Two or more enteropathogens are associated with diarrhoea in Mexican children

Paniagua, Gloria Luz; Monroy, Eric; García-González, Octavio Patricio; Alonso, Javier; Negrete, Erasmo; Vaca, Sergio

doi:10.1186/1476-0711-6-17

Cited by 58 publications

(60 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies in Mexico also recognize the importance of E coli in childhood diarrhoea and in asymptomatic infections. A more recent Mexican case-control study reported that in more than 50% of cases of diarrhoea there was more than one pathogen implicated, including any combination of E. histolytica, Salmonella, or E. coli pathogens [33]. Case-control studies reported from Argentina have concentrated more on STEC, as this country has a high incidence of hemolytic uremic syndrome associated with O157:H7 and non-O157:H7 STEC strains [34].…”

Section: Discussionmentioning

confidence: 99%

Enterotoxigenic Escherichia coli associated with childhood diarrhoea in Colombia, South America

Gómez‐Duarte

Romero-Herazo

Páez-Canro

et al. 2013

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Intestinal Escherichia coli pathogens are major causes of diarrhoeal disease in children under five years of age worldwide. The aim of this study is to evaluate the association of E. coli pathotypes with childhood diarrhoea in Colombia. Methodology: A case-control study was conducted in 815 samples from children younger than five years of age in Cartagena, Colombia (466 cases and 349 controls). Controls were randomly selected 1:1 to cases, to obtain 349 cases and 349 controls. Results: This study revealed that 27 (7.44%) cases and 12 (3.43%) controls were positives for any of the E. coli pathotypes. The difference observed was statistically significant indicating that E. coli pathotypes were associated with cases of childhood diarrhoea. Enterotoxigenic E. coli (ETEC) was the most common pathotype associated with childhood diarrhoea. Additional E. coli pathotypes were also identified. Conclusions: We conclude that after the adjustment by age, sex and socioeconomic stratum, the odds ratio obtained by logistic regression shows an association between infection with ETEC and childhood diarrhoea.

show abstract

Section: Discussionmentioning

confidence: 99%

Enterotoxigenic Escherichia coli associated with childhood diarrhoea in Colombia, South America

Gómez‐Duarte

Romero-Herazo

Páez-Canro

et al. 2013

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…It has been shown by numerous studies carried out in developing countries (3,10,27) that more than one enteric pathogen can be detected in stool samples of diarrheal patients. Mixed pathogens are identifiable in 12% to 26% of individuals with diarrhea; ETEC and V. cholerae O1 can be isolated together in about 13% of samples from patients with acute watery diarrhea in Bangladesh (5,12,33,40,44).…”

mentioning

confidence: 99%

Concomitant EnterotoxigenicEscherichia coliInfection Induces Increased Immune Responses toVibrio choleraeO1 Antigens in Patients with Cholera in Bangladesh

