5% clinical and parasitologic response at 28 days.13 However, a larger recent trial in Papua New Guinea

of Cytoskeletal Signaling inhibitor 195 children with vivax malaria treated with different artemisinin-based combination therapies compared with conventional chloroquine-sulfadoxine-pyrimethamine (CQ-SP) demonstrated adequate clinical and parasitologic response of only 69% in the dihydroartemisinin-piperaquine group compared to 13% in the CQ-SP group.14 In summary, CRPV is emerging as a clinically significant issue among travelers with imported malaria. Awareness of epidemiology and a detailed travel exposure are critically important to the recognition of CRPV. Mefloquine is an effective treatment for patients potentially infected with CRPV, and treatment strategies for P. vivax may eventually need to be reconsidered if CRPV becomes more widespread. Further research is needed to elucidate the mechanisms of resistance and to validate better prospective assays for chloroquine resistance. Malaria prophylaxis for travel to destinations with CRPV may not require change if P. falciparum is the predominant clinical concern, but an expanded role for primaquine in prevention could be considered.15 Pre-travel advice to travelers going check details to such destinations should include discussion of CRPV and the risk of resistance and/or relapse. The authors state they have no conflicts of

interest to declare. “
“Splinter hemorrhages appear in a variety of conditions. One identified cause is ascent to altitude, but trauma and extreme conditions have Amino acid been thought to be responsible. We document the appearance of splinter hemorrhages in a group of adults during several days of easy touring at an altitude of 11,000 feet (3,350 m). Splinter hemorrhages are seen in conditions of varying severity

including (but not limited to) infective endocarditis, vasculitis, the antiphospholipid syndrome, chronic meningococcemia, ingestion of tyrosine kinase inhibitors, trauma,[1] and activities of daily living (especially in the elderly).[1, 2] Chronic[4] or acute[5, 6] exposure to high altitude has also been associated with this finding, but, in this scenario, extreme conditions and trauma have been thought to play a causative role. This report describes splinter hemorrhages associated solely with ascent to moderately high altitude and in the absence of associated trauma or extreme conditions. This 71-year-old physician presented for evaluation of numerous splinter hemorrhages (Figure 1). He denied fever, chills, muscle or joint pains, chest pain, difficulty breathing, or neurologic symptoms. He had no known heart murmur, and was in general good health, with hypertension, well controlled on hydrochlorthiazide and atenolol, and diabetes, well controlled on metformin 500 mg daily (hemoglobin A1c = 5.6). He had just returned from a 7-day trip to Peru where he spent 2 days in Cuzco (altitude 11,000 feet) and 1 day in Machu Picchu (altitude 8,000 feet).

It may, however, have a developmental component that we cannot exclude. This impairment also cannot be considered as a general learning deficit of the PN-1 KO mice as their fear

conditioning learning is comparable to their WT littermates. In addition, while we found no evidence that they are more susceptible to learning fear, we cannot exclude that the threshold for fear acquisition is lower for PN-1 KO mice. Our study is the first demonstration as far as we know that a serpin can influence emotional learning such as fear extinction. Earlier reports have shown that serine proteases can influence fear conditioning. Acutely stressed mice lacking the protease tissue plasminogen activator exhibit reduced contextual fear learning compared with WT animals (Norris & Strickland, 2007). On the other hand, mice lacking another activity-dependent serine protease, neuropsin, display increased fear after cued fear conditioning compared with

WT littermates, even in Selleckchem CH5424802 the absence of stress (Horii et al., 2008). Mice with a targeted deletion of the cancer metabolism inhibitor serine protease-activated receptor-1 (PAR-1), also known as the thrombin receptor, show reduced fear retrieval after cued fear conditioning (Almonte et al., 2007). PN-1 inhibits many of the above involved proteases and reduces PAR-1 activation (Scott et al., 1985; Stone et al., 1987; Kvajo et al., 2004; Feutz et al., 2008). In addition to a reduced proteolytic inhibition, a further impact of the absence of PN-1 could be an altered cellular signaling triggered by high molecular weight complexes between PN-1 and its target proteins (Vaillant et al., 2007; Fayard et al., 2009). Consequently, our

