Diffusely Adherent Escherichia coli as a Cause of Acute Diarrhea in Young Children in Northeast Brazil: a Case-Control Study
Isabel C. A. ScaletskySandra H. FabbricottiRozane L. B. CarvalhoClaudia Regina NunesHélcio S. MaranhãoMauro Batista de MoraisUlysses Fagundes‐Neto
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ABSTRACT In a prospective study carried out in two urban centers in northeastern Brazil, 195 HEp-2-adherent Escherichia coli strains were isolated; 110 were identified as the only pathogen in stools of children with diarrhea, and 85 were from controls. Enteropathogenic E. coli isolates were identified in 21 children with diarrhea (8.9%) and 7 children without diarrhea (3.0%), and they were significantly associated with diarrhea ( P < 0.01). Enteroaggregative E. coli strains were isolated from 40 children with diarrhea (16.9%) and 38 children without diarrhea (16.4%) and showed no correlation with diarrhea ( P > 0.5). In 49 children with diarrhea (20.7%) and 40 children without diarrhea (17.3%), diffusely adherent E. coli (DAEC) isolates were detected and were not found to be associated with diarrhea ( P = 0.41). However, after stratification, for children older than 12 months of age a significant correlation between DAEC infection and diarrhea was detected ( P = 0.01). These results suggest that DAEC isolates should be considered potential pathogens in northeastern Brazil and also confirm the association of DAEC with age-dependent diarrhea.Keywords:
Enteroaggregative Escherichia coli
A PCR method was developed to detect enteropathogenic Escherichia coli (localized adherence) and enteroaggregative Escherichia coli. A portion of the structural gene (bfpA) encoding bundle-forming pilus (BFP), was amplified by the PCR for the detection of enteropathogenic Escherichia coli. It proved to be sensitive and specific in detecting enteropathogenic Escherichia coli. For the detection of enteroaggregative Escherichia coli, a portion of aggR (a transcriptional activator of aggA coding a major fimbrial subunit) was amplified. Although few strains showing non-aggregative adherence gave positive result, the PCR method was shown to have greater sensitivity than the probe assay in detecting enteroaggregative Escherichia coli.
Enteropathogenic Escherichia coli
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The purpose of this study was to determine the role of enteroaggregative Escherichia coli (EAEC) in the development of traveler's diarrhea and the clinical response of patients with EAEC diarrhea following treatment with ciprofloxacin. Sixty-four travelers with diarrhea and no other recognized enteropathogen were enrolled in treatment studies in Jamaica and Mexico from July 1997 to July 1998. EAEC was isolated from 29 travelers (45.3%). There was a significant reduction in the duration of posttreatment diarrhea in the 16 patients treated with ciprofloxacin, as compared with that in the 13 patients who received placebo (mean of 35.3 versus 55.5 hours; P = .049). There was a nonsignificant reduction in the mean number of unformed stools passed during the 72 hours after enrollment in the ciprofloxacin-treated group (5.6), as compared with that in the placebo group (7.5) (P = .128). This study provides additional evidence that EAEC should be considered as a cause of antibiotic-responsive traveler's diarrhea.
