Enterotoxigenic Escherichia coli associated with childhood diarrhoea in Colombia, South America

Introduction: Intestinal Escherichia coli pathogens are major causes of diarrhoeal disease in children under five years of age worldwide. The aim of this study is to evaluate the association of E. coli pathotypes with childhood diarrhoea in Colombia. Methodology: A case-control study was conducted in 815 samples from children younger than five years of age in Cartagena, Colombia (466 cases and 349 controls). Controls were randomly selected 1:1 to cases, to obtain 349 cases and 349 controls. Results: This study revealed that 27 (7.44%) cases and 12 (3.43%) controls were positives for any of the E. coli pathotypes. The difference observed was statistically significant indicating that E. coli pathotypes were associated with cases of childhood diarrhoea. Enterotoxigenic E. coli (ETEC) was the most common pathotype associated with childhood diarrhoea. Additional E. coli pathotypes were also identified. Conclusions: We conclude that after the adjustment by age, sex and socioeconomic stratum, the odds ratio obtained by logistic regression shows an association between infection with ETEC and childhood diarrhoea.

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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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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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Risk of pulmonary toxicity of bleomycin and filgrastim

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218804293 ◽

2018 ◽

Vol 25 (7) ◽

pp. 1638-1644 ◽

Cited By ~ 2

Author(s):

Magali Laprise-Lachance ◽

Pierre Lemieux ◽

Jean-Pierre Grégoire

Keyword(s):

Relative Risk ◽

Odds Ratio ◽

Pulmonary Toxicity ◽

Case Control Study ◽

Cell Cancer ◽

Case Control ◽

Germ Cell Cancer ◽

The Difference ◽

Nested Case Control ◽

Control Study

Objectives To estimate the relative risk of pulmonary toxicity in patients exposed to a bleomycin-based chemotherapy including filgrastim compared to a similar chemotherapy without filgrastim. Methods We conducted a nested case–control study of patients treated with BEP (bleomycin, etoposide and cisplatin) for germ cell cancer or with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) for Hodgkin’s lymphoma at the Hôtel-Dieu de Lévis Hospital between 31 October 2000 and 30 June 2016. The relative risk was estimated by an adjusted odds ratio (aOR) using a propensity score-adjusted regression analysis. Results Thirteen cases of pulmonary toxicity, representing 14.7% of the 88 patients included in the study, were matched with 65 controls. A higher proportion of women (31.8%) than men (11.3%) developed pulmonary toxicity although the difference was not statistically significant ( P = 0.08). Within the cohort, two deaths related to lung toxicity were observed among cases where no filgrastim was used. The risk of pulmonary toxicity associated with the addition of filgrastim was not statistically significant (aOR = 2.48 95% CI = 0.50 to 12.19). Conclusion The results add further evidence that the concomitant use of filgrastim might not increase the risk of pulmonary toxicity of bleomycin. It also suggests that female patients might be more likely to develop this adverse effect. A clinical trial would be needed to confirm this result.

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

Journal of Medical Microbiology ◽

10.1099/jmm.0.47093-0 ◽

2007 ◽

Vol 56 (8) ◽

pp. 1086-1096 ◽

Cited By ~ 33

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.

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Escherichia Coli O157:H7 Outbreak Associated with Consumption of Ground Beef, June–July 2002

Public Health Reports ◽

10.1177/003335490512000211 ◽

2005 ◽

Vol 120 (2) ◽

pp. 174-178 ◽

Cited By ~ 100

Author(s):

Richard L. Vogt ◽

Laura Dippold

Keyword(s):

Escherichia Coli ◽

Case Control Study ◽

Ground Beef ◽

Case Control ◽

Pulse Field ◽

Environmental Study ◽

E Coli ◽

Pulse Field Gel Electrophoresis ◽

Environmental Investigation ◽

Control Study

Objective. A case-control and environmental study tested the hypothesis that purchasing and eating ground beef from a specific source was the cause of a cluster of cases of hemolytic uremic syndrome (HUS) and Escherichia coli ( E. coli) O157:H7 gastroenteritis. Methods. A case-control study comparing risk factors was conducted over the telephone on nine case-patients with 23 selected controls. An environmental investigation was conducted that consisted of reviewing beef handling practices at a specific local supermarket and obtaining ground beef samples from the store and two households with case-patients. Results. The analysis of the case-control study showed that eight case-patients (89%) purchased ground beef at Grocery Chain A compared with four controls who did not develop illness (17%) (matched odds ratio=undefined; 95% confidence interval 2.8, ∞; p=0.006). The environmental investigation showed that Grocery Chain A received meat from Meatpacker A. Laboratory analysis of meat samples from Meatpacker A and Grocery Chain A and stool samples from some patients recovered an identical strain of E. coli O157:H7 according to pulse-field gel electrophoresis. Conclusions. Both the case-control and environmental studies showed that purchasing ground beef at Grocery Chain A, which received ground beef from Meatpacker A, was the major risk factor for illness in eight case-patients; the ninth case-patient was found to be unrelated to the outbreak. Furthermore, meat from Meatpacker A was associated with a nationwide outbreak of E. coli O157:H7 illness that resulted in the second largest recall of beef in U.S. history at the time.

