{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T16:59:48Z","timestamp":1774717188359,"version":"3.50.1"},"reference-count":49,"publisher":"Microbiology Society","issue":"11","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018336","name":"National Institute for Health Research Health Protection Research Unit","doi-asserted-by":"crossref","award":["111815"],"award-info":[{"award-number":["111815"]}],"id":[{"id":"10.13039\/100018336","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,7]]},"abstract":"<jats:p>\n                  <jats:bold>Introduction.<\/jats:bold> Shiga toxin-producing <jats:italic>Escherichia coli<\/jats:italic> (STEC) are zoonotic, gastrointestinal pathogens characterized by the presence of the Shiga toxin (<jats:italic>stx<\/jats:italic>) gene. Historically, STEC O157:H7 clonal complex (CC) 11 has been the most clinically significant serotype; however, recently there has been an increase in non-O157 STEC serotypes, including STEC O103:H2 belonging to CC17.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Gap statement.<\/jats:bold> STEC O103:H2 is an STEC serotype frequently isolated in England, although little is known about the epidemiology, clinical significance, associated public health burden or evolutionary context of this strain.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Aim.<\/jats:bold> Surveillance data and whole-genome sequencing data were analysed to determine the microbiological characteristics and public health burden of CC17, including the clinically significant serotype O103:H2, in England and Wales.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methodology.<\/jats:bold> Isolates of <jats:italic>E. coli<\/jats:italic> belonging to CC17 (<jats:italic>n<\/jats:italic>=425) submitted to the Gastrointestinal Bacteria Reference Unit from 2014 to 2022 were whole genome sequenced, integrated with enhanced surveillance questionnaire data and analysed retrospectively.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results.<\/jats:bold> Overall, diagnoses of CC17 infection increased every year since 2014. Most cases were female (58.5%), with the highest proportion of cases belonging to the 0\u20134 age group (<jats:italic>n<\/jats:italic>=83\/424, 19.6%). Clinical presentation data identified diarrhoea (92.1%), abdominal pain (72.4%) and blood in stool (55.3%) as the most frequent symptoms, while 20.4%\u2009cases were admitted to hospital and 1.3% developed haemolytic uraemic syndrome. The five most common established serotypes were O103:H2 (64.5%), O123:H2 (11.1%), O151:H2 (6.6%), O71:H2 (3.3%) and O4:H2 (2.6%). The majority of CC17 isolates (78.6%) had the <jats:italic>stx1a\/eae<\/jats:italic> virulence gene combination. Nine outbreak clusters of STEC infections that were mainly geographically dispersed and temporally related were identified and associated with foodborne transmission.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusions.<\/jats:bold> Nationwide implementation of PCR to detect non-O157 STEC and improvements to algorithms for the follow-up of PCR-positive faecal specimens is recommended. Enhanced surveillance is necessary to assess the incidence of CC17 infection and overall burden of this CC within the UK population.<\/jats:p>","DOI":"10.1099\/jmm.0.001928","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T15:16:38Z","timestamp":1730992598000},"source":"Crossref","is-referenced-by-count":4,"title":["Genotypic analysis of Shiga toxin-producing Escherichia coli clonal complex 17 in England and Wales, 2014\u20132022"],"prefix":"10.1099","volume":"73","author":[{"given":"Ching-Ying J.","family":"Poh","sequence":"first","affiliation":[{"name":"NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK"},{"name":"Gastrointestinal Bacteria Reference Unit, UK Health Security Agency, Colindale, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ella V.","family":"Rodwell","sequence":"additional","affiliation":[{"name":"Gastro and Food Safety (One Health) Division, UK Health Security Agency, Colindale, London, UK"},{"name":"NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gauri","family":"Godbole","sequence":"additional","affiliation":[{"name":"Gastro and Food Safety (One Health) Division, UK Health Security Agency, Colindale, London, UK"},{"name":"NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8600-9169","authenticated-orcid":false,"given":"Claire","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Gastrointestinal Bacteria Reference Unit, UK Health Security Agency, Colindale, London, UK"},{"name":"NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00022-13"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001375"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268822000206"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2108739"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.3201\/eid2204.151485"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.2903\/j.efsa.2020.5967"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckaa232"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2024.1364026"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed7110356"},{"key":"R10","article-title":"UK Standards for Microbiology Investigations Gastroenteritis Issued by the Standards Unit, National Infection Service, PHE. 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