ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Food Microbiology
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1577277
This article is part of the Research TopicCritical- and High-Priority Pathogens in the Food ChainView all 5 articles
Enteroaggregative Escherichia coli Foodborne Outbreak in Shandong Province, China (2023): Comprehensive Epidemiology and Genomic Resistance Profiling
Provisionally accepted
Lu Liu
Shuang Wang
Yu Xiaolin
yuzhen Chenyanru Chengaoxiang SunZiqing Liulixiao Chenghuaning Zhang*zengqiang Kou*- Shandong Center for Disease Control and Prevention, Shandong, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Enteroaggregative Escherichia coli (EAEC) is an emerging and intricate diarrheagenic bacterial pathogen responsible for acute and persistent diarrhea in children, adults, and travelers. Despite its clinical significance, the global understanding of EAEC outbreaks and pathogen characteristics remains limited due to its complex epidemiological profile. Furthermore, existing literature on outbreak management often lacks robust evidence to identify infection sources, and comprehensive guidelines for trace-back investigations and molecular source tracking are notably insufficient. This study presented a retrospective analysis of a foodborne diarrheal outbreak caused by EAEC in a county school in Shandong Province, China, in 2023. A total of 15 EAEC isolates were identified, including 13 from stool samples, one from sauced beef, and one from flies. Epidemiological and phylogenetic analyses pinpointed the EAEC isolates from sauced beef as the primary causative agent of the outbreak. Genomic comparisons revealed significant genetic consistency across nine outbreak-associated strains, particularly in virulence gene profiles, antimicrobial resistance gene profiles, molecular typing, and genetic evolution. These findings underscored the utility of whole-genome sequencing in elucidating the genetic diversity of EAEC within specific environments and tracing its origins, thereby supporting targeted interventions such as infection control and prevention strategies. Notably, the study also identified an extensively drug-resistant (XDR) EAEC strain from flies in the canteen, harboring both the mcr-1 and blaCTX-M-132 resistance genes. This unexpected discovery highlighted the critical importance of applying the "One Health" approach, emphasizing the need for continuous surveillance of antibiotic-resistant bacteria in animals and environmental sources to mitigate potential public health risks.
Keywords: enteroaggregative Escherichia coli (EAEC), Foodborne outbreaks, antimicrobial resistance, Whole-genome sequencing, "One Health" approach
Received: 17 Feb 2025; Accepted: 09 Jun 2025.
Copyright: © 2025 Liu, Wang, Xiaolin, Chen, Chen, Sun, Liu, Cheng, Zhang and Kou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
huaning Zhang, Shandong Center for Disease Control and Prevention, Shandong, China
zengqiang Kou, Shandong Center for Disease Control and Prevention, Shandong, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.