Retrospective case-control study of diffusely adhering Escherichia coli and clinical features in children with diarrhea

Poitrineau, Pascale Lacombe; Forestier, Christiane; Meyer, M.; Jallat, C; Rich, C; Malpuech, G; Champs, Christophe de

doi:10.1128/jcm.33.7.1961-1962.1995

Cited by 34 publications

(17 citation statements)

References 12 publications

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“…The first DNA probe, named daaC, was generated by Stapleton et al (413) and was a 300-bp PstI fragment of plasmid pSSS1 (daa operon), coding for part of an accessory protein of F1845 adhesin expressed by the diarrheagenic Afa/Dr DAEC C1845 strain (43). This DNA probe has been used in a large majority of the epidemiological studies of the association of Afa/Dr DAEC with diarrhea and urinary tract infections (1,5,68,112,127,130,131,141,143,152,208,209,256,257,293,329,344,364,366,367,400). Another constructed DNA probe, named drb (130), was a 260-bp PstI fragment of plasmid pIL14 (afa-1 operon) coding for the AfaE-I adhesin expressed by the uropathogenic Afa/Dr DAEC KS52 strain (243).…”

Section: Diagnosismentioning

confidence: 99%

“…Epidemiological studies conducted by use of colony blotting with the daaC DNA probe have demonstrated an age-related incidence of Afa/Dr DAEC in diarrhea in children, which apparently begins after age 2 or 3 (112,127,141,143,152,167,208,209,256,344,364). Moreover, E. coli strains expressing Afa/Dr adhesins have been found with similar frequencies in patients with diarrhea and control subjects (127,167,356).…”

Section: Diagnosismentioning

confidence: 99%

“…The incidence of diarrhea due to E. coli determined in two pediatric cohorts from a low-socioeconomic-level community in Santiago, Chile, showed that in all cohorts ETEC strains were important pathogens, EPEC strains were present during the first year of life in the newborn cohort, and DAEC strains increased with age in the age-cross-sectional cohort (256). A retrospective case-control study has shown that among children suffering from gastroenteritis in whom DAEC was present, those who were daaC positive spent significantly longer in the hospital than those who were daaC negative (344). A 1-year prospective study of hospitalized children in France, including 220 patients with diarrhea and 211 matched controls, showed that Afa/Dr DAEC was the predominant pathotype, since 30.7% were detected by their adherence pattern and 13.7% were detected with the daaC probe (127).…”

Section: Vol 18 2005mentioning

confidence: 99%

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Pathogenesis of Afa/Dr Diffusely AdheringEscherichia coli

2005

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Over the last few years, dramatic increases in our knowledge about diffusely adhering Escherichia coli (DAEC) pathogenesis have taken place. The typical class of DAEC includes E. coli strains harboring AfaE-I, AfaE-II, AfaE-III, AfaE-V, Dr, Dr-II, F1845, and NFA-I adhesins (Afa/Dr DAEC); these strains (i) have an identical genetic organization and (ii) allow binding to human decay-accelerating factor (DAF) (Afa/DrDAF subclass) or carcinoembryonic antigen (CEA) (Afa/DrCEA subclass). The atypical class of DAEC includes two subclasses of strains; the atypical subclass 1 includes E. coli strains that express AfaE-VII, AfaE-VIII, AAF-I, AAF-II, and AAF-III adhesins, which (i) have an identical genetic organization and (ii) do not bind to human DAF, and the atypical subclass 2 includes E. coli strains that harbor Afa/Dr adhesins or others adhesins promoting diffuse adhesion, together with pathogenicity islands such as the LEE pathogenicity island (DA-EPEC). In this review, the focus is on Afa/Dr DAEC strains that have been found to be associated with urinary tract infections and with enteric infection. The review aims to provide a broad overview and update of the virulence aspects of these intriguing pathogens. Epidemiological studies, diagnostic techniques, characteristic molecular features of Afa/Dr operons, and the respective role of Afa/Dr adhesins and invasins in pathogenesis are described. Following the recognition of membrane-bound receptors, including type IV collagen, DAF, CEACAM1, CEA, and CEACAM6, by Afa/Dr adhesins, activation of signal transduction pathways leads to structural and functional injuries at brush border and junctional domains and to proinflammatory responses in polarized intestinal cells. In addition, uropathogenic Afa/Dr DAEC strains, following recognition of β1 integrin as a receptor, enter epithelial cells by a zipper-like, raft- and microtubule-dependent mechanism. Finally, the presence of other, unknown virulence factors and the way that an Afa/Dr DAEC strain emerges from the human intestinal microbiota as a “silent pathogen” are discussed

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Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Vol 18 2005mentioning

confidence: 99%

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Pathogenesis of Afa/Dr Diffusely AdheringEscherichia coli

