Epidemiological survey of the enteropathogenic Escherichia coli isolated from children with diarrhoea

Escherichia coli was isolated in 382 (94 per cent) of 406 children from 0 to 3 years of age who had been hospitalized for diarrhoea at the Hospital Municipal Salles Neto, Rio de Janeiro. Enteropathogenic Escherichia coli strains were isolated in 67 samples (18 per cent), distributed among the serogroups that were tested as follows: 0111 (33 per cent); 0125 (19 per cent); 0126, 0127, and 0142 (9 per cent); 0128 and 0119 (8 per cent); 055 (5 per cent); 0114 (2 per cent). No strains of EPEC belonging to serogroups 086, 0126, and 0158 were found. Among the samples in which EPEC strains were isolated, 15.0 per cent were children living in dwellings which had piped systems of water supply and drain, whereas with regard to those living in houses without such facilities, this percentage raised to 24 per cent. Similar results were found when the availability of water supply of drainage were taken separately.     

Enterotoxigenic Escherichia coli and other enteropathogens in paediatric diarrhoea in Addis Ababa

This study was performed during two weeks among 86 paediatric outpatients of poor socio-economic background. A control group comprised 60 healthy children. Enterotoxigenic Escherichia coli (ETEC) was the most common diarrhoeal agent isolated (26%). Strains of ETEC producing heat-labile (LT) only or LT and heat-stable (ST) enterotoxin were isolated from 11% each and ETEC producing ST only from 4% of the patients. ETEC was also found not infrequently among controls (10%). ETEC with O-antigens 78, 6 and 8 were shown to harbour colonization factors. Enterotoxigenic bacteria were found as contaminants in 5 of 24 feeding bottles investigated. Enteropathogenic Escherichia coli (EPEC) and Shigella species were isolated from 8% each and rotavirus from 24% of the patients. Twelve patients infected with ETEC only were compared to 66 patients not infected with ETEC. Patients infected with ETEC had a relatively mild disease and it was not possible by clinical findings to distinguish those patients infected with ETEC, LT and/or ST producing, carrying or not carrying colonization factors from those infected with other agents. This study underlines the need for extended studies of the clinical significance of ETEC infection in developing countries.     

Escherichia coli diarrhoea in children

Summary Bacteriological examination of stools from 90 cases of diarrhoea in children up to the age of 5 years, has been carried out to determine the incidence and occurrence ofEsch. coli, both alone and in association with other intestinal bacterial.Esch. col. were isolated in 23 cases. 12 serotypes have been found, and only one of them (055) belonged to the recognised enteropathogenic variety. Amongst the rest 09: K (A): H-occurred frequently. The complete absence of Shigella and Salmonella organisms was observed in the present series. From the Central Research Institute, Kasauli and the Department of Pediatrics, Medical College and Rajendra Hospital, Patiala.     

Antibiogram of enteropathogenic e. coli strains in infantile diarrhoea

Antibiotic sensitivity of 65 strains of enteropathogenic E. Coli, isolated from 194 cases of infantile diarrhoea was done. All the three serotypes 026, 086 and 055 Were found to be sensitive to garamycin and furazoladine, while most of these were resistant to chloramphenicol. 026 and 086 strains were resistant to neomycin also whereas it was effective against 055.     

Childhood diarrhoea and its association with enteropathogenic Esch. coli

Summary and Conclusions Six hundred and twenty children with diarrhoea were studied. The maximum number of patients were seen in the age group of 7 to 12 months, i.e., an incidence of 46%. 75% of diarrhoea patients were below the age of one year. The peak incidence (52%) of diarrhoea was observed during the months of May to August. 64.5% of the patients had varying degrees of undernutrition associated with diarrhoea. In 71 children, bacteriological studies were done. Bacterial pathogens were isolated only in 29% of the stool samples. EnteropathogenicEsch. coli was the commonest pathogen isolated (21.1%). The serotypes frequently isolated were 086, 0119 012o and 0128. 0111 and 055 serotypes ofEsch. coli were not detected in the present series. It is suggested that approximately one-third of cases of diarrhoea in children are due to pathogenic organisms. From the Departments of Pediatrics and Microbiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry-6.     