results suggest a possible involvement of serine proteases in fear extinction ADP ribosylation factor as well. We evaluated short- and long-term patterns of neuronal activation in the amygdala by comparing Fos immunoreactivity and pαCamKII protein levels in the amygdala of WT and PN-1 KO mice to find cellular correlates of this behavioral deficit. We concentrated on the amygdala because of the striking pattern of PN-1 expression in GABAergic neurons as well as its central role in integrating fear inputs. It is possible that other affected brain areas contribute to the overall extinction deficit in the PN-1 KO mouse, e.g. the prefrontal cortex (Quirk & Mueller, 2008) or the hippocampus (Corcoran et al., 2005). In WT mice, Fos immunoreactivity increased in the no extinction and extinction groups as expected in the LA and BA after fear retrieval and extinction acquisition, compared with the naive control group (Herry & Mons, 2004). The Fos-immunopositive cells possibly represent subsets of the two populations of cells recently shown to be activated differentially by fear and extinction protocols (Herry et al., 2008). This response was shifted in PN-1 KO mice, namely the increase was higher than the WT response after fear retrieval in the no extinction group and lower than the WT in the extinction group.

The gold standard test for HIV infection in infancy was HIV DNA PCR on peripheral blood lymphocytes. www.selleckchem.com/products/bmn-673.html In a number of studies, including the large French perinatal cohort, equal or increased early sensitivity with amplification of viral RNA with no false positives

has been reported [330, 331]. Infants infected intrapartum may have low peripheral blood HIV levels, so HIV DNA/RNA may not be amplified from all infected infants at birth. Indeed a positive HIV DNA/RNA result within 72 hours of birth is taken as presumptive evidence of intrauterine transmission. Within the first few weeks of life the sensitivity of the viral diagnostic tests increases dramatically and by 3 months of age 100% of non-breastfed HIV-positive infants are likely to be detected [331]. Although HIV RNA and DNA assays have similar sensitivity, RNA assays commonly require 1 mL of plasma. If the sample requires dilution due to a low volume, which is often the case with paediatric samples, the Ibrutinib lower limit of detection will be increased (with a corresponding decrease in assay sensitivity). Ideally, the lower limit of detection should not exceed 100 copies/mL following dilution. In addition where MTCT may have occurred

in utero, subsequent maternal antiretroviral therapy with agents that cross the placenta could lead to a false-negative RNA result in an infected infant. This risk would be highest in a late-presenting mother. In this situation the infant should be tested using DNA PCR. The same considerations regarding using primers known to amplify maternal virus apply to

both RNA and DNA assays. In view of the genomic diversity of HIV, a maternal sample should always be obtained for HIV DNA or RNA amplification with, or prior to, the first infant sample to confirm that the primers PRKACG used detect the maternal virus. If the maternal virus cannot be detected then a different primer set and/or test should be used. There has been an increase in the number of cases, usually mothers established on antiretroviral therapy long term with fully suppressed HIV, where it has not been possible to amplify maternal DNA using four different primer sets. HIV DNA/RNA results on their infants should therefore be interpreted with caution and in the light of clinical and serological findings. Infant HIV diagnostic testing should be undertaken at birth, 6 weeks and 12 weeks of age. Evidence from the French perinatal cohort demonstrated that neonatal ART, especially if more than one drug, can delay the detection of both HIV DNA and RNA in the infant [332]. For this reason, the second and third HIV molecular tests are performed at 2 weeks and 2 months after stopping PEP, i.e. usually at 6 weeks and 12 weeks of age.

, 2008);

however, no Na+/H+ antiporters have been identified at the molecular level in the extremophiles colonizing the Dagong Ancient Brine Well. In recent years, metagenomic libraries have been widely used for mining novel genes HKI-272 mw or products of pharmacological importance directly from some environments without necessarily cultivating microorganisms first (Cardenas & Tiedje, 2008; Vakhlu et al., 2008). Many novel genes have also been identified with this approach (Cowan et al., 2005; Schmeisser et al., 2007). In this study, we constructed a metagenomic library by directly extracting DNA from the brine in the Dagong Ancient Brine Well. Screening of Na+/H+ antiporters was performed by function complementation of the antiporter-deficient Escherichia coli strain KNabc that lacks three major genes, nhaA, nhaB and chaA, coding Na+/H+ antiporters (Nozaki et al., 1996). After the identification of the Na+/H+ antiporter genes, the structure and function of the protein it encoded were analyzed. This is the first report of the identification of a novel Na+/H+ antiporter gene from a metagenome from a special man-made ancient hypersaline environment. The halophile genomic DNAs were prepared from the brine in the Dagong Ancient Brine Well using methods originally described by Moon with modifications (Moon et al., 2004). Briefly, 100-mL samples were GSK2126458 mouse centrifuged at 14 000 g and 4 °C for

