Typical Enteroaggregative and Atypical Enteropathogenic Types of
            <i>Escherichia coli</i>
            Are the Most Prevalent Diarrhea-Associated Pathotypes among Brazilian Children

Araujo, Joel M.; Tabarelli, Graciela F.; Aranda, Katia R. S.; Fabbricotti, Sandra H.; Fagundes-Neto, Ulysses; Mendes, Caio; Scaletsky, Isabel C. A.

doi:10.1128/jcm.00084-07

Cited by 97 publications

(98 citation statements)

References 23 publications

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“…Despite ample evidence that EAEC is the most common DEC [35][36][37][38][39], it remains less wellknown compared to EPEC, EIEC AND ETEC ( Table 1).…”

Section: Enteroaggregative E Coli (Eaec)mentioning

confidence: 99%

Enteroaggregative E. coli O104 from an outbreak of HUS in Germany 2011, could it happen again?

Chattaway

Dallman

Okeke

et al. 2011

J Infect Dev Ctries

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Enterohaemorrhagic E. coli (EHEC) particularly O157:H7 (Sequence type 11 complex), is the best documented and most well-known of E. coli that cause diarrhoea. The importance of EHEC lies in the severity of disease. Outbreaks can infect thousands of people causing bloody diarrhoea and haemolytic uremic syndrome (HUS) that in turn can result in protracted illness or even death. The ability of EHEC to colonise the human gut is normally associated with the presence of genes from another group of diarrhoeagenic E. coli, the enteropathogenic E. coli (EPEC), via the locus of enterocyte effacement. However, the massive outbreak in Germany was caused by an EHEC which had acquired virulence genes from yet another group of diarrhoeagenic E. coli, the enteroaggregative E. coli (EAEC). In reality EAEC is probably the most common bacterial cause of diarrhoea but is not identified in most diagnostic laboratories. This outbreak emphasises the importance of being able to detect all diarrhoeagenic E. coli and not to focus on E. coli O157:H7 alone. Routine surveillance systems for EAEC, a once ignored global pathogen, would go a long way to reaching this goal. This review describes methods for identifying non-O157 EHEC and describes the key genetic features of EHEC and EAEC. Our aim is to provide information for laboratories and policy makers which enables them to make informed decisions about the best methods available for detecting newly emergent strains of diarrhoeagenic E. coli.

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“…Despite ample evidence that EAEC is the most common DEC [35][36][37][38][39], it remains less wellknown compared to EPEC, EIEC AND ETEC ( Table 1).…”

Section: Enteroaggregative E Coli (Eaec)mentioning

confidence: 99%

Enteroaggregative E. coli O104 from an outbreak of HUS in Germany 2011, could it happen again?

Chattaway

Dallman

Okeke

et al. 2011

J Infect Dev Ctries

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“…For unknown reasons, the incidence of EPEC infections in regions where they were most common has decreased significantly (38). Instead, a group of diarrheagenic E. coli strains bearing serotypes found among EPEC and non-EPEC strains and lacking the EAF has emerged as a significant cause of gastrointestinal disease (1,3,9,19,37). These strains share some of the virulence traits of typical EPEC strains but are categorically considered a new pathogroup, referred to as atypical EPEC (aEPEC) (22,46).…”

