The International Centre for Reference and Research on Escherichia and Klebsiella
The Laboratory is the National Reference Laboratory (NRL) for typing of E. coli and Klebsiella. The Centre collects surveillance data for national and international authorities. The Centre coordinates typing and participates in research projects in Denmark and abroad. It provides advice and counselling on detection and typing.
As of 2008, the centre functions as microbiological support for surveillance at the EU level for the European Centre for Disease Prevention and Control (ECDC) in Stockholm. This is done in collaboration with the European Union Reference Laboratory (EU-CRL) for Escherichia coli, including Shiga toxin-producing E. coli (STEC), Instituto Superiore di Sanità (ISS) in Rome. The centre organises annual external quality programmes (EQA) for ECDC and internationally in collaboration with the Global Foodborne Disease Network (GFN) and WHO’s Department of Food Safety and Zoonoses (FOS) in Geneva.
- Serotyping of Escherichia coli: Complete characterisation of bacterial somatic (O-), flagella- (H-) and capsular- (K-) antigens
- Virulence characterisation: Detection of relevant virulence factors (adhesins, toxins etc.) using DNA techniques and inoculation of cell cultures. Production of Shiga toxin, the enzyme β-glucuronidase, and biochemical reaction patterns
- Whole genome sequencing – especially on STEC. in silico analyses provide information on both the O:H serotype and the virulence profile of an E.coli isolate.
The majority of routine analyses are accredited by DANAK according to ISO 17025.
|Characterisation provides information on which of the following groups an E. coli isolate belongs to:
|STEC||Shiga toksin-producing E. coli (synonymous with Vero cytotoksin-producing E. coli (VTEC)|
|AEEC||Attaching and Effacing E. coli (eae positive, non-classical EPEC)|
|EPEC||Enteropatogenic E. coli. (Classical and new O:H serotypes); an updated list can be obtained from Flemming Scheutz|
||Enteroinvasive E. coli
||Enterotoxigenic E. coli including isolates, that are positive for astA
||Enteroaggregative E. coli
||Diffusely Adherent E. coli
||Extraintestinal Pathogenic E. coli
||Uropathogenic E. coli
1. Non-accredited analyses:
DNA fingerprints: Pulsed Field Gel Electrophoresis (PFGE), sequencing of the genes for Shiga toxin (stx), subtyping of stx genes. Serotyping of isolates from urinary tract infections, blood and meningitis. Whole genome sequencing.
2. Technical expertise
Evaluation of bacterial virulence, of contamination in production facilities, eg. by ongoing surveillance as part of quality control and specifically in situations where unwanted transmission has occurred.
3. Advice and counselling
The Centre can assist in evaluations of possible transmission routes and risk assessments if relevant (HACCP).
- Zoonoses Annual Report (The Zoonoses Annual Report provides data on the Danish STEC surveillance)
- STEC is a notifiable disease in Denmark and reported weekly in EPI-NEWS, week 12, 2014
- External quality assessment scheme for typing of verocytotoxin-producing E. coli, self-funded participants, 2014-2015 EQA self-funded report 2014-2015 (pdf)
- External quality assessment scheme for typing of verocytotoxin-producing E. coli, self-funded participants, 2015-2016 EQA self-funded report 2015-2016 (pdf)
- The Danish E. coli network comprises all the Clinical Microbiological departments at 14 regional hospitals.
- The International Centre for Reference and Research on Escherichia and Klebsiella
- Food and Waterborne Diseases (FWD)-ECDC: Flemming Scheutz is the Danish contact point for STEC (and E. coli)
- WHO Food Safety and Global Foodborne Disease Network (GFN): Collaboration on External Quality Assurance (EQA) programmes
- Flemming Scheutz is a member of The International VTEC Symposium Steering Committee (IVSSC). 11th International Symposium on Shiga Toxin (Verocytotoxin) - Producing Escherichia coli Infections. These symposiums are held every third year and the next is scheduled as VTEC2021 in Canada
- Consultant for Community Reference Laboratories (CRL) network, EU’s network for Food and Feed funded by DG SANCO.
- External expert for European Food Safety Authority (EFSA) BIOHAZ Working Group on “Pathogenicity assessment of Shiga toxin-producing Escherichia coli (STEC) and the public health risk posed by contamination of food with STEC (EFSA-Q-2018-00293)”.
- Seven new O antigens
- Standardisation of serotyping techniques
- Nomenclature of Shiga toxins
- Molecular methods for typing of virulent E. coli isolates
The Centre functions as ECDC’s microbiological support and organises an annual EQA on sero- and virulence typing of 10-12 STEC strains
In Denmark, the Centre organises an annual EQA programme. As of 2011, this has included 15 different types of DEC, reflecting Danish epidemiology.
- Zoonoses Annual Report
- Joint JEMRA FAO/WHO Report, 2018: Shiga toxin-producing Escherichia coli (STEC) and food: attribution, characterization, and monitoring
- Seventh external quality assessment scheme for typing of verocytotoxin-producing Escherichia coli
- Standard Operation Procedures for O & H serotyping and reference strains
- stx detection & subtyping protocol