{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T10:59:45Z","timestamp":1793444385306,"version":"4.5.0"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2003,9,1]],"date-time":"2003-09-01T00:00:00Z","timestamp":1062374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Three types of cytolethal distending toxin (CDT), namely, CDT-I, CDT-II, and CDT-III, have been described in\n            <jats:italic>Escherichia coli<\/jats:italic>\n            . Using primers designed for the detection of sequences common to the\n            <jats:italic>cdtB<\/jats:italic>\n            genes, we analyzed by PCR a set of 21 CDT-producing\n            <jats:italic>E. coli<\/jats:italic>\n            strains of intestinal and extraintestinal origins isolated from human and different animal species in several European countries and in the United States. On the basis of the existing differences in the\n            <jats:italic>cdtB<\/jats:italic>\n            genes,\n            <jats:italic>cdt<\/jats:italic>\n            -I-,\n            <jats:italic>cdt<\/jats:italic>\n            -II-, and\n            <jats:italic>cdt<\/jats:italic>\n            -III-specific primer pairs were designed and used for\n            <jats:italic>cdt<\/jats:italic>\n            typing. These new primers successfully differentiated all of the previously described\n            <jats:italic>cdt<\/jats:italic>\n            genes. Six strains proved to be\n            <jats:italic>cdt-<\/jats:italic>\n            I; eight strains proved to be\n            <jats:italic>cdt<\/jats:italic>\n            -III. However, none of the type I-, II-, and III-specific primers generated amplicons from six CDT\n            <jats:sup>+<\/jats:sup>\n            strains, suggesting the existence of a new\n            <jats:italic>cdt<\/jats:italic>\n            variant. Sequence analysis of the amplicons from two untypeable genes confirmed the existence of a new\n            <jats:italic>cdt<\/jats:italic>\n            variant that we called\n            <jats:italic>cdt<\/jats:italic>\n            -IV. Using the new specific primers,\n            <jats:italic>cdt<\/jats:italic>\n            -IV was detected in human, porcine, and poultry strains of intestinal and extraintestinal origins. To validate all sets of\n            <jats:italic>cdt<\/jats:italic>\n            specific primers, a group of 353 human\n            <jats:italic>E. coli<\/jats:italic>\n            strains isolated in Hungary was then investigated for the presence of\n            <jats:italic>cdt<\/jats:italic>\n            genes. This included 190 strains isolated from patients with urinary tract infections (UTI), 51 strains isolated from other (nonurinary) extraintestinal infections, and 112 intestinal strains isolated from healthy individuals. Of 190 UTI strains, 15 (7.9%) had\n            <jats:italic>cdt<\/jats:italic>\n            genes. Of 51 non-UTI extraintestinal strains 3 (5.9%) contained the\n            <jats:italic>cdt<\/jats:italic>\n            gene, and 1 (0.9%) of 112 healthy intestinal strains was PCR positive. Five strains proved to be\n            <jats:italic>cdt<\/jats:italic>\n            -I, and fourteen strains proved to be\n            <jats:italic>cdt<\/jats:italic>\n            -IV. The CDT-producing extraintestinal strains belonged to a wide variety of serogroups, including O2, O6, O75, and O170. In conclusion, we have developed a new PCR typing system for CDT able to detect a new CDT variant present in pathogenic\n            <jats:italic>E. coli<\/jats:italic>\n            strains obtained from animals and humans.\n          <\/jats:p>","DOI":"10.1128\/jcm.41.9.4285-4291.2003","type":"journal-article","created":{"date-parts":[[2003,9,4]],"date-time":"2003-09-04T18:34:38Z","timestamp":1062700478000},"page":"4285-4291","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":155,"title":["Production of Cytolethal Distending Toxins by Pathogenic\n            <i>Escherichia coli<\/i>\n            Strains Isolated from Human and Animal Sources: Establishment of the Existence of a New\n            <i>cdt<\/i>\n            Variant (Type IV)"],"prefix":"10.1128","volume":"41","author":[{"given":"Istva\u0301n","family":"To\u0301th","sequence":"first","affiliation":[{"name":"Veterinary Medical Research Institute of the Hungarian Academy of Sciences, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fre\u0301derique","family":"He\u0301rault","sequence":"additional","affiliation":[{"name":"UMR1225, Institut National de la Recherche Agronomique de Microbiologie Moleculaire, Ecole Nationale Ve\u0301te\u0301rinaire de Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lothar","family":"Beutin","sequence":"additional","affiliation":[{"name":"Division of Emerging Bacterial Pathogens, Robert Koch Institute, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Oswald","sequence":"additional","affiliation":[{"name":"UMR1225, Institut National de la Recherche Agronomique de Microbiologie Moleculaire, Ecole Nationale Ve\u0301te\u0301rinaire de Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.34.3.717-719.1996"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1099\/0022-1317-49-2-177"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.65.9.3774-3780.1997"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","unstructured":"Birnboim H. 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