Interaction between attaching and effacing Escherichia coli serotypes O157:H7 and O26:K60 in cell culture

Ruminants harbour both O157:H7 and non-O157 Attaching Effacing Escherichia coli (AEEC) strains but to date only non-O157 AEEC have been shown to induce attaching effacing lesions in naturally infected animals. However, O157 may induce lesions in deliberate oral inoculation studies and persistence is considered dependent upon the bacterially encoded locus for enterocyte effacement. In concurrent infections in ruminants it is unclear whether non-O157 AEEC contribute either positively or negatively to the persistence of E. coli O157:H7. To investigate this, and prior to animal studies, E. coli O157:H7 NCTC 12900, a non-toxigenic strain that persists in conventionally reared sheep, and non-toxigenic AEEC O26:K60 isolates of sheep origin were tested for adherence to HEp-2 tissue culture alone and in competition one with another. Applied together, both strains adhered in similar numbers but lower than when either was applied separately. Pre-incubation of tissue culture with either one strain reduced significantly (P < 0.05) the extent of adherence of the strain that was applied second. It was particularly noticeable that AEEC O26 when applied first reduced adherence and inhibited microcolony formation, as demonstrated by confocal microscopy, of E. coli O157:H7. The possibility that prior colonisation of a ruminant by non-O157 AEEC such as O26 may antagonise O157 colonisation and persistence in ruminants is discussed.     

Virulence factors in Escherichia coli isolated from piglets with neonatal and post-weaning diarrhea in Japan

A total of 567 strains of Escherichia coli were isolated from piglets with neonatal diarrhea (ND) or post-weaning diarrhea (PWD) in Japan. They were investigated for enterotoxigenicity and possession of adhesins and O antigens. There were clear differences between the strains of ND origin and those of PWD origin in the occurrence of enterotoxigenic E. coli (ETEC) strains, type of enterotoxin and frequency of adhesins: ETEC was found in 77 (25.7%) of 300 strains of ND origin and in 137 (51.3%) of 267 strains of PWD origin. ETEC strains producing heat-labile enterotoxin (LT) or heat-stable enterotoxin (STa), alone or in combination were evenly distributed among the strains of PWD origin. In contrast most of the ETEC strains of ND origin produced LT alone. Adhesins appeared in 42 (54.5%) of 77 ETEC strains of ND origin and in 36 (26.3%) of 137 ETEC strains of PWD origin. Adhesins were less common in ETEC strains of PWD origin than in those of ND origin. Some K99-positive ETEC strains of PWD origin produced both LT and STa. There was a similarity in the distribution of O antigens, particularly O149 and O157, between the strains of ND origin and those of PWD origin.     

动物源E.coli O157∶H7 stx基因的检测与系统进化分析

为了解2009－2010年间在河南、甘肃地区分离鉴定的5株大肠埃希菌O157(E.coli O157)携带stx的情况及不同分离株间stx分子进化与变迁的情况,本研究利用PCR方法对分离株进行了stx基因检测,并完成了序列测定与系统演化分析。结果表明,5株不同动物源的分离株均含有stx1及stx2基因。序列分析结果显示5株分离株间stx1、stx2的核苷酸及氨基酸同源性均较高;stx1基因均与参考株中的山羊源和食品源E.coli O157菌株的同源性较高,进化树中遗传距离最近;分离株的stx2基因与多株牛源及少数人源参考株也具有较高的同源性,进化树中虽然5株分离菌均在一个大主干分支中,但分离株27与其他各分离株及参照株遗传距离最远,独自处于一次级分支中;分离株L37与W、12与50分别分布于牛源、人源E.coli O157小次级分支中;由此可推测,分离株所携带的stx1很有可能是经食品源或羊源E.coli O157传递而来;分离株L37与W、分离株12与50的stx2可能是由牛源、人源E .coli O157菌株传递而来,分离株27的stx2来源不清楚。研究结果表明,5株E.coli O157分离株均含有stx1、stx2基因,但两个基因的起源存在差异。     

Study on the Virulence Gene Distribution and Genetic Evolution of Cattle Shiga Toxin-producing Escherichia coli Isolates

