Acute and chronic diarrhoea and abdominal colic associated with enteroaggregative Escherichia coli in young children living in western Europe

Hi, Huppertz; Rutkowski, Stefan; Aleksić, S.; Karch, Helge

doi:10.1016/s0140-6736(96)12485-5

Cited by 106 publications

(67 citation statements)

References 14 publications

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“…Eight (42%) of the 19 children with diarrhea and EAEC were found to harbor one or two additional potentially enterovirulent agents, EPEC being the most frequently detected (Table 4). The detection of multiple pathogens in diarrheic children with EAEC has also been reported from other studies (7,12,13). Since EPEC in this study was found in similar frequencies in diarrheic children and in nondiarrheic children, the pathogenic role of E. coli harboring only the eaeA gene has to be questioned.…”

Section: Discussionsupporting

confidence: 79%

“…Almost half of the patients with diarrhea positive for EAEC, but none of the control children with EAEC, had a history of recent travel outside of Switzerland. For comparison, a study conducted by Huppertz et al in Germany found that approximately one-third of the children with diarrhea and detection of EAEC had traveled abroad (13). However, no information on the travel history was provided for other patients with diarrhea or for asymptomatic children.…”

Section: Discussionmentioning

confidence: 99%

“…The importance of EAEC bacteria as diarrheagenic agents in children remains controversial. Although the association of EAEC with diarrhea in children has been documented in different studies in industrially developing and developed countries (4,5,7,13,15,19,23), other studies did not associate EAEC with diarrhea (2,8,11). This lack of association may be partially explained by the significant strain-to-strain heterogeneity due to the presence of various presumed virulence factors that are not conserved among all EAEC bacteria or by the subjective interpretation of the standard laboratory test, i.e., the observation of an aggregative adherence pattern in a HEp-2 cell assay.…”

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confidence: 94%

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Prevalence of Enteroaggregative Escherichia coli among Children with and without Diarrhea in Switzerland

et al. 2003

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In a prospective study between July 1999 and September 2000, stool specimens of children below the age of 16 years with (n ‫؍‬ 187) and without (n ‫؍‬ 137) diarrhea were tested for the presence of enterovirulent bacteria by standard culture methods and by PCR. Targets for the PCR were the plasmid pCVD432 for enteroaggregative Escherichia coli (EAEC), the verotoxin 1 and verotoxin 2 genes for enterohemorrhagic E. coli, ipaH for enteroinvasive E. coli (EIEC) and Shigella spp., genes coding for heat-stable and heat-labile toxins for enterotoxigenic E. coli (ETEC), and the eaeA gene for enteropathogenic E. coli. The following bacteria could be associated with diarrhea: Salmonella enterica (P ‫؍‬ 0.001), Campylobacter spp. (P ‫؍‬ 0.036), ETEC (P ‫؍‬ 0.012), and EAEC (P ‫؍‬ 0.006). The detection of EAEC, ETEC, and S. enterica was strongly associated with a history of recent travel outside of Switzerland. EAEC isolates were found in the specimens of 19 (10.2%) of 187 children with diarrhea and in those of 3 (2.2%) of 137 children without diarrhea (P ‫؍‬ 0.006) and were the most frequently detected bacteria associated with diarrhea. Among the children below the age of 5 years, the specimens of 18 (11.9%) of 151 with diarrhea were positive for EAEC, while this agent was found in the specimens of 2 (2.2%) of 91 controls (P ‫؍‬ 0.007). Enteropathogenic E. coli isolates were found in the specimens of 30 (16.4%) of the patients and in those of 15 (10.9%) of the controls, with similar frequencies in all age groups (P > 0.05). We conclude that EAEC bacteria are involved in a significant proportion of diarrhea cases among children. Children younger than 5 years of age are more often affected by EAEC than older children.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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confidence: 94%

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Prevalence of Enteroaggregative Escherichia coli among Children with and without Diarrhea in Switzerland

et al. 2003

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“…Fever and abdominal colic were detected in 16 and 24% of the infected children respectively. However, abdominal colic was observed more frequently among infected individuals in other studies [32].…”

