Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025
Abstract
In January 2025, the Escherichia coli National Reference Center of France detected an outbreak of hemolytic uremic syndrome (HUS) in adults, caused by Shiga toxin-producing E. coli negative for locus of enterocyte effacement (LEE). The outbreak included 18 confirmed cases of E. coli infection, 5 probable or possible cases detected by in-house specific PCR, and 2 additional cases from Scotland and Belgium. Whole-genome sequencing identified the outbreak strain as O77 g:K92:H18, belonging to phylogroup D; the strain harbored the Shiga toxin 2 gene variant stx2d-073-C165-02 and a 134-kb plasmid with enterotoxin genes (estb-STb2 and eltAB). Epidemiologic investigation implicated raw-milk cheese as the contamination source. The strain represents a singular hybrid pathotype of Shiga toxin-producing and enterotoxigenic E. coli, expressing a K92 capsule with known cross-immunogenicity to Neisseria meningitidis group C, which could explain the absence of pediatric cases. Related strains have been identified in international databases since 2005, suggesting global emergence.
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BibTeX
@article{larminat2026hemolytic,
title = {{Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025}},
author = {Justine de Larminat and Kevin La and Philippe Bidet and André Birgy and Sandrine Liguori and Pierre Phlipaux and Celine Courroux and Florence Crombé and Jorge Blanco and Paul Coppo and Antoine Dossier and Laurence Armand-Lefevre and François Xavier Weill and Carolina Silva Nodari and Gabrielle Jones and Aurelie Cointe and Stéphane Bonacorsi},
journal = {Emerging Infectious Diseases},
year = {2026},
month = oct,
doi = {10.3201/eid3204.251417},
url = {https://pasteur.hal.science/pasteur-05801258v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025
AU - Justine de Larminat
AU - Kevin La
AU - Philippe Bidet
AU - André Birgy
AU - Sandrine Liguori
AU - Pierre Phlipaux
AU - Celine Courroux
AU - Florence Crombé
AU - Jorge Blanco
AU - Paul Coppo
AU - Antoine Dossier
AU - Laurence Armand-Lefevre
AU - François Xavier Weill
AU - Carolina Silva Nodari
AU - Gabrielle Jones
AU - Aurelie Cointe
AU - Stéphane Bonacorsi
PY - 2026
DA - 2026/10/15
JO - Emerging Infectious Diseases
DO - 10.3201/eid3204.251417
UR - https://pasteur.hal.science/pasteur-05801258v1
AB - In January 2025, the Escherichia coli National Reference Center of France detected an outbreak of hemolytic uremic syndrome (HUS) in adults, caused by Shiga toxin-producing E. coli negative for locus of enterocyte effacement (LEE). The outbreak included 18 confirmed cases of E. coli infection, 5 probable or possible cases detected by in-house specific PCR, and 2 additional cases from Scotland and Belgium. Whole-genome sequencing identified the outbreak strain as O77 g:K92:H18, belonging to phylogroup D; the strain harbored the Shiga toxin 2 gene variant stx2d-073-C165-02 and a 134-kb plasmid with enterotoxin genes (estb-STb2 and eltAB). Epidemiologic investigation implicated raw-milk cheese as the contamination source. The strain represents a singular hybrid pathotype of Shiga toxin-producing and enterotoxigenic E. coli, expressing a K92 capsule with known cross-immunogenicity to Neisseria meningitidis group C, which could explain the absence of pediatric cases. Related strains have been identified in international databases since 2005, suggesting global emergence.
SN - 1080-6040
SN - 1080-6059
ER -