The Threat of Foodborne "Big Six"

Abstract

Foodborne diseases are infectious or toxic diseases that can cause serious health problems and significant economic losses. These diseases cause 600 million illnesses and 420,000 deaths worldwide annually. Most foodborne diseases are caused by microorganisms and the toxins they produce. One of the most important foodborne infectious agents is Escherichia coli (E. coli). E. coli strains are classified into six groups according to the diseases they cause, virulence factors, clinical symptoms they cause in patients, their interactions with the intestinal mucosa, epidemiology and serotypes. In recent years, among these serotypes, Shiga toxin-producing E. coli (STEC), which is seen as an important threat to public health, has come to the forefront of the literature. E. coli O157 was the most well-known STEC serotype in the world, affecting individuals of all age groups, especially young children, and causing significant health problems. However, in recent years, the isolation of other serogroups from serious infections caused by E. coli has raised serious concerns. In response, the US Food and Drug Administration (FDA) identified six non-O157 serogroups of E. coli (O26, O45, O103, O111, O121 and O145) found in foods, known as the "Big Six". Outbreaks from these serogroups have led to reports from the US Centres for Disease Control and Prevention (CDC) and the European Food Safety Authority (EFSA). This review discusses the importance of the Big Six E. coli serogroups, which are frequently encountered today and cause significant public health problems.

Keywords

• Big Six E. coli
• E. coli
• epidemic
• foodborne diseases
• STEC

Gıda Kaynaklı “Büyük Altı” Tehlikesi

Öz

Gıda kaynaklı hastalıklar, ciddi sağlık problemlerine ve önemli ekonomik kayıplara yol açabilen, enfeksiyöz ya da toksik karakterli hastalıklardır. Bu hastalıklar, dünya çapında yıllık 600 milyon hastalığa ve 420.000 ölüme sebep olmaktadır. Gıda kaynaklı hastalıkların çoğunluğunu, mikroorganizmalar ile bunların ürettiği toksinler oluşturmaktadır. En önemli gıda kaynaklı enfeksiyon etkenlerinden biri Escherichia coli (E. coli)’dir. E. coli suşları, sebep oldukları hastalıklara, virulans faktörlerine, hastalarda oluşturdukları klinik semptomlara, bağırsak mukozası ile olan etkileşimlerine, epidemiyolojilerine ve serotiplerine göre sınıflandırılarak altı grupta toplanır. Son yıllarda bu serotiplerden halk sağlığı için önemli bir tehdit olarak görülen, shiga toksin üreten E. coli (STEC) literatürde ön plana çıkmıştır. E. coli O157, dünya üzerinde başta küçük çocuklar olmak üzere tüm yaş gruplarındaki bireyleri etkileyerek, önemli sağlık problemlerine sebep olan, en fazla bilinen STEC serotipiydi. Fakat son yıllarda E. coli’nin neden olduğu ciddi enfeksiyon tablolarından diğer serogrupların da izole edilmesi ciddi endişelere yol açmıştır. Bunun üzerine ABD Gıda ve İlaç Dairesi (FDA), “Büyük Altılı (Big Six)’’ olarak bilinen, gıdalarda bulunan ve O157 dışı altı serogrup E. coli (O26, O45, O103, O111, O121 ve O145) tanımlamıştır. Bu serogruplardan kaynaklanan salgınlar ABD Hastalık Kontrol ve Korunma Merkezleri (CDC) ve Avrupa Gıda Güvenliği Kurumu (EFSA)’nun raporlar yayınlamasına sebep olmuştur. Bu derlemede, günümüzde sıklıkla karşılaşılan ve önemli halk sağlığı problemlerine sebep olan Büyük Altılı (Big Six) E. coli serogruplarının önemi ele alınmıştır.

Anahtar Kelimeler

• Büyük Altılı E. coli
• E. coli
• gıda kaynaklı hastalıklar
• salgın
• STEC

Kaynakça

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