Escherichia coli O157:H7 in Iran: Time to Look Closer

International Journal of Enteric Pathogens

Volume 4 - Number 3

Article Type: Letter to editor
Abstract: Dear Editor, Shiga toxin-producing Escherichia coli (STEC) has long been considered as a major  cause of bloody diarrhea, and a life-threatening condition named hemolytic uremic syndrome (HUS) in humans worldwide. Historically, the serotype O157:H7 STEC caused two  large outbreaks in the United States and Japan  in 1993 and 1996, respectively. This serotype  has been frequently reported as a cause of  diarrhea and HUS and therefore is the most investigated serotype worldwide. A brief  search shows numerous reports of O157 E. coliin Iran among isolates from different animal species and occasionally humans–albeit not associated with severe cases. For instance, O157 E. colihas been reported in humans (uncomplicated diarrhea), sheep, goats, cattle, water buffalos and camels in Iran in recent years. At the same time, to the best of our knowledge, there has not been any outbreak reported in association with this serotype in humans in Iran. Accordingly, we can draw two hypotheses explaining this. First, it can be resulted from a lack of comprehensive monitoring that might need revising routine diagnostic algorithms, and the second could be the presence of less virulent clones of O157 E. colicirculating in Iran. With the context of the later hypothesis, we can explain this in brief as our current knowledge on virulence of this serotype increased substantially in the genomics era.
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