Association of atypical enteropathogenic Escherichia coli (EPEC) with prolonged diarrhoea

2004 ◽  
Vol 53 (11) ◽  
pp. 1137-1144 ◽  
Author(s):  
Jan E Afset ◽  
Lars Bevanger ◽  
Pål Romundstad ◽  
Kåre Bergh
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Healthy Children ◽  
Routine Testing ◽  
Atypical Epec ◽  
High Prevalence ◽  
Typical Epec ◽  
Stool Specimens ◽  
And Child Health ◽  
Control Study

The aim of the present case control study was to investigate the prevalence of atypical enteropathogenic Escherichia coli (EPEC) and its possible role in causing diarrhoea among children < 5 years of age in Norway. Stool specimens received in the laboratory from children with suspected gastroenteritis (n = 251) were, in addition to routine testing, analysed for the presence of EPEC by PCR of the eae, bfpA and stx genes. Specimens from healthy children (n = 210) recruited from Maternal and Child Health Centres were analysed for EPEC only. EPEC isolates (eae +, stx −) were classified as typical (bfpA +) or atypical (bfpA −), and were tested for O : K serogroup. Information on duration of diarrhoea was recorded in a questionnaire and from referral forms. Atypical EPEC was diagnosed in 37 patients (14.7 %) compared to 21 (10.0 %) of the healthy controls [Odds ratio (OR) = 1.4, P = 0.3]. Only three isolates, all from patients, belonged to EPEC serogroups. One patient had typical EPEC. Twenty (22.5 %) of 89 patients with diarrhoea lasting ⩾14 days had atypical EPEC. The association between atypical EPEC and prolonged diarrhoea (OR = 2.1, P = 0.04) was caused by a high prevalence among female patients (40.6 %). In conclusion, atypical EPEC was found to be slightly more prevalent in patients than controls, without any overall significant association with diarrhoea. However, a significant association was observed with diarrhoea lasting 14 days or more, a finding that may indicate a role for atypical EPEC in prolonged disease.

scholarly journals Diarrhoeagenic Escherichia coli and other causes of childhood diarrhoea: a case–control study in children living in a wastewater-use area in Hanoi, Vietnam

2007 ◽  
Vol 56 (8) ◽  
pp. 1086-1096 ◽  
Author(s):  
Bui Thi Thu Hien ◽  
Do Thuy Trang ◽  
Flemming Scheutz ◽  
Phung Dac Cam ◽  
Kåre Mølbak ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Vaccine Development ◽  
Health Benefit ◽  
Clinical Information ◽  
Case Control ◽  
E Coli ◽  
Untreated Wastewater ◽  
High Prevalence ◽  
Control Study

A case–control study was conducted to identify the aetiology of diarrhoeal diseases in pre-school children in a suburban area of Hanoi where the use of untreated wastewater in agriculture and aquaculture is a common practice. Stool specimens and clinical information were collected from 111 pairs of children with diarrhoea and healthy controls. A total of 73 cases (66 %) and 41 controls (36 %) had an enteric pathogen. The pathogens most often associated with diarrhoea were rotavirus (17 % of cases) and Entamoeba histolytica (15 %), followed by Shigella (5 %). Diarrhoeagenic Escherichia coli (DEC) was found in 23 % of both patients and controls. Characterization of DEC by serotyping, antimicrobial susceptibility test and PFGE showed that DEC represented by different pathotypes belonged to various serotypes. Except for three enterotoxigenic E. coli strains, typing by PFGE revealed no correlation between pathotype and serotype of DEC strains. This suggests a high prevalence of a variety of DEC subtypes in this area. For this particular region, vaccine development strategies targeting rotavirus and Shigella are likely to be of public health benefit, whereas the role of DEC and preventive measures need to be further elaborated.

Isolation of atypical enteropathogenic Escherichia coli from children with and without diarrhoea in Delhi and the National Capital Region, India

2010 ◽  
Vol 59 (10) ◽  
pp. 1156-1162 ◽  
Author(s):  
Pankaj Kumar Ghosh ◽  
Arif Ali
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Agents ◽  
Virulence Gene ◽  
Healthy Children ◽  
National Capital Region ◽  
Capital Region ◽  
E Coli ◽  
Atypical Epec ◽  
National Capital ◽  
Typical Epec

