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Volume 15, Number 9—September 2009

Phylogeny and Disease Association of Shiga Toxin–producing Escherichia coli O91

Alexander MellmannComments to Author , Angelika Fruth, Alexander W. Friedrich, Lothar H. Wieler, Dag Harmsen, Dirk Werber, Barbara Middendorf, Martina Bielaszewska, and Helge Karch
Author affiliations: Institute of Hygiene and the National Consulting Laboratory on Hemolytic Uremic Syndrome, Münster, Germany (A. Mellman, A.W. Friedrich, D. Harmsen, B. Middendorf, M. Bielaszewska, H. Karch); Department of Periodontolgy, Münster (D. Harmsen); Robert Koch Institute, Wernigerode, Germany (A. Fruth); Free University Berlin, Berlin, Germany (L.H. Wieler); Robert Koch Institute, Berlin (D. Weber)

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Table 1

Distribution of disease severity across 10 different sequence types of 100 STEC O91 strains isolated from humans*

ST (Serotype) Most severe symptom of patients infected with STEC O91
Total no. strains
HUS (n = 4) BD (n = 8) D (n = 79) A (n = 9)
ST33 (O91:H14/H/Hnt) 0 5 51 7 63
ST442 (O91:H21) 4 3 12 1† 20
ST641 (O91:H10) 0 0 2 0 2
ST690 (O91:H14) 0 0 8 1 9
ST1020 (O91:H8) 0 0 1 0 1
ST1048 (O91:H14) 0 0 1 0 1
ST1051 (O91:H14) 0 0 1 0 1
ST1052 (O91:H14) 0 0 1 0 1
ST1053 (O91:H14) 0 0 1 0 1
ST1054 (O91:Hnt) 0 0 1 0 1

*ST, sequence type; STEC, Shiga toxin–producing Escherichia coli; H, H-antigen nonmotile strains; Hnt, H-antigen nontypeable strains; HUS, hemolytic uremic syndrome; BD, bloody diarrhea; D, diarrhea without visible blood; A, asymptomatic infection (1 patient infected with ST442 [STEC O91:H21] had abdominal cramps without diarrhea).
†Abdominal cramps without diarrhea.

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