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  • Review Article
  • Published:

Super-shedding and the link between human infection and livestock carriage of Escherichia coli O157

Nature Reviews Microbiology volume 6, pages 904–912 (2008)Cite this article

Key Points

  • Escherichia coli O157 is one of the most important causes of bloody diarrhoea and haemolytic uraemic syndrome (HUS), especially in children and the elderly, and is therefore a zoonosis of substantial public health concern.

  • The incidence of E. coli O157 infection in Scotland is consistently one of the highest in the world.

  • The epidemiology of E. coli O157 could be largely driven by a small number of colonized cattle — its main reservoir — that for a period shed large numbers of bacteria (>104 CFU per gram of faeces), and are therefore called super-shedders.

  • We currently have only a limited understanding of both the nature and the determinants of super-shedding. However, super-shedding has been observed to be associated with colonization at the terminal rectum and it may be also more probable with certain pathogen phage types.

  • Super-shedding has important consequences for the epidemiology of E. coli O157 in cattle and for the risk of human infection, particularly through environmental exposure.

  • Super-shedding may be important in other bacterial and viral infections. If so, this will have profound implications for our understanding of the epidemiology and control of many infectious diseases. For E. coli O157 in cattle, this could potentially lead to a reduction in the risk of human infections.

Abstract

Cattle that excrete more Escherichia coli O157 than others are known as super-shedders. Super-shedding has important consequences for the epidemiology of E. coli O157 in cattle — its main reservoir — and for the risk of human infection, particularly owing to environmental exposure. Ultimately, control measures targeted at super-shedders may prove to be highly effective. We currently have only a limited understanding of both the nature and the determinants of super-shedding. However, super-shedding has been observed to be associated with colonization at the terminal rectum and might also occur more often with certain pathogen phage types. More generally, epidemiological evidence suggests that super-shedding might be important in other bacterial and viral infections.

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Figure 1: The worldwide burden of Escherichia coli O157.
Figure 2: The chain of events that link super-shedding cattle and the risk of human infection with Escherichia coli O157.
Figure 3: Mixture-distribution analysis of Escherichia coli counts in bovine faecal samples.
Figure 4: Colonization of the terminal rectum of cattle by Escherichia coli O157.

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Acknowledgements

This study was part of IPRAVE, Epidemiology and Evolution of Enterobacteriaceae Infections in Humans and Domestic Animals, funded by the Wellcome Trust. D.G. is funded by DEFRA under the Veterinary Training and Research Initiative and by LK0006. The authors thank all members of the IPRAVE consortium who are listed in Supplementary information S1 (table).

Author information

Authors and Affiliations

  1. Centre for Infectious Diseases, University of Edinburgh, Kings Buildings, Edinburgh, EH9 3JT, UK

    Margo Chase-Topping & Mark Woolhouse

  2. Immunity and Infection Division, The Roslin Institute and R(D)SVS, University of Edinburgh, Chancellor's Building, Edinburgh, EH16 4SB, UK

    David Gally

  3. Research Division, Scottish Agricultural College, Animal Health Group, King's Buildings, West Mains Road, Edinburgh, EH9 3JG, UK

    Chris Low

  4. Institute for Comparative Medicine, Faculty of Veterinary medicine, University of Glasgow, Bearsden Road, Glasgow, G61 1QH, UK

    Louise Matthews

Authors
  1. Margo Chase-Topping
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  2. David Gally
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  3. Chris Low
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  4. Louise Matthews
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  5. Mark Woolhouse
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Corresponding authors

Correspondence to Margo Chase-Topping or Mark Woolhouse.

Supplementary information

Supplementary information S1 (table)

Institutions and people in the IPRAVE consortium (PDF 179 kb)

Related links

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DATABASES

Entrez Genome Project

Escherichia coli

Mycobacterium avium subsp. paratuberculosis

Salmonella enterica subsp. enterica serovar Typhimurium

FURTHER INFORMATION

IPRAVE

SUPPLEMENTARY INFORMATION

S1 (table)

Glossary

Verocytotoxin

A class of bacterial toxin produced by some Escherichia coli strains and Shigella species. The name is derived from the ability of the secreted protein to kill Vero (African green monkey kidney) cells in culture.

Immunomagnetic separation

A laboratory tool used to enhance the sensitivity of bacterial culture techniques. Antibodies that coat paramagnetic beads bind to any Escherichia coli O157 in the test sample, thereby capturing the cells and facilitating their concentration for subsequent routine culture.

Odds ratio

An odds ratio is defined as the ratio of the odds of an event occurring in one group to the odds of it occurring in another group. If the probabilities of the event in each of the groups are p (first group) and q (second group), then the odds ratio is

An odds ratio of 1 indicates that the condition or event under study is equally likely in both groups. An odds ratio that is greater than 1 indicates that the condition or event is more likely in the first group, whereas an odds ratio that is less than 1 indicates that the condition or event is less likely in the first group.

Phage type

A method for discriminating bacterial strains based on their differing susceptibility to lysis by bacteriophages.

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Chase-Topping, M., Gally, D., Low, C. et al. Super-shedding and the link between human infection and livestock carriage of Escherichia coli O157. Nat Rev Microbiol 6, 904–912 (2008). https://doi.org/10.1038/nrmicro2029

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