Necrotoxigenic Escherichia coli (NTEC) are defined on the basis of the production of a cytotoxin causing occurence of giant multinucleated cells (CHO, Vero, HeLa, HEp-II) in culture and necrosis after intradermal injection in rabbits or intrafoodpad in mice and therefore named Cytotoxic Necrotizing Factor (CNF). Two CNF toxins differing by their biological, antigenic and genetic properties have been described, CNF1 and CNF2. NTEC are associated with various digestive, urinary and systemic infections in mammals: NTEC1 in humans, domestic and some wild mammals; NTEC2 almost exclusively in domestic and wild ruminants.
The purpose of the work reported here was to study the general and putative virulent, classical and molecular properties of a collection of bovine, canine, feline, human and porcine NTEC1 strains and of bovine NTEC2 strains, to: i) define the identity card of NTEC1 and NTEC2 strains in an attempt to better understand their putative virulence factors and to improve their diagnosis; and ii) compare and differentiate the NTEC1 strains isolated from humans and animals in the possible case of a public health problem.
The typing assays were either phenotypic for the production of aerobactin (Aer), of colicin (Col), and of haemolysin (Hlyalpha, Hlybeta and entero-Hly), for the resistance to the bactericidal activity of the serum (RS), for the serotyping, and for the biotyping, or genetic for the CNF1 and CNF2 toxins, for the Cytolethal Distending Toxins (CDT-I, -II, -III, -IV), for the fimbrial adhesins of the P (Pap/Prs), S (Sfa/F1C), and F17 (a, b, c, d) families, and for the afimbrial adhesins of the Afa family (Afa, Nfa, Dr, F1845, M). Colony hybridization was used as a first screening assay to recognise the presence of homologous DNA sequences within the strains. Polymerase Chain Reaction (PCR) was subsequently used to type the variant(s) of the gene(s) detected, coding for the different CNF (cnf1, cnf2) and CDT (cdtB-I, cdtB-II, cdtB-III, cdtB-IV) toxins or for the different P (papGI, papGII, papGIII), S (sfa, foc), F17 (f17Aa, f17Ab, f17Ac, f17Ad, f17GI, f17GII) and Afa (afa8-D, afa8-E) fimbrial and afimbrial adhesins.
During a first study, genetic assays were developed and standardized. DNA probes were derived from the gene coding for the CNF2 toxin after its cloning: a first probe fragment detected the NTEC2 strains (pEOSW03 fragment), while a second probe fragment could detect, and differentiate, both NTEC1 and NTEC2 strains (pEOSW01 fragment). In parallel, probes to detect genes coding for the CDT toxins, for fimbrial adhesins of the P, S and F17 families and for afimbrial adhesins of the Afa family were derived and tested on a collection of bovine NTEC1 and NTEC2 strains, to obtain standardized experimental conditions for the future studies.
During a second study all phenotypic and genetic assays previously designed were applied on collections of NTEC strains of bovine (45 NTEC1 and 98 NTEC2 strains), canine (99 NTEC1 strains), feline (33 strains), human (65 strains), and porcine (129 strains) origin. The results obtained can be summarized as follows. The majority of NTEC1 strains from cats, dogs, humans and pigs were positive with probes for the P (80-91%) and/or S (74-86%) fimbrial adhesins. F17 and Afa probe-positive NTEC1 strains were much rarer (0-12%). Bovine NTEC1 strains gave similar results with the P (75% of probe-positive strains) and F17 (7% of probe-positive strains) probes, but were distinguished by lower frequency of S probe-positive (42%) and higher frequency of Afa probe-positive (20%) strains. The other frequently positive properties were production of Hlyalpha/beta (81-100%) and RS (82-96%). Aer was produced by variable proportions of bovine, human and porcine NTEC1 strains (478%), and by only 4% of canine strains. The other genes or properties were too rarely detected (CDT <4-15%>, entero-Hly <0-9%>, Col <22-34%> or too variable (serotypes, biotypes), to be considered as useful in the typing of NTEC1 strains. The bovine NTEC2 strains were mainly positive for the F17 fimbrial (52%) and/or Afa afimbrial (24%) adhesins, and for a CDT toxin (83%). In contrast, strains positive for the P and/or S fimbrial adhesins were anecdotic (6%). To the other assays, the bovine NTEC2 strains gave results comparable to those obtained with NTEC1 strains, with one main difference, i.e. the lower number of strains producing a Hlyalpha/beta (37%).
During a third study the probe-positive strains were tested with the appropriate PCR assays to identify the variant(s) of the gene detected by colony hydridization. Most of the results obtained with NTEC1 and NTEC2 strains were various for the CDT toxins and for the antigenic and adhesin variant(s) of the P, S, and F17 fimbrial adhesins. The main two exceptions to this variability were the bovine NTEC2 strains which harboured the cdtB-III gene coding for the CDT-III toxin, and all animal and human NTEC1 and NTEC2 strains which harboured the afa8-D and afa8-E genes coding for the Afa-VIII afimbrial adhesin.
At the end a general identity profile could be defined for the NTEC1 strains: CFN1+ P and/or S+ Hlyalpha/beta+ RS+ which corresponds to 73% of the 45 bovine, 91% of the 23 canine, 88% of the 65 human and 75% of the 129 porcine strains studied. This profile could even be more precisely defined for the canine NTEC1 strains: CNF1+ PapGIII and/or S+ Hlyalpha/beta+ RS+ biotype9+. In contrast the most frequent identity profile of the bovine NTEC2 strains: CNF2+ CDT-III+ F17 and/or Afa-VIII+ RS+, grouped only half (40%) of the 98 strains studied.
According to these results, no assay can replace individually the search for the production of CNF1 or CNF2 toxin, or for their encoding genes, in the diagnosis of NTEC strains. So test result associations were also examined, more especially the associations between Hlyalpha/beta and fimbriae P from the one hand, or sorbose fermentation (biotypes 1, 2, 3, 4, 9, 10, 11 and 12) from the other hand.
The first association was indeed very frequent amongst bovine, canine, human and porcine NTEC1 strains (64-81%). The second association was even more frequent amongst 78-100% of bovine, canine and human NTEC1, but not amongst porcine NTEC1 strains (50%). Neither association was frequent amongst NTEC2 strains. These results do not however allow to propose these assays for the diagnosis of NTEC1 strains, since several non-NTEC strains can be positive for these associations of properties.
As a conclusion, our research studies confirmed and completed the identity profiles of bovine, canine, feline, human and porcine NTEC1 and bovine NTEC2 strains, and of some of their potential virulence properties according the host and the bacteria: P, S, F17 and/or Afa adhesins as colonisation factors; CNF and CDT toxins to cross the intestinal mucosal barrier and/or to cause toxic effects on the host tissues; production of an aerobactin and of an alpha or beta hemolysin and resistance to the bactericidal activity of the serum for survival within the host blood stream and internal tissues and organs.
On the other hand, the results did not allow the development of a new methodology in the diagnosis of NTEC1 and/or NTEC2 strains, nor bring new arguments in the debate over a potential role of animal NTEC1 strains as zoonotic agents. Indeed animal and human strains were positive for the adhesins belonging to the same families (P, S, F17 and/or Afa) and carrying the same antigenic and adhesin variants (PapGII or PapGIII; Sfa or F1C; F17Ac ande F17GII; Afa-VIII).