Clinical Implications of Enteroadherent Escherichia coli

Abstract

Pathogenic Escherichia coli that colonize the small intestine primarily cause gastrointestinal illness in infants and travelers. The main categories of pathogenic E. coli that colonize the epithelial lining of the small intestine are enterotoxigenic E. coli enteropathogenic E. coli and enteroaggregative E. coli. These organisms accomplish their pathogenic process by a complex, coordinated multistage strategy, including non-intimate adherence mediated by various adhesins. These so called “enteroadherent E. coli ” categories subsequently produced toxins or effector proteins that are either secreted to the milieu or injected to the host cell. Finally, destruction of the intestinal microvilli results from the intimate adherence or the toxic effect exerted over the epithelia, resulting in water secretion and diarrhea. In this review, we summarize the current state of knowledge regarding these enteroadherent E. coli strains and the present clinical understanding of how these organisms colonize the human intestine and cause disease.

Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

“…The secretion of toxins is thought to play an important role in secretory diarrhea, which is a typical clinical manifestation of EAEC infection (4,9,40). The cytotoxic effects of EAEC involve the secretion of serine protease autotransporters of the Enterobacteriaceae (SPATEs) (41).…”

“…One important cause of infectious diarrhea is the so-called diarrheagenic Escherichia coli (DEC) group (1,2). The following subgroups of DEC have been defined: enterotoxigenic E. coli (ETEC), Shiga toxin-producing E. coli (STEC), enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), and enteroaggregative E. coli (EAEC) (3)(4)(5). Recently, the pathogenicity of these pathotypes, including EAEC, was reviewed (5); in this review, we focus on the epidemiology and disease manifestations of EAEC specifically.…”

Enteropathogenic Escherichia coli: foe or innocent bystander?

“…The tEPEC strains can cause abundant secretory diarrhea with mucus and significant losses of water and electrolyte in the feces (15). In addition, EPEC may lead to severe malabsorption of nutrients, which would progress to nutritional aggravation and persistence of diarrhea (16).…”

Antibiotic resistance and biofilm formation in children with Enteropathogenic Escherichia coli (EPEC) in Brazilian Amazon

“…The 78.9% (56/71) resistance to cefuroxime was higher than that recorded for diarrheagenic E. coli strains isolated in samples from children in the age group 5 years in China (57.4%) [28]. According to Arenas Hernández et al, EPEC strains are more often resistant to ampicillin, tetracycline, streptomycin and sulfonamides [18]. In addition, the mean resistance recorded for EPEC was similar to that recorded for other diarrheagenic E. coli, which recorded more than 23% resistance to ampicillin, tetracycline and trimethoprim / sulfamethoxazole [29].…”

“…Thus, the aim of the current study was to investigate the ability of EPEC isolates to form biofilm and to develop an antimicrobial resistant profile. Previous studies have recorded EPEC resistance to multiple antibiotics, mainly the resistance shown by typical EPEC isolates [18].…”