<unk>  is an enteroaggregative Escherichia coli strain of the bacterium Escherichia coli, and the cause of the 2011<unk>  outbreak. The "O" in the serological classification identifies the cell wall lipopolysaccharide antigen, and the "H" identifies the flagella antigen. Analysis of genomic sequences obtained by BGI Shenzhen shows that the<unk> :H4 outbreak strain is an enteroaggregative E. coli (EAEC or EAggEC) type that has acquired Shiga toxin genes, presumably by horizontal gene transfer. Genome assembly and copy-number analysis both confirmed that two copies of the Shiga toxin stx2 prophage gene cluster are a distinctive characteristic of the genome of the<unk> :H4 outbreak strain. The<unk> :H4 strain is characterized by these genetic markers: * Shiga toxin stx2 positive * tellurite resistance gene cluster positive * intimin adherence gene negative * β-lactamases ampC, ampD, ampE, ampG, ampH are present. The European Commission (EC) integrated approach to food safety defines a case of Shiga-like toxin-producing E. coli (STEC) diarrhea caused by<unk> :H4 by an acute onset of diarrhea or bloody diarrhea together with the detection of the Shiga toxin 2 (Stx2) or the Shiga gene stx2. Prior to the 2011 outbreak, only one case identified as<unk> :H4 had been observed, in a woman in South Korea in 2005.
Escherichia coli O104:H4
Escherichia coli O104:H21
Escherichia coli O121
Escherichia coli O157:H7
Enteroaggregative Escherichia coli
Campylobacter upsaliensis
Salmonella enterica subsp. enterica
Salmonella