scholarly journals Bacterial Factors Associated with Lethal Outcome of Enteropathogenic Escherichia coli Infection: Genomic Case-Control Studies

2015 ◽  
Vol 9 (5) ◽  
pp. e0003791 ◽  
Author(s):  
Michael S. Donnenberg ◽  
Tracy H. Hazen ◽  
Tamer H. Farag ◽  
Sandra Panchalingam ◽  
Martin Antonio ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control ◽  
Enteropathogenic Escherichia Coli ◽  
Case Control Studies ◽  
Lethal Outcome ◽  
Factors Associated ◽  
Escherichia Coli Infection

scholarly journals Clonal groups of enteropathogenic Escherichia coli isolated in case-control studies of diarrhoea in Bangladesh

2000 ◽  
Vol 49 (2) ◽  
pp. 177-185 ◽  
Author(s):  
M. ANSARUZZAMAN ◽  
M.J. ALBERT ◽  
S. NAHAR ◽  
R. BYUN ◽  
M. KATOULI ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control ◽  
Enteropathogenic Escherichia Coli ◽  
Case Control Studies

scholarly journals Factors associated with typical enteropathogenic Escherichia coli infection among children <5 years old with moderate-to-severe diarrhoea in rural western Kenya, 2008–2012

2020 ◽  
Vol 148 ◽  
Author(s):  
K. Fagerli ◽  
R. Omore ◽  
S. Kim ◽  
J. B. Ochieng ◽  
T. L. Ayers ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Severe Diarrhoea ◽  
Western Kenya ◽  
Factors Associated ◽  
Case Comparison ◽  
Escherichia Coli Infection ◽  
Logistic Regressions ◽  
Stool Specimens ◽  
Polymerase Chain

Abstract Typical enteropathogenic Escherichia coli (tEPEC) infection is a major cause of diarrhoea and contributor to mortality in children <5 years old in developing countries. Data were analysed from the Global Enteric Multicenter Study examining children <5 years old seeking care for moderate-to-severe diarrhoea (MSD) in Kenya. Stool specimens were tested for enteric pathogens, including by multiplex polymerase chain reaction for gene targets of tEPEC. Demographic, clinical and anthropometric data were collected at enrolment and ~60-days later; multivariable logistic regressions were constructed. Of 1778 MSD cases enrolled from 2008 to 2012, 135 (7.6%) children tested positive for tEPEC. In a case-to-case comparison among MSD cases, tEPEC was independently associated with presentation at enrolment with a loss of skin turgor (adjusted odds ratio (aOR) 2.08, 95% confidence interval (CI) 1.37–3.17), and convulsions (aOR 2.83, 95% CI 1.12–7.14). At follow-up, infants with tEPEC compared to those without were associated with being underweight (OR 2.2, 95% CI 1.3–3.6) and wasted (OR 2.5, 95% CI 1.3–4.6). Among MSD cases, tEPEC was associated with mortality (aOR 2.85, 95% CI 1.47–5.55). This study suggests that tEPEC contributes to morbidity and mortality in children. Interventions aimed at defining and reducing the burden of tEPEC and its sequelae should be urgently investigated, prioritised and implemented.

scholarly journals Factors related to the development of health-promoting community activities in Spanish primary healthcare: two case–control studies

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015934 ◽  
Author(s):  
Sebastià March ◽  
Joana Ripoll ◽  
Matilde Jordan Martin ◽  
Edurne Zabaleta-del-Olmo ◽  
Carmen Belén Benedé Azagra ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Personal Characteristics ◽  
Case Control ◽  
Undergraduate Training ◽  
Case Control Studies ◽  
Community Characteristics ◽  
Factors Associated ◽  
Community Activities ◽  
Secondary Sources ◽  
Health Promoting