10 min, and the slurry was resuspended with 5 mL phosphate-buffered saline (pH 7.5) centrifuged at 5 g for 2 min at room temperature. The dispersion was again centrifuged at 14 000 g and 4 °C for 2 min. The bacterial cell pellets obtained were directly used for extracting environmental DNA using the Ultra-Clean Soil DNA Kit (Mo Bio Laboratories, Solana Beach, CA). Total DNA was subsequently subjected to electrophoresis in 0.8% agarose gels and stored

at −20 °C. An overnight culture of E. coli KNabc was inoculated into 100 mL of a modified Luria–Bertani medium (LBK medium) consisting of 1.0% tryptone, 0.5% yeast extract Florfenicol and 87 mM KCl, and then grown at 37 °C under aerobic conditions to an OD600 nm of 0.4. Cells were harvested by centrifugation at 4000 g for 10 min at 4 °C and washed three times in 10 mL of ice-cold sterile 10% glycerol solution before electrocompetent preparation (Yang et al., 2006). The halophile genomic DNAs were partially digested with Sau3AI to produce 1.5–6 kbp fragments. These DNA fragments were separated by agarose electrophoresis and ligated into pUC18, which had been digested with BamHI and dephosphorylated with bacterial alkaline phosphatase, using T4 DNA ligase (Mayumi et al., 2008). The ligated recombinant plasmids (20–200 ng) were added to 50 μL of competent cells of E. coli KNabc suspension and mixed thoroughly. Electroporation was carried out at field strength of 16 kV cm−1 in combination with an electric resistance of 300 Ω at 25 mF in a 0.1-cm electroporation cuvette.

In contrast to intracellular production, the efficient secretion of TGase or pro-TGase is considerably more cost-effective for the recovery and purification of the protein in E. coli because it does not require a cell disruption step (Mergulhao et al., 2005). In addition, secretion of

the enzyme will benefit the rapid and high throughput Obeticholic Acid mw screening of mutant libraries for desired catalytic properties. In this study, the pro-TGase from S. hygroscopicus was successfully secreted in E. coli using the TGase signal peptide or the pelB signal peptide. The secreted pro-TGase was directly transformed into an active form after the addition of dispase to the culture supernatant of the recombinant strain. This is the first report of pro-TGase secretion by E. coli. In addition, we identified the residues in the pro-region of S. hygroscopicus TGase that affect the solubility and secretion of TGase in E. coli. Streptomyces hygroscopicus WSH03-13, which secretes TGase, was isolated in a previous study (Cui et al., 2007). Escherichia

coli JM109 and pMD® 19-T Simple Vector (Takara, Dalian, China) Caspase inhibitor plasmids were used for the construction of TGase-related genes. Escherichia coli BL21(DE3) and pET-22b+ (Novogen, ON, Canada) were used for the expression of pro-TGase. Streptomyces hygroscopicus genomic DNA was isolated as described previously (Kieser et al., 2000). Cloning of the TGase gene containing flanking regions from S. hygroscopicus was performed in two steps. First, the pro-TGase gene was cloned from S. hygroscopicus genomic DNA by PCR using TG-NcoI and TG-BamHI primers (Table 1) that were designed based on the conserved terminal sequence of pro-TGases from Streptomyces platensis, Streptomyces cinnamoneus, and Streptomyces fradiae (GenBank accession nos. AY555726, AB085698, and DQ432028). The target PCR product was inserted into the NcoI-BamHI sites of pET-22b+ selleck chemicals and was sequenced. Secondly, based on the sequence of the pro-TGase gene, an inverse PCR (Ochman et al., 1988) was performed to amplify the flanking regions of the cloned pro-TGase gene. Streptomyces hygroscopicus genomic DNA was digested

with PstI. The digested DNA was circularized and served as the inverse PCR template. The inverse PCR primers ITG1 and ITG2 (Table 1) were designed based on the sequence of the cloned pro-TGase gene. The PCR product containing the flanking regions of the pro-TGase gene was cloned and sequenced. Assembling the gene sequences of the pro-TGase and its flanking regions generated a TGase-related fragment that was named tgh (Fig. 1a). The signal peptide sequence prediction was performed on the signalp 3.0 Server (http://www.cbs.dtu.dk/services/SignalP/). The promoter region sequence was predicted by bdgp (http://www.fruitfly.org/seq_tools/promoter.html). Homology searches, alignments, and other basic analyses of the nucleotide sequence were completed using vector NTI Advance 11.0 (Invitrogen, Beijing, China). A sequence-based homology model of S.