Section: Discussionmentioning

confidence: 53%

Use of PCR to identify enteroaggregative Escherichia coli as an important cause of acute diarrhoea among children living in Calcutta, India

Pal¹,

Chakrabarti²,

Dutta³

et al. 1999

Journal of Medical Microbiology

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The importance of enteroaggregative Escherichia coli (EAggEC) as a possible aetiological agent of acute diarrhoea among children in Calcutta, India, was investigated. Simultaneously the use of a previously described PCR diagnostic system was assessed for its ability to identify EAggEC infection. E. coli strains isolated during a 1-year casecontrol study from faecal samples of 388 children aged <5 years, with or without diarrhoea, were examined for EAggEC by HeLa cell adherence assay in parallel with a PCR assay with primers generated from an EAggEC DNA probe. A blind comparison was made between the two methods to determine their diagnostic potential. E. coli isolates that adhered to HeLa cells in an aggregative pattern were the sole isolates significantly more often in 254 cases (9%) than in 134 control (2%) children. Age stratification showed that EAggEC were isolated more frequently from children aged <36 months. The EAggEC isolates belonged to several 0 serogroups and showed multiple drug resistance. Both methods were positive for 26 samples, nine samples were positive by PCR alone and seven samples were positive by culture alone, thus indicating a 78% sensitivity and 97% specificity for the PCR assay. EAggEC is an important aetiological agent of acute diarrhoea among infants in and around Calcutta, and the PCR diagnostic system may be useful to identify such infection in epidemiological studies.

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“…Enteroaggregative Escherichia coli (EAEC) has been implicated as an emerging cause of persistent and acute diarrhea in both developing and developed countries (5,18,21,26,32,39). Several epidemiological investigations of diarrhea suggest that EAEC is an important etiologic agent (25,31,33).…”

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confidence: 99%

Virulence Characteristics and Molecular Epidemiology of Enteroaggregative Escherichia coli Isolates from Hospitalized Diarrheal Patients in Kolkata, India

et al. 2004

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Enteroaggregative Escherichia coli (EAEC) is an important diarrheal enteropathogen defined by aggregative adherence to cultured epithelial cells. We have detected EAEC from 121 (6.6%) of 1,826 hospitalized patients admitted with diarrhea to the Infectious Diseases Hospital in Kolkata, India. Watery diarrhea was recorded significantly (P ‫؍‬ 0.0142) more often in children. The majority of the EAEC isolates were not serotypeable (62%) and showed resistance to five or more antibiotics (76%). We studied different virulence genes and the molecular epidemiology of 121 EAEC isolates recovered from diarrheal patients. A PCR assay for detection of virulence genes, an assay for determination of clump formation in liquid culture, and a HeLa cell adherence assay were carried out to characterize the EAEC isolates. Investigations were also conducted to correlate the virulence gene profiles with diarrheal symptoms and molecular epidemiology by pulsed-field gel electrophoresis (PFGE). Two or more virulence genes were detected in 109 (90.1%) EAEC isolates. In the cluster analysis, some isolates with specific gene profiles and phenotypes formed a group or subcluster. This study highlights the comparative distributions of three fimbrial adhesins and other virulence genes among EAEC isolates. The diverse virulence gene and PFGE profiles, along with the existence of diverse serotypes and antibiograms, suggests that the EAEC isolates are genetically heterogeneous in Kolkata.

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Acute and chronic diarrhoea and abdominal colic associated with enteroaggregative Escherichia coli in young children living in western Europe

Cited by 106 publications

References 14 publications

Prevalence of Enteroaggregative Escherichia coli among Children with and without Diarrhea in Switzerland

Prevalence of Enteroaggregative Escherichia coli among Children with and without Diarrhea in Switzerland

Use of PCR to identify enteroaggregative Escherichia coli as an important cause of acute diarrhoea among children living in Calcutta, India

Virulence Characteristics and Molecular Epidemiology of Enteroaggregative Escherichia coli Isolates from Hospitalized Diarrheal Patients in Kolkata, India

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