Enteropathogenic and enteroaggregative E. coli in stools of children with acute gastroenteritis in Davidson County, Tennessee

Foster, Monique A.; Iqbal, Junaid; Zhang, Chengxian; McHenry, Rendie; Cleveland, Brent; Romero-Herazo, Yesenia; Fonnesbeck, Chris; Payne, Daniel C.; Chappell, James D.; Halasa, Natasha; Gómez‐Duarte, Oscar G.

doi:10.1016/j.diagmicrobio.2015.07.016

Cited by 28 publications

(17 citation statements)

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“…Our study reflected that EPEC constituted 54.0% of DEC isolates, a little higher than that reported by Yu et al [ 4 ], which supported the need for follow-up epidemiological studies in childhood diarrhea. EAEC strains have been associated with traveler’s diarrhea in both developing and industrialized countries [ 27 , 28 ]. Studies carried out in Brazil and Mexico revealed EAEC to be the primary pathotype, with respective rates of 50% [ 12 ] and 52.1% [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study

et al. 2018

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BackgroundDiarrhea is the leading infectious cause of childhood morbidity and mortality. Among bacterial agents, diarrheagenic Escherichia coli (DEC) is the major causal agent of childhood diarrhea in developing countries, particularly in children under the age of 5 years. Here, we performed a hospital-based prospective study to explore the pathotype distribution, epidemiological characteristics and antibiotic resistance patterns of DEC from < 5-year-old diarrheal children.MethodsBetween August 2015 and September 2016, 684 stool samples were collected from children (< 5 years old) with acute diarrhea. All samples were cultured and identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and biochemical tests. PCR was used for subtyping, and enteropathogenic E. coli (EPEC) isolates were identified simultaneously with serology. Furthermore, antimicrobial sensitivity tests and sequencing of antibiotic resistance-related genes were conducted.ResultsDEC strains were identified in 7.9% of the 684 stool samples. Among them, the most commonly detected pathotype was EPEC (50.0% of DEC), of which 77.8% were classified as atypical EPEC (aEPEC). Age and seasonal distribution revealed that DEC tended to infect younger children and to occur in summer/autumn periods. Multidrug-resistant DEC isolates were 66.7%; resistance rates to ampicillin, co-trimoxazole, cefazolin, cefuroxime, cefotaxime, and ciprofloxacin were ≥ 50%. Among 5 carbapenem-resistant DEC, 60.0% were positive for carbapenemase genes (2 blaNDM-1 and 1 blaKPC-2). Among 30 cephalosporin-resistant DEC, 93.3% were positive for extended-spectrum β-lactamase (ESBL) genes, with blaTEM-1 and blaCTX-M-55 being the most common types. However, no gyrA or gyrB genes were detected in 16 quinolone-resistant isolates. Notably, aEPEC, which has not received much attention before, also exhibited high rates of drug resistance (81.0%, 66.7%, and 14.3% for ampicillin, co-trimoxazole, and carbapenem resistance, respectively).ConclusionsEPEC was the most frequent DEC pathotype in acute diarrheal children, with aEPEC emerging as a dominant diarrheal agent in central China. Most DEC strains were multidrug-resistant, making even ciprofloxacin unsuitable for empiric treatment against DEC infection. Among carbapenem-resistant DEC strains, those harboring blaNDM-1 and blaKPC-2 were the main causal agents. blaTEM-1 and blaCTX-M-55 were the major genetic determinants associated with high levels of cephalosporin resistance.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2936-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study

et al. 2018

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“…Furthermore, the proportion of aEPEC strains has increased, and aEPEC strains have outnumbered tEPEC strains and have also been associated with childhood diarrhea in some developing and developed countries 12, 18, 67, 91, 112, 129. However, the increase in prevalence of aEPEC may also reflect the refined discrimination between tEPEC and aEPEC 12, 18, 91…”

