Pathotypes of diarrheagenic Escherichia coli in children attending a tertiary care hospital in South India

Rajendran, Priya; Ajjampur, Sitara Swarna Rao; Chidambaram, Divya; Chandrabose, Gunasekaran; Thangaraj, Bhuvaneswari; Sarkar, Rajiv; Samuel, Prasanna; Rajan, D. Prasanna; Kang, Gagandeep

doi:10.1016/j.diagmicrobio.2010.06.003

Cited by 66 publications

(72 citation statements)

References 46 publications

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“…In Switzerland, a frequency of 8% of DEC was found among children with diarrhea [20], while among Caribbean-Colombian children, a rate of 14.4% was reported [26], and in Brazil, rates from 7.6% to 48% [11,[27][28][29][30] have been reported. In India, a frequency of 52% of DEC was found among children under five years of age with diarrhea [31], and in Ghana, these bacteria were recovered from 77% of children and 38% of adults with diarrhea [32]. These studies also showed that DEC are important causes of diarrhea.…”

Section: Discussionmentioning

confidence: 53%

Impact of Aeromonas and diarrheagenic Escherichia coli screening in patients with diarrhea in Paraná, southern Brazil

Assis

Wolf

Surek

et al. 2014

J Infect Dev Ctries

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Introduction: A wide diversity of bacterial agents may cause diarrhea, presenting challenges to clinical laboratories to define a diagnosis. Considering that most stool cultures are negative, we screened stool samples from patients with diarrhea for the presence of 14 bacterial enteropathogens, aiming to establish which of them should be included in routine stool analysis. Methodology: Stool samples from 400 patients with diarrhea were analyzed for the presence of Salmonella, Shigella, Campylobacter, Aeromonas, Plesiomonas shigelloides, Vibrio, Yersinia enterocolitica, and diarrheagenic Escherichia coli using conventional microbiological methods and PCR. Two distinct samples were studied; one included predominantly patients involved in outbreaks, and the other patients of low socioeconomic status presenting sporadic cases of diarrhea. Results: In total, 86 cultures (21.5%) were positive. Mixed infections were found in five patients, leading to recovery of 91 strains of enteropathogenic bacteria: Salmonella Enteritidis (9.2%), Aeromonas (7.2%), diarrheagenic E. coli (5.2%), and C. jejuni (1%). However, Salmonella predominated, with 11.5% frequency in diarrhea outbreaks, while Aeromonas predominated among patients of low socioeconomic status, with 14.6% frequency. Conclusion: Aeromonas and diarrheagenic E. coli, which are not routinely screened for, deserve to be included in laboratory screening panels.

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Section: Discussionmentioning

confidence: 53%

Impact of Aeromonas and diarrheagenic Escherichia coli screening in patients with diarrhea in Paraná, southern Brazil

Assis

Wolf

Surek

et al. 2014

J Infect Dev Ctries

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“…In a number of studies, EAEC has been isolated in almost equal numbers from patients suffering from diarrhea and from control groups (15,133,137). This finding has been proposed to be a result of acquired immunity (105,137) due to poor sanitary conditions as well as frequent exposure to pathogenic E. coli strains, resulting in the development of protective antibodies and colonization rather than infection.…”

Section: Discussionmentioning

confidence: 98%

“…The aggR gene is highly conserved among EAEC strains and has been found to be associated with diarrhea in several studies (105,133,154). A strong correlation between the CVD432 probe and the aggR gene has been reported (7,52,69).…”

Section: Discussionmentioning

confidence: 99%

“…A high rate of carriage of EAEC in young children has been reported by several other studies. EAEC was found in greater numbers in the control group in a case-control study (133) conducted between 2003 and 2006 in South India. This study investigated the etiology of diarrhea in children Ͻ5 years of age.…”