2005

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“…Diffusely adhering E. coli (DAEC) is a newly proposed pathotype of diarrheagenic E. coli based on epidemiological studies [1]. However, the enteric pathogenicity of these strains has not yet been established, while DAEC strains have been implicated as agents of diarrhea in several studies [3][4][5][6][7][8], others have not identified DAEC as a diarrheal agent [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Secreted autotransporter toxin produced by a diffusely adheringEscherichia colistrain causes intestinal damage in animal model assays

Taddei¹,

Fasano²,

Ferreira³

et al. 2005

FEMS Microbiology Letters

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Bacterial diarrheal diseases remain a major cause of morbidity and mortality in developing countries. Diffusely adhering Escherichia coli (DAEC) is a newly proposed category of diarrheagenic E. coli based on epidemiological studies. Sat, a new virulence factor of some uropathogeic Escherichia coli, was described with a vacuolating cytotoxic action in bladder and kidney tissues. In the present study, we analyzed the Sat effects, produced by a DAEC strain in rabbit ileal intestinal tissue and cultured epithelial cells. We observed enterotoxic activity in rabbit ileum tissues by Ussing chamber assays, a pronounced fluid accumulation in rabbit ileum loops with villous necrosis observed in the histopathologic examination, and morphological changes in monolayer cultures of Y1 adrenal cells. Our results suggest that DAEC strains may be involved in diarrhea.

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“…However, the relationship between Afa/Dr DAEC and diarrhea in children as a function of age has been more convincingly demonstrated in age cross-sectional studies showing an increased incidence in children Ͻ1 to 5 years of age. These studies were conducted in the United States (116), Mexico (117), and different South American countries, including Chile (118), Brazil (58,71,(119)(120)(121), Colombia (122), Peru (123)(124)(125)(126)(127), and Argentina (128), as well as in Thailand (50), Bangladesh (129), Japan (119), New Caledonia (45,63,130), various places in Africa (131)(132)(133), and European countries, includ-ing the United Kingdom (134) and France (135,136). In Afa/Dr DAEC strains isolated from stools of children, the sat gene has been found in almost half of the diarrhea-associated Afa/DrDAEC strains and was not present in all the non-diarrhea-associated Afa/ DrDAEC strains (137).…”

Section: Diarrheamentioning

confidence: 99%

Pathogenesis of Human Diffusely Adhering Escherichia coli Expressing Afa/Dr Adhesins (Afa/Dr DAEC): Current Insights and Future Challenges

Servin

2014

Clin Microbiol Rev

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SUMMARY The pathogenicity and clinical pertinence of diffusely adhering Escherichia coli expressing the Afa/Dr adhesins (Afa/Dr DAEC) in urinary tract infections (UTIs) and pregnancy complications are well established. In contrast, the implication of intestinal Afa/Dr DAEC in diarrhea is still under debate. These strains are age dependently involved in diarrhea in children, are apparently not involved in diarrhea in adults, and can also be asymptomatic intestinal microbiota strains in children and adult. This comprehensive review analyzes the epidemiology and diagnosis and highlights recent progress which has improved the understanding of Afa/Dr DAEC pathogenesis. Here, I summarize the roles of Afa/Dr DAEC virulence factors, including Afa/Dr adhesins, flagella, Sat toxin, and pks island products, in the development of specific mechanisms of pathogenicity. In intestinal epithelial polarized cells, the Afa/Dr adhesins trigger cell membrane receptor clustering and activation of the linked cell signaling pathways, promote structural and functional cell lesions and injuries in intestinal barrier, induce proinflammatory responses, create angiogenesis, instigate epithelial-mesenchymal transition-like events, and lead to pks -dependent DNA damage. UTI-associated Afa/Dr DAEC strains, following adhesin-membrane receptor cell interactions and activation of associated lipid raft-dependent cell signaling pathways, internalize in a microtubule-dependent manner within urinary tract epithelial cells, develop a particular intracellular lifestyle, and trigger a toxin-dependent cell detachment. In response to Afa/Dr DAEC infection, the host epithelial cells generate antibacterial defense responses. Finally, I discuss a hypothetical role of intestinal Afa/Dr DAEC strains that can act as “silent pathogens” with the capacity to emerge as “pathobionts” for the development of inflammatory bowel disease and intestinal carcinogenesis.

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Retrospective case-control study of diffusely adhering Escherichia coli and clinical features in children with diarrhea

Cited by 34 publications

References 12 publications

Pathogenesis of Afa/Dr Diffusely AdheringEscherichia coli

Pathogenesis of Afa/Dr Diffusely AdheringEscherichia coli

Secreted autotransporter toxin produced by a diffusely adheringEscherichia colistrain causes intestinal damage in animal model assays

Pathogenesis of Human Diffusely Adhering Escherichia coli Expressing Afa/Dr Adhesins (Afa/Dr DAEC): Current Insights and Future Challenges

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