et al. 2010

View full text Add to dashboard Cite

Vibrio cholerae O1 and enterotoxigenic Escherichia coli (ETEC) are major bacterial pathogens that cause dehydrating disease requiring hospitalization of children and adults. The cholera toxin (CT) produced by V. cholerae O1 and the heat-labile toxin (LT) and/or heat-stable toxin (ST) of ETEC are responsible for secretory diarrhea. We have observed that about 13% of hospitalized diarrheal patients are concomitantly infected with V. cholerae O1 and ETEC. In order to understand the outcome of such dual infections on the clinical and immunological responses in cholera patients, we studied patients infected with V. cholerae O1 (group VC; n ‫؍‬ 25), those infected with both V. cholerae O1 and ETEC (group VCET; n ‫؍‬ 25), and those infected with ETEC only (group ET; n ‫؍‬ 25). The VCET group showed more severe dehydration and had a higher intake of intravenous fluid and more vomiting than the ETEC group (P ‫؍‬ 0.01 to 0.003). The VCET patients showed higher vibriocidal responses and increased antibody titers to cholera toxin and lipopolysaccharide (LPS) in plasma than did the V. cholerae O1 patients (P ‫؍‬ 0.02 to <0.001). All responses in the V. cholerae O1 and in the VCET groups were more robust than those seen in the group infected with ETEC only (P ‫؍‬ 0.01 to <0.001). We thus show that concomitant colonization with ETEC induces immune responses to V. cholerae antigens that are more robust than those seen with V. cholerae O1 infection alone. It is possible that LT or other factors expressed by ETEC may play a role as a mucosal adjuvant in enhancing the immune responses to V. cholerae O1.Vibrio cholerae O1 and enterotoxigenic Escherichia coli (ETEC) are two major bacterial pathogens responsible for community-based infections and hospitalizations of both adults and children. Cholera and ETEC diarrhea together may account for nearly 50% of the million or so cases of diarrhea occurring annually in Bangladesh (11,37). The pathogenesis of disease caused by V. cholerae O1 and that of disease caused by ETEC are similar. The cholera toxin (CT) produced by V. cholerae O1 and the heat-labile enterotoxin (LT) of ETEC share 80% identity at the nucleotide level (39). LT produced by ETEC is structurally, functionally, and immunologically very similar to CT produced by Vibrio cholerae. Each toxin consists of a toxin A subunit that shares 75% homology with each other (CTA and LTA, respectively), which is noncovalently associated with five identical B subunits (CTB and LTB, respectively) (43). LTB and CTB also show a high degree of homology to each other, with an 85% conservation of amino acids in the mature proteins. There is evidence from crystallographic studies that LTB and CTB pentamers are also structurally similar (25,41,42). There has been a high degree of immunological cross-reactivity between these proteins reported by many investigators, with both shared and unique epitopes (45); the majority of antibodies are directed against epitopes on the assembled pentamers. Both V. cholerae and ETEC share similar type II secretion s...

show abstract

“…ETEC appears to be endemic in other urban and developing sites of Latin America. 19,24,25,46,47 Differences in epidemic behavior between EIEC and ETEC may be explained by infectious dose and environmental tolerance. EIEC has a lower endpoint on the infectious dose range than ETEC (10 6 -10 10 organisms compared with 10 8 -10 10 ) 2 and thus, amplification of an epidemic through person-to-person transmission may be more likely.…”

Section: Discussionmentioning

confidence: 99%

“…Crosssectional studies of multiple pathotypes suggest that ETEC is the predominant circulating pathotype. 6,[24][25][26][27] However, previous research from northwestern Ecuador suggests that EIEC is the dominant pathogen in this region. 28 Longitudinal data would be important to confirm that these patterns hold over time.…”

Section: Introductionmentioning

confidence: 99%

Distribution of Enteroinvasive and Enterotoxigenic Escherichia coli Across Space and Time in Northwestern Ecuador

Bhavnani¹,

Bayas²,

López³

et al. 2016

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Although Escherichia coli infections are common throughout the developing world, their prevalence patterns in space and over time are not well characterized. We used serial case control data collected from 16 communities in northwestern Ecuador between 2004 and 2010, to examine the prevalence of enteroinvasive E. coli (EIEC) and enterotoxigenic E. coli (ETEC). At its peak, the regional prevalence of EIEC was 8.3 infections/100 persons but this decreased to 1 infection/1,000 persons. The regional prevalence of ETEC ranged from 8 infections/1,000 persons to 3.7 infections/100 persons. The prevalence pattern of EIEC resembled that of a large epidemic whereas the prevalence of ETEC was more stable over time. Here, we provide community-based evidence for temporal shifts in the dominant E. coli pathotype from EIEC to ETEC over a multi-year time period. Furthermore, genotype analysis suggests that a given strain of EIEC and ETEC can persist in this region for long periods, up to 24 and 55 months, respectively.

show abstract

Two or more enteropathogens are associated with diarrhoea in Mexican children

Cited by 58 publications

References 34 publications

Enterotoxigenic Escherichia coli associated with childhood diarrhoea in Colombia, South America

Enterotoxigenic Escherichia coli associated with childhood diarrhoea in Colombia, South America

Concomitant EnterotoxigenicEscherichia coliInfection Induces Increased Immune Responses toVibrio choleraeO1 Antigens in Patients with Cholera in Bangladesh

Distribution of Enteroinvasive and Enterotoxigenic Escherichia coli Across Space and Time in Northwestern Ecuador

Contact Info

Product

Resources

About