Enterohaemorrhagic Escherichia coli in Central African Republic

Germani, Y; Soro, B.; Vohito, M. D.; Morel, Olivier; Morvan, Jacques

doi:10.1016/s0140-6736(05)62636-0

Cited by 42 publications

(31 citation statements)

References 4 publications

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“…Considering that bloody diarrhea outbreaks due to E. coli O157 were recently observed in eastern and southern parts of Africa, 27,28 this bacteria should be considered to be a putative causative agent of hemorrhagic colitis epidemics in the Central African Republic. Our report presents the first description in this country of non-EPEC strains with different patterns of adherence to HEp-2 cells in adults with diarrhea.…”

Section: Discussionmentioning

confidence: 99%

Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.

Germani¹,

Minssart²,

Vohito³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. A study of the etiologies of diarrhea in adults in relation to their human immunodeficiency virus (HIV) serostatus and number of CD4ϩ cells was carried out in the Central African Republic. In cases and controls, multiparasitism was observed. Salmonella spp. were identified mainly during acute diarrhea, with 50% of the S. enteritidis isolated during the study being responsible for septicemia and/or urinary tract infection in immunodeficient patients. Enteroaggregative Escherichia coli (EAggEC) were the most frequently identified agent in HIVϩ patients with persistent diarrhea; 42.8% of the patients with EAggEC as sole pathogens had bloody diarrhea, and these strains were negative for the presence of a virulence plasmid. Coccidia were found in those with acute and persistent diarrhea. Blood was observed in 53.3% of infections involving coccidia as the sole pathogen. Microsporidium spp. and Blastocystis hominis were found only in HIVϩ patients with persistent diarrhea. Shigella spp., Campylobacter spp., and Entamoeba histolytica were found in HIVϩ and HIVϪ dysenteric patients; bacteria resembling spirochetes that could not be cultivated were identified only in HIVϩ cases with dysentery. Shiga-like toxin-producing E. coli O157:HϪ was isolated from two cases with hemolytic-uremic syndrome. Fungi were identified as the sole pathogen in 6.4% of the HIVϩ patients with persistent diarrhea. Most of enteropathogenic bacteria identified were resistant to ampicillin and trimethoprim-sulfamethoxazole, remained susceptible to ampicillin plus clavulanic acid, and were susceptible to amikacin, gentamicin, and ciprofloxacin.

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Section: Discussionmentioning

confidence: 99%

Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.

Germani¹,

Minssart²,

Vohito³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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“…Most other recommendations concur [174]. In addition to outbreaks, sporadic EHEC isolates have almost always been found when sought in Africa [14,21,65,89,133,143,172,[175][176][177]. Although the isolation rate was low in all these instances, they further emphasize the importance of considering EHEC in the differential diagnosis of bloody diarrhea.…”

Section: Enterohemorrhagic E Colimentioning

confidence: 98%

“…In 1996, Germanii et al [172] described an EHEC outbreak in Central African Republic. Like subsequent EHEC epidemics in Africa, it was mistaken for a Shigella outbreak and it was only molecular tests performed abroad that revealed that EHEC was the culprit.…”

Section: Enterohemorrhagic E Colimentioning

confidence: 99%

“…In almost all EHEC outbreaks, the causative organism has been identified outside the country and after the outbreak has abated. Moreover, EHEC outbreaks have typically co-occurred with outbreaks of other diarrheal pathogens [14,167,[171][172][173].…”

Section: Enterohemorrhagic E Colimentioning

confidence: 99%

“…Bovines have emerged as an important reservoir for EHEC in Africa as well [168,178]. In the Central African Republic, Germani et al [172] associated EHEC infection with eating Kanda, a snack consisting of meat from a small bovine referred to as Zebu and marrow steamed in banana leaves. Steamed Kanda is sold days after preparation at roadsides, at ambient temperatures [172].…”

Section: Enterohemorrhagic E Colimentioning

confidence: 99%

See 2 more Smart Citations

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Okeke

2009

J Infect Dev Ctries

127

103

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Diarrhea is a leading cause of illness and death, particularly in developing countries. Enteropathogenic Escherichia coli, enterotoxigenic E. coli (ETEC), enteroinvasive E. coli, enterohemorrhaghic E. coli (EHEC), enteroaggregative E. coli (EAEC) and diffusely adherent E. coli (DAEC) have been associated with diarrheal disease in different parts of Africa, particularly among young children, HIV-positive individuals, and visitors from abroad. Each of these E. coli pathotypes uses distinct mechanisms, which are only partially understood, to colonize infected hosts and produce diarrhea. All known diarrheagenic E. coli pathotypes have been reported from diverse locations within Africa but the true burden from these pathogens is unknown because very few studies seeking these organisms with discriminatory methodology have been performed. Recent reports implicate ETEC and EAEC in a considerable proportion of childhood and travellers' diarrheas and suggest that some sub-types of these categories may have greater epidemiological significance than others. The significant contribution of EHEC to bloody diarrhea and hemolytic uremic syndrome is underappreciated because diagnostic capacity for this pathotype is generally inferior to that for confounders such as Shigella and Entamoeba. Recent studies in Africa have revealed the worrisome emergence of antimicrobial resistance and high asymptomatic carriage rates for diarrheagenic E. coli but bacterial and host factors that predispose to disease, as well as non-human reservoirs, are largely unknown. Future diarrheal disease research needs to focus on broadening the repertoire of pathogens sought in epidemiological surveys to include multiple categories of diarrheagenic E. coli while building capacity to detect these pathogens in local reference laboratories.

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Epidemiology of Human Infections byEscherichia coli0157 and other Verocytotoxin‐ProducingE. coli

Tozzi

Gorietti

Caprioli

2004

Verocytotoxigenic E. Coli

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Enterohaemorrhagic Escherichia coli in Central African Republic

Cited by 42 publications

References 4 publications

Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.

Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Epidemiology of Human Infections byEscherichia coli0157 and other Verocytotoxin‐ProducingE. coli

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