Heat stable enterotoxin produced by Escherichia coli in acute diarrhoea.

We screened 569 children with acute onset diarrhoea from five Italian towns for heat stable enterotoxin produced by Escherichia coli. We compared an enzyme linked immunoabsorbent assay (ELISA) with the standard suckling mouse assay for detection of the enterotoxin. A total of 31 (5.4%) children were found who had strains of E coli that produced heat stable enterotoxin: 26 strains were positive in both tests, four only in the suckling mouse assay, and one only in the ELISA. Compared with the suckling mouse assay the sensitivity of the ELISA was 87% and the specificity was 99.8%. The mean age of the children with E coli that produced heat stable enterotoxin was 22 months. Fifteen (48%) of the children had ingested potentially contaminated food and five (17%) had a previous contact with someone with diarrhoea. The clinical picture was milder than that described in developing countries. Faecal osmolality and the osmolal gap were consistent with a secretory diarrhoea in 12 out of 15 (80%) of these children. The mean duration of the diarrhoea was five days. Heat stable enterotoxin produced by E coli is a common cause of mild diarrhoeal illness in Italian children.     

Trimethoprim-resistant Shigella and enterotoxigenic Escherichia coli strains in children in Thailand

The percentage of Shigella and enterotoxigenic Escherichia coli (ETEC) strains resistant to trimethoprim (TMP)-sulfamethoxazole isolated from children with diarrhea at the outpatient department of the Children's Hospital in Bangkok increased from 3 and 0%, respectively, in 1982 to 29% and 25% in 1986. One hundred thirty-nine Shigella and 22 ETEC strains resistant to greater than 1024 micrograms/ml of trimethoprim (TMPr) isolated from children with diarrhea in Bangkok in 1984 and 1985 were analyzed for the presence of type I, II and III plasmid-specific dihydrofolate reductase (DHFR) genes. Thirty-two percent (45 of 139) of TMPR Shigella had genes encoding type II and 9% (13 of 139) had genes encoding type I DHFR genes. Fifty percent (11 of 22) of TMPR ETEC had type II and 14% (3 of 22) had type I DHFR genes. Plasmids encoding DHFR were identified by the Southern technique in 24% (14 of 58) of Shigella and 1 of 14 ETEC that contained genes encoding DHFR. Plasmids coding for type II DHFR were transferred to E. coli K12 by conjugation from 13 of 14 Shigella and a plasmid coding for type I DHFR was transferred from the single ETEC containing a plasmid coding for type I DHFR. Genes coding for DHFR were presumably situated on the chromosome in 76% (44 of 58) of Shigella and 93% (13 of 14) of ETEC that contained genes encoding DHFR. Since 58% (81 of 139) of TMPR Shigella and 36% (8 of 22) of TMPR ETEC strains examined did not contain genes encoding type I, II or III DHFR, high level TMP resistance was presumably caused by other types of DHFR genes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Lactobacillus plantarum inhibits the intestinal epithelial migration of neutrophils induced by enteropathogenic Escherichia coli

BACKGROUND: Lactobacillus plantarum is a Gram-positive bacillus known for its effect as a probiotic agent. The goal of the study was to determine whether L. plantarum is capable of inhibiting the transepithelial neutrophil migration induced by enteropathogenic Escherichia coli (EPEC). METHODS: Cultured intestinal epithelial T-84 cell monolayers were rapidly infected with EPEC. L. plantarum or culture supernatants were added to the monolayers before and after the infection. Indium-labeled neutrophils were added to the basolateral side of inverted monolayers. After 150-minute incubation, radioactivity of the neutrophils that migrated in the physiologic direction was assayed, and the number of migrating neutrophils was calculated. L. plantarum