The epidemiology, microbiology and clinical impact of Shiga toxin-producing XXXX in England, 2009-2012.

@entity1 @entity23345 @entity2142 @entity526
UNASSIGNED: Between 1 January 2009 and 31 December 2012 in England, a total of 3717 cases were reported with evidence of Shiga toxin-producing @entity526 (STEC) infection, and the crude incidence of STEC infection was 1  80/100 000 @entity1 -years. Incidence was highest in @entity1 aged 1-4 years (7  63/100 000 @entity1 -years). Females had a higher incidence of STEC than males [rate ratio (RR) 1  24, P < 0  001], and white ethnic groups had a higher incidence than non-white ethnic groups (RR 1  43, P < 0  001). Progression to @entity2142 ( @entity2142 ) was more frequent in females and @entity1 . Non-O157 STEC strains were associated with higher hospitalization and @entity2142 rates than O157 STEC strains. In STEC O157 cases, phage type (PT) 21/28, predominantly indigenously acquired, was also associated with more severe disease than other PTs, as were strains encoding @entity23345 genes. Incidence of STEC was over four times higher in @entity1 residing in rural areas than urban areas (RR 4  39, P < 0  001). Exposure to livestock and/or their faeces was reported twice as often in cases living in rural areas than urban areas (P < 0  001). Environmental/animal contact remains an important risk factor for STEC transmission and is a significant driver in the burden of sporadic STEC infection. The most commonly detected STEC serogroup in England was O157. However, a bias in testing methods results in an unquantifiable under-ascertainment of non-O157 STEC infections. Implementation of PCR-based diagnostic methods designed to detect all STEC, to address this diagnostic deficit, is therefore important.