In particular, the nature of the polysaccharides

available for fungal growth induced a specific transcriptional response aiming at the targeted enzymatic degradation of the given polysaccharides. “
“Natural and anthropogenic impacts such as terrestrial runoff, influence the water quality along the coast of the Great Barrier Reef (GBR) and may in turn affect coral reef communities. Associated bacterial biofilms respond rapidly to environmental conditions and are potential Etoposide clinical trial bioindicators for changes in water quality. As a prerequisite to study the effects of water quality on biofilm communities, appropriate biofilm substrates for deployment in the field must be developed and evaluated. This study investigates the effect of different settlement substrates (i.e. glass slides, ceramic tiles, coral skeletons and reef sediments) on bacterial biofilm communities grown in situ for 48 days at two locations in the Whitsunday Island Group (Central GBR) during two sampling times. Bacterial communities associated with the biofilms were analysed using terminal restriction fragment length polymorphism

(T-RFLP) and clone library analyses of 16S rRNA genes. Findings revealed that substrate type had little influence on bacterial community composition. Of particular relevance, glass slides and coral skeletons exhibited very similar communities during both sampling Venetoclax in vitro times, suggesting the suitability of standardized glass slides for long-term biofilm indicator studies in tropical coral reef ecosystems. Similar to coastal regions worldwide, local natural and anthropogenic impacts such as land runoff from agriculture deliver inorganic nutrients, sediments, freshwater and pesticides to the coastal and coral reef waters of the Great Barrier Reef (GBR) (Bell, 1991), and thereby influence the

water quality of this ecosystem. ID-8 Coral reefs harbour abundant bacterial biofilms that are crucial catalysts of biogeochemical nutrient cycling (Battin et al., 2003) and are therefore critical to reef ecosystem functioning. This underlines the necessity to understand community composition and function of microorganisms within coral reef-associated biofilms. Marine biofilms are complex microbial communities comprising of surface-attached microorganisms embedded in an extracellular polymeric matrix (Mihm et al., 1981). The bacterial communities within biofilms respond rapidly to changing environmental conditions, and therefore bacterial community composition of artificially and field grown biofilms have previously been used as bioindicators for water quality in freshwater (Campbell et al., 2011), estuarine (Jones et al., 2007; Nocker et al., 2007) and temperate and polar coastal marine environments (Moss et al., 2006; Webster & Negri, 2006; Dang et al., 2008). In addition, biofilms may also be potential bioindicators for water quality in tropical coastal coral reef ecosystems (Kriwy & Uthicke, 2011).

Although the incidence of MRSA infections may be declining, HIV-infected persons continue to experience significantly higher rates

compared with the general population and appear to have an increased susceptibility for recurrence. The reasons for the elevated rates are multifactorial, but probably related to lifestyle behaviours (e.g. high-risk sexual activities and drug use), underlying immune dysfunction, and higher rates of antibiotic Epigenetics Compound Library use and hospitalizations. The precise relationship between HIV infection and MRSA infection has yet to be fully elucidated, and further research is needed, especially in the area of optimal treatment and preventive strategies. In the meantime, reduction of risk factors, including immunosuppression and high-risk sexual

behaviours, should be considered. The authors have no financial interest in this work. All authors contributed to the content of the manuscript and concurred with the decision to submit it for publication. The content and views expressed in this publication are Venetoclax ic50 the sole responsibility of the authors and do not necessarily reflect the views or policies of the Departments of the Army, Navy, Air Force, Department of Defense, nor the U.S. Government. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. This work is original and has not been published elsewhere. “
“The aim of the study was to compare health-related quality of life (HRQL) over 96 weeks in patients receiving no treatment or 24 or 60 weeks of combination antiretroviral therapy (cART)

