Abstract
Using colony blot hybridization with stx(2) and eae probes and agglutination in anti-O157 lipopolysaccharide serum, we isolated stx(2)-positive and eae-positive sorbitol-fermenting (SF) enterohemorrhagic Escherichia coli (EHEC) O157:NM (nonmotile) strains from initial stool specimens and stx-negative and eae-positive SF E. coli O157:NM strains from follow-up specimens (collected 3 to 8 days later) from three children. The stx-negative isolates from each patient shared with the corresponding stx(2)-positive isolates fliC(H7), non-stx virulence traits, and multilocus sequence types, which indicates that they arose from the stx(2)-positive strains by loss of stx(2) during infection. Analysis of the integrity of the yecE gene, a possible stx phage integration site in EHEC O157, in the consecutive stx(2)-positive and stx-negative isolates demonstrated that yecE was occupied in stx(2)-positive but intact in stx-negative strains. It was possible to infect and lysogenize the stx-negative E. coli O157 strains in vitro using an stx(2)-harboring bacteriophage from one of the SF EHEC O157:NM isolates. The acquisition of the stx(2)-containing phage resulted in the occupation of yecE and production of biologically active Shiga toxin 2. We conclude that the yecE gene in SF E. coli O157:NM is a hot spot for excision and integration of Shiga toxin 2-encoding bacteriophages. SF EHEC O157:NM strains and their stx-negative derivatives thus represent a highly dynamic system that can convert in both directions by the loss and gain of stx(2)-harboring phages. The ability to recycle stx(2), a critical virulence trait, makes SF E. coli O157:NM strains ephemeral EHEC that can exist as stx-negative variants during certain phases of their life cycle.