Toxins and virulence factors of enterotoxigenicEscherichia coliassociated with strains isolated from indigenous children and international visitors to a rural community in Guatemala

Abstract

SUMMARYDiarrhoea remains a common cause of illness in Guatemala, with children suffering most frequently from the disease. This study directly compared the frequency, enterotoxin, and colonization factor (CF) profiles of enterotoxigenic Escherichia coli (ETEC) strains isolated from children living in a rural community in Guatemala and from Western visitors to the same location during the same seasons, using similar detection methodologies. We found that ETEC accounted for 26% of severe cases of diarrhoea in children requiring hospitalization, 15% of diarrhoea in the community, and 29% of travellers' diarrhoea in visitors staying ⩾2 weeks. The toxin and CF patterns of the ETEC strains isolated from both groups differed significantly (P < 0·0005) as determined by χ2 = 60·39 for CFs and χ2 = 35 for toxins, while ETEC phenotypes found in Guatemalan children were comparable to those found in children from other areas of the world.

Identification of common virulence factors present in enterotoxigenicEscherichia coliisolated from diarrhoeal patients in Kolkata, India

“…) and Guatemala (Torres et al . ) the trend was LT > ST > ST+LT. Global enteric multicenter study (GEMS) in several developing countries reported that ETEC strains with either ST or together with LT were associated with moderate to severe diarrhoea (Kotloff et al .…”

“…In ETEC isolates from indigenous children and international visitors to a rural community in Guatemala, a large percentage analysed for CFs lacked a detectable CF (Torres et al . ). These results indicated the possibility of the existence of other CFs that are yet to be identified.…”

Colonization Factors in Enterotoxigenic Escherichia coli Strains in Travelers to Mexico, Guatemala, and India Compared with Children in Houston, Texas

“…12 A challenge to vaccine development is the temporal, regional, and population-specific variabilities in ETEC CFs expressed. 13 There is heterogeneity in the ETEC strains circulating among the pediatric population in developing countries and the strains infecting traveler's to that country as supported in a recent study in Guatemala that toxins and CF do not completely overlap among indigenous children and adult travelers, 14 and is further supported by the systematic review performed by Isidean and others. 6 Thus, a vaccine for ETEC needs to have broad coverage for both travelers to, and pediatric populations in the developing world.…”

Development of an enterotoxigenic Escherichia coli vaccine based on the heat-stable toxin

“…[1][2][3] These very common infections are estimated to cause some 25,000 child deaths annually and contribute to child malnutrition. 1 Besides, ETEC is the leading cause of diarrhea among tourists 4,5 and military personnel 6,7 staying in ETEC endemic regions. Deaths associated with ETEC infection are declining worldwide; nevertheless, morbidity remains high.…”