Molecular mechanisms of enterotoxigenic Escherichia coli infection

Fleckenstein, James M.; Hardwidge, Philip R.; Munson, George P.; Rasko, David A.; Sommerfelt, Halvor; Steinsland, Hans

doi:10.1016/j.micinf.2009.10.002

Cited by 256 publications

(233 citation statements)

References 96 publications

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“…Between 8% and 36% of ETEC isolates from different locations express the longus pilus, generally in conjunction with other CS antigens [100][101][102][103]. ETEC strains may possesses one or more nonfimbrial adhesins (recently reviewed by Fleckenstein et al [104]). One of these, EtpA, is a glycoprotein that links flagella to host cells and may be a potential vaccine candidate [105,106].…”

Section: Enteropathogenic E Colimentioning

confidence: 99%

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

Okeke

2009

J Infect Dev Ctries

125

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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Section: Enteropathogenic E Colimentioning

confidence: 99%

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

Okeke

2009

J Infect Dev Ctries

125

103

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“…1 The organism encodes two toxins, heat labile enterotoxin (LT) and heat stable enterotoxin (ST), that initiate fluid secretion into the intestinal lumen resulting in watery diarrhea. 2 In most cases, the genes that encode these toxins reside on plasmids. 3 The ETEC strain H10407 is a human isolate collected during an acute diarrheal outbreak in Bangladesh.…”

Section: Introductionmentioning

confidence: 99%

Development and Accuracy of Quantitative Real-Time Polymerase Chain Reaction Assays for Detection and Quantification of Enterotoxigenic Escherichia coli (ETEC) Heat Labile and Heat Stable Toxin Genes in Travelers' Diarrhea Samples

Youmans¹,

Ajami²,

Jiang³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Enterotoxigenic Escherichia coli (ETEC), the leading bacterial pathogen of travelers' diarrhea, is routinely detected by an established DNA hybridization protocol that is neither sensitive nor quantitative. Quantitative real-time polymerase chain reaction (qPCR) assays that detect the ETEC toxin genes eltA, sta1, and sta2 in clinical stool samples were developed and tested using donor stool inoculated with known quantities of ETEC bacteria. The sensitivity of the qPCR assays is 89%, compared with 22% for the DNA hybridization assay, and the limits of detection are 10,000-fold lower than the DNA hybridization assays performed in parallel. Ninety-three clinical stool samples, previously characterized by DNA hybridization, were tested using the new ETEC qPCR assays. Discordant toxin profiles were observed for 22 samples, notably, four samples originally typed as ETEC negative were ETEC positive. The qPCR assays are unique in their sensitivity and ability to quantify the three toxin genes in clinical stool samples.

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“…35,36 One is an enterotoxin and the other is a colonization factor. Colonization factors should be essential for EASTEC as well as for ETEC.…”

Section: Discussionmentioning

confidence: 99%

An Outbreak of Diarrhea in Mandera, Kenya, Due to Escherichia coli Serogroup O-Nontypable Strain That Had a Coding Gene for Enteroaggregative E. coli Heat-Stable Enterotoxin 1

Ochi

Shah²,

Odoyo³

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. In an outbreak of gastroenteritis in December 2009, in Mandera, Kenya, Escherichia coli O-nontypable (ONT) strain was isolated from stool specimens of patients (18/24, 75%). The E. coli ONT organisms could not be assigned to any of the recognized diarrheagenic groups of E. coli. However, they possessed the enteroaggregative E. coli heat-stable enterotoxin-1 gene. The cell-free culture filtrates of the E. coli ONT strain isolated from the outbreak cases induced considerable amount of fluid accumulation in suckling mouse intestine, indicating production of an enterotoxic factor(s). These results identify E. coli that did not have any diarrheagenic characteristics except astA as the etiological agent of the diarrheal outbreak in Mandera. It is however considered necessary to characterize the fluid accumulation factor(s) to determine whether any novel toxins were responsible for the fluid accumulation. Moreover, it is important to study dissemination of strains producing the enterotoxic factor(s) to assess their public health significance distribution in the environment.

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Molecular mechanisms of enterotoxigenic Escherichia coli infection

Cited by 256 publications

References 96 publications

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

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

Development and Accuracy of Quantitative Real-Time Polymerase Chain Reaction Assays for Detection and Quantification of Enterotoxigenic Escherichia coli (ETEC) Heat Labile and Heat Stable Toxin Genes in Travelers' Diarrhea Samples

An Outbreak of Diarrhea in Mandera, Kenya, Due to Escherichia coli Serogroup O-Nontypable Strain That Had a Coding Gene for Enteroaggregative E. coli Heat-Stable Enterotoxin 1

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