A total of 17 typical and atypical enteropathogenic Escherichia coli (EPEC) were isolated from 396 children with and without diarrhoea. Out of 12 EPEC isolates from patients with diarrhoea, 3 (25 %) were atypical EPEC while 9 (75 %) were typical EPEC. It was observed that atypical EPEC strains had colonized the intestines of healthy children and its isolation rates were higher in healthy children than in children with diarrhoea. Interestingly all of the atypical EPEC isolates carried a megaplasmid, mostly comparable with the size of EPEC adherence factor (EAF) encoding gene but no virulence gene was detected in this megaplasmid. Studies also indicated that multidrug resistance EPEC are emerging and all the atypical EPEC strains showed significantly less resistance to all antimicrobial agents used in this study than typical EPEC. This study also supports the opinion that Shiga toxin-producing E. coli does not pose a major threat to human health in India. Subtyping analysis reveals that eae-α1, eae-β2 and eae-λ could be common EPEC subtypes prevalent in children with diarrhoea in Delhi. The present study is believed to be the first report of the detection of atypical EPEC from children without diarrhoea and records of isolation of eae-γ1, eae-γ2 and the rare eae-λ subtype in India. The data also indicated that typical EPEC are a common cause of diarrhoea and atypical EPEC are emerging as colonizers of the intestine of children with and without diarrhoea in Delhi and the National Capital Region, India.

scholarly journals The prevalence and virulence characteristics of enteroaggregative Escherichia coli at an urgent-care clinic in the USA: a case–control study

2009 ◽  
Vol 58 (4) ◽  
pp. 403-407 ◽  
Author(s):  
David Cennimo ◽  
Atif Abbas ◽  
David B. Huang ◽  
Tom Chiang
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Case Control ◽  
Urgent Care ◽  
Care Clinic ◽  
The Usa ◽  
Stool Specimens ◽  
Urgent Care Clinic ◽  
Necrosis Factor ◽  
Control Study

This case–control study examined the prevalence of enteroaggregative Escherichia coli (EAEC), its genes and elicited inflammatory response, and the stool characteristics of adult patients with and without acute diarrhoeal illness presenting to an urgent-care clinic in the USA. A total of 1004 individual stool specimens (253 from patients with acute diarrhoeal illness and 751 from patients without diarrhoeal illness) were collected between 1 June 2003 and 30 June 2008. EAEC was identified as the sole cause of acute diarrhoeal illness in 6 % (n=15) of patients and in 2 % (n=15) without diarrhoeal illness. Control patients (n=15) were similar to case patients (n=15) for age, gender and co-morbidities. The EAEC genes aggR, aap, aat, astA and/or set1A were identified more frequently in case patients compared with control patients (P <0.05). aggR-positive EAEC elicited higher levels of interleukin (IL)-1ra, IL-6, IL-8 and tumour necrosis factor-α compared with aggR-negative EAEC during co-incubation with HCT-8 cells. Patients with EAEC diarrhoea and isolates with the genes aggR, aap, aatA, astA or set1A had stools characterized by gross mucus and the presence of faecal leukocytes (P <0.05). These results indicate that EAEC is a potential cause of acute diarrhoeal illness affecting patients presenting to an acute-care clinic in the USA and suggest that aggR, aap, aatA, astA and set1A may be markers for virulence.

scholarly journals Risk factors for Escherichia coli bacteraemia: a population-based case-control study

The Lancet ◽  
2017 ◽  
Vol 390 ◽  
pp. S85 ◽  
Author(s):  
Jiao Song ◽  
Angharad Walters ◽  
Damon Berridge ◽  
Ashley Akbari ◽  
Meirion Evans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Control Study

scholarly journals Risk factors and outcomes of carbapenem-nonsusceptible Escherichia coli bacteremia: A matched case–control study

2011 ◽  
Vol 44 (2) ◽  
pp. 125-130 ◽  
Author(s):  
Hong-Jyun Chang ◽  
Po-Chang Hsu ◽  
Chien-Chang Yang ◽  
An-Jing Kuo ◽  
Ju-Hsin Chia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Case Control Study ◽  
Case Control ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

scholarly journals Cognitive development of children with Kawasaki disease and the parenting stress of their caregivers in Taiwan: a case–control study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042996
Author(s):  
Liang-Jen Wang ◽  
Zi-Yu Tsai ◽  
Ling-Sai Chang ◽  
Ho-Chang Kuo
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Parenting Stress ◽  
Case Control Study ◽  
Short Form ◽  
Case Control ◽  
Stress Index ◽  
Secondary Outcome ◽  
Healthy Children ◽  
Control Study

ObjectiveKawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multisystemic vasculitis common in patients with KD may influence blood perfusion in the brain, and thus caregivers of children with KD may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (coronary artery lesion (CAL)). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.DesignA case–control study with consecutive sampling.SettingA medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan).ParticipantsThis study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% boys) and 85 healthy children (mean age: 6.4 years, 54.1% boys).Primary and secondary outcome measuresBased on the children’s age, each patient with KD and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index (PSI)-Short Form.ResultsWe observed no significant differences in any developmental index, cognitive function or parenting stress between patients with KD and controls. Among the children with KD, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL. Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college or lower.ConclusionCaregivers’ education is associated to parenting stress, and caregivers of patients with KD who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfil their parenting roles.

scholarly journals 717. Antibiotic treatment of Shiga toxin-producing Escherichia coli related gastroenteritis and the risk of hemolytic uremic syndrome: a population based matched case-control study in Japan

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S409-S410
Author(s):  
Shota Myojin ◽  
Kyongsun Pak ◽  
Mayumi Sako ◽  
Tohru Kobayashi ◽  
Takuri Takahashi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Case Control ◽  
Age Group ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Abstract Background The role of therapeutic intervention, particularly antibiotics, for Shiga toxin-producing Escherichia coli (STEC) related infection is controversial. Methods We performed a population based matched case-control study to assess the association between treatment (antibiotics, antidiarrheal agents and probiotics) for STEC related infections and HUS development. We identified all STEC HUS patients as cases and matched five non-HUS patients as controls using the data from the National Epidemiological Surveillance of Infectious Diseases (NESID) between January 1, 2017, and December 31, 2018. Further medical information was obtained by standardized questionnaires answered by physicians who registered each patient. We used multivariate conditional logistic regression model to evaluate the association between exposures (use of antibiotics, use of antidiarrheal agents, days between disease onset and fosfomycin administration [within two or three days]) and the development of HUS, by matched odds ratios (OR) and 95% confidence intervals (CI). Covariates we used were sex, age group, area code, presence of diarrhea and other factors. We also performed subgroup analyses using age (adults and children) as a stratification factor. Results 7,760 STEC related patients were registered in the NESID. We selected patients who had a record of HUS diagnosis (n=182) and matched controls without HUS (n=910). After collecting standardized paper-based questionnaires, we enrolled 90 HUS patients and 371 non-HUS patients for analysis. In the main analysis, matched OR of fosfomycin was 0.75(0.47-1.20) in all ages, 1.41(0.51-3.88) in adults and 0.58(0.34-1.01) in children. Matched OR of antidiarrheal agents was 2.07(1.07-4.03) in all ages, 1.84(0.32-10.53) in adults, 2.65(1.21-5.82) in children. Matched OR of probiotics was 0.86(0.46-1.61) in all ages, 0.76(0.21-2.71) in adults, 1.00(0.48-2.09) in children. There was no significant association between the timing of fosfomycin use in the first two or five days of illness and HUS development in any age group. Conclusion Our results suggest that fosfomycin might decrease the risk of HUS in children younger than 15 years of age with STEC confirmed bacterial gastroenteritis. Disclosures All Authors: No reported disclosures

scholarly journals Escherichia coli O157:H7 outbreak linked to salami, British Columbia, Canada, 1999

2004 ◽  
Vol 132 (2) ◽  
pp. 283-289 ◽  
Author(s):  
D. M. MacDONALD ◽  
M. FYFE ◽  
A. PACCAGNELLA ◽  
A. TRINIDAD ◽  
K. LOUIE ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Meat Products ◽  
Case Control ◽  
Pfge Pattern ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

An outbreak of E. coli O157:H7 infections was identified in November 1999 with a fivefold increase in the occurrence of laboratory-confirmed cases of E. coli O157:H7 infection. A matched case-control study was conducted. Samples of food from cases and from retailers were analysed for the presence of E. coli O157:H7. A total of 143 cases were identified over a 12-week period with the same pulsed-field gel electrophoresis (PFGE) pattern. The case-control study found that Company A salami was significantly associated with illness (Mantel–Haenszel matched odds ratio 10·0, 95% CI 1·4–434, P=0·01). Company A salami tested positive for E. coli O157:H7 and isolates had the same PFGE pattern as case isolates. An immediate voluntary national recall of Company A dry fermented meat products took place. Findings from the investigation of this outbreak suggest that the hold-and-test option may not be adequate to prevent shiga-toxigenic Escherichia coli (STEC) infection in salami consumers.

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