during primary HIV-1 infection (PHI). A multicentre prospective cohort study of PHI patients, with an embedded randomized trial, was carried out. HRQL was assessed with the Medical Outcomes Loperamide Study Health Survey for HIV (MOS-HIV) and a symptom checklist administered at weeks 0, 8, 24, 36, 48, 60, 72, 84 and 96. Mixed linear models were used for the analysis of differences in HRQL among the three groups. A total of 112 patients were included in the study: 28 received no treatment, 45 received 24 weeks of cART and 39 received 60 weeks of cART. Over 96 weeks of follow-up, the groups receiving 24 and 60 weeks of cART had better cognitive functioning than the no-treatment group (P = 0.005). Patients receiving 60 weeks of cART had less pain (P = 0.004), better role functioning (P = 0.001), better physical functioning (P = 0.02) and a better physical health summary score (P = 0.006) than the groups receiving no treatment or 24 weeks of cART. Mental health was better in patients receiving 24 weeks of cART than in patients in the no-treatment group or the group receiving 60 weeks of cART (P = 0.02). At week 8, patients in the groups receiving 24 and 60 weeks of cART reported more nausea (P = 0.

Although the incidence of MRSA infections may be declining, HIV-infected persons continue to experience significantly higher rates

compared with the general population and appear to have an increased susceptibility for recurrence. The reasons for the elevated rates are multifactorial, but probably related to lifestyle behaviours (e.g. high-risk sexual activities and drug use), underlying immune dysfunction, and higher rates of antibiotic CX-4945 supplier use and hospitalizations. The precise relationship between HIV infection and MRSA infection has yet to be fully elucidated, and further research is needed, especially in the area of optimal treatment and preventive strategies. In the meantime, reduction of risk factors, including immunosuppression and high-risk sexual

behaviours, should be considered. The authors have no financial interest in this work. All authors contributed to the content of the manuscript and concurred with the decision to submit it for publication. The content and views expressed in this publication are TSA HDAC solubility dmso the sole responsibility of the authors and do not necessarily reflect the views or policies of the Departments of the Army, Navy, Air Force, Department of Defense, nor the U.S. Government. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. This work is original and has not been published elsewhere. “
“The aim of the study was to compare health-related quality of life (HRQL) over 96 weeks in patients receiving no treatment or 24 or 60 weeks of combination antiretroviral therapy (cART)

during primary HIV-1 infection (PHI). A multicentre prospective cohort study of PHI patients, with an embedded randomized trial, was carried out. HRQL was assessed with the Medical Outcomes PAK5 Study Health Survey for HIV (MOS-HIV) and a symptom checklist administered at weeks 0, 8, 24, 36, 48, 60, 72, 84 and 96. Mixed linear models were used for the analysis of differences in HRQL among the three groups. A total of 112 patients were included in the study: 28 received no treatment, 45 received 24 weeks of cART and 39 received 60 weeks of cART. Over 96 weeks of follow-up, the groups receiving 24 and 60 weeks of cART had better cognitive functioning than the no-treatment group (P = 0.005). Patients receiving 60 weeks of cART had less pain (P = 0.004), better role functioning (P = 0.001), better physical functioning (P = 0.02) and a better physical health summary score (P = 0.006) than the groups receiving no treatment or 24 weeks of cART. Mental health was better in patients receiving 24 weeks of cART than in patients in the no-treatment group or the group receiving 60 weeks of cART (P = 0.02). At week 8, patients in the groups receiving 24 and 60 weeks of cART reported more nausea (P = 0.

Author contributions: KA, EW, JG, CLY, PR and AQ were involved in the design, execution and data analysis of the study, and in the writing of the manuscript. DW, AP, JML, CC and CO reviewed the design of the study and were involved in its execution. Conflicts of interest: KA has received honoraria for check details consultancy work from Boehringer Ingelheim Pharmaceuticals Inc. DJW has received research grants from GlaxoSmithKline, Bristol-Myers Squibb, Boehringer Ingelheim Pharmaceuticals Inc, Merck,

Gilead Sciences, Tibotec, Pfizer and ViiV. He has also been a consultant at advisory boards and speaker bureaus for GlaxoSmithKline, Bristol-Myers Squibb, Boehringer Ingelheim Pharmaceuticals Inc, Tibotec, Gilead Sciences and Pfizer. CO has received travel sponsorships from, provided advice to, and received research grants from Janssen, ViiV, GlaxoSmithKline, Merck Sharp & Dohme, Bristol-Myers Squibb,