This study was aimed to understand the relationship of virulence gene distribution and genetic evolution between cattle originated Shiga toxin-producing Escherichia coli (STEC) and human originated enterohaemorrhagic Escherichia coli (EHEC) O157. This experiment collected 18 strains STEC in a dairy farm from Jiangsu province and 9 STEC reference strains (human, sheep, swine and avian), according to the method of U.S. Centers for Disease Prevention and Control Center (PulseNet), using the XbaⅠ enzyme digestion and pulsed field gel electrophoresis (PFGE) analysis, virulence genes were detected in some STEC isolates. The virulence gene distribution of O157 from different origin was remarkably different. The cattle originated STEC O157 and the human originated EHEC O157:H7 (EDL933W) had the most similar virulence gene distribution. In contrast, virulence genes were lack in cattle STEC O18 and O26, even though the cattle STEC O18 and O26 had the similar genotype as human EHEC O157:H7 (EDL933W). PFGE of Xba Ⅰ digested chromosomal DNA from 27 isolates of STEC exhibited 22 profiles. In general,the Dice coefficients of different originated STEC ranged from 72% to 100%.Cattle STEC O157 had a high similarity with two strains of human originated EHEC O157, while a low similarity was demonstrated between cattle STEC O157 and STEC O157 of swine and avian. The Dice coefficients of the cattle STEC O157 and the two strains of human EHEC O157 ranged from 83% to 95%. The Dice coefficients of cattle STEC O26 (Ⅶ,Ⅷ) and the two strains of human EHEC O157 were more than 82%. Therefore, it was concluded that the cattle STEC O157 and human EHEC O157 had a closer relationship in terms of virulence gene distribution and in genetic evolution.     

牛源产志贺毒素大肠杆菌分离株的毒力基因分布和遗传进化分析

为了探讨牛源产志贺毒素大肠杆菌（Shiga toxin-producing Escherichia coli,STEC）分离株在毒力基因分布和遗传进化方面与人源EHEC O157菌株之间的关系,本试验选择收集来自江苏某奶牛场的STEC菌株18株以及人源、羊源、猪源、禽源STEC参考菌株9株,参照美国疾病预防控制中心PulseNet推荐的方法,运用XbaⅠ酶进行酶切并完成脉冲肠凝胶电泳（PFGE）分型和聚类分析;同时对部分STEC菌株进行毒力基因检测。结果表明,经毒力基因检测,不同来源的O157菌株毒力基因分布不尽相同,其中牛源STEC O157与参考株EHEC O157∶H7（EDL933W）的基因排谱最为相近;牛源STEC O18和O26的基因排谱与参考株EHEC O157∶H7（EDL933W）类似,但存在部分基因的缺失。对27株不同来源的STEC分离株进行PFGE,产生了22种不同的酶切图谱。总体来看,不同来源的STEC Dice相似性系数在72%~100%之间。牛源O157分离株与猪源及禽源O157菌株的相似度偏低,而与两株人源O157分离株的相似度偏高,Dice相似性系数在83%~95%之间,牛源O26（克隆群Ⅶ、Ⅷ）与人源O157的相似性系数 > 82%。显然,从牛群中分离到的部分STEC菌株与人源EHEC O157具有较近的遗传进化关系。     

Persistence of Escherichia coli O157:H7 in experimentally infected swine

These experiments determined the ability of Escherichia coli O157:H7 to colonize and persist in pigs simultaneously inoculated with other pathogenic E. coli strains. Three-months-old pigs were inoculated with a mixture of five E. coli strains. The mixture included two Shiga toxigenic E. coli (STEC) O157:H7 strains, two enterotoxigenic E. coli (ETEC) strains and one enteropathogenic E. coli (EPEC) strain. A high dose mixture with all five strains at 10(10)CFU/animal (CFU: colony forming units) and a low dose mixture with the STEC strains at 10(7)CFU and the EPEC and ETEC strains remaining at 10(10)CFU were used. The STEC strains persisted in the alimentary tracts of some pigs at 2 months post-inoculation, following inoculation with both the high and low dose mixtures. When all strains were given at 10(10)CFU (high dose) the STEC strains persisted in greater numbers and in more pigs than did the other E. coli strains. The results demonstrated that persistent colonization (> or =2 months) by E. coli O157:H7 can occur in pigs. These findings were similar to those reported from sheep inoculated with the same mixture of E. coli strains. The results are consistent with reports suggesting that pigs have the potential to be reservoir hosts for STEC O157:H7.     

