EnteroaggregativeEscherichia coli: An Emerging Enteric Food Borne Pathogen

Abstract

Enteroaggregative Escherichia coli (EAEC) are quite heterogeneous category of an emerging enteric pathogen associated with cases of acute or persistent diarrhea worldwide in children and adults, and over the past decade has received increasing attention as a cause of watery diarrhea, which is often persistent. EAEC infection is an important cause of diarrhea in outbreak and non-outbreak settings in developing and developed countries. Recently, EAEC has been implicated in the development of irritable bowel syndrome, but this remains to be confirmed. EAEC is defined as a diarrheal pathogen based on its characteristic aggregative adherence (AA) to HEp-2 cells in culture and its biofilm formation on the intestinal mucosa with a “stacked-brick” adherence phenotype, which is related to the presence of a 60 MDa plasmid (pAA). At the molecular level, strains demonstrating the aggregative phenotype are quite heterogeneous; several virulence factors are detected by polymerase chain reaction; however, none exhibited 100% specificity. Although several studies have identified specific virulence factor(s) unique to EAEC, the mechanism by which EAEC exerts its pathogenesis is, thus, far unknown. The present review updates the current knowledge on the epidemiology, chronic complications, detection, virulence factors, and treatment of EAEC, an emerging enteric food borne pathogen.

Enteroaggregative E. coli O104 from an outbreak of HUS in Germany 2011, could it happen again?

“…Studies have shown a wide selection of EAEC serotypes and many are untypeable [30][31][32]; therefore, serotyping is not a useful tool in distinguishing this problematic group.…”

“…Thank you to the authors of published MLST data [18,24,32] which was used for the analysis in this paper.…”

Animal models of enteroaggregativeEscherichia coliinfection

“…[6][7][8] Also, EAEC has been identified as a common cause of acute diarrheal illness in children and adults in inpatient and emergency units throughout the United States. 9 The alarming rise in attention to EAEC led to its inclusion on the National Institutes of Health category B list of infectious organisms of potential importance as a bioterrorism weapon in 2002. 10 In May 2011 an outbreak of E. coli O104:H4 occurred in Germany where more than 4,000 people became victims to infection and 54 of these cases resulted in death; the highest frequency of deaths ever recorded for an E. coli outbreak.…”

Distribution and Molecular Characterization of Enteroaggregative Escherichia coli Isolated from Children in A Case-control Study of Acute Diarrhea in Thailand

“…EAEC is associated with traveler's diarrhea [4,5], endemic chronic pediatric diarrhea [6,7] and persistent diarrhea in immunocompromised patients [8,9]. EAEC is increasingly considered as an emerging enteric pathogen [10,11]. Among the diarrheagenic E. coli pathotypes, EAEC is more heterogeneous, with limited information on the roles and importance of specific virulence genes and putative gene products.…”