Genetic determinants of pathogenicity of Escherichia coli isolated from children with acute diarrhea in Maputo, Mozambique

Sumbana, José João; Taviani, Elisa; Manjate, Alice; Paglietti, Bianca; Santona, Antonella; Colombo, Mauro

doi:10.3855/jidc.6122

Cited by 12 publications

(13 citation statements)

References 13 publications

(30 reference statements)

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“…In contrast with our findings, recent studies conducted in sub-Saharan Africa associated EIEC to diarrhea [35,36]. At least, the lower circulation of EHEC is not surprisingly, since previous studies conducted in Mozambique revealed low circulation of this pathotype in Manhiça [5] and absence in Maputo city [11,14,15]. Nevertheless, the circulation of EHEC have been reported from a number of other locations in Africa, including Nigeria [37], and Uganda [38].…”

Section: Discussioncontrasting

confidence: 99%

“…Previous reports on DEC prevalence in Maputo city (80 km from Manhiça) described a variable circulation of EIEC (0.3-21%) in children with diarrhea [11,14,15], although not associated with the disease, whereas the detection of DAEC by phenotypic assay was significantly associated with diarrhea (22.8% in cases vs. 11% in controls, p < 0.0001) [11]. It is unknow which factors are implicated in the variation of epidemiology of EIEC and DAEC between Manhiça (rural setting) and Maputo (urban setting).…”

Section: Discussionmentioning

confidence: 97%

“…In Mozambique, despite the trend of diarrheal decline over the years (1997–2011), it remains among the major causes of morbidity and mortality in children aged less than 5 years [ 12 ], particularly in Manhiça district [ 13 ]. Studies reporting the occurrence of DEC in Mozambique remain scarce, and often focus on molecular screening of the three most common pathotypes (EAEC, ETEC and EPEC) [ 5 , 11 , 14 – 17 ] rather than all DEC. As part of the Global Enteric Multicenter Study (GEMS) we have previously demonstrated that ETEC, producing stable toxin (ST-ETEC) was the only E. coli pathotype associated to moderate-to-severe diarrhea (MSD) [ 16 ] and less-severe diarrhea (LSD) [ 17 ] in toddlers (12–23 months) in Mozambique. However, GEMS did not assess the potential role of less common pathotypes (EIEC, EHEC and DAEC).…”

Section: Introductionmentioning

confidence: 99%

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Low frequency of enterohemorrhagic, enteroinvasive and diffusely adherent Escherichia coli in children under 5 years in rural Mozambique: a case-control study

et al. 2020

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Background Diarrheagenic Escherichia coli (DEC) are among the leading pathogens associated with endemic diarrhea in low income countries. Yet, few epidemiological studies have focused the contribution of enterohemorrhagic E. coli (EHEC), enteroinvasive E. coli (EIEC) and diffusely adherent E. coli (DAEC). Methods We assessed the contribution of EHEC, EIEC and DAEC isolated from stool samples from a case-control study conducted in children aged < 5 years in Southern Mozambique between December 2007 and November 2012. The isolates were screened by conventional PCR targeting stx1 and stx2 (EHEC), ial and ipaH (EIEC), and daaE (DAEC) genes. Results We analyzed 297 samples from cases with less-severe diarrhea (LSD) matched to 297 controls, and 89 samples from cases with moderate-to-severe diarrhea (MSD) matched to 222 controls, collected between November 3, 2011 and November 2, 2012. DEC were more common among LSD cases (2.7%, [8/297] of cases vs. 1.3% [4/297] of controls; p = 0.243]) than in MSD cases (0%, [0/89] of cases vs. 0.4%, [1/222] of controls; p = 1.000). Detailed analysis revealed low frequency of EHEC, DAEC or EIEC and no association with diarrhea in all age strata. Although the low frequency, EIEC was predominant in LSD cases aged 24–59 months (4.1% for cases vs. 0% for controls), followed by DAEC in similar frequency for cases and controls in infants (1.9%) and lastly EHEC from one control. Analysis of a subset of samples from previous period (December 10, 2007 and October 31, 2011) showed high frequency of DEC in controls compared to MSD cases (16.2%, [25/154] vs. 11.9%, [14/118], p = 0.383, respectively). Among these, DAEC predominated, being detected in 7.7% of cases vs. 17.6% of controls aged 24–59 months, followed by EIEC in 7.7% of cases vs. 5.9% of controls for the same age category, although no association was observed. EHEC was detected in one sample from cases and two from controls. Conclusions Our data suggests that although EHEC, DAEC and EIEC are less frequent in endemic diarrhea in rural Mozambique, attention should be given to their transmission dynamics (e.g. the role on sporadic or epidemic diarrhea) considering that the role of asymptomatic individuals as source of dissemination remains unknown.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Low frequency of enterohemorrhagic, enteroinvasive and diffusely adherent Escherichia coli in children under 5 years in rural Mozambique: a case-control study

et al. 2020

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“…Atypical EPEC have been recovered from children's diarrhea in countries and population groups of middle to high socioeconomic level [ 34 , 35 ]. Typical EPEC strains are still prevalent in poor regions of sub-Saharan Africa [ 36 ], but in other developing areas, aEPEC predominates as seen in developed countries [ 37 ]. In America, tEPEC (as defined through classic serogroup determination) was prevalent some decades ago, mainly in developing regions [ 13 , 15 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

