MICROBIOLOGY


by Uropathogenic Escherichia coli: Mechanisms of Infection and Treatment Options. Int J Mol Sci. 2023 Jun23;24(13):10537. doi:10.3390/ ijms241310537


14 World Health Organization. Enterotoxigenic Escherichia coli (ETEC). (WHO, 2024) www.who.int/teams/ immunization-vaccines-and-biologicals/ diseases/enterotoxigenic-escherichia-coli- (etec)


15 UK Health Security Agency. E. coli advice issued amid rise in cases. (Gov.co.uk, 2024) www.gov.uk/government/news/e-coli- advice-issued-amid-rise-in-cases


Fig 3. Pro-Lab Prolex Non-O157 STEC assay.


and development. The WHO sees vaccination research and development for extra-intestinal E. coli to be of high priority across all regions.21


n Development of STEC vaccines aimed at neutralising Shiga toxins are also under investigation, with primary aims to prevent colonisation via the Stx adherence factor and specific Shiga- toxin inactivation vaccines in both humans and cattle.22 While vaccination research and development are ongoing, considerable progress has been made. Future research and development will focus on improving antigen coverage, scalability, cost effectiveness, and hopefully development of multivalent vaccines that target multiple strains simultaneously, offering broad-spectrum protection.


Summary In conclusion Escherichia coli exemplifies the dual nature of microorganisms in human health. While its commensal strains underpin gut health and biotechnological innovation, pathogenic variants, and misplaced commensals, pose significant clinical and public health challenges. The need for simple, affordable, and effective identification diagnostics within routine laboratories is required. Moreover, advances in vaccine development are essential for mitigating the disease burden of E. coli. It goes without saying that addressing antimicrobial resistance and ensuring equitable access to possible interventions require global collaboration, paving the way for a future where E. coli’s benefits are fully harnessed, and its threats effectively managed.


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Escherichia. Adv Appl Microbiol. 2006;60:133-196. doi:10.1016/S0065- 2164(06)60005-1


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3 LeBlanc JG, Milani C, de Giori GS, Sesma F, van Sinderen D, Ventura M. Bacteria as vitamin suppliers to their host: a gut microbiota perspective. Curr Opin Biotechnol. 2013;24(2):160-168. doi:10.1016/j.copbio.2012.08.005


4 Lodish, HF. Molecular Cell Biology. 4th edn. New York, W.H. Freeman, 2000.


5 World Health Organization. Guidelines for drinking-water quality: fourth edition incorporating the first and second addenda. (WHO, 2022) https://www.who. int/publications/i/item/9789240045064


6 Paton JC, Paton AW. Pathogenesis and diagnosis of Shiga toxin-producing Escherichia coli infections. Clin Microbiol Rev. 1998;11(3):450-479. doi:10.1128/ CMR.11.3.450


7 Centers for Disease Control and Prevention. E. coli (Escherichia coli). (CDC, 2023) https://www.cdc.gov/ecoli


8 Kaper JB, Nataro JP, Mobley HL. Pathogenic Escherichia coli. Nat Rev Microbiol. 2004;2(2):123-140. doi:10.1038/ nrmicro818


9 Ochoa TJ, Contreras CA. Enteropathogenic Escherichia coli infection in children. Curr Opin Infect Dis. 2011;24(5):478-483. doi:10.1097/ QCO.0b013e32834a8b8b


10 Mead PS, Griffin PM. Escherichia coli O157:H7. Lancet. 1998;352(9135):1207- 1212. doi:10.1016/S0140-6736(98)01267-7


11 Tarr PI, Gordon CA, Chandler WL. Shiga- toxin-producing Escherichia coli and haemolytic uraemic syndrome. Lancet. 2005;365(9464):1073-1086. doi:10.1016/ S0140-6736(05)71144-2


12 Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in the United States–major pathogens. Emerg Infect Dis. 2011;17(1):7-15. doi:10.3201/eid1701. p11101


13 Zhou Y, Zhou Z, Zheng L, et al. Urinary Tract Infections Caused


16 Mundasad S. Supermarket sandwiches linked to E. coli outbreak. (BBC, 2024) www.bbc.co.uk/news/articles/ cz448dj4x8xo


17 Pro-Lab Diagnostics. Prolex Latex Agglutination Kits. (Pro-Lab, 2024) https:// pro-lab.co.uk/product-category/prolextm- latex-agglutination/


18 Pro-Lab Diagnostics. E. coli Typing. (Pro- Lab, 2024) https://pro-lab.co.uk/product/e- coli-typing-e-coli-etec-eiec-e-coli-ehec- epec-eiec/


19 UK NEQAS. Non-O157 STEC diagnostic practices. (UK NEQAS, 2024) https://www. ukneqas.org


20 Svennerholm AM, Tobias J. Vaccines against enterotoxigenic Escherichia coli. Expert Rev Vaccines. 2008;7(6):795- 804. doi:10.1586/14760584.7.6.795


21 Hasso-Agopsowicz M, Hwang A, Hollm- Delgado MG, et al. Identifying WHO global priority endemic pathogens for vaccine research and development (R&D) using multi-criteria decision analysis (MCDA): an objective of the Immunization Agenda 2030. EBioMedicine. 2024;110:105424. doi:10.1016/j. ebiom.2024.105424


22 Fingermann M, Avila L, De Marco MB, et al. OMV-based vaccine formulations against Shiga toxin producing Escherichia coli strains are both protective in mice and immunogenic in calves. Hum Vaccin Immunother. 2018;14(9):2208-2213. doi:10.1080/21645515.2018.1490381


Dr Neil Bentley OBE is an experienced biomedical scientist with over 40 years of science, management, and leadership experience within the field of pathology and public health. In a 25-year career with Public Health England (PHE) he was most recently Deputy Director Pathogen Genomics- COVID Programme until October 2022, previously he was Head of Specialist Microbiology Technical Services at PHE’s National Infection Service. He is currently Scientific Officer at Pro-Lab Diagnostics.


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