Section: Typical and Atypical Enteropathogenic E Colimentioning

confidence: 99%

Diarrheagenic Escherichia coli

Gomes

Elias

Scaletsky

et al. 2016

Brazilian Journal of Microbiology

432

353

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Most Escherichia coli strains live harmlessly in the intestines and rarely cause disease in healthy individuals. Nonetheless, a number of pathogenic strains can cause diarrhea or extraintestinal diseases both in healthy and immunocompromised individuals. Diarrheal illnesses are a severe public health problem and a major cause of morbidity and mortality in infants and young children, especially in developing countries. E. coli strains that cause diarrhea have evolved by acquiring, through horizontal gene transfer, a particular set of characteristics that have successfully persisted in the host. According to the group of virulence determinants acquired, specific combinations were formed determining the currently known E. coli pathotypes, which are collectively known as diarrheagenic E. coli. In this review, we have gathered information on current definitions, serotypes, lineages, virulence mechanisms, epidemiology, and diagnosis of the major diarrheagenic E. coli pathotypes.

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“…aEPEC from sequence type (ST) 302 (serotype O108:H9) have been isolated from both healthy and diseased hosts, and the environment. They have been isolated from healthy pigs (Fröhlicher et al, 2008;Malik et al, 2017;Reid et al, 2017), water tanks in a poultry slaughterhouse (Alonso et al, 2014) and pork products made for human consumption (Lugsomya et al, 2018), and have been associated with diarrheic rabbits , pigs (Kleta et al, 2014), and humans (Foster et al, 2015). Yet to date, no genomic comparisons of E. coli ST302 strains, nor a complete ST302 genome, has been published.…”

Section: Introductionmentioning

confidence: 99%

Escherichia coli ST302: Genomic Analysis of Virulence Potential and Antimicrobial Resistance Mediated by Mobile Genetic Elements

et al. 2020

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aEPEC are associated with persistent diarrhea, and diarrheal outbreaks in both humans and animals worldwide. They are differentiated from typical EPEC by the lack of bundleforming pili, and from EHEC by the lack of phage-mediated stx toxins. However, phylogenetic analyses often associate aEPEC with EHEC, promoting the hypothesis that aEPEC are the progenitors of EHEC, which is supported by aEPEC conversion to EHEC by stx-carrying phages. While aEPEC can cause disease outright, the potential to acquire stx, one of the most potent bacterial toxins known, merits close monitoring. Escherichia coli ST302 (O108:H9, O182:H9, O45:H9) are aEPEC that have been isolated from diarrheic human, pig and rabbit hosts, as well as in healthy pigs, however, no study to date has focused on E. coli ST302 strains. Through WGS and hybrid assembly we present the first closed chromosome, and two circularized plasmids of an ST302 strain-F2_18C, isolated from a healthy pig in Australia. A phylogenetic analysis placed E. coli ST302 strains in proximity to EHEC ST32 (O145:H28) strains. Public databases were interrogated for WGSs of E. coli ST302 strains and shortread gene screens were used to compare their virulence-associated gene (VAG) and antimicrobial resistance gene (ARG) cargo. E. coli ST302 strains carry diverse VAGs, including those that typically associated with extraintestinal pathogenic E. coli (ExPEC). Plasmid comparisons showed that pF2_18C_FIB shared homology with EHEC virulence plasmids such as pO103 while pF2_18C_HI2 is a large multidrug resistance IncHI2:ST3 plasmid. A comparison of 33 HI2:ST3 plasmids demonstrated that those of Australian origin have not acquired resistances to extended-spectrum beta-lactams, colistin, fosfomycin or rifampicin, unlike those originating from Asia. F2_18C was shown to carry two additional pathogenicity islands-ETT2, and the STEC-associated PAI CL3 , plasmid-associated heavy metal resistance genes, as well as several unoccupied stxphage attachment sites. This study sheds light on the virulence and AMR potential of E. coli ST302 strains and informs AMR genomic surveillance.

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Enteropathogenic and enteroaggregative E. coli in stools of children with acute gastroenteritis in Davidson County, Tennessee

Cited by 28 publications

References 41 publications

Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study

Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study

Diarrheagenic Escherichia coli

Escherichia coli ST302: Genomic Analysis of Virulence Potential and Antimicrobial Resistance Mediated by Mobile Genetic Elements

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