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The prevalence of various pathotypes of Escherichia coli was investigated during a case-control study conducted in children diarrhoea in Yaoundé. Isolates obtained from the stools samples of children aged 6 months to 5 years were selected on phenotypic basis, and identified by virulence genes detection using polymerase chain reactions. The most prevalent pathotype was enteroaggregative Escherichia coli (25.8%). Enteropathogenic Escherichia coli (3.6%), enterotoxigenic Escherichia coli (1%), and enteroinvasive Escherichia coli (0.2%) followed. No shiga toxin-producing Escherichia coli were identified. Enteroaggregative Escherichia coli was not associated with diarrhoea (cases 26.1%, controls 25.5%; P=0,887), unlike enteropathogenic Escherichia coli (cases 6.7%, controls 1%; P=0.003). Investigations into documented potentials of enteroaggregative Escherichia coli in causing diarrhoea and other related pathologies indicated that it could be a major public health threat in Cameroon despite the fact that it was not found associated with clinical diarrhoeal cases in this study. Keywords: Cameroon, diarrhoeagenic Escherichia coli, public health. Int. J. Biol. Chem. Sci. Vol. 2 (3) 2008: pp. 272-280
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Journal Article Diffuse and Enteroaggregative Patterns of Adherence of Enteric Escherichia coli Isolated from Aboriginal Children from the Kimberley Region of Western Australia Get access Stuart T. Gunzburg, Stuart T. Gunzburg Departments of Microbiology and Medicine, University of Western Australia, Nedlands, and Health Department of Western Australia, East Perth Search for other works by this author on: Oxford Academic PubMed Google Scholar Barbara J. Chang, Barbara J. Chang Departments of Microbiology and Medicine, University of Western Australia, Nedlands, and Health Department of Western Australia, East Perth Reprints or correspondence: Dr. B. J. Chang, University Department of Microbiology. QE II Medical Centre, Nedlands, 6009, Western Australia. Search for other works by this author on: Oxford Academic PubMed Google Scholar Simon J. Elliott, Simon J. Elliott Departments of Microbiology and Medicine, University of Western Australia, Nedlands, and Health Department of Western Australia, East Perth Search for other works by this author on: Oxford Academic PubMed Google Scholar Valerie Burke, Valerie Burke Departments of Microbiology and Medicine, University of Western Australia, Nedlands, and Health Department of Western Australia, East Perth Search for other works by this author on: Oxford Academic PubMed Google Scholar Michael Gracey Michael Gracey Departments of Microbiology and Medicine, University of Western Australia, Nedlands, and Health Department of Western Australia, East Perth Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 167, Issue 3, March 1993, Pages 755–758, https://doi.org/10.1093/infdis/167.3.755 Published: 01 March 1993 Article history Received: 25 June 1992 Revision received: 06 October 1992 Published: 01 March 1993
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In the pigeon industry, treating and preventing diarrhea is vital because it is a serious health problem for pigeons. This study investigated the incidence of diarrhea in three pigeon farms in Shanghai, and analyzed the microflora through 16S rDNA high-throughput sequencing. Four strains of Escherichia coli (E. coli) isolated from pigeon diarrhea feces were administered via gavage to healthy pigeons, with each pigeon receiving 2×108 CFU. Pigeons that developed diarrhea after E. coli challenge were treated with 3g of Lactobacillus salivarius SNK-6 (L. salivarius SNK-6) health sand (1.6×107 CFU/g). Then, a mass feeding experiment expanded to 688 pairs of pigeons with three replicates, each receiving 3 g of health sand containing L. salivarius SNK-6 (1.6 × 107 CFU/g) every 2 weeks, and fecal status monitored and recorded. The study found that the relative abundance of the Lactobacillus genus and L. salivarius in feces from pigeons with diarrhea was significantly lower than in normal pigeon feces (P<0.05). In contrast, E. coli showed a higher abundance and diversity in feces from pigeons with diarrhea than in normal feces (P<0.05). Three out of the four isolated E. coli strains caused pigeon diarrhea, resulting in a significant reduction in microbial diversity in fecal samples (P<0.05). Both the small group attack experiment and the mass-fed additive experiment in pigeon farms demonstrated that feeding L. salivarius SNK-6 effectively cured and prevented diarrhea. Pigeons fed with L. salivarius SNK-6 exhibited no diarrhea, while the control group had a 10% diarrhea rate. In summary, a deficiency of Lactobacillus or a high abundance of E. coli in the intestine could easily cause pigeon diarrhea. Feeding L. salivarius SNK-6 could treat pigeon diarrhea, and continuous supplementation could maintain stable preventive effects.
