A Prospective Study of Enteropathogenic Escherichia coli in Endemic Diarrheal Disease

Abstract

The rate of isolation of Escherichia coli belonging to the traditional serotypes enteropathogenic for infants was studied prospectively in two groups. Group 1 consisted of children with diarrhea and of controls without gastrointestinal disease who were matched for age and inpatient or outpatient status. Group 2 consisted of families entered in a prospective study of rotavirus infections. In group 1 enteropathogenic Escherichia coli were found in 13 (6%) of 220 children younger than 12 months of age and in nine (6%) of 143 children 12--35 months of age, all of whom had diarrhea. Enteropathogenic E. coli were found in only one of an equal number of matched controls (P = 0.002 and 0.004, respectively). In group 2 enteropathogenic E. coli were present in seven (18%) of 38 specimens obtained during diarrheal episodes, as compared with five (1%) of 492 specimens obtained when there was no diarrhea (P less than 0.001). The enteropathogenic E. coli isolated were not enterotoxigenic. The most common serogroup was O111, but many different O:H serotypes were detected. Thus, the association of enteropathogenic E. coli with endemic diarrhea was significant, even though no enteropathogenic mechanism was apparent.

Role of the eaeA gene in experimental enteropathogenic Escherichia coli infection.

“…Enteropathogenic Escherichia coli (EPEC)' are a leading cause of diarrhea among infants on five continents (1)(2)(3)(4)(5). With the 1.…”

“…With the 1. Abbreviations used in this paper: ANCOVA, analysis of covariance; EAF, EPEC adherence factor; EPEC, enteropathogenic Escherichia coli.…”

Adhesion and its role in the virulence of enteropathogenic Escherichia coli

“…In some studies, strains belonging to EPEC 0 serogroups did not appear to be associated with disease (74,155). Although the serotyping methods in some of these studies were inadequate, as H types were not confirmed and in some cases full 0-antigen determination was not performed (91), these reports led to confusion as to the role of EPEC in disease. At the same time, microbiologists became aware of E. coli strains that produced potent enterotoxins (enterotoxigenic E. coli [ETEC]) or possessed invasive properties (enteroinvasive E.…”

“…Some workers argued that EPEC strains were nonvirulent, that bacteriological investigations for EPEC should be abandoned, and that laboratories should look for ETEC and EIEC isolates with clearly defined virulence properties (74,173). Others proposed a more cautious approach, suggesting that until more information was available, EPEC should be regarded as true pathogens (91,172).…”

Escherichia coliin gastroenteritis of children in Auckland, New Zealand

“…With the realization that some strains of E. coli can produce one or more of a number of toxigenic factors (Sack, 1975;Orskov et al 1976; Evans, Evans & Du Pont, 1977;Klipstein et al 1978) serotyping has seemed less important. However a statistical association between diarrhoeal disease in children in the community and EPEC isolation has recently been confirmed in sporadic cases of gastroenteritis (Gurwith et al 1978), and a survey of serotypes of E. coli from a variety of sources (Bettelheim, 1978) demonstrated that certain 'OH' serotypes are much more commonly associated with infantile gastroenteritis than others.…”