Diarrheagenic Escherichia coli and Acute and Persistent Diarrhea in Returned Travelers

To determine the role of diarrheagenic Escherichia coliin acute and persistent diarrhea in returned travelers, a case control study was performed. Enterotoxigenic E. coli (ETEC) was detected in stool samples from 18 (10.7%) of 169 patients and 4 (3.7%) of 108 controls. Enteroaggregative E. coli (EAggEC) was detected in 16 (9.5%) patients and 7 (6.5%) controls. Diffuse adherent E. coli strains were commonly present in both patients (13%) and controls (13.9). Campylobacter andShigella species were the other bacterial enteropathogens most commonly isolated (10% of patients, 2% of controls). Multivariate analysis showed that the presence of ETEC was associated with acute diarrhea (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.5 to 29.1; P = 0.005), but not with persistent diarrhea (OR, 1.6; 95% CI, 0.4 to 7.4). EAggEC was significantly more often present in patients with acute diarrhea than in controls (P = 0.009), but no significant association remained after multivariate analysis. ETEC and EAggEC are frequently detected in returned travelers with diarrhea. The presence of ETEC strains is associated with acute but not with persistent diarrhea.

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Molecular Detection of Diarrheagenic Escherichia coli from Children with Acute Diarrhea in Tertiary Care Hospitals of Dhaka, Bangladesh.

Asian Journal of Medical Sciences ◽

10.3126/ajms.v5i2.8576 ◽

2013 ◽

Vol 5 (2) ◽

pp. 59-66 ◽

Cited By ~ 1

Author(s):

Sushmita Roy ◽

SM Shamsuzzaman ◽

Kazi Z Mamun

Keyword(s):

Escherichia Coli ◽

Multiplex Pcr ◽

Acute Diarrhea ◽

Tertiary Care ◽

Medical Science ◽

Pcr Assay ◽

E Coli ◽

Diarrheagenic Escherichia Coli ◽

Multiplex Pcr Assay ◽

Stool Samples

Objective: Multiplex PCR assay was used for diagnosis of diarrheagenic Escherichia coli (DEC) in stool samples of children (under 5 years) with acute diarrhea. Methods: Samples were collected from January 2011 to December 2011, from Dhaka Medical College Hospital and Dhaka Shishu Hospital. Multiplex PCR with five specific primer pairs to detect enteropathogenic E. coli (eae, bfp), enterotoxigenic E. coli (lt, st) and enteroaggregative E. coli (aat) were used. However, enteroinvasive E. coli, enterohemorrhagicE. coli and diffusely adhererentE. coli were not sought. Result: In total, 135 (67.5%) E. coli were isolated from 200 stool samples. The prevalence of DEC was 68 (34%). Among DEC, most frequently isolated pathotype was EPEC 40 (58.82%), followed by ETEC 24 (35.29%) and EAggEC 18 (26.47%). Among the EPEC, 5 (12.5%) were typical EPEC. Among the 68 DEC positive cases, 22 samples contained more than one pathogenic gene in various combinations. Among the combination of DEC, EPEC+ETEC combination was 6 (27.27%) followed by ETEC+EAggEC 4 (18.18%), EPEC+EAggEC and ETEC+EPEC+EAggEC were both in 3 (13.6%). Conclusion:This study shows that DEC is a common cause of childhood diarrhea in Dhaka city of Bangladesh. By using multiplex PCR assay, DEC can be diagnosed in one PCR reaction that makes a conclusive diagnosis of diarrhea. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8576 Asian Journal of Medical Science, Volume-5(2) 2014: 59-66

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A Localized Adherence-Like Pattern as a Second Pattern of Adherence of Classic Enteropathogenic Escherichia coli to HEp-2 Cells That Is Associated with Infantile Diarrhea

Infection and Immunity ◽

10.1128/iai.67.7.3410-3415.1999 ◽

1999 ◽

Vol 67 (7) ◽

pp. 3410-3415 ◽

Cited By ~ 50

Author(s):

Isabel C. A. Scaletsky ◽

Margareth Z. Pedroso ◽

Carlos A. G. Oliva ◽

Rozane L. B. Carvalho ◽

Mauro B. Morais ◽

...