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A total of 220 enteroadherent Escherichia coli were identified from 729 Egyptian children with diarrhea using the HEp-2 adherence assay. Enteropathogenic E.coli (EPEC = 38) was common among children <6 months old and provoked vomiting, while diffuse-adhering E.coli (DAEC = 109) induced diarrheal episodes of short duration, and enteroaggregative E.coli (EAEC = 73) induced mild non-persistent diarrhea. These results suggest that EPEC is associated with infantile diarrhea in Egyptian children.
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The neonatal period is very important in calves. It is extremely important to closely monitor newborn calves with good colostrum management during this period. In this study, the aim was to investigate whether the clinical parameters in the first 15 days after calves are born are correlated with diarrhea and whether those values are the early clinical predictors of the diarrhea that will occur in this period and also to investigate the correlation between diarrhea and the failure of transfer of passive immunity (FTPI). Eighty-two Holstein calves were used in the study. The calves were examined systemically every day and were scored according to a standard form. In the first 15 day period, 64.63% of the calves had diarrhea. In diarrheic calves, the most common findings on the previous day without diarrhea were fetid feces (43.40%), changes in the consistency and color of feces, and a decrease in the temperature of the ears (35.85%). According to non diarrheic calves, fetid feces (P < 0.01), changes in the consistency and color of feces, and nasal discharge were more common among diarrheic calves on the day before diarrhea (p < 0.001). The duration of diarrhea in calves with FTPI was longer than without FTPI. As a result, it is important for calves to be monitored daily in the first 15 days, looking for early signs of diarrhea in this period, namely fetid feces and changes in the consistency and the color of the feces. In addition, coexistence of any fecal changes with the decrease in the temperature of the ears may be clinical predictors of diarrhea. As a result of the daily monitoring of the calves, although the morbidity rate was high, none of the animals died.
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Fecal samples from 74 horses with diarrhea were examined microscopically for leukocytes and epithelial cells. The diarrhea was categorized as either acute (less than two weeks) or chronic, Salmonella positive or negative, and mild or severe (based on the fecal consistency). A large number of fecal leukocytes was strongly suggestive of salmonellosis; however, approximately 1/3 of the horses with Salmonella-negative diarrhea also shed fecal leukocytes. Fecal leukocytes were more common in horses with acute and/or severe diarrhea regardless of cause. Numbers of fecal colonic mucosal epithelial cells were increased in severe diarrhea, and their presence in horses with chronic diarrhea was correlated with salmonellosis. The study supports the concept that fecal leukocytes and epithelial cells occur in increased numbers in equine salmonellosis but also occur in other types of diarrhea.
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Enteroaggregative Escherichia coli (EAEC) causes acute and persistent diarrhea among children, HIV-infected patients, and travelers to developing countries. We have searched for 18 genes-encoding virulence factors associated with aggregative adherence, dispersion, biofilm, toxins, serine protease autotransporters of Enterobacteriaceae (SPATEs) and siderophores, analyzed in 172 well-characterized EAEC strains (aggR+) isolated from stool samples of 97 children with diarrhea and 75 healthy controls from a passive surveillance diarrhea cohort study in Peru. Eighty-one different genetic profiles were identified, 37 were found only associated with diarrhea and 25 with control samples. The most frequent genetic profile was aggC+aatA+aap+shf+fyuA+, present in 19 strains, including diarrhea and controls. The profile set1A+set1B+pic+ was associated with diarrhea (P < 0.05). Of all genes evaluated, the most frequent were aatA (CVD 342) present in 159 strains (92.4%) and fyuA in 157 (91.3%). When EAEC strains were analyzed as a single pathogen (excluding co-infections), only pic was associated with diarrhea (P < 0.05) and with prolonged diarrhea (diarrhea ≥ 7 days) (P < 0.05). In summary, this is the first report on the prevalence of a large set of EAEC virulence genes and its association with diarrhea in Peruvian children. More studies are needed to elucidate the exact role of each virulence factor.
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