Persistent cross-species transmission systems dominate Shiga toxin-producing Escherichia coli O157:H7 epidemiology in a high incidence region: a genomic epidemiology study
Abstract
Background
Several areas of the world suffer notably high incidence of Shiga toxin-producing Escherichia coli , among them Alberta, Canada. We assessed the impact of persistent cross-species transmission systems on the epidemiology of E. coli O157:H7 in Alberta.
Methods
We sequenced and assembled 229 E. coli O157:H7 isolates originating from collocated cattle (n=108) and human (n=121) populations from 2007-2015 in Alberta. We constructed a timed phylogeny using BEAST2 using a structured coalescent model. We then extended the tree with human isolates through 2019 (n=430) to assess the long-term disease impact of locally persistent lineages. Shiga toxin gene ( stx ) profile was determined for all isolates.
Results
During 2007 to 2015, we estimated 108 (95% HPD 104, 112) human lineages arose from cattle lineages, and 14 (95% HPD 5, 23) from other human lineages; i.e., 88.5% of human lineages arose from cattle lineages. We identified 11 persistent lineages local to Alberta, which were associated with 38.0% (95% CI 29.3%, 47.3%) of human isolates. Of 117 isolates in locally persistent lineages, 6.0% carried only the Shiga toxin gene stx2a and the rest both stx1a and stx2a . During the later period, six locally persistent lineages continued to be associated with human illness, including 74.7% (95% CI 68.3%, 80.3%) of reported cases in 2018 and 2019. The stx profile of isolates in locally persistent lineages shifted from the earlier period, with 51.2% encoding only stx2a .
Conclusions
Our study identified multiple locally evolving lineages transmitted between cattle and humans persistently associated with E. coli O157:H7 illnesses for up to 13 years. Of concern, there was a dramatic shift in locally persistent lineages toward strains with the more virulent stx2a -only profile. Locally persistent lineages may be a principal cause of the high incidence of E. coli O157:H7 in locations such as Alberta and offer opportunities for understanding the disease ecology supporting E. coli O157:H7 persistence, as well as for local prevention efforts.
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