Infantile Diarrhea Produced by Heat-Stable Enterotoxigenic<i>Escherichia coli</i>

In this study, 27 volunteers received one of three non-O group 1 Vibrio cholerae strains in doses as high as 109 CFU. Only one strain (strain C) caused diarrhea: this strain was able to colonize the gastrointestinal tract, and produced a heat-stable enterotoxin (NAG-ST). Diarrhea was not seen with a strain (strain A) that colonized the intestine but did not produce NAG-ST, nor with a strain (strain B) that produced NAG-ST but did not colonize. Persons receiving strain C had diarrhea and abdominal cramps. Diarrheal stool volumes ranged from 154 to 5,397 ml; stool samples from the patient having 5,397 ml of diarrhea were tested and found to contain NAG-ST. The median incubation period for illness was 10 h. There was a suggestion that occurrence of diarrhea was dependent on inoculum size. Immune responses to homologous outer membrane proteins, lipopolysacchide, and whole-cell lysates were demonstrable with all three strains.Our data demonstrate that V. cholerae of 0 groups other than I are able to cause severe diarrheal disease. However, not all strains are pathogenic for humans: virulence of strain C may be dependent on its ability both to colonize the intestine and to produce a toxin such as NAG-ST. (J. Clin. Invest. 1990.

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“…2). The role of STh and STp in production of human and porcine diarrheal illness, respectively, is well established (57,68,69 …”

Section: Discussionmentioning

confidence: 99%

Experimental non-O group 1 Vibrio cholerae gastroenteritis in humans.

Morris¹,

Takeda²,

Tall³

et al. 1990

J. Clin. Invest.

116

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“…LT, which structurally and functionally resembles cholera toxin, was initially thought to be the more significant than ST. However, a large US nursery outbreak in 1974-75 was attributed to STproducing ETEC [92] and shortly after, Levine et al [93] demonstrated that strains producing ST alone were capable of eliciting diarrhea, nausea, vomiting and abdominal cramps in adult volunteers. This finding is backed by epidemiological evidence, including controlled studies performed in different parts of Africa, which suggest that ST-producing ETEC are more strongly associated with childhood diarrhea than are LT-producing strains, even though the latter may be more common overall [41,65,91,94].…”

Section: Enteropathogenic E Colimentioning

confidence: 99%

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Okeke

2009

J Infect Dev Ctries

120

103

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Diarrhea is a leading cause of illness and death, particularly in developing countries. Enteropathogenic Escherichia coli, enterotoxigenic E. coli (ETEC), enteroinvasive E. coli, enterohemorrhaghic E. coli (EHEC), enteroaggregative E. coli (EAEC) and diffusely adherent E. coli (DAEC) have been associated with diarrheal disease in different parts of Africa, particularly among young children, HIV-positive individuals, and visitors from abroad. Each of these E. coli pathotypes uses distinct mechanisms, which are only partially understood, to colonize infected hosts and produce diarrhea. All known diarrheagenic E. coli pathotypes have been reported from diverse locations within Africa but the true burden from these pathogens is unknown because very few studies seeking these organisms with discriminatory methodology have been performed. Recent reports implicate ETEC and EAEC in a considerable proportion of childhood and travellers' diarrheas and suggest that some sub-types of these categories may have greater epidemiological significance than others. The significant contribution of EHEC to bloody diarrhea and hemolytic uremic syndrome is underappreciated because diagnostic capacity for this pathotype is generally inferior to that for confounders such as Shigella and Entamoeba. Recent studies in Africa have revealed the worrisome emergence of antimicrobial resistance and high asymptomatic carriage rates for diarrheagenic E. coli but bacterial and host factors that predispose to disease, as well as non-human reservoirs, are largely unknown. Future diarrheal disease research needs to focus on broadening the repertoire of pathogens sought in epidemiological surveys to include multiple categories of diarrheagenic E. coli while building capacity to detect these pathogens in local reference laboratories.

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“…The causative organism belonged to a previously undescribed serogroup, E. coli 0 159, and produced ST but not LT. In the same year Ryder et al (1976) reported an outbreak which affected 55 of 205 infants in the special-care nursery of a large hospital in the United States. The epidemic strain belonged to serogroup 078 and again produced ST but not LT. Rowe et al (1978) described a further outbreak in Britain that affected 10 of 18 babies in the special-care unit of a Gloucester hospital and was caused by a strain of E. coli 06 that produced ST and LT.…”

Section: Epidemic Infantile Enteritis In Developed Countriesmentioning

confidence: 99%

Escherichia colidiarrhoea

Gross

Rowe

1985

J. Hyg.

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Ever since Escherich (1885) first isolated the organism now known asEscherichia colifrom the stools of infants, medical microbiologists have been faced with the problem of distinguishing between those strains capable of causing diarrhoea and those that are harmless gut commensals. Epidemiological investigations were greatly facilitated by the description by Kauffmann (1947) of a serotyping scheme forE. coli, and Taylor (1961) later reported that 17 0 serogroups ofE. colihad been implicated as possible causes of epidemic infantile enteritis. These infantile enteropathogenicE. coli(EPEC), having been discovered by epidemiological studies using serotyping, belonged by definition to a restricted range of serogroups. More recently it was shown that otherE. colistrains may produce enterotoxins, and these enterotoxigenicE. coli(ETEC) usually belong to particular serogroups which are different from those associated with EPEC.E. colistrains belonging to a third range of serogroups may cause an illness resembling shigella dysentery, and these may be regarded as entero-invasiveE. coli(EIEC).E. colistrains that cause diarrhoea may therefore be considered as three groups, as follows.

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Infantile Diarrhea Produced by Heat-Stable EnterotoxigenicEscherichia coli

Cited by 144 publications

References 17 publications

Experimental non-O group 1 Vibrio cholerae gastroenteritis in humans.

Experimental non-O group 1 Vibrio cholerae gastroenteritis in humans.

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Escherichia colidiarrhoea

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