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Fluoroquinolone resistance in Escherichia coli isolates after exposure to non-fluoroquinolone antibiotics: a retrospective case–control study

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa128 ◽

2020 ◽

Vol 75 (7) ◽

pp. 1985-1992

Author(s):

Linda E Chaname Pinedo ◽

Robin Bruyndonckx ◽

Boudewijn Catry ◽

Katrien Latour ◽

Herman Goossens ◽

...

Keyword(s):

Escherichia Coli ◽

Case Control Study ◽

Tertiary Care ◽

Antibiotic Use ◽

Case Control ◽

Urine Samples ◽

Fluoroquinolone Resistance ◽

E Coli ◽

Fluoroquinolone Antibiotics ◽

Control Study

Abstract Objectives To investigate whether prior exposure to non-fluoroquinolone antibiotics increases the risk of fluoroquinolone resistance in Escherichia coli. Methods This was a secondary analysis of data collected retrospectively in a case–control study linking microbiological test results (isolated bacteria and their susceptibility) of urine samples routinely collected from primary, secondary and tertiary care patients in Belgium with information on prior antibiotic use at the patient level up to 1 year previously. Results In urine samples from 6125 patients, 7204 E. coli isolates were retrieved [1949 fluoroquinolone-resistant isolates (cases) and 5255 fluoroquinolone-susceptible isolates (controls)]. After adjusting for potential confounders (including fluoroquinolone use) and correcting for multiple testing there were lower odds of fluoroquinolone resistance in E. coli isolates after exposure to cefazolin (OR = 0.65; 95% CI = 0.52–0.81; P = 0.00014) and higher odds after exposure to trimethoprim/sulfamethoxazole (OR = 1.56; 95% CI = 1.23–1.97; P =0.00020) or nitrofurantoin (OR = 1.50; 95% CI = 1.23–1.84; P =0.000083). A sensitivity analysis excluding samples with antibiotic use during the 6 months prior to the sampling date confirmed the higher odds of fluoroquinolone resistance after exposure to trimethoprim/sulfamethoxazole and nitrofurantoin. Conclusions Assuming no residual confounding or other biases, this study suggests that exposure to non-fluoroquinolone antibiotics, i.e. trimethoprim/sulfamethoxazole and nitrofurantoin, might be causally related to fluoroquinolone resistance in E. coli isolates from urinary samples. Future prospective research is needed to confirm non-fluoroquinolone antibiotics as potential drivers of fluoroquinolone resistance.

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An outbreak of Escherichia coli O157:H7 infections following a dairy education school field trip in Washington state, 2015

Epidemiology and Infection ◽

10.1017/s0950268817002862 ◽

2017 ◽

Vol 146 (4) ◽

pp. 442-449 ◽

Cited By ~ 1

Author(s):

K. G. Curran ◽

K. E. Heiman Marshall ◽

T. Singh ◽

Z. Doobovsky ◽

J. Hensley ◽

...

Keyword(s):

Escherichia Coli ◽

Case Control Study ◽

First Grade ◽

Case Control ◽

Prevention Measures ◽

Environmental Testing ◽

E Coli ◽

Source Of Infection ◽

Education School ◽

Control Study

AbstractOn 27 April 2015, Washington health authorities identified Escherichia coli O157:H7 infections associated with dairy education school field trips held in a barn 20–24 April. Investigation objectives were to determine the magnitude of the outbreak, identify the source of infection, prevent secondary illness transmission and develop recommendations to prevent future outbreaks. Case-finding, hypothesis generating interviews, environmental site visits and a case–control study were conducted. Parents and children were interviewed regarding event activities. Odds ratios (OR) and 95% confidence intervals (CI) were computed. Environmental testing was conducted in the barn; isolates were compared to patient isolates using pulsed-field gel electrophoresis (PFGE). Sixty people were ill, 11 (18%) were hospitalised and six (10%) developed haemolytic uremic syndrome. Ill people ranged in age from <1 year to 47 years (median: 7), and 20 (33%) were female. Twenty-seven case-patients and 88 controls were enrolled in the case–control study. Among first-grade students, handwashing (i.e. soap and water, or hand sanitiser) before lunch was protective (adjusted OR 0.13; 95% CI 0.02–0.88, P = 0.04). Barn samples yielded E. coli O157:H7 with PFGE patterns indistinguishable from patient isolates. This investigation provided epidemiological, laboratory and environmental evidence for a large outbreak of E. coli O157:H7 infections from exposure to a contaminated barn. The investigation highlights the often overlooked risk of infection through exposure to animal environments as well as the importance of handwashing for disease prevention. Increased education and encouragement of infection prevention measures, such as handwashing, can prevent illness.

