Human Diarrheal Infections: Diagnosis of Diarrheagenic Escherichia coli Pathotypes

Miliwebsky, Elizabeth; Schelotto, Felipé; Varela, Gustavo; Luz, Daniela; Chinen, Isabel; Piazza, Roxane M. F.

doi:10.1007/978-3-319-45092-6_15

Cited by 18 publications

(23 citation statements)

References 92 publications

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“…Despite using identical microbiological methods in both studies, delay or difficulties in the sample transport, differences between studied populations, influence of nondeclared previous antibiotic treatment, or other factors may provide additional support to explain a reduced frequency in etiologic diagnosis. However, if appropriate resources and laboratory conditions had been available, investigation of norovirus, usage of CIN for all Yersinia cultures, added primers for EAEC PCR, or molecular methods directly applied to feces could have identified a higher proportion and diversity of involved pathogens [ 11 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several overlapping virulent types that are capable of gene transfer include enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC), Shiga-toxin-producing E. coli (STEC), and enteroinvasive E. coli (EIEC). Diffuse-adherent E. coli DAEC or adherent-invasive E. coli AIEC is also a potential member of DEC that requires further study [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…Diarrheagenic E. coli (DEC) is reported as one of the leading causes of gastrointestinal disorders worldwide and signified as an important issue to address in public health . In low‐ to middle‐income countries, >40% of diarrheal episodes among children are caused by diarrheagenic E. coli pathotypes . These pathotypes also play a considerable role in diarrhea morbidity in the Indian population .…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8][9] In low-to middle-income countries, >40% of diarrheal episodes among children are caused by diarrheagenic E. coli pathotypes. 10 These pathotypes also play a considerable role in diarrhea morbidity in the Indian population. [11][12][13] Remarkably, distinct DEC pathotypes display specific virulence arsenal which transforms the predominant repertoire available for diagnostic and therapeutic approaches.…”

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confidence: 99%

Molecular characterization of diarrheagenic Escherichia coli pathotypes: Association of virulent genes, serogroups, and antibiotic resistance among moderate‐to‐severe diarrhea patients

Thakur

Jain

Changotra

et al. 2018

Clinical Laboratory Analysis

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“…Nevertheless, the designation of certain isolates into a pathotype is complicated due to the plasticity of the E. coli genome resulting in the emergence of hybrid strains; besides, DEC epidemiology varies in different regions of the world and may depend on the host and environmental factors (Croxen et al, 2013 ). It is important to note that DEC pathotypes have been largely disregarded because of the lack of laboratory capabilities (Piazza et al, 2010 ; Miliwebsky et al, 2016 ). Moreover, in several case-control studies, it shows almost equal distribution, especially in EPEC and EAEC pathotypes (Bueris et al, 2007 ; Hernandes et al, 2009 ; Gomes et al, 2016 ; Imdad et al, 2018 ; Dias et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Enteropathogens and Virulence Traits in Brazilian Children With and Without Diarrhea

Merino

Nakano

Delannoy

et al. 2020

Front. Cell. Infect. Microbiol.

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The use of molecular diagnostics for pathogen detection in epidemiological studies have allowed us to get a wider view of the pathogens associated with diarrhea, but the presence of enteropathogens in asymptomatic individuals has raised several challenges in understanding the etiology of diarrhea, and the use of these platforms in clinical diagnosis as well. To characterize the presence of the most relevant bacterial enteropathogens in diarrheal episodes, we evaluated here the prevalence of diarrheagenic E. coli pathotypes, Salmonella spp., and Yersinia enterocolitica in stool samples of children with and without diarrhea using real-time quantitative PCR (qPCR). We found that the presence of genetic markers associated with bacterial pathogens was significantly higher in stool samples from the diarrhea group compared to the control ( P < 0.001). Bacterial loads in samples positive for eae and aggR markers were also determined. Compared to samples from asymptomatic children, a significantly higher number of copies of the eae gene were found in diarrhea samples. Also, the presence of genetic markers associated with STEC strains with clinical significance was evaluated in eae -positive samples by high-throughput real-time PCR. The data presented herein demonstrated that asymptomatic children of an urban area in Brazil might be enteropathogen reservoirs, especially for STEC.

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Human Diarrheal Infections: Diagnosis of Diarrheagenic Escherichia coli Pathotypes

Cited by 18 publications

References 92 publications

DiarrheagenicEscherichia coliAssociated with Acute Gastroenteritis in Children from Soriano, Uruguay

DiarrheagenicEscherichia coliAssociated with Acute Gastroenteritis in Children from Soriano, Uruguay

Molecular characterization of diarrheagenic Escherichia coli pathotypes: Association of virulent genes, serogroups, and antibiotic resistance among moderate‐to‐severe diarrhea patients

Prevalence of Enteropathogens and Virulence Traits in Brazilian Children With and Without Diarrhea

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