Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Medina, Anicia M.; Rivera, Fulton P.; Romero, Liliana M.; Kolevic, Lenka A.; Castillo, María E.; Verne, Eduardo; Hernandez, Roger; Mayor, Yovanna E.; Barletta, Francesca; Mercado, Erik H.; Ochoa, Theresa J.

doi:10.4269/ajtmh.2010.09-0596

Cited by 23 publications

(19 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding has been proposed to be a result of acquired immunity (105,137) due to poor sanitary conditions as well as frequent exposure to pathogenic E. coli strains, resulting in the development of protective antibodies and colonization rather than infection. This has been stated in studies conducted in developing countries.…”

Section: Discussionmentioning

confidence: 90%

“…In a number of studies, EAEC has been isolated in almost equal numbers from patients suffering from diarrhea and from control groups (15,133,137). This finding has been proposed to be a result of acquired immunity (105,137) due to poor sanitary conditions as well as frequent exposure to pathogenic E. coli strains, resulting in the development of protective antibodies and colonization rather than infection.…”

Section: Discussionmentioning

confidence: 97%

“…An association between EAEC and diarrhea has not been reported by all studies on HIV-related diarrhea. EAEC was found in equal numbers in diarrhea cases and controls among HIV-positive children in Peru (137), where EAEC was detected by PCR targeting the aggR gene. Another study found that HIV patients were more likely to be EAEC positive: 29.5% versus 14% in the HIV-negative group.…”

Section: Association Between Eaec and Hiv-related Diarrheamentioning

confidence: 99%

See 2 more Smart Citations

Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

et al. 2014

View full text Add to dashboard Cite

SUMMARY Enteroaggregative Escherichia coli (EAEC) represents a heterogeneous group of E. coli strains. The pathogenicity and clinical relevance of these bacteria are still controversial. In this review, we describe the clinical significance of EAEC regarding patterns of infection in humans, transmission, reservoirs, and symptoms. Manifestations associated with EAEC infection include watery diarrhea, mucoid diarrhea, low-grade fever, nausea, tenesmus, and borborygmi. In early studies, EAEC was considered to be an opportunistic pathogen associated with diarrhea in HIV patients and in malnourished children in developing countries. In recent studies, associations with traveler's diarrhea, the occurrence of diarrhea cases in industrialized countries, and outbreaks of diarrhea in Europe and Asia have been reported. In the spring of 2011, a large outbreak of hemolytic-uremic syndrome (HUS) and hemorrhagic colitis occurred in Germany due to an EAEC O104:H4 strain, causing 54 deaths and 855 cases of HUS. This strain produces the potent Shiga toxin along with the aggregative fimbriae. An outbreak of urinary tract infection associated with EAEC in Copenhagen, Denmark, occurred in 1991; this involved extensive production of biofilm, an important characteristic of the pathogenicity of EAEC. However, the heterogeneity of EAEC continues to complicate diagnostics and also our understanding of pathogenicity.

show abstract

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Association Between Eaec and Hiv-related Diarrheamentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

et al. 2014

View full text Add to dashboard Cite

show abstract

“…EAEC is associated with diarrhea, failure to thrive, weight loss, and stunted growth in children living in developing countries (Steiner et al, 1998; Albert et al, 1999; Lima et al, 2000; Medina et al, 2010; Hebbelstrup Jensen et al, 2014). EAEC-positive children were seen to have increased levels of fecal lactoferrin and Il-1β, regardless of the presence of gastrointestinal symptoms in a Brazilian study (Steiner et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea

Jensen

Poulsen

Rasmussen

et al. 2017

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish children. We aimed to improve the current diagnostics of EAEC and enable targeting of strains with an expected severe disease course. Questionnaires answered by parents provided information regarding duration of diarrhea and presence of blood or mucus. A total of 295 EAEC strains were collected from children with acute (≤7 days) and persistent diarrhea (≥14 days) and were compared by using multiplex PCR targeting the genes sat, sepA, pic, sigA, pet, astA, aatA, aggR, aaiC, aap, agg3/4C, ORF3, aafA, aggA, agg3A, agg4A, and agg5A. Furthermore, the distribution of EAEC genes in strains collected from cases of bloody, mucoid, and watery diarrhea was investigated. The classification and regression tree analysis (CART) was applied to investigate the relationship between EAEC virulence genes and diarrheal duration and type. Persistent diarrhea was associated with strains lacking the pic gene (p = 0.002) and with the combination of the genes pic, sat, and absence of the aggA gene (p = 0.05). Prolonged diarrhea was associated with the combination of the genes aatA and astA (p = 0.03). Non-mucoid diarrhea was associated with strains lacking the aatA gene (p = 0.004). Acute diarrhea was associated with the genes aggR, aap, and aggA by individual odds ratios. Resistance toward gentamicin and ciprofloxacin was observed in 7.5 and 3% of strains, respectively. Multi-drug resistance was observed in 38% of strains. Genetic host factors have been associated with an increased risk of EAEC-associated disease. Therefore, we investigated a panel of risk factors in two groups of children—EAEC-positive and EAEC-negative—to identify additional factors predisposing to disease. The duration of breastfeeding was positively correlated with the likelihood of belonging to the EAEC-negative group of children.

show abstract

“…In a study of HIV-infected children in Peru, 74% of the diarrheagenic E. coli strains detected were highly resistant to ampicillin (74%) and cotrimoxazole (70%) (684). The current Infectious Disease Society of America practice guidelines for the management of infectious diarrhea recommend fluoroquinolones for the treatment of immunocompromised patients (685).…”

Section: Clinical Considerationsmentioning

confidence: 99%

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

et al. 2013

View full text Add to dashboard Cite

SUMMARY Although Escherichia coli can be an innocuous resident of the gastrointestinal tract, it also has the pathogenic capacity to cause significant diarrheal and extraintestinal diseases. Pathogenic variants of E. coli (pathovars or pathotypes) cause much morbidity and mortality worldwide. Consequently, pathogenic E. coli is widely studied in humans, animals, food, and the environment. While there are many common features that these pathotypes employ to colonize the intestinal mucosa and cause disease, the course, onset, and complications vary significantly. Outbreaks are common in developed and developing countries, and they sometimes have fatal consequences. Many of these pathotypes are a major public health concern as they have low infectious doses and are transmitted through ubiquitous mediums, including food and water. The seriousness of pathogenic E. coli is exemplified by dedicated national and international surveillance programs that monitor and track outbreaks; unfortunately, this surveillance is often lacking in developing countries. While not all pathotypes carry the same public health profile, they all carry an enormous potential to cause disease and continue to present challenges to human health. This comprehensive review highlights recent advances in our understanding of the intestinal pathotypes of E. coli .

show abstract

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Cited by 23 publications

References 27 publications

Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

Contact Info

Product

Resources

About