{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T21:29:14Z","timestamp":1784842154717,"version":"3.55.0"},"reference-count":81,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T00:00:00Z","timestamp":1760227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Implementation of molecular detection methodology of Shiga toxin-producing Escherichia coli (STEC) in Danish patients began in 1997. Since then, changes in molecular detection methods and diagnostic criteria have led to the present situation, in which almost all diarrhoeal stool specimens are examined for STEC. Whole genome sequencing (WGS) of STEC isolates referred to the national reference laboratory has increased the detailed characterisation, and revealed a large spectrum, of STEC types, including cross-over pathotypes typically associated with extraintestinal disease or traveller\u2019s diarrhoea. Association of subtype stx2a (and stx2d) with the risk of developing haemolytic uraemic syndrome (HUS) was confirmed. These changes have resulted in an increase in the number of diagnosed STEC cases from 31 cases in 1997 to 1432 in 2023. Similar increases in Europe have also been recorded. Culture of STEC is, on the other hand, declining, which poses a challenge to the identification of multiple STEC infections and outbreaks. Syndromic (PCR) test panels have also resulted in an increase in the detection of multiple microorganisms. Double or triple infections have increased the role of clinical microbiologists in interpreting and assessing the significance of diagnostic results and have also increased the need for high-quality curation of surveillance data.<\/jats:p>","DOI":"10.3390\/microorganisms13102342","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T05:48:21Z","timestamp":1760420901000},"page":"2342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Shiga Toxin-Producing E. coli (STEC) from Danish Patients, 1997\u20132023: Diagnostic Trends and Bacteriological Findings"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3931-4846","authenticated-orcid":false,"given":"Flemming","family":"Scheutz","sequence":"first","affiliation":[{"name":"The International <i>Escherichia<\/i> and <i>Klebsiella<\/i> Centre, Section of Foodborne Infections, Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0350-105X","authenticated-orcid":false,"given":"Katrine Grimstrup","family":"Joensen","sequence":"additional","affiliation":[{"name":"The International <i>Escherichia<\/i> and <i>Klebsiella<\/i> Centre, Section of Foodborne Infections, Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5575-7252","authenticated-orcid":false,"given":"Susanne","family":"Schj\u00f8rring","sequence":"additional","affiliation":[{"name":"The International <i>Escherichia<\/i> and <i>Klebsiella<\/i> Centre, Section of Foodborne Infections, Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bente","family":"Olesen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Copenhagen University, Herlev Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 52, 2730 Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen","family":"Engberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Zealand University Hospital, 4600 Koege, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2456-6108","authenticated-orcid":false,"given":"Hanne Marie","family":"Holt","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Odense University Hospital, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2370-417X","authenticated-orcid":false,"given":"Hans Linde","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Aalborg University Hospital, 9000 Aalborg, Denmark"},{"name":"Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Lemming","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Aarhus University Hospital, 8200 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Section 445, Copenhagen University Hospital, Amager\/Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1253-5403","authenticated-orcid":false,"given":"Lisbeth","family":"L\u00fctzen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Sygehus Lilleb\u00e6lt, 6000 Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3297-3814","authenticated-orcid":false,"given":"Marc Trunjer Kusk","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Diagnostics, Syddansk Universitetshospital, Esbjerg og Grindsted Sygehus, Finsensgade 35, 6700 Esbjerg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Sch\u00f8nning","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Copenhagen University Hospital\u2014Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5349-7802","authenticated-orcid":false,"given":"Eva M\u00f8ller","family":"Nielsen","sequence":"additional","affiliation":[{"name":"The International <i>Escherichia<\/i> and <i>Klebsiella<\/i> Centre, Section of Foodborne Infections, Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,12]]},"reference":[{"key":"ref_1","first-page":"245","article-title":"Prevention and control of enterohaemorrhagic Escherichia coli (EHEC) infections: Memorandum from a WHO meeting. 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