Keyword(s):

Escherichia Coli ◽

Acute Diarrhea ◽

Gastrointestinal Symptoms ◽

Secretory Diarrhea ◽

Persistent Diarrhea ◽

Infantile Diarrhea ◽

E Coli ◽

Typical Epec ◽

Relationship Of

ABSTRACT Escherichia coli strains that cause nonbloody diarrhea in infants are known to present three distinct patterns of adherence to epithelial cells, namely, localized (LA), diffuse (DA), and aggregative (AA) adherence. Strains with LA (typical EnteropathogenicEscherichia coli [EPEC]) are well recognized as a cause of secretory diarrhea, but the role of strains with DA (DAEC) is controversial, and strains with AA (EAEC) have been more frequently related to persistent diarrhea whereas its relationship with acute diarrhea is not well defined. To determine the relationship of the different types of E. coli adherence patterns with acute diarrhea (lasting less than 14 days) and persistent diarrhea (lasting more than 14 days) in São Paulo, Brazil, we studied stool specimens from 40 infants under 1 year of age with diarrhea and 40 age-matched control infants without any gastrointestinal symptoms. Twenty-eight (35.0%) of eighty cases yielded adherent E. coli (HEp-2 cells). Strains with localized and aggregative adherence were associated with acute and persistent diarrhea. A total of 11.2% of the adherent strains were typical EPEC serotypes and hybridized with the enteroadherence factor probe; 5.0% were EAEC and hybridized with the EAEC probe. DAEC strains were isolated from 10.0% of patients and 7.5% of controls and did not hybridize with the two probes used (daaC and AIDA-I). Strains with a localized adherence-like pattern (atypical EPEC) were found significantly more frequently (P = 0.028) in cultures from children with diarrhea (17.5%) than in controls (2.5%).

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

Epidemiology and Infection ◽

10.1017/s0950268803001651 ◽

2004 ◽

Vol 132 (2) ◽

pp. 283-289 ◽

Cited By ~ 55

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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Diarrheagenic Escherichia coli and Shigella Strains Isolated from Children in a Hospital Case-Control Study in Hanoi, Vietnam

Journal of Clinical Microbiology ◽

10.1128/jcm.01219-07 ◽

2008 ◽

Vol 46 (3) ◽

pp. 996-1004 ◽

Cited By ~ 35

Author(s):

B. T. T. Hien ◽

F. Scheutz ◽

P. D. Cam ◽

O. Serichantalergs ◽

T. T. Huong ◽

...

Keyword(s):

Escherichia Coli ◽

Case Control Study ◽

Case Control ◽

Hospital Case ◽

Diarrheagenic Escherichia Coli ◽

Control Study

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Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2019-216736 ◽

2020 ◽

Vol 79 (5) ◽

pp. 605-611

Author(s):

Riitta Tuompo ◽

Tinja Lääveri ◽

Timo Hannu ◽

Sari H Pakkanen ◽

Juha Kirveskari ◽

...

Keyword(s):

Escherichia Coli ◽

Multivariate Analysis ◽

Antibiotic Treatment ◽

Reactive Arthritis ◽

Musculoskeletal Symptoms ◽

E Coli ◽

Increased Risk ◽

Stool Samples ◽

Study Participants

ObjectivesUsing a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers.MethodsA total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed.ResultsFrom among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers’ diarrhoea did not prevent development of MSK symptoms.ConclusionA total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms.

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Haemolytic uraemic syndrome and Shiga toxin-producing Escherichia coli infection in children in France

Epidemiology and Infection ◽

10.1017/s0950268899003623 ◽

2000 ◽

Vol 124 (2) ◽

pp. 215-220 ◽

Cited By ~ 53

Author(s):

B. DECLUDT ◽

P. BOUVET ◽

P. MARIANI-KURKDJIAN ◽

F. GRIMONT ◽

P. A. D. GRIMONT ◽

...