ObjectiveSpanish primary healthcare teams have the responsibility of performing health-promoting community activities (CAs), although such activities are not widespread. Our aim was to identify the factors related to participation in those activities.DesignTwo case–control studies.SettingPerformed in primary care of five Spanish regions.SubjectsIn the first study, cases were teams that performed health-promoting CAs and controls were those that did not. In the second study (on case teams from the first study), cases were professionals who developed these activities and controls were those who did not.Main outcome measuresTeam, professional and community characteristics collected through questionnaires (team managers/professionals) and from secondary sources.ResultsThe first study examined 203 teams (103 cases, 100 controls). Adjusted factors associated with performing CAs were percentage of nurses (OR 1.07, 95% CI 1.01 to 1.14), community socioeconomic status (higher vs lower OR 2.16, 95% CI 1.18 to 3.95) and performing undergraduate training (OR 0.44, 95% CI 0.21 to 0.93). In the second study, 597 professionals responded (254 cases, 343 controls). Adjusted factors were professional classification (physicians do fewer activities than nurses and social workers do more), training in CAs (OR 1.9, 95% CI 1.2 to 3.1), team support (OR 2.9, 95% CI 1.5 to 5.7), seniority (OR 1.06, 95% CI 1.03 to 1.09), nursing tutor (OR 2.0, 95% CI 1.1 to 3.5), motivation (OR 3.7, 95% CI 1.8 to 7.5), collaboration with non-governmental organisations (OR 1.9, 95% CI 1.2 to 3.1) and participation in neighbourhood activities (OR 3.1, 95% CI 1.9 to 5.1).ConclusionsProfessional personal characteristics, such as social sensitivity, profession, to feel team support or motivation, have influence in performing health-promoting CAs. In contrast to the opinion expressed by many professionals, workload is not related to performance of health-promoting CAs.

Multistate Outbreak of Escherichia coli O145 Infections Associated with Romaine Lettuce Consumption, 2010‡§

2013 ◽  
Vol 76 (6) ◽  
pp. 939-944 ◽  
Author(s):  
E. V. TAYLOR ◽  
T. A. NGUYEN ◽  
K. D. MACHESKY ◽  
E. KOCH ◽  
M. J. SOTIR ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Chart Review ◽  
The United States ◽  
Case Control ◽  
Bloody Diarrhea ◽  
Severe Illness ◽  
Case Control Studies ◽  
Romaine Lettuce ◽  
Outbreak Strain

Non-O157 Shiga toxin–producing Escherichia coli (STEC) can cause severe illness, including hemolytic uremic syndrome (HUS). STEC O145 is the sixth most commonly reported non-O157 STEC in the United States, although outbreaks have been infrequent. In April and May 2010, we investigated a multistate outbreak of STEC O145 infection. Confirmed cases were STEC O145 infections with isolate pulsed-field gel electrophoresis patterns indistinguishable from those of the outbreak strain. Probable cases were STEC O145 infections or HUS in persons who were epidemiologically linked. Case-control studies were conducted in Michigan and Ohio; food exposures were analyzed at the restaurant, menu, and ingredient level. Environmental inspections were conducted in implicated food establishments, and food samples were collected and tested. To characterize clinical findings associated with infections, we conducted a chart review for case patients who sought medical care. We identified 27 confirmed and 4 probable cases from five states. Of these, 14 (45%) were hospitalized, 3 (10%) developed HUS, and none died. Among two case-control studies conducted, illness was significantly associated with consumption of shredded romaine lettuce in Michigan (odds ratio [OR] = undefined; 95%confidence interval [CI] = 1.6 to undefined) and Ohio (OR = 10.9; 95%CI = 3.1 to 40.5). Samples from an unopened bag of shredded romaine lettuce yielded the predominant outbreak strain. Of 15 case patients included in the chart review, 14 (93%) had diarrhea and abdominal cramps and 11 (73%) developed bloody diarrhea. This report documents the first foodborne outbreak of STEC O145 infections in the United States. Current surveillance efforts focus primarily on E. coli O157 infections; however, non-O157 STEC can cause similar disease and outbreaks, and efforts should be made to identify both O157 and non-O157 STEC infections. Providers should test all patients with bloody diarrhea for both non-O157 and O157 STEC.

