ReviewEscherichia fergusonii
Introduction
Escherichia coli (Bacterium coli) has become by far the most studied bacterium in microbiological research, since its discovery by Theodor Escherich in 1885, probably due to the many different pathogenic isolates that have been recovered from various sites in humans and animals. Bacterium coli was placed in the genus Escherichia in honor of its discoverer in 1919 (Castellani and Chalmers, 1919). It has taken almost 65 years (a century after the discovery by Escherich) before the existence of other species in the genus Escherichia was reported (Farmer et al., 1985). This was probably due to the phenotypic similarity of the various species within the genus Escherichia and the fact that diagnostic tools to identify them, such as PCR (Gokhale et al., 2014, Simmons et al., 2014), whole genome sequencing (Touchon et al., 2009, Walk et al., 2009, Forgetta et al., 2012) and improved growth media including sorbitol or adonitol plates were not available until relatively recently (Pohl et al., 1984, March and Ratnam, 1986, Crawford-Miksza et al., 2009, Wragg et al., 2009, Foster et al., 2010).There are currently seven recognized species in the genus Escherichia. Besides E. coli the genus comprises the species Escherichia albertii (Huys et al., 2003), Escherichia blattae (Burgess et al., 1973), Escherichia fergusonii (Farmer et al., 1985), Escherichia hermanii (Brenner et al., 1982a) and Escherichia vulneris (Brenner et al., 1982b). Escherichia adecarboxylata has also been proposed as a species in the genus Escherichia, but was later reclassified Leclercia adecarboxylata (Tamura et al., 1986). Within the genus Escherichia, E. fergusonii is the closest relative of E. coli, as shown by DNA hybridization (64% similarity)(Lawrence et al., 1991), which may cause difficulty in the diagnostics of these species depending on the diagnostic method used. For example, the ability of E. fergusonii to acquire large portions of the E. coli genome may interfere with PCR dependent diagnostics (Fegan et al., 2006). The other members of the genus are isolated much less frequently than E. coli but from similar sites in the bodies of humans and animals. A striking feature of E. coli is the estimated number of 10,000 naturally occurring varieties/serotypes (and perhaps much more) that exist. These varieties are in part due to the huge number of subtle antigenic variations on the surface of their cells and the presence of “so called” virulence factors. The phylogeny of the genus Escherichia is a complex-story, within the family Enterobactereaceae Escherichia, Shigella and Salmonella are classified as separate genera, but it is argued by some that they are actually Escherichia species (Lan and Reeves, 2002, Escobar-Paramo et al., 2003, Hyma et al., 2005, Yang et al., 2007). Shigella spp. are clinically rather than phylogenetically defined and can be seen as pathogenetic lineages of E. coli. Salmonella was demonstrated to merit the status of a specific species (Ochman and Groisman, 1994). E. coli and Shigella genomes have 70–100% DNA homology. They are positive for indole production, lysine decarboxylase, ornithine decarboxylase and methyl red. While the four different species of Shigella are recognized as E. coli strains (vide supra), E. fergusonii (and E. albertii) are so different from this group that they merit species status (Walk et al., 2009, Forgetta et al., 2012).
Section snippets
Historical perspective
E. fergusonii, formerly known as enteric Group 10, is an infrequently occurring but emerging (Savini et al., 2008) animal and human pathogen, that was named in honor of the American microbiologist William H. Ferguson (Farmer et al., 1985). At the time of discovery the clinical significance of E. fergusonii was uncertain but since then E. fergusonii has been isolated mainly from cases of wound infection, urinary tract infection, bacteremia, diarrhea, pancreatic carcinoma, endophtalmitis and
Infections in animals
Many of the reports on the isolation of E. fergusonii from both animals and humans are case reports in which this bacterium was found to be the infectious agent. In contrast, very few studies have been conducted with the specific intention of isolating E. fergusonii. Oh et al. (2012) isolated and characterized heat-labile enterotoxin producing E. fergusonii from healthy chickens in South Korea. The authors recovered 43 LT producing E. fergusonii isolates, sixteen of which transferred the gene
Infections in humans
The clinical manifestations of E. fergusonii infections in humans include bacteremia, urinary tract infections and diarrhea. The original species description of E. fergusonii was based on isolates recovered from a wide range of human sources including blood, urine, feces and an abdominal wound (Farmer et al., 1985). Later publications on the isolation of E. fergusonii from urinary tract infections (Savini et al., 2008, Bours et al., 2010, Lagacé-Wiens et al., 2010), from a case of sepsis (
Diagnostics
The lack of a selective medium for the isolation of E. fergusonii from materials such as feces, which has a high background flora has been a major hurdle to its detection. Isolation is performed on MacConkey agar in most studies. Wragg et al. (2009) used sorbitol MacConkey agar. The use of citrate adonitol agar significantly reduces the background flora and enhances recovery of E. fergusonii from animal fecal samples (Foster et al., 2010). The need for biochemical tests like a positive
Therapy and prevention
Treatment of E. fergusonii infections is similar to that of E. coli infections but treatment results are more and more hampered by emerging antibiotic resistant strains (Diarrasouba et al., 2007, Fricke et al., 2009). Multidrug-resistant E. fergusonii strains and ESBL producing isolates have been reported repeatedly (Savini et al., 2008, Bours et al., 2010, Lagacé-Wiens et al., 2010, Forgetta et al., 2012, Rayamajhi et al., 2011). Lai et al. (2011) describe a bacteremia caused by E. fergusonii
Prevalence
As mentioned before, the majority of reports on the occurrence of E. fergusonii are case reports. From these reports it has become clear that E. fergusonii can be found worldwide in diseased humans and animals. Studies in which more than only one or a few E. fergusonii cases have been described are rare. Bours et al. (2010) found E. fergusonii to be the third most frequently occurring isolate in human urinary tract infections in Latin America after E. coli and Serratia spp. E. fergusonii, E.
Conclusions
The exact prevalence of cases where E. fergusonii causes illness is not known. Nor is it known whether the organism occurs as a commensal in humans and animals. A remarkable number of the E. fergusonii isolates obtained are multi-resistant and it is suggested that E. fergusonii is becoming resistant to the available antimicrobial therapy (Savini et al., 2008, Rayamajhi et al., 2011, Forgetta et al., 2012). In those studies where virulence factors or virulence genes in E. fergusonii have been
Future research
E. coli and E. fergusonii are each other closest relatives within the genus Escherichia. This and the fact that some E. fergusonii isolates possess genotypic and phenotypic features found in known pathotypes of E. coli lead to a number of questions: is E. fergusonii in fact another E. coli? (but just a little different). What is the prevalence of E. fergusonii, how much under-reported is it? Is the host-specificity of E. coli and E. fergusonii the same? Do pathotypes like UPEF (Urinary
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