Escherichia coliin gastroenteritis of children in London and Jamaica

Abstract

SUMMARYThe jejunal and stool flora of children with gastroenteritis in London and in Jamaica was examined. Although bacterial colonization of the small bowel was commonly detected, it was unusual to find the same serotype ofE. coliin both jejunum and stool, and none of the jejunal strains ofE. coliproduced either heat-labile or heat-stable enterotoxin. Some strains ofE. colicausing infant gastroenteritis are neither toxigenic nor invasive, and other mechanisms must be sought to account for their pathogenicity.

Gastroenteritis in London and Jamaica: a clinical and bacteriological study

“…2. They show similar trends to those in the previous study (Ellis-Pegler et al 1978), and reveal no striking differences between the two geographical groups.…”

“…If the mere presence of raised bacterial counts in the small bowel cannot be ascribed a pathogenic role, the significance of individual bacterial genera must be assessed. We have studied especially the serotype and toxin production of the strains of E. coli found in stool and jejunum in Jamaica and England and these, reported elsewhere (Ellis-Pegler et al 1978) do not support the notion that small bowel invasion by toxigenic E. coli is a common cause of gastro-enteritis, although widespread colonization of the bowel with a particular strain of E. coli is well described (Thomson, 1955) and was found in two of our patients. The possible significance of other components of the small bowel flora in causing diarrhoea can only be determined by further work on the metabolic activities of these organisms of the type now being undertaken by several workers.…”

“…Ifpositive, biochemical identification and monovalent serum titrations were added. From the patients intubated, strains of E. coli isolated from small bowel or stool were subjected to more detailed analysis (Ellis-Pegler et al 1978), and fully serotyped at the Central Public Health Laboratory, Colindale.…”

“…1 (part 1). Aerobic stool flora in acute gastroenteritis (a), convalescents (b) and normal controls (c) children and are further investigated and discussed elsewhere (Ellis-Pegler et al 1978). Three Jamaican children were intubated again during convalescence (6, 6 and 7 days respectively after admission) when their diarrhoea had stopped.…”

Bacteriostasis ofEscherichia coliby milk. VI. The in-vitro bacteriostatic property of Gambian mothers' breast milk in relation to the in-vivo protection of their infants against diarrhoeal disease

“…We are ignorant of the pattern of small intestinal colonization in children up to 6 months of age in The Gambia. In a study in Jamaica and London on 1-monthto 2-year-old children hospitalized with diarrhoea (Ellis-Pegler et al 1979) in which strains isolated from the jejunum were serotyped and tested for toxin production, there was no convincing evidence of the prime involvement of E. coli of pathogenic or toxigenic serotype nor of production of toxin, Although the degree of correlation, or rather lack of it, between in-vitro bacteriostasis of E. coli by milk and the freedom from diarrhoea of the Gambian babies is not surprising in the complex field situation studied, we had hoped to achieve a more positive indication of the protective potential of the bacteriostatic system. Knowing which properties of milk to monitor to ensure protective cover in at-risk recipients is important in developing countries for breast-fed babies and elsewhere in the context of milk banks.…”