mentioning

confidence: 99%

Fimbrial Adhesins Produced by Atypical Enteropathogenic Escherichia coli Strains

Hernandes

Velsko

Sampaio³

et al. 2011

Appl Environ Microbiol

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Atypical enteropathogenic Escherichia coli (aEPEC) has emerged as a significant cause of pediatric diarrhea worldwide; however, information regarding its adherence mechanisms to the human gut mucosa is lacking. In this study, we investigated the prevalence of several (fimA, ecpA, csgA, elfA, and hcpA) fimbrial genes in 71 aEPEC strains isolated from children with diarrhea (54 strains) and healthy individuals (17 strains) in Brazil and Australia by PCR. These genes are associated with adhesion and/or biofilm formation of pathogenic and commensal E. coli. Here, the most prevalent fimbrial genes found, in descending order, were hcpA (98.6%), ecpA (86%), fimA (76%), elfA (72%), and csgA (19.7%). Phenotypic expression of pili in aEPEC strains was assessed by several approaches. We were not able to detect the hemorrhagic coli pilus (HCP) or the E. coli lamininbinding fimbriae (ELF) in these strains by using immunofluorescence. Type 1 pili and curli were detected in 59% (by yeast agglutination) and 2.8% (by Congo red binding and immunofluorescence) of the strains, respectively. The E. coli common pilus (ECP) was evidenced in 36.6% of the strains on bacteria adhering to HeLa cells by immunofluorescence, suggesting that ECP could play an important role in cell adherence for some aEPEC strains. This study highlights the complex nature of the adherence mechanisms of aEPEC strains involving the coordinated function of fimbrial (e.g., ECP) and nonfimbrial (e.g., intimin) adhesins and indicates that these strains bear several pilus operons that could potentially be expressed in different niches favoring colonization and survival in and outside the host.

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“…In Brazil, the most prevalent diarrhea-associated pathotypes among children are the typical entero aggregative and atypical enteropathogenic types of Escherichia coli [34]. Typical (tEPEC) and atypical (aEPEC) enteropathogenic Escherichia coli strains are the main diarrhea infectious agents [35][36][37].…”

Section: Diarrhea Epidemiology and Pathogenesismentioning

confidence: 99%

Vaccine Against Entheropathogenic E. colii: A Systematic Review

Vasconcellos¹,

Silva²,

Nascimento³

et al. 2017

IJVR

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Enteric diseases are a major cause of childhood death in the developing world, ranking as the second cause of death in children. Enteropathogenic Escherichia coli(EPEC) are important diarrheal pathogens of children under 5 years of age. Due to high mortality, several international organizations such as the WHO and UNICEF have dedicated preventive and control programs for diarrheal diseases. Among the suggested initiatives aiming to prevent infectious diarrhea include vaccine development and improvement in sanitation and water and food supplies.Upon contact with host cells, EPEC delivers an array of virulence protein factors, which integrated actions interferes with the normal adjusting the targets molecular cell functions leading to diarrhea. The locus of entherocyte effacement (LEE)pathogenicity island contains genes encoding synthesis of the EPEC virulence factors membrane adhesin intimin, T3SS (Esc and Sep proteins), chaperones (Ces proteins), translocators (EspA, EspB, and EspD), effector proteins (EspF, EspG, EspH, Map and EspZ), the translocated intimin receptor (Tir), and the regulatory protein Ler (LEEencoded regulator).Bundle-forming pilus (BfpA) is another virulence factor that mediates the initial contact between EPEC and the host cell. BfpA is encoded by a gene localized on a 50-70 MDa plasmid and is designated as EPEC adherence factor (EAF). BfpA, intimin and translocated Tir initiate EPEC infection. This repertoire of virulence factors offers strategic epitopes as vaccine candidates.Employing the proposed technologies for modern vaccines, recombinant Mycobacterium smegmatis (Smeg) and Mycobacterium bovis BCG strains were constructed to express BfpA, intimin and EspA. Recombinant clones were selected based on kanamycin resistance. Recombinant proteins are immunogenic, and the resultant antibodies recognize and block EPEC adhesion onto HEp-2 target cells. In attention to regulatory agency recommendations, kanamycin should not be used to produce rBCG expressing the E. coli EPEC virulence factors BfpA, intimin and EspA. Accordingly, an expression system with a Pasteur auxotrophic BCG mutant for leucine (BCG Pasteur ΔleuD) and a replicative vector (pUP410)should be used. Obtained recombinants will be grown in large scale, and their immunogenic effectivity and human safety submitted to WHO indicated quality controls.

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Typical Enteroaggregative and Atypical Enteropathogenic Types of Escherichia coli Are the Most Prevalent Diarrhea-Associated Pathotypes among Brazilian Children

Cited by 97 publications

References 23 publications

Enteroaggregative E. coli O104 from an outbreak of HUS in Germany 2011, could it happen again?

Enteroaggregative E. coli O104 from an outbreak of HUS in Germany 2011, could it happen again?

Fimbrial Adhesins Produced by Atypical Enteropathogenic Escherichia coli Strains

Vaccine Against Entheropathogenic E. colii: A Systematic Review

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