The significance of enteroaggregative Escherichia coli in the etiology of hospitalized diarrhoea in Calcutta, India and the demonstration of a new honey-combed pattern of aggregative adherence

Abstract

Previous studies have identified enteroadherent Escherichia coli that exhibit localized adherence, diffuse adherence and atypical diffuse adherence as diarrhoeagenic agents associated with infantile diarrhoea in Calcutta, India. In this study, a DNA probe specific for enteroaggregative adherence was used to determine the etiological significance of enteroaggregative E. coli in the causation of diarrhoea. From a total of 330 strains of E. coli recovered from 159 cases of acute secretory diarrhoea and 174 cases of invasive diarrhoea, 20 strains hybridized with the probe, whereas of the 25 E. coli strains recovered from 25 healthy controls only 1 strain hybridized with the probe. Of the 21 probe positive strains, 19 adhered to HeLa cells in the typical stacked-brick pattern while 2 strains recovered from 2 cases of secretory diarrhoea adhered to the glass surface in a hitherto undescribed formation which we have termed, based on the appearance, as the honey-comb pattern. The enteroaggregative E. coli strains identified in this study did not produce any conventional enterotoxins and were significantly associated with patients with secretory diarrhoea (10.7%) than with invasive diarrhoea (1.7%). The results of this study indicate that enteroaggregative E. coli play a causal role in acute secretory diarrhoea in this part of the world which lends credence to the involvement of a potent toxin in the pathogenesis of EAggEC mediated infections.

Virulence Characteristics and Molecular Epidemiology of Enteroaggregative Escherichia coli Isolates from Hospitalized Diarrheal Patients in Kolkata, India

“…The incidence rate of EAEC among diarrheal patients in our study was 6.6%, which closely matches that found in a previous hospital-based surveillance study conducted in Kolkata (39). However, the detection rate was 9.8% among pediatric cases (12).…”

“…Enteroaggregative Escherichia coli (EAEC) has been implicated as an emerging cause of persistent and acute diarrhea in both developing and developed countries (5,18,21,26,32,39). Several epidemiological investigations of diarrhea suggest that EAEC is an important etiologic agent (25,31,33).…”

Diarrheagenic Escherichia coli pathotypes isolated from children with diarrhea in the Federal Capital Territory Abuja, Nigeria

“…In this study, the detection rate for EAEC was 2.0% and its occurrence was limited to children under 36 months of age. This observed rate is in sharp contrast with reported low and high detection rates of 5%-6% and 20%-38% in many studies from developing countries [4,41,42]. Furthermore, the result of the present study disagrees with the significant association of EAEC infection with children 0-2 months of age but not with older infants as reported from Venezuela [43].…”

Susceptibility patterns of enteroaggregative Escherichia coli associated with traveller's diarrhoea: emergence of quinolone resistance

“…Another area of high prevalence found in the present study was the Indian subcontinent (15%). The importance of EAggEC as a cause of diarrhoea in children in this geographical area has been shown in several studies [1,28,29].…”