected each

    PCR system differently, or to possible STEC variants that 

    cannot be equally detected with the two PCR systems, which

    would be in agreement with the increasing number of variants

    described in the literature over the last few years (Gyles et al.,

    1988; Weinstein et al., 1988; Gannon et al., 1990; Ito et al.,

    1990; Hii et al., 1991; Lin et al., 1993; Kim et al., 1997; Paton

    et al., 1992, 1993a,b, 1995; Pierard et al., 1998). These variants

    have usually been described as Stx2 strains of STEC, while

    variants derived from Stx1 strains have rarely been reported

    (Paton et al., 1993a, 1995). 5′-nuclease PCR typing of the  stx

    genes demonstrated that 14 (19%) samples carried  stx1  genes,

    38 (51.3%) carried stx2 genes, and 22 (29.7%) carried both  stx1and stx2 genes (Table 1).

    Multiplex real-time PCR detection of   E. coli  O26,  E. coli

    O103, E. coli  O111,  E. coli  O145 and  E. coli  O157 confirmed

    only 18 positives out of the 74 positives obtained by the 5′-

    nuclease PCR targeting the   stx   genes. This suggests that the

    overall contamination by the main pathogenic   E. coli   O-

    serogroups of major public health concern was around 3.5% in

    these food samples, broken down as 2.6% in minced meat and

    4.8% in raw milk. The MPN values would indicate an overall

     potential contamination ranging from 1 to 2 MPN STEC cells of highly pathogenic serogroup/kg, meaning that contamination of 

     beef meat and raw milk by highly pathogenic serogroups of 

    STEC is very low, and that the risk of consumer infection by

    human pathogenic strains of STEC present in these samples is

     probably very minor.

    The 18 samples tested positive in multiplex real-time PCR 

    were identified with high precision by simplex real-time PCR 

    (Table 1). Eight samples were positive with   E. coli   O145, 1

    sample was positive with  E. coli  O103, 1 sample was positive

    with   E. coli  O157, 4 samples were positive with both   E. coli

    O145 and   E. coli   O157, 2 samples were positive with both

     E. coli  O103 and E. coli O145, 1 sample was positive with both

     E. coli  O103 and E. coli O157, and 1 sample was positive with

     both   E. coli   O26 and   E. coli   O145. None of the samples

    analyzed tested positive with   E. coli   O111. The overall

    contamination of beef meat and raw milk by   E. coli   O157

    was 1%, which is in strong agreement with the reported

    worldwide E. coli  O157 incidence in these food products. The

     prevalence of  E. coli  O26 and  E. coli  O103 was very low at 1

    and 3 positive samples, respectively, which is in the lower range

    of worldwide reported incidence for these two serotypes. The

     prevalence of   E. coli  O145 (positive in 3% of samples) was

    unexpectedly higher than the prevalence of other serogroups.

    This study demonstrates that different O-serogroups of 

     E. coli   of major public health concern are able to enter the

     processing chain in the meat and dairy industries. However,there is increasing evidence in the literature that many of these

    STEC O-serogroups may not produce Shiga-toxin, nor will

    they posses the  stx genes. Fig. 2 illustrates that both toxigenic

    ( stx-positive) and non-toxigenic ( stx-negative) strains coex-

    isted within each O-serogroup. Therefore, when both  stx  and

    O-serogroup gene sequences were detected in certain foods

    (2.6% of minced meat and 4.8% of raw milk), there was no

    evidence that these signals were displayed by a pathogenic  E.

    coli strain. As mentioned in Fig. 1, isolation of clones from the

    food mixture should be performed to confirm or notthe positive

     presumptive result. But, this isolation step is still problematic

    and time-consuming using the current commercially availablemedia. Whatever the difficulties to isolate STEC from foods,

    the idea of combining detection of  stx and genes encoding O-

    groups is a good approach along our way to optimise methods

    for detection of pathogenic STEC. The rapid (within 36 h)

    detection and typing of the  stx  and O-serogroups of STEC in

    food raw materials should be helpful in forming a response to

     E. coli  food poisoning.

    Acknowledgment

    This work was partially funded by  Ministère de l'Agriculture

    et de la Pêche, Direction Générale de l'Alimentation   (French

    Ministry for Agriculture and Fisheries), Paris, France.

    Fig. 2. Diagram showing the coexistence of both toxigenic ( stx-positive) and non-toxigenic ( stx-negative) strains within each O-serogroup tested.

    287S. Perelle et al. / International Journal of Food Microbiology 113 (2007) 284 – 288

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