University of Massachusetts Medical School Faculty Publications


Shiga toxin-producing Escherichia coli O104:H4: an emerging pathogen with enhanced virulence

UMMS Affiliation

Department of Microbiology and Physiological Systems; Department of Pathology

Publication Date


Document Type



Communicable Diseases, Emerging; Disease Outbreaks; Escherichia coli Infections; Europe; Genome, Bacterial; Humans; Shiga-Toxigenic Escherichia coli; Virulence


Bacteria | Digestive System Diseases | Immunology and Infectious Disease | Microbiology | Pathogenic Microbiology


Pathogenic Escherichia coli are genetically diverse and encompass a broad variety of pathotypes, such as enteroaggregative E. coli (EAEC) or enterohemorrhagic E. coli (EHEC), which cause distinct clinical syndromes. The historically large 2011 German outbreak of hemolytic uremic syndrome (HUS), caused by a Shiga-toxin producing E. coli (STEC) of the serotype O104:H4, illustrated the emerging importance of non-O157 STEC. STEC O104:H4, with features characteristic of both enteroaggregative E. coli and enterohemorrhagic E. coli, represents a unique and highly virulent pathotype. The German outbreak both allowed for the evaluation of several potential therapeutic approaches to STEC-induced HUS and emphasizes the importance of early and specific detection of both O157 and non-O157 STEC.

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Citation: Infect Dis Clin North Am. 2013 Sep;27(3):631-49. doi: 10.1016/j.idc.2013.05.002. Epub 2013 Jul 24. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Infectious disease clinics of North America

PubMed ID