Keyword(s):

Escherichia Coli ◽

Prospective Study ◽

Shiga Toxin ◽

Haemolytic Uraemic Syndrome ◽

Serum Samples ◽

E Coli ◽

Escherichia Coli Infection ◽

Stool Samples ◽

Polymerase Chain

We conducted a study to determine the incidence of haemolytic uraemic syndrome (HUS) in children in France and to assess the role of Shiga-toxin-producing Escherichia coli (STEC) infection in the aetiology of HUS. In collaboration with the Société de Néphrologie Pédiatrique we undertook a retrospective review of all cases of HUS hospitalized from January 1993 to March 1995 and a 1-year prospective study (April 1995–March 1996) of epidemiological and microbiological features of cases of HUS. The polymerase chain reaction (PCR) procedure was used to detect stx, eae, e-hlyA genes directly from case stool samples. Serum samples from cases were examined for antibodies to lipopolysaccharide (LPS) of 26 major STEC serogroups. Two hundred and eighty-six cases were reported. The average incidence per year was 0·7/105 children < 15 years and 1·8/105 children < 5 years. During the prospective study, 122/130 cases were examined for evidence of STEC infection using PCR and/or serological assays and 105 (86%) had evidence of STEC infection. Serum antibodies to E. coli O157 LPS were detected in 79 (67%) cases tested. In conclusion, this study showed that STEC infection is an important cause of HUS in children in France, with a high proportion related to the O157 serogroup.

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Risk Factors for Infection with Escherichia coli in Nursing Home Residents Colonized with Fluoroquinolone-Resistant E. coli

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.3 ◽

2015 ◽

Vol 36 (5) ◽

pp. 575-577 ◽

Cited By ~ 4

Author(s):

Sara Manning ◽

Ebbing Lautenbach ◽

Pam Tolomeo ◽

Jennifer H. Han

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Nursing Home ◽

Case Control Study ◽

Urinary Catheter ◽

Nursing Home Residents ◽

Case Control ◽

Clinical Infection ◽

E Coli ◽

Control Study

A case-control study to determine risk factors for clinical infection with Escherichia coli was conducted among nursing home residents colonized with fluoroquinolone-resistant E. coli. Among 94 subjects, 11 (12%) developed infections with E. coli. Risk factors included the presence of a urinary catheter or tracheostomy, diabetes mellitus, and trimethoprim-sulfamethoxazole exposure.Infect Control Hosp Epidemiol 2015;00(0): 1–3

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1434. Risk Factors for Community-Acquired Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase (ESBL) Producing Escherichia coli in Children: A Case–Control Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1298 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S523-S524

Author(s):

Frank Zhu ◽

Rodado Maria ◽

Basim Asmar ◽

Hossein Salimnia ◽

Ronald Thomas ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Case Control Study ◽

Case Control ◽

Antibiotic Usage ◽

Ethnic Background ◽

E Coli ◽

Tract Infections ◽

Control Study

Abstract Background In recent years, there has been an increasing incidence of community-acquired urinary tract infections (UTI) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli. However, the risk factors of ESBL-producing bacteria in community-acquired (CA)-UTI in children in the USA remain unclear. Methods A retrospective case–control study of UTI due to CA-ESBL-producing E. coli during a 5-year period (2011–2016) was performed. Control cases of non-ESBL-producing E. coli UTI were matched by age, gender, and year of infection. Medical records were manually reviewed to collect data for potential risk factors for ESBL-positive infection. Results A total of 111 patients with ESBL-producing E coli UTI and 103 control patients were included. The proportion of ESBL-producing E coli UTI ranged from 7% to 15% per year. The median age was 4 years with female predominance (84%). The ESBL group was predominantly African American (32%) followed by patients of Middle Eastern (ME) ethnic background (31%). Risk factors by univariate analysis were vesicoureteral reflux (VUR): (20.9 ESBL group vs. 6% controls; P = 0.002), prior antibiotic usage in the previous 3 months (including β-lactams), prior UTI (last 3 months), recent hospitalization (last 3 months) and ME ethnic background. However, multivariate analysis showed that only prior antibiotic usage (P = 0.001) and ME ethnic background (P < 0.001) remained statistically significant. 18% (11/60) of patients exposed to prior antibiotic use in the ESBL group were on long-term antibiotic prophylaxis for VUR. Conclusion Risk factors for CA-ESBL-producing E coli UTI in children were: (1) antibiotic usage within the previous 3 months and (2) ME background. Prior antibiotic usage as a risk factor reinforces the need for judicious use of antibiotics. The high percentage of patients in this group (18%) receiving long-term antibiotic prophylaxis for VUR warrants further study as this practice may increase the prevalence of ESBL-producing infections in a population at high risk for UTI. The increased risk among children of ME ethnic background warrants further study to evaluate possible additional associated risk factors such as recent international travel or contact with international travelers. Disclosures All authors: No reported disclosures.

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