Identification of Escherichia coli O157:H7-strains from pigs with postweaning diarrhoea and amplification of their virulence marker genes by PCR

Escherichia coli isolated from pigs with postweaning diarrhoea were examined by PCR for the presence of the O157 rfb gene responsible for the biosynthesis of E coli O157 lipopolysaccharide. Among the 372 isolates tested, 38 (10.2 per cent) were of the O157 serogroup, but none of these possessed the H7 determinant. Further analysis of the E coli O157 isolates revealed that seven of them had the genes responsible for the production of Shiga toxin 1 and eaeA intimin, four other strains had genes responsible for the production of Shiga toxin 2, and four other strains were positive for the enterohaemolysin gene.     

Isolation of Verocytotoxin-producing Escherichia coli O157:H7 from cattle at slaughter in Italy.

Cattle arriving for slaughter at a large abattoir in northern Italy between April 1997 and January 1998 were examined for intestinal carriage of Verocytotoxin-producing Escherichia coli (VTEC) O157 using an immunomagnetic separation technique. Sixty sorbitol non-fermenting VTEC O157 strains were isolated from 59 (13.1%) of the 450 cattle examined. In particular, VTEC O157 was found in 37 (16.6%) of 223 feedlot cattle and in 22 (16.1%) of 137 dairy cull cows, but not in the 90 veal calves sampled. The isolation rate was higher during warm weather (17.5%), falling to an average of 2.9% during the winter months. VT-negative, O157 latex-agglutinating E. coli strains were isolated from 23 (5.1%) of the 450 animals. PCR analysis showed that all 60 VTEC O157 strains carried the VT2 gene and that 25 strains also carried the VT1 gene. In addition, four of the VT-negative, O157 latex-agglutinating E. coli strains carried the VT2 gene. Atypical biochemical features were observed in some VTEC O157: two strains (3.3%) showed beta-glucuronidase activity, and seven (11.7%) produced urease.     

猪源大肠杆菌O157∶H7毒力差异株的转录组测序分析

为了解大肠杆菌O157∶H7毒力差异株转录组差异,丰富O157∶H7转录组数据信息,本研究采用Illumina HiSeq^TM 2000平台对两株大肠杆菌O157∶H7毒力差异株进行高通量测序,测序数据采用测序评估、基因功能注释等生物信息学方法进行分析。结果发现,经过测序,两个菌株分别获得3 113 118和2 944 912条reads,比对到参考基因组上的reads分别占总reads的83.76%和78.97%。以中等毒力株为参考,在高毒力株中共获得941个差异表达基因,其中上调基因637个,下调基因304个。GO功能注释分析表明,差异表达基因主要与催化活性功能、黏附、转运活性、受体活性、酶调节活性、定位、生化调节、运动等诸多生理生化过程相关;KEGG富集分析发现共有425个基因注释到160个代谢通路中,其中新陈代谢、核糖体、鞭毛合成、嘧啶代谢、糖类代谢、细菌趋化等通路显著富集。此次通过大肠杆菌O157∶H7毒力差异株转录组研究对差异表达基因涉及的信号调控及可能的功能基因进行了探索,丰富了转录组信息,为进一步开展大肠杆菌O157∶H7毒力相关基因的研究及分子调控机制奠定了基础。     

牛源大肠杆菌O157:H7的分离鉴定

为调查新疆部分地区E.coli O157：H7的感染情况和菌株致病性,从新疆阿克苏、伊犁、塔城3个地区的牛场采集新鲜粪样564份,对E.coli O157：H7进行分离与鉴定。利用E.coli营养肉汤（EC肉汤）对样品进行增菌后,用山梨醇麦康凯培养基（SMAC）平板选择性培养,再经过4-甲基伞形酮-β-D葡萄糖醛酸苷培养基（MUG）的筛选,对疑似菌株进行生化和PCR鉴定,并将分离鉴定到的菌株进行小鼠攻毒试验。结果显示,从伊犁地区采集的样品中共分离出2株E.coli O157：H7（Y166和Y226）,其检出率为0.88%;小鼠攻毒试验中,Y166和Y226试验组小鼠在48 h内全部死亡,具有一定致病性;从阿克苏、塔城所采样品中未分离到E.coli O157：H7。     

Detection and characterization of verocytoxin-producing Escherichia coli types (VTEC) from different sources]

