Escherichia coli O104:H4 is a rare enterohemorrhagic

Enterohemorrhagic

Enterohemorrhagic microorganisms are those that, as part of their pathogenesis, cause bloody diarrhea and colitis. While many pathogens are enterohemorrhagic, most cases observed are derived of E. coli serotype O157:H7. The E. coli O104:H4 strain identified as the cause of the 2011 outbreak in...

 strain of the bacterium

Bacteria

Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

 Escherichia coli, and the cause of the 2011 Escherichia coli O104:H4 outbreak. The "O" in the serological classification identifies the cell wall lipopolysaccharide

Lipopolysaccharide

Lipopolysaccharides , also known as lipoglycans, are large molecules consisting of a lipid and a polysaccharide joined by a covalent bond; they are found in the outer membrane of Gram-negative bacteria, act as endotoxins and elicit strong immune responses in animals.-Functions:LPS is the major...

 antigen, and the "H" identifies the flagella antigen.

Analysis of genomic sequences

DNA sequencing

DNA sequencing includes several methods and technologies that are used for determining the order of the nucleotide bases—adenine, guanine, cytosine, and thymine—in a molecule of DNA....

 obtained by BGI

Beijing Genomics Institute

BGI , known as the Beijing Genomics Institute prior to 2008, is one of the world’s premier genome sequencing centers. Its sequencing output is expected to soon surpass the equivalent of more than 15,000 human genomes per year....

 Shenzhen show that the O104:H4 outbreak strain is an enteroaggregative E. coli (EAEC or EAggEC) type that has acquired Shiga toxin

Shiga toxin

Shiga toxins are a family of related toxins with two major groups, Stx1 and Stx2, whose genes are considered to be part of the genome of lambdoid prophages. The toxins are named for Kiyoshi Shiga, who first described the bacterial origin of dysentery caused by Shigella dysenteriae. The most common...

 genes, presumably by horizontal gene transfer

Horizontal gene transfer

Horizontal gene transfer , also lateral gene transfer , is any process in which an organism incorporates genetic material from another organism without being the offspring of that organism...

.
Genome assembly

Sequence assembly

In bioinformatics, sequence assembly refers to aligning and merging fragments of a much longer DNA sequence in order to reconstruct the original sequence. This is needed as DNA sequencing technology cannot read whole genomes in one go, but rather reads small pieces of between 20 and 1000 bases,...

 and copy number analysis both confirmed that two copies of the Shiga toxin

Shiga toxin

Shiga toxins are a family of related toxins with two major groups, Stx1 and Stx2, whose genes are considered to be part of the genome of lambdoid prophages. The toxins are named for Kiyoshi Shiga, who first described the bacterial origin of dysentery caused by Shigella dysenteriae. The most common...

 stx2 prophage

Prophage

A prophage is a phage genome inserted and integrated into the circular bacterial DNA chromosome. A prophage, also known as a temperate phage, is any virus in the lysogenic cycle; it is integrated into the host chromosome or exists as an extrachromosomal plasmid. Technically, a virus may be called...

 gene cluster are a distinctive characteristic of the genome

Genome

In modern molecular biology and genetics, the genome is the entirety of an organism's hereditary information. It is encoded either in DNA or, for many types of virus, in RNA. The genome includes both the genes and the non-coding sequences of the DNA/RNA....

 of the O104:H4 outbreak strain.
The O104:H4 strain is characterized by the following genetic markers:

• Shiga toxin stx2 positive,
• terE positive (tellurite
  Tellurite
  Tellurite is a rare oxide mineral composed of tellurium dioxide .It occurs as prismatic to acicular transparent yellow to white orthorhombic crystals. It occurs in the oxidation zone of mineral deposits in association with native tellurium, emmonsite and other tellurium minerals. Its name comes...
  
   resistance gene cluster),
• eae negative (intimin
  Intimin
  Intimin is a virulence factor of EPEC and EHEC E. coli strains. It is an attaching and effacing protein which with other virulence factors is responsible for enteropathogenic and enterohaemorrhagic diarrhoea.According to a TIME magazine Q & A story with Martin Wiedmann, a professor of food...
  
   adherence gene),
• β-lactamases
  Beta-lactamase
  Beta-lactamases are enzymes produced by some bacteria and are responsible for their resistance to beta-lactam antibiotics like penicillins, cephamycins, and carbapenems . These antibiotics have a common element in their molecular structure: a four-atom ring known as a beta-lactam...
  
   ampC, ampD, ampE, ampG, ampH are present.

The European Commission

European Commission

The European Commission is the executive body of the European Union. The body is responsible for proposing legislation, implementing decisions, upholding the Union's treaties and the general day-to-day running of the Union....

 (EC) integrated approach to food safety defines a case of Shiga-like toxin producing E. coli (STEC) diarrhea

Diarrhea

Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

 caused by O104:H4 by an acute onset of diarrhea or bloody diarrhea together with the detection of the Shiga toxin 2 (Stx2) or the
Shiga gene stx2.
Prior to the 2011 outbreak, only one case identified as O104:H4 had been observed, in a woman in South Korea in 2005.

Pathophysiology

E. Coli O104 is a shiga toxin

Shiga toxin

Shiga toxins are a family of related toxins with two major groups, Stx1 and Stx2, whose genes are considered to be part of the genome of lambdoid prophages. The toxins are named for Kiyoshi Shiga, who first described the bacterial origin of dysentery caused by Shigella dysenteriae. The most common...

–producing E. coli (STEC). These toxins are what cause us to become sick. The method of how these toxins make us sick is they stick to the intestinal cells and aggravate the cells along the intestinal wall. This in turn usually can cause bloody stools to occur. Other effects that can come from this bacteria is Hemolytic uremic syndrome (HUS). Which is a condition characterized by destruction of red blood cells and this over a long period of time can cause kidney failure develop.Some common symptoms of HUS are vomiting, bloody diarrhea, and blood in the urine.

Infection

How someone becomes infected with such a resistant bacteria like the E. Coli O104:H4, is when food with contaminated feces is consumed; meaning this illness is typically food born. Most recently in 2011, there was an outbreak of the E. Coli O104:H4 strain in Germany that caused dozens to die, and landed hundreds of US citizens in the hospital. The infection was eventually traced back to some sprots that had been contaminated.

Treatment

The first step to treating someone that appears to have E. Coli O104:H4 symptoms are to test their stools. The stool test is then sent a lab to see if it has any remnants of STEC (Shiga-toxin–producing E. coli) can be found; if STEC is found it is a good chance that E. Coli O104:H4 or another form of STEC is present. With the help of lab tests a doctor can diagnose a patient so they can properly be treated. One thing that makes E. Coli O104:H4 very difficult to treat is that it is resistant to most antibiotics except carbapenems; in fact, E. Coli O104:H4 is resistant to at least 14 different types of antibiotics.

Prevention

The biggest thing that we can do to prevent the spread of such virulent bacteria such as E. Coli O104:H4 is by doing simple things which include: washing our hands, washing our food, and properly cooking our food so we can be sure that the majority pathogenic bacterium are destroyed.