Acute undifferentiated human diarrhea in the tropics

Gorbach, Sherwood L.; Banwell, John G.; Chatterjee, B. D.; Jacobs, Bart C.; Sack, R. Bradley

doi:10.1172/jci106560

Cited by 200 publications

(64 citation statements)

References 34 publications

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“…36 Earlier studies have implicated ETEC with watery, cholera-like diarrhea in India and Brazil. 37,38 In this study, 81% of the patients who had ETEC diarrhea reported watery stools. This could mean that 81% of the ETEC-associated diarrhea patients were dehydrated, though treatment data were not available at the time of analysis.…”

Section: Resultsmentioning

confidence: 60%

Toxins and colonization factor antigens of enterotoxigenic Escherichia coli among residents of Jakarta, Indonesia.

Oyofo¹,

Subekti²,

Svennerholm³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. Infection caused by enterotoxigenic Escherichia coli (ETEC) poses a serious health problem among children and adults in developing countries. Colonization of the small intestinal mucosa by ETEC strains is mediated by antigenically specific fimbriae, also known as colonization factor antigens (CFA). The significance of this study arises from reports that active and passive immunization with ETEC strains harboring CFAs has previously been shown to induce protective immunity against diarrhea in animal models. The aim of this study was to determine toxin-associated CFAs of ETEC isolated from a diarrheal disease case-control study in Jakarta, Indonesia. Thirteen hundred and twenty-three diarrheic and control patients with lactose-fermenting colonies were screened by ganglioside GM1-enzyme-linked immunosorbent assay (GM1-ELISA) for heat-labile (LT) and heat-stable (ST) toxins. Two hundred and forty-six (19%) ETEC isolates identified by GM1-ELISA for the LT/ST toxins were screened for CFAs by Dot blot assay using monoclonal antibodies against CFA/I, II, and IV and against the putative colonization antigens (PCF) PCFO159, PCFO166, CS7, and CS17. Of the 246 ETEC isolates, 177 (72%) elaborated ST, 56 (23%) produced LT, while 13 (5%) elicited both the ST and LT toxins. CFA testing of the 246 ETEC isolates showed that 21 (8%) expressed CFA/I, 3 (1%) exhibited CFA/II, 14 (6%) elaborated CFA/IV, while 7 (3%) expressed PCFO159 and PCFO159 plus CS5. No CFAs or PCFs could be associated with 201 (82%) of the ETEC strains. This report documents the types of CFAs associated with ETEC strains in Jakarta, Indonesia. These data may help current research efforts on the development of CFA-based vaccines for humans against ETEC and provide additional information for future ETEC vaccine trials in Southeast Asia.

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Section: Resultsmentioning

confidence: 60%

Toxins and colonization factor antigens of enterotoxigenic Escherichia coli among residents of Jakarta, Indonesia.

Oyofo¹,

Subekti²,

Svennerholm³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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show abstract

“…These findings suggest that essentially the same flora is present in both terminal ileitis and colitis but in the latter, severe and bloody diarrhoea may prevent the establishment of the characteristic anaerobic flora of Crohn's disease. A similar breakdown of the anaerobic part of the flora has also been observed in other cases of diarrhoea, whether aspecific or caused by Vibrio cholerae or enteropathogenic E8cherichia coli (Moore, Cato & Holdeman, 1969;Gorbach et al 1970Gorbach et al , 1971. The suggestion that the flora in terminal ileitis and colitis is essentially the same is strengthened by the fact that Crohn's patients react to the presence of coccoid rods in the intestinal tract by the production of agglutinating antibodies (Wensinck & Van de Merwe, 1981).…”

Section: Discussionmentioning

confidence: 58%

The faecal flora of patients with Crohn's disease

Wensinck

1975

Antonie van Leeuwenhoek

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“…Normally, the oxygen-sensitive anaerobes find in the large intestine conditions of low oxidation-reduction potential and relative stasis that are conducive to growth. The rapid passage of intestinal contents that occurs in diarrhoea appears to produce a less favourable environment (Gorbach et al, 1971). …”

Section: Discussionmentioning

confidence: 99%