Prevalence of Enteric Pathogens among International Travelers with Diarrhea Acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay)

Jiang, Zhi‐Dong; Lowe, Brett; Verenkar, M. P.; Ashley, Deanna; Steffen, Robert; Tornieporth, Nadia; Sonnenburg, Frank von; Waiyaki, Peter; DuPont, Herbert L.

doi:10.1086/338834

Cited by 242 publications

(174 citation statements)

References 25 publications

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“…In theory, ETEC adhesins, so called coli-surface (CS) antigens, represent a more useful target for vaccine development than toxins; however, there are over 20 known CS antigens and while a multicomponent vaccine is a possibility, the relative importance of each one varies with geography [26,86,96,97]. Some CS antigens assemble into fimbrial or fibrillar structures called colonization factor antigens (CFAs) of which there are four morphological types.…”

Section: Enteropathogenic E Colimentioning

confidence: 99%

“…This too has provided much useful data in that etiologic agents of travellers' and infantile diarrhea are often similar; however, they are occasionally not and until any region is well-studied, the degree of overlap remains a subject of conjecture [3]. Also, many travellers do not share risk factors with endemic residents [96]. Most of the published data on diarrheagenic E. coli is from studies where infected people or pathogenic strains were exported.…”

Section: Diagnosis Of Diarrheagenic E Coli: What Is It Needed and Homentioning

confidence: 99%

“…Resistance rates in many African countries, although very high, have been lower than in other parts of the developing world. In one comparative study of travellers' diarrhea bacterial isolates, strains from Mombasa, Kenya, were significantly less likely to be resistant to three or more agents than isolates from Goa, India, and Montego Bay Jamaica [96]. However, resistance in the Mombasa isolates was, at 30%, high enough to warrant concern.…”

Section: Clinically Relevant Unanswered Questions About the Biology Omentioning

confidence: 99%

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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%

Section: Diagnosis Of Diarrheagenic E Coli: What Is It Needed and Homentioning

confidence: 99%

Section: Clinically Relevant Unanswered Questions About the Biology Omentioning

confidence: 99%

See 1 more Smart Citation

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

Okeke

2009

J Infect Dev Ctries

125

103

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“…1) (Jiang et al 2002). The most effective among the fluoroquinolones (Ofloxacin) affects DNA gyrase which is critical for nucleic acid replication (Drlica and Zhao 1997).…”

Section: Resultsmentioning

confidence: 99%

Antibiotic resistance and genetic diversity in water-borne Enterobacteriaceae isolates from recreational and drinking water sources

Kumar

Tripathi

Garg

2012

Int. J. Environ. Sci. Technol.

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A total of 240 water-borne bacteria including 72 Escherichia coli, 83 Enterobacter, 30 Klebsiella, 36 Salmonella and 19 Shigella spp. isolates from drinking and recreational water sources were assessed for antibiotic resistance and genetic diversity. Escherichia coli (88.89 %) and species of Enterobacter (86.75 %), Klebsiella (83.33 %) and Salmonella (100 %) were resistant to cefadroxil, while [94 % Shigella spp. were resistant to cefaclor and cefuroxime. Ofloxacin was the most effective antibiotic against isolates of all the genera. Multiple antibiotic resistance index identified dug well, pond and piped water supplies as high risk sources of enteric pathogens. Random amplified polymorphic DNA analysis and restriction fragment length polymorphism of amplified 16S rRNA gene were studied for genetic relatedness of Enterobacteriaceae isolates. Primer P1254 identified 10, 16, 4, 4 and 1 distinct random amplified polymorphic DNA group(s) of E. coli, Enterobacter, Klebsiella, Salmonella and Shigella species, respectively. Unlike random amplified polymorphic DNA, restriction fragment length polymorphism using AluI and HaeIII could not segregate isolates in different genetic profiles. 16S rRNA gene of three Enterobacter spp. strains from different sources with similar restriction fragment length polymorphism but different random amplified polymorphic DNA patterns was sequenced, and identified as Enterobacter hormaechei strains skg0061, 0062 and 0063. The sequence information has been submitted to GenBank (HQ322393-95). Biochemically similar but genetically diverse Enterobacteriaceae members from drinking and recreational water sources exhibited varying antibiotic sensitivity. Contamination of water sources with such multiple antibiotic-resistant enteric pathogens poses threat to human health.

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“…Enterotoxigenic Escherichia coli (ETEC) is an important cause of diarrhea among children in developing countries (28,29) and among travelers to ETEC endemic areas (18). Two virulence attributes that characterize ETEC are the colonization of the small intestine surface and the production of enterotoxins.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of enterotoxigenic Escherichia coli (ETEC) adhesion to Caco-2 cells by human milk and its immunoglobulin and non-immunoglobulin fractions

Oliveira¹,

Bessler²,

Báo³

et al. 2007

Braz. J. Microbiol.

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Enterotoxigenic Escherichia coli (ETEC) is the most common cause of diarrhea in children in developing countries and among travelers to ETEC endemic areas. ETEC diarrhea is caused by colonization of the small intestine mediated by colonization factor (CF) antigens, and subsequent elaboration of enterotoxins. Breast feeding has been related to protection against enteric infections. The protective effect of human milk can be ascribed to its immunoglobulin content, specially secretory immunoglobulin A (sIgA), and to nonimmunoglobulin components such as free oligosaccharides, glycoproteins and glycolipids. In this study we investigated the effect of whole human milk and its fractions immunoglobulin and non-immunoglobulin on the adherence of ETEC strains possessing different CFs to Caco-2 cells, as well as the ability of sIgA and free secretory component (fSC) to bind to bacterial superficial proteins. Pooled human milk from three donors were fractionated by gel filtration and analyzed by SDS-PAGE. Our results revealed that whole human milk and its proteins fractions, containing sIgA and fSC, inhibited adhesion ETEC strains harboring different colonization factors antigens. We also verified that sIgA and fSC, using immunoblotting and immunogold labeling assays, bound to some fimbrial proteins and other material present in bacterial surface. Our findings suggest that whole human milk and its fractions may contribute to protection against ETEC infections by blocking bacterial adhesion mediated by different colonization antigens.

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Prevalence of Enteric Pathogens among International Travelers with Diarrhea Acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay)

Cited by 242 publications

References 25 publications

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

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

Antibiotic resistance and genetic diversity in water-borne Enterobacteriaceae isolates from recreational and drinking water sources

Inhibition of enterotoxigenic Escherichia coli (ETEC) adhesion to Caco-2 cells by human milk and its immunoglobulin and non-immunoglobulin fractions

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