Serotypes ofEscherichia coliin Sudden Infant Death Syndrome

Abstract

Aim: To examine the diversity of Escherichia coli serotypes found in the intestinal contents of infants who died of Sudden Infant Death Syndrome (SIDS) compared with that in comparison infants. Methods and Results: Over the 3‐year period, 1989–1991, in South Australia and Victoria (Australia), a total of 687 E. coli isolates from 231 patients with SIDS (348 isolates), 98 infants who had died from other causes (144 isolates) and 160 healthy infants (195 isolates) were studied. The isolates from patients with SIDS were found to represent 119 different serotypes; the isolates from ‘other cause’ infants represent 97 different serotypes; and the isolates from healthy infants represent 117 different serotypes. The seven common serotypes isolated most frequently from infants with SIDS belonged to those associated with extra‐intestinal infections in humans. Compared to healthy infants (6%), these were found in significantly higher proportions among infants who died of other causes (13%, P < 0·05) or infants with SIDS (18·7%, P = 0·0002). Conclusions: Despite these sources yielding a wide variety of serotypes of E. coli, a pattern of certain potential pathotypes of E. coli being associated with SIDS is apparent. Significance and Impact of the Study: While SIDS remains one of the most important diagnoses of postneonatal death, its causes are still unexplained. If E. coli has a role in the pathogenesis of SIDS (as suggested by the pathotypes identified on the basis of serotype), further studies may reveal novel virulence factors that may clarify the role of this bacterium in SIDS.

A perspective on SIDS pathogenesis. The hypotheses: plausibility and evidence

“…This area of SIDS research having compiled considerable supportive evidence has had difficulties in achieving broad acceptance for reasons that are not immediately apparent but seem to be sustained by opinion outside scientific reason. The work is well supported by the findings of groups led by Blackwell [17-19], Morris [20,21], Smith [22], Bettelheim [23-26], Murrell [27] and Goldwater [16,26,28-31]. Goldwater's group extended the hypothesis to encompass inherent or acquired deficiency in pathogen recognition [32], which is predicated on the findings of significant sterile site bacterial infection [33,28], which is proposed to represent a footprint of commonly occurring bacteremic events of infancy and childhood [34] from which most individuals achieve uncomplicated recovery.…”

<p>Virulence and Resistance Determinants of Uropathogenic <em>Escherichia coli</em> Strains Isolated from Pregnant and Non-Pregnant Women from Two States in Mexico</p>

“…We also found a considerable percentage (22% Puebla and 10% Sonora) of non-typable strains, which could be suggestive of new serotypes present in Mexico. Interestingly, some serotypes that were found have been associated with disease conditions in animals and unconventional situations such as corpses of infants with sudden death syndrome 64,65 . With these results, we could propose that UPEC strains are not serotypically restricted, because despite having found a great variety of serotypes, some are non-typables or are associated with other pathotypes.…”

The effect of prenatal maternal infection on respiratory function in mouse offspring: evidence for enhanced chemosensitivity

“…The impairments we observed in lung structure and ventilatory stability due to maternal inflammation/infection may contribute to the increased risk of sudden infant death syndrome (SIDS) in preterm infants. There is a wealth of supportive evidence linking SIDS to inflammation/infection, which includes autopsy findings of infection and inflammatory markers in SIDS victims (6,28,47,55) and an increased risk of SIDS in winter months (13). Unrecognized hypoxemia has also been firmly implicated in SIDS, with evidence including brain stem gliosis (39,48,74,76), elevated hypoxanthine in vitreous humor (53,64), and increased VEGF in cerebral spinal fluid (34) of SIDS victims.…”