[Escherichia coli 0104:H4: a hybrid pathogen]

In 2011, an outbreak linked to a entero-haemorrhagic Escherichia coli strain, affecting adults more frequently, occurred in Germany, with 4320 bloody diarrhea cases, 850 cases of hemolytic uremic syndrome (HUS) and 82 deaths. Meanwhile, an epidemic affecting 24 patients took place in Bègle with similar epidemiological characteristics. These two strains were associated with consumption of contaminated seeds fenugreck by a particularly virulent strain belonging to a rare serotype, E. coli serotype O104:H4. This strain is a triple hybrid : it produces a shigatoxin, the adhesion at the gastrointestinal mucosa is related to the presence of fimbriae as enteroaggregants E. coli (ECAA), and has virulence factors of E. coli outer intestinal (EXPEC). In addition, it produced a ß-lactamasetype extended-spectrum CTXM15.