Hemolytic uremic syndrome (HUS) is caused by enterohemorrhagic E. coli (EHEC) belonging to a few serovars embracing strains of O26, O103, O111, O118, O145 and O157 serogroup, respectively. In own investigations 3.791 food specimen of animal origin were investigated by use of an enzyme-immuno-assay (EIA) and the polymerase chain reaction (PCR). All E. coli isolates (n = 459) of food as well as isolates from cattle feces (n = 440), from HUS patients (n = 50) and asymptomatic human carriers (n = 16) were investigated by means of the PCR using primer pairs for verocytotoxin genes (vtx1, vtx2, vtx2c, vtx2d, vtx2e), the E. coli attaching und effacing gene (eae), the enterohemolysin-gene (ehlyA) and the vt2 transporter protein-gene (ile X tRNA). Differences were found in respect to the eae- and the ile X tRNA genes, which could be detected in significantly higher ratios in the isolates from patients and human carriers. Furthermore vtx2d strains were exclusively analyzed to each 25% in food and cattle strains. In six food samples pathogenic strains of serovar O157 were detected whereas some of the cattle strains were estimated to belong to EHEC serovars O26:H11, O118:H- and O157:H7. The own data support the thesis that the risk for human beings is affiliated to a great extent by direct contact with ruminants, followed by person-to-person transmission. Regarding the epidemiological data the thesis that each VTEC strain ist potentially an EHEC strain can not longer be substantiated.     

Molecular characterisation of Shiga toxin-producing Escherichia coli O157 strains isolated in Poland

Ten Escherichia coli O157 strains isolated from cattle and children in Poland were investigated by the use of molecular biological methods. All strains possessed the intimin and enterohaemolysin genes and harboured the genetic determinants for Stx2 toxin (five isolates), Stx1 toxin (two strains) or both (three isolates). The genetic relatedness of the strains was examined by restriction fragment length polymorphism (RFLP) of chromosomal DNA digested with Xbal and Notl. Nine closely related RFLP patterns were observed. Comparison of bovine and human E coli O157 isolates based on the analysis of Xbal and Notl digested profiles showed that all strains belonged to one genetic cluster. These results indicate that cattle must be considered as a possible source of human E coli O157 infection in Poland.     

Occurrence and characterization of verocytotoxigenic Escherichia coli (VTEC) strains from dairy farms in Trinidad

A cross-sectional study was conducted to determine the prevalence and characteristics of verocytotoxigenic Escherichia coli (VTEC) on 25 dairy farms each located in Waller field and Carlsen field farming areas in Trinidad. On each selected farm, faecal samples were collected from milking cows, calves and humans; rectal swabs were obtained from pet farm dogs; bulk milk was sampled as well as effluent from the milking parlour. Escherichia coli was isolated from all sources on selective media using standard methods. Isolates of E. coli were subjected to slide agglutination test using E. coli O157 antiserum, vero cell cytotoxicity assay to detect verocytotoxin (VT) and heat labile toxin (LT) production, the polymerase chain reaction (PCR) to detect VT genes, and the dry spot test to screen for E. coli O157 and non-O157 strains. In addition, faecal samples from animal and human sources were tested for VT genes using PCR. Of a total of 933 E. coli isolates tested by the slide test, eight (0.9%) were positive for the O157 strain. The vero cell cytotoxicity assay detected VT-producing strains of E. coli in 16.6%, 14.6%, 3.2% and 7.1% of isolates from cows, calves, farm dogs and humans respectively (P < 0.05; chi(2)). For LT production, the highest frequency was detected amongst isolates of E. coli from calves (10.8%) and the lowest (0.0%) amongst isolates from humans and bulk milk (P < 0.05; chi(2)). Of the 61 VT-producing isolates by vero cell cytotoxicity assay tested by PCR, the VT, LT and eae genes were detected in 62.3%, 4.9% and 1.6% respectively (P < 0.05; chi(2)). Amongst the 45 E. coli isolates that were VT positive (vero cell) or VT-gene positive by PCR, 2.2%, 2.2%, 4.4% and 6.7% belonged to non-O157 strains O91, O111, O103 and O157, respectively, as determined by the Dry spot test. Detection of VTEC strains in milk and dairy animals poses a health risk to consumers of milk originating from these farms. In addition, the demonstration of VTEC strains in humans, VT gene in faecal samples and E. coli isolates as well as non-O157 VTEC strains of E. coli are being documented for the first time in the country.     