scholarly journals The Magnitude of the Association between Fluoroquinolone Use and Quinolone-Resistant Escherichia coli and Klebsiella pneumoniae May Be Lower than Previously Reported

2004 ◽  
Vol 48 (6) ◽  
pp. 1934-1940 ◽  
Author(s):  
Maureen K. Bolon ◽  
Sharon B. Wright ◽  
Howard S. Gold ◽  
Yehuda Carmeli
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Case Control ◽  
Fluoroquinolone Resistance ◽  
Effect Estimate ◽  
Random Effects Model ◽  
Case Control Studies ◽  
True Effect Size ◽  
Strong Risk Factor ◽  
Multivariable Analyses

ABSTRACT Case-control analyses of resistant versus susceptible isolates have implicated fluoroquinolone exposure as a strong risk factor for fluoroquinolone-resistant isolates of Enterobacteriaceae. We suspect that such methodology may overestimate this association. A total of 84 cases with fluoroquinolone-resistant isolates and 578 cases with fluoroquinolone-susceptible isolates of Escherichia coli or Klebsiella pneumoniae were compared with 608 hospitalized controls in parallel multivariable analyses. For comparison of previous estimates, the results of 10 published case-control studies of risk for fluoroquinolone resistance in isolates of Enterobacteriaceae were pooled by using a random-effects model. Exposure to fluoroquinolones was significantly positively associated with fluoroquinolone resistance (odds ratio [OR], 3.17) and negatively associated with fluoroquinolone susceptibility (OR, 0.18). Multivariable analyses yielded similar estimates (ORs, 2.04 and 0.10, respectively). As data on antibiotic exposure were limited to inpatient prescriptions, misclassification of fluoroquinolone exposure in persons who received fluoroquinolones as outpatients may have led to an underestimation of the true effect size. Pooling the results of previously published studies in which a direct comparison of fluoroquinolone-resistant and fluoroquinolone-susceptible cases was used resulted in a markedly higher effect estimate (OR, 18.7). Had we directly compared resistant and susceptible cases, our univariate OR for the association between fluoroquinolone use and the isolation of resistant Enterobacteriaceae would have been 19.3, and the multivariate OR would have been 16.5. Fluoroquinolone use is significantly associated with the isolation of fluoroquinolone-resistant Enterobacteriaceae; however, previous studies likely exaggerated the magnitude of this association.

Outbreak of enterotoxigenic Escherichia coli O169 enteritis in schoolchildren associated with consumption of kimchi, Republic of Korea, 2012

2013 ◽  
Vol 142 (3) ◽  
pp. 616-623 ◽  
Author(s):  
S. H. CHO ◽  
J. KIM ◽  
K. -H. OH ◽  
J. K. HU ◽  
J. SEO ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Cohort Studies ◽  
Case Control ◽  
Enterotoxigenic Escherichia Coli ◽  
Adjusted Relative Risk ◽  
Case Control Studies ◽  
Food Items ◽  
Laboratory Surveillance ◽  
Retrospective Cohort Studies ◽  
Foodborne Outbreaks

SUMMARYEnterotoxigenic Escherichia coli (ETEC) is now recognized as a common cause of foodborne outbreaks. This study aimed to describe the first ETEC O169 outbreak identified in Korea. In this outbreak, we identified 1642 cases from seven schools. Retrospective cohort studies were performed in two schools; and case-control studies were conducted in five schools. In two schools, radish kimchi was associated with illness; and in five other schools, radish or cabbage kimchi was found to have a higher risk among food items. Adjusted relative risk of kimchi was 5·87–7·21 in schools that underwent cohort studies; and adjusted odds ratio was 4·52–12·37 in schools that underwent case-control studies. ETEC O169 was isolated from 230 affected students, and was indistinguishable from the isolates detected from the kimchi product distributed by company X, a food company that produced and distributed kimchi to all seven schools. In this outbreak, we found that the risk of a kimchi-borne outbreak of ETEC O169 infection is present in Korea. We recommend continued monitoring regarding food safety in Korea, and strengthening surveillance regarding ETEC O169 infection through implementation of active laboratory surveillance to confirm its infection.

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