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Abstract

Strains of Escherichia coli, hybridising with a DNA probe for enteroaggregative E. coli (EAggEC), were isolated from patients with infectious intestinal disease (IID) or gastro-enteritis, and healthy controls during the study of IID in England. Of 3506 cases presenting with an IID, 160 (4.6%) had faecal EAggEC as compared with 46 (1.7%) of 2772 healthy controls, 53% of EAggEC isolated from each of the 'case' and the 'control' groups adhered in a 'stacked-brick' formation. Strains from cases and controls belonged to over 39 and 14 different serogroups respectively, and approximately half of the strains isolated did not react with antisera in the current somatic antigen serotyping scheme. Forty-nine cases with EAggEC (31%) had a known history of foreign travel. Over 50% of strains isolated from cases and controls were resistant to one or more of eight antimicrobials, and antimicrobial resistance was not statistically significantly more common among cases with a known history of foreign travel (p = 0.57). These data form part of the largest investigation carried out on these organisms in the UK to date and provide the most comprehensive analysis of strains of EAggEC isolated from the general population of England.

Complete Genome Sequence and Comparative Metabolic Profiling of the Prototypical Enteroaggregative Escherichia coli Strain 042

“…Indeed, two large prospective surveillance studies in the UK and USA identified EAEC amongst the most commonly isolated bacterial species from individuals with diarrhea, with isolation rates similar to Campylobacter jejuni and greater than Salmonella sp. [8], [9]. Furthermore, a meta-analysis of the previously published case control studies from a variety of different geographical regions clearly supports a role for EAEC in mediating diarrheal disease, and the increasing number of reports in which EAEC is implicated as the agent mediating diarrhea suggest that this is an important emerging pathogen [10].…”

An Investigation of the Diversity of Strains of Enteroaggregative Escherichia coli Isolated from Cases Associated with a Large Multi-Pathogen Foodborne Outbreak in the UK

“…Hwoever, it was not possible to compare the serotypes isolates following the outbreak with the serotypes of strains of EAEC currently circulating in England as there are very little data on domestically acquired strains of EAEC. Surveillance data indicates that the majority of strains of EAEC isolate in England are from cases of travellers' diarrhoea [12], [50].…”

“…Two independent, large, prospective studies of diarrhoea aetiology conducted in the UK (1993–1996) and USA (2002–2004) reported a similar EAEC prevalence in patients with diarrhoea: 4.6% (160/3506) and 4.5% (37/823) in the UK and US studies, respectively, and 1.7% in control subjects from both studies [11], [12]. Clinical symptoms include watery diarrhoea, often with mucus, low grade fever, abdominal pain, nausea and vomiting [10].…”

Genotypic and Phenotypic Characterisation of Enteroaggregative Escherichia coli from Children in Rio de Janeiro, Brazil

“…However, it is worth recalling many studies have demonstrated the presence of EAEC strains in healthy controls (ca. 2%) and that the rate of recovery of EAEC in symptomatic individuals is approximately 3-fold higher [44], [45]. Therefore, a simplistic hypothesis would suggest that approximately one third of the strains isolated from symptomatic individuals are not associated with disease but simply part of the resident commensal flora.…”