Allelic types of long polar fimbriae in bovine and human Escherichia coli O157 strains

Long polar fimbriae (Lpf) are recently discovered adhesins and increasingly important genetic markers of pathogenic Escherichia coli strains. The presence and genotype diversity of Lpf operons was screened in a collection of 97 Escherichia coli O157 strains representing different pathotypes, isolated from healthy cattle (n = 43) and human patients (n = 54) in several countries. Individual structural genes of Lpf were scanned by PCR, and allelic variants were detected with a recently developed typing scheme. Ninety-five strains carried at least one whole Lpf operon (genes lpfABCD and/or lpfABCDE). The 64 enterohaemorrhagic (EHEC) and 24 enteropathogenic (EPEC) strains all carried two Lpf operons, allele 3 of lpfA1 and allele 2 of lpfA2, a combination characteristic of the O157:H7/NM serotype. Out of the 9 bovine atypical (AT; stx-, eae-) strains, 7 carried one complete Lpf operon, allele 1 of lpfA2. The atypical strains belonged to main phylogenetic groups A and B1, while the EHEC and EPEC strains were from group D. Lpf variants carried by the 72 strains of the Escherichia coli Reference Collection (ECOR) were determined with the same typing scheme. Alleles were detected in 25 strains, of which 6 were found negative for the respective Lpf operons in earlier studies. The marker value of the Lpf allelic combination for the O157:H7/NM serotype was confirmed, and further evidence was given for the presence of at least two different genetic lineages of atypical bovine E. coli O157 strains.     

Applicability of a multiplex PCR to detect O26, O45, O103, O111, O121, O145, and O157 serogroups of Escherichia coli in cattle feces

Shiga toxin-producing Escherichia coli (STEC), particularly O157, are major food borne pathogens. Non-O157 STEC, particularly O26, O45, O103, O111, O121, and O145, have also been recognized as a major public health concern. Unlike O157, detection procedures for non-O157 have not been fully developed. Our objective was to develop a multiplex PCR to distinguish O157 and the 'top six' non-O157 serogroups (O26, O45, O103, O111, O121, and O145) and evaluate the applicability of the multiplex PCR to detect the seven serogroups of E. coli in cattle feces. Published sequences of O-specific antigen coding genes, rfbE (O157) and wzx and wbqE-F (non-O157), were analyzed to design serogroup-specific primers. The specificity of amplifications was confirmed with 138 known STEC strains and the reaction yielded the expected amplicons for each serogroup. In feces spiked with pooled 7 STEC strains, the sensitivity of the detection was 4.1 × 10(5)CFU/g before enrichment and 2.3 × 10(2) after 6h enrichment in E. coli broth. Additionally, 216 fecal samples from cattle were collected and tested by multiplex PCR and cultural methods. The multiplex PCR revealed a high prevalence of all seven serogroups (178 [O26], 108 [O45], 149 [O103], 30 [O111], 103 [O121], 5 [O145], and 160 [O157]) of 216 samples in fecal samples. Cultural procedures identified 33.1% (53/160) and 35.5% (11/31) of PCR-positive samples for E. coli O157 and non-O157 serogroups, respectively. Samples that were culture-positive were all positive by the multiplex PCR. The multiplex PCR can be used to identify serogroups of putative STEC isolates.     

Characterization of pathogenic Escherichia coli isolated from humans in Austria: phenotypes, toxin gene types and epidemiology

One hundred and ten clinical Escherichia coli isolates of serovar O157 (n = 102) and O26 (n = 8) were characterized for the presence of putative virulence genes by PCR. All but one of these isolates contained the eae gene. The EHEC-hly gene could be detected in all E. coli O157 and in 50% of E. coli O26 isolates. Forty-five (40.9%) of the 110 E. coli were positive for both stx(1) and stx(2) genes, 2 (1.8%) isolates were positive for stx(1) and 57 isolates (51.8%) were positive for stx(2) only. Among the 102 stx(2) positive isolates, 14 (13.7%) E. coli O157 contained also the stx(2c) variant gene. No other stx(2) variant was identified. Six clinical isolates (five E. coli O157:H7 and one E. coli O26) did not contain stx genes. Ten non-pathogenic E. coli isolates which were amplified as controls didn't contain any stx and eae gene but two of the ten strains contained the EHEC-hly gene. By their growth on chromogenic media, all but two of 50 E. coli O157 could be differentiated from eight E. coli O26 and 10 non-pathogenic E. coli. Sixty-one of the O157:H7 isolates were further subjected to pulsed-field gel electrophoresis (PFGE) which identified 49 distinguishable patterns. In five cases where contact infection among family members was suspected, indistinguishable PFGE patterns confirmed the epidemiological relatedness of the isolates. Moreover, two PFGE clusters were identified which comprised five and three strains, respectively. These findings indicate the occurrence of both family and diffuse outbreaks of E. coli O157 infections in Austria during recent years and demonstrate the need for molecular subtyping of these pathogens.     