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Swimming-associated haemorrhagic colitis due to Escherichia coli O157[ratio ]H7 infection: evidence of prolonged contamination of a fresh water lake

Epidemiology and Infection ◽

10.1017/s095026889700770x ◽

1997 ◽

Vol 119 (1) ◽

pp. 1-8 ◽

Cited By ~ 75

Author(s):

D. ACKMAN ◽

S. MARKS ◽

P. MACK ◽

M. CALDWELL ◽

T. ROOT ◽

...

Keyword(s):

Escherichia Coli ◽

Fresh Water ◽

Case Control Study ◽

Case Control ◽

Clinical Isolates ◽

Probable Case ◽

E Coli ◽

Water Lake ◽

Control Study ◽

Fresh Water Lake

We describe an Escherichia coli O157[ratio ]H7 outbreak associated with a fresh water lake at a county park. Campers were surveyed for diarrhoeal illness within 10 days of their visit, and a case-control study of day visitors was conducted. A confirmed case was a symptomatic person with a stool culture positive for E. coli O157[ratio ]H7 and a probable case was a person with bloody diarrhoea. Clinical isolates of E. coli O157 were subtyped by pulsed field gel electrophoresis (PFGE). In the camper survey, 12 (38%) of 32 swimmers had a diarrhoeal illness (relative risk [RR]=12·4; 95% confidence interval [RR]=1·7–89·7). For the case-control study, the 12 cases were more likely than controls to have purposefully ingested lake water (odds ratio [OR]=6·9, 95% CI=0·9–55·8). The PFGE patterns of six clinical isolates were indistinguishable. This report further demonstrates that contaminated fresh-water lakes can be the source of community outbreaks of E. coli O157[ratio ]H7.

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A Canadian Multicentre Case-Control Study of SporadicEscherichia coli0157:H7 Infection

Canadian Journal of Infectious Diseases ◽

10.1155/1999/606342 ◽

1999 ◽

Vol 10 (2) ◽

pp. 117-121 ◽

Cited By ~ 2

Author(s):

Donna Holton ◽

Jeff Wilson ◽

Andrea Ellis ◽

David Haldane ◽

Nicole April ◽

...

Keyword(s):

Risk Factors ◽

Odds Ratio ◽

Case Control Study ◽

Population Attributable Fraction ◽

Ground Beef ◽

Case Control ◽

Attributable Fraction ◽

Personal Hygiene ◽

E Coli ◽

Control Study

OBJECTIVE: To evaluate further risk factors forEscherichia coli0157:H7 infection including consumer preferences related to the consumption of ground beef and the role of person-to-person transmission of this infection.PATIENTS AND METHODS: A case-control study of sporadicE coli0157:H7 infection was undertaken in five Canadian cites from June to December 1991. One hundred cases ofE coli0157:H7 infection were age- and sex-matched to 200 neighbourhood controls. Cases and controls were interviewed face-to-face to obtain information on potential risk factors for infection and health outcomes. Daycare providers of case and control children were interviewed regarding risk factors for infection at the institutional level. Contacts of cases and controls who reported diarrhea in the seven days before the case onset date were also interviewed about their symptoms and risk factors.RESULTS: All cases had diarrhea during the course of their illness and 90 (90%) reported bloody diarrhea. Four (4%) were reported to have developed hemolytic uremic syndrome; however, there were no fatalities. Sixty-one (61%) of patients were hospitalized. Two variables were associated with infection in the final conditional logistic regression model: eating pink hamburger patties (odds ratio = 12.4, P=0.0001, population attributable fraction =40.2%) and contact with a nonhousehold member suffering from diarrhea (odds ratio = 7.0, P=0.0054, population attributable fraction = 10.3%) in the seven days before illness. Forty per cent of cases and controls who indicated that they prefer well done hamburgers said they would eat a ‘pink’ hamburger if served to them rather than ask that the hamburger be cooked longer.CONCLUSIONS: Health care workers should remain vigilant in their efforts to educate the public as to the risks associated with the consumption of ground beef that is inadequately cooked, and the importance of personal hygiene in the prevention of enteric illness.

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