DiarrheagenicEscherichia coliAssociated with Acute Gastroenteritis in Children from Soriano, Uruguay

Peirano

Bianco

Navarro

et al. 2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Introduction Acute diarrheal disease still deserves worldwide attention due to its high morbidity and mortality, especially in developing countries. While etiologic determination is not mandatory for management of all individual cases, it is needed for generating useful epidemiologic knowledge. Diarrheagenic Escherichia coli (DEC) are relevant enteropathogens, and their investigation requires specific procedures to which resources and training should be dedicated in reference laboratories. Methodology Following the hypothesis that enteric pathogens affecting children in towns located in the interior of Uruguay may be different from those found in Montevideo, we conducted a diagnostic survey on acute diarrheal disease in 83 children under 5 years of age from populations in the south of the country. Results DEC pathotypes were the only bacterial pathogens found in diarrheal feces (20.48%), followed by rotavirus (14.45%) and enteric adenovirus (4.81%). Atypical EPEC (aEPEC) was the most frequent DEC pathotype identified, and unexpectedly, it was associated with bloody diarrheal cases. These patients were of concern and provided with early consultation, as were children who presented with vomiting, which occurred most frequently in rotavirus infections. aEPEC serotypes were diverse and different from those previously reported in Montevideo children within the same age group and different from serotypes identified in regional and international studies. Enteroinvasive (EIEC) O96 : H19, associated with large outbreaks in Europe, was also isolated from two patients. Antibiotic susceptibility of pathogenic bacteria identified in this study was higher than that observed in previous national studies, which had been mainly carried out in children from Montevideo. Conclusion The reduced number of detected species, the marked prevalence of aEPEC, the scarce resistance traits, and the diverse range of serotypes in the virulent DEC identified in this study confirm that differences exist between enteropathogens affecting children from interior towns of Uruguay and those circulating among children in Montevideo.

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“…In developing countries, it has also been recognised as an agent of infantile diarrhoea, and it can also be found in non-diarrhoea samples [65,66]. In South Africa, a prevalence of 20% was reported in children with diarrhoea [61], while a prevalence of 19% has been reported in Mozambique [67]. In this study, it was observed that the eaeA gene was expressed more from samples of children without fever and vomiting, agreeing with previous a study in Denmark where 44% of infected children did not show any sign or symptom of diarrhoea [68].…”

Section: Prevalence Of Dec Pathotypesmentioning

confidence: 99%

Mixed Aetiology of Diarrhoea in Infants Attending Clinics in the North-West Province of South Africa: Potential for Sub-Optimal Treatment

et al. 2020

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Routine diagnostic methods for the aetiologic agents of diarrhoea in most developing countries are usually not sensitive enough, leading to under-diagnosis. Thus, this study investigated possible mixed diarrhoeal aetiology by using cultures and real-time polymerase chain reactions (PCR) in children younger than four years old in the Northwest Province, South Africa. In total, 505 stool samples were collected from symptomatic and asymptomatic children who were attending three clinics and the Brits hospital in Madibeng District, between September 2016 and December 2017. Rotavirus, norovirus, Campylobacter, Arcobacter, and diarrhoeagenic Escherichia coli (DEC) were targeted. Campylobacter spp. (24.6%), Arcobacter (15.8%) and DEC (19.6%) were detected using PCR; only Campylobacter spp. (29.7%) and DEC (26.9%) were detected through the culture. Campylobacter jejuni (36%), Campylobacter coli (28%), Campylobacter upsalensis (12%), and Arcobacter butzleri (15.8%) were the only spp. of Campylobacter and Arcobacter identified. The eaeA gene (31.4%) of enteropathogenic E. coli/enterohaemorrhagic E. coli (EPEC/EHEC) was the most prevalent DEC virulence gene (VG) identified. Rotavirus and norovirus were detected at 23.4% and 20%, respectively. Mixed viral aetiology (7.3%) and the co-infection of A. butzleri and Campylobacter (49%) were recorded. A mixed bacterial-viral aetiology was observed in 0.6% of the specimens. Sensitive diagnostic procedures like PCR should be considered to provide the best treatment to children experiencing diarrhoea.

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Genetic determinants of pathogenicity of Escherichia coli isolated from children with acute diarrhea in Maputo, Mozambique

Cited by 12 publications

References 13 publications

Low frequency of enterohemorrhagic, enteroinvasive and diffusely adherent Escherichia coli in children under 5 years in rural Mozambique: a case-control study

Low frequency of enterohemorrhagic, enteroinvasive and diffusely adherent Escherichia coli in children under 5 years in rural Mozambique: a case-control study

DiarrheagenicEscherichia coliAssociated with Acute Gastroenteritis in Children from Soriano, Uruguay

Mixed Aetiology of Diarrhoea in Infants Attending Clinics in the North-West Province of South Africa: Potential for Sub-Optimal Treatment

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