Gilead Sciences and Boehringer Ingelheim Pharmaceuticals Inc. AP, JML and CC do not have any conflicts of interest. AQ, EW, CLY, PR and JG are employees of Boehringer Ingelheim Pharmaceuticals Inc. Y-27632 cell line “
“The objective of this study was to establish the level of awareness of HAND among healthcare providers, the screening tools that are currently used in its detection and factors that limit cognitive assessments. We distributed a 12-item questionnaire to doctors and nurses who work in the Department of Genitourinary Medicine and Infectious

Disease (GUIDE) service and also to doctors who work in the emergency department (ED) at St James Hospital. 35 surveys were collected, 54% (n = 19) from the GUIDE service and 46% (n = 16) from the ED. 82% (n = 29) of participants were doctors from interns to consultants. There was reasonable appreciation among participants with regards the prevalence of neurocognitive impairment (estimated at 29.1% among patients on HAART, and 39.3% among patients not on HAART). Screening tools were rarely used by GUIDE and ED clinicians (25% vs. 15% of the time). The Mini Mental State Examination (MMSE) was previously used by 37% (n = 13) of the group. Very few people had used the HIV Dementia Scale (HIVDS) 6% (n = 2). this website 34% of respondents felt that ‘Orientation in Person, Place and Time was a sufficient screening tool for cognitive assessment’. Lack of time, exposed environment and lack of availability of screening tool were cited as limitations to cognitive screening in the ED environment. This study examines awareness of HAND among healthcare providers and also reasons for inadequate assessment. There is a need for consensus on screening guidelines. A quick, easy to use and readily available screening tool may have a role in the acute setting in identifying high-risk patients. “
“To assess the risk factors associated with heterosexual HIV transmission among South Indian discordant couples enrolled in clinical care.

In some SF O157, two identical copies of the stx2EDL933 gene have been reported, resulting in increased production of stx. However, an association between increased stx production and enhanced virulence as compared to strains with only one stx2EDL933 copy was not observed (Bielaszewska et al., 2006). Furthermore, loss of AZD6244 solubility dmso the stx2 phage in SF O157 followed by regain of the phage in the same SF O157 strain has been reported,

thus giving SF O157 the ability to recycle stx2 (Mellmann et al., 2008). The stx genes are encoded in the late region of lambdoid prophages, where they are located downstream of the late promoter pR′ and late terminator tR′. The stx genes are expressed from pR′ as a late protein, and the anti-terminator activity from the Q protein is necessary for read through of the late terminator, tR′ and activation of Selleck PTC124 pR′ (Schmidt, 2001). Although the stx

genes have their own functional promoters (Calderwood et al., 1987; Schmidt, 2001), induction of the prophage and transcription from pR′ is important for the expression of the stx genes as well as for the release of stx from the bacteria (Wagner et al., 2001). Two different q genes, q933 and q21, have been identified in NSF O157, giving evidence of higher production of stx2 in strains positive for the q933 gene (LeJeune et al., 2004; Koitabashi et al., 2006; Matsumoto et al., 2008). Additionally, mutations in the stx2 promoter region have been observed in strains GNA12 containing the q21 gene, which further affects the expression of stx2 negatively (Matsumoto et al., 2008). Dowd and Williams compared expression of stx2 between two genetically diverse lineages of E. coli O157:H7 and observed that lineage I produced significantly more toxin than lineage II (Dowd & Williams, 2008). Furthermore, when using the stx8

primer set, all the lineage I strains were positive, whereas all lineage II strains were negative (Dowd & Williams, 2008). They, therefore, predicted that the stx8 primers were useful to differentiate lineage I and lineage II (Dowd & Williams, 2008). Draft genome sequences of two SF O157 strains are published (Rump et al., 2011), but to our knowledge, little is known about the genomic regulation of stx2EDL933 expression in such strains. Thus, in the present study, we aimed to examine factors at the genomic level that might influence the expression of stx2 in SF O157. Among the 35 human clinical isolates of SF O157 recovered in Norway, 17 harboured the stx2 gene and were included in the present study (Table 1). Only one stx2 positive strain from each patient belonging to the 2009–2011 outbreak cluster was included. All isolates were from the strain collection at the Norwegian Institute of Public Health and were recovered from 2005 through 2011.