Evolution in action

Over the last three weeks, a rare form of Escherichia coli has made an appearance in Germany.

E. coli is a normal inhabitant of the gut of man and animals and is found there in very large numbers.  They are mostly harmless and actually help us by producing vitamin K.  However, some strains are pathogenic and cause diarrhoea.

Individual strains are recognised by their antigenic signature. The antigens are found on the surface of the cells, on the flagella and in the capsule that surrounds the cells.  Thus one of the strains that hits the news quite frequently is referred to as O157:H7.

The strain now causing havoc in Europe is E. coli O104:H4.  This has rarely been seen as a cause of disease.  However, the current outbreak is shaping up to be one of the most dangerous ever seen.

Why has this happened?

That's a question that none of us can answer yet, but the information on this strain is growing rapidly.  It can produce a very damaging toxin, called Shigatoxin.  The bacterium causes bloody diarrhoea, which is bad enough in itself.  But bacteria producing this toxin can also go on to produce Haemolytic Uraemic Syndrome, normally affecting around 2 to 10% of patients, who are often very young or immunocompromised.  However, O104:H4 appears to be very virulent and around 30% of patients, who were not in the high risk group, have developed this life-threatening syndrome.  So far, 18 people have died.

The fact is, bacteria evolve very rapidly.  We see one strain develop resistance to an antibiotic and soon other strains become resistant too.  This happens because bacteria can  exchange genetic information by a number of different mechanisms.  The rate of mutation might be very small, perhaps one in 10 million replications produces a mutant and most of these mutations are probably lethal.  However, a single cell can potentially produce a population of around 17 million cells in 8 hours.  That allows for a lot of mutations.  If even one of these mutants has some advantage over the rest of the population, or at least no disadvantage, the mutation will spread through the population.

This might surprise you, but bacteria also suffer from virus infections.  These viruses, or bacteriophages, invade the cells and cause them to make more virus particles before bursting open to restart the infection cycle.  Occasionally, the new virus particles contain a bit of bacterial DNA and transfer it to the next host.  Sometimes, whole genes can be transferred.

It appears that O104:H4 has not only the Shigatoxin gene, almost certainly transferred by bacteriophage, but has also picked up some other virulence factors.  This is why it is so dangerous - the toxin is very damaging to human cells, particularly in the kidney, and the bacterium appears very capable of initiating infection.

I believe we are seeing evolution in action.  A normally benign bacterium has become a killer.