Section: Eaec As a Cause Of Childhood Diarrhea In Developing Countriesmentioning

confidence: 99%

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Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

et al. 2014

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SUMMARY Enteroaggregative Escherichia coli (EAEC) represents a heterogeneous group of E. coli strains. The pathogenicity and clinical relevance of these bacteria are still controversial. In this review, we describe the clinical significance of EAEC regarding patterns of infection in humans, transmission, reservoirs, and symptoms. Manifestations associated with EAEC infection include watery diarrhea, mucoid diarrhea, low-grade fever, nausea, tenesmus, and borborygmi. In early studies, EAEC was considered to be an opportunistic pathogen associated with diarrhea in HIV patients and in malnourished children in developing countries. In recent studies, associations with traveler's diarrhea, the occurrence of diarrhea cases in industrialized countries, and outbreaks of diarrhea in Europe and Asia have been reported. In the spring of 2011, a large outbreak of hemolytic-uremic syndrome (HUS) and hemorrhagic colitis occurred in Germany due to an EAEC O104:H4 strain, causing 54 deaths and 855 cases of HUS. This strain produces the potent Shiga toxin along with the aggregative fimbriae. An outbreak of urinary tract infection associated with EAEC in Copenhagen, Denmark, occurred in 1991; this involved extensive production of biofilm, an important characteristic of the pathogenicity of EAEC. However, the heterogeneity of EAEC continues to complicate diagnostics and also our understanding of pathogenicity.

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“…The pediatric lethality index caused by diarrhea in Brazil is higher [29]. Gastrointestinal Infections (GIs) are among the leading causes of childhood mortality worldwide and are responsible for millions of deaths every year; India has surpassed Brazil (200.0000) [30][31][32]. Among the causative agents are several pathotypes of non-invasive Escherichia coli that cause diarrhea but do not produce heat-labile or heat-stable enterotoxins [33].…”

Section: Diarrhea Epidemiology and Pathogenesismentioning

confidence: 99%

Vaccine Against Entheropathogenic E. colii: A Systematic Review

Vasconcellos¹,

Silva²,

Nascimento³

et al. 2017

IJVR

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Enteric diseases are a major cause of childhood death in the developing world, ranking as the second cause of death in children. Enteropathogenic Escherichia coli(EPEC) are important diarrheal pathogens of children under 5 years of age. Due to high mortality, several international organizations such as the WHO and UNICEF have dedicated preventive and control programs for diarrheal diseases. Among the suggested initiatives aiming to prevent infectious diarrhea include vaccine development and improvement in sanitation and water and food supplies.Upon contact with host cells, EPEC delivers an array of virulence protein factors, which integrated actions interferes with the normal adjusting the targets molecular cell functions leading to diarrhea. The locus of entherocyte effacement (LEE)pathogenicity island contains genes encoding synthesis of the EPEC virulence factors membrane adhesin intimin, T3SS (Esc and Sep proteins), chaperones (Ces proteins), translocators (EspA, EspB, and EspD), effector proteins (EspF, EspG, EspH, Map and EspZ), the translocated intimin receptor (Tir), and the regulatory protein Ler (LEEencoded regulator).Bundle-forming pilus (BfpA) is another virulence factor that mediates the initial contact between EPEC and the host cell. BfpA is encoded by a gene localized on a 50-70 MDa plasmid and is designated as EPEC adherence factor (EAF). BfpA, intimin and translocated Tir initiate EPEC infection. This repertoire of virulence factors offers strategic epitopes as vaccine candidates.Employing the proposed technologies for modern vaccines, recombinant Mycobacterium smegmatis (Smeg) and Mycobacterium bovis BCG strains were constructed to express BfpA, intimin and EspA. Recombinant clones were selected based on kanamycin resistance. Recombinant proteins are immunogenic, and the resultant antibodies recognize and block EPEC adhesion onto HEp-2 target cells. In attention to regulatory agency recommendations, kanamycin should not be used to produce rBCG expressing the E. coli EPEC virulence factors BfpA, intimin and EspA. Accordingly, an expression system with a Pasteur auxotrophic BCG mutant for leucine (BCG Pasteur ΔleuD) and a replicative vector (pUP410)should be used. Obtained recombinants will be grown in large scale, and their immunogenic effectivity and human safety submitted to WHO indicated quality controls.

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Pathotypes of diarrheagenic Escherichia coli in children attending a tertiary care hospital in South India

Cited by 66 publications

References 46 publications

Impact of Aeromonas and diarrheagenic Escherichia coli screening in patients with diarrhea in Paraná, southern Brazil

Impact of Aeromonas and diarrheagenic Escherichia coli screening in patients with diarrhea in Paraná, southern Brazil

Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

Vaccine Against Entheropathogenic E. colii: A Systematic Review

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