Study on Seasonal Impact to the Distribution of Bovine E.coli O157: H7 in Xinjiang

To study the impact of season to the distribution of bovine E.coli O157:H7,samples of anus swabs (399),feces (68),water (29) and feed (43) were collected in the spring, summer,autumn and winter from A,B and C farms of Xinjiang. After enrichment by EC broth, SMAC and MUG selective culture were then performed. Finally,PCR was used for identification and virulence gene detection of isolated strains. A total of 5 E.coli O157:H7 strains were isolated from 539 samples from three farms (0.93%,5/539), 2 of them were from spring (1.44%,2/139),1 from autumn(0.56%,1/180),2 from winter (1.38%,2/145) and no strains were isolated from summer samples. One strain were isolated from anus swab samples in farm B (0.69%,1/145) and one were isolated from anus swabs (0.66%,1/152) and three strains were isolated from feed samples in farm C (20.00%,3/15),and no target strains were isolated from water samples. The distribution of bovine E. coli O157:H7 had obvious seasonal characteristics.One E.coli O157:H7 strain of farm B was isolated from autumn and four of farm C were from isolated spring (2 strain) and winter (2 strain),and the isolation rate of E. coli O157:H7 in spring and winter were higher than that in summer and autumn. In conclusion,under the special climate characteristics and feeding mode in Xinjiang,to prevent and control the spreading of E. coli O157:H7 of cattle,we must pay great attention on hygiene management of pens at cold season, specially avoiding the feed contaminated by feces.     

Testing of a Chemiluminescence Enzyme Immunoassay for selective detection of E. Coli O157 from ground beef samples

The aim of this study was to evaluate a Chemiluminescence Enzyme Immunoassay (CLIA) developed for the detection of E. coli O157:H7, using different E. coli O157 serotypes. The sensitivity and specificity of the kit were determined from the tenfold dilutions of the 24-hour broth cultures of the test strains. According to the results obtained in this trial, the sensitivity of the kit is 10(3)-10(4) cells ml-1, and it is specific for E. coli O157. Twenty-five g ground raw beef samples were prepared and inoculated with E. coli O157:H7 at different CFU g-1. The samples were incubated in 225 ml of modified E. coli broth with novobiocin (mEC + n) at 42 degrees C for 4 h and the immunoassays were performed following the instructions of the manufacturer. According to the results obtained by the CLIA test 10(1)-10(2) E. coli O157 g-1 can be detected from the sample. So this kit seems to be suitable for screening the samples before selective cultivation of E. coli O157:H7.     

Variable and strain dependent colonisation of chickens by Escherichia coli O157

The prevalence of enterohaemorrhagic Escherichia coli (EHEC) O157 in poultry is considered minimal compared with other species, especially ruminants. However, deliberate inoculation studies have shown that poultry are readily and persistently infected by this organism but that the mechanism of colonisation is independent of intimin, a recognised factor in host-EHEC interactions in mammalian species, and may be dependent upon flagella. Few strains of EHEC O157 have been tested in poultry and here 1-day-old and 6-week-old chicks were inoculated with seven non-toxigenic E. coli O157 strains in separate experiments. Persistence was measured semi-quantitatively by bacteriological assessment of E. coli O157 cultured from cloacal swabs (shedding score). In the 1-day-old chick model that was monitored for 43 days, all seven strains established well after inoculation. In the 6-week-old chicken model, one strain established and gave consistently high shedding for the duration of the experiment (156 days). Whereas of the remaining six strains, two persisted for 113 days, two persisted for 43 days, one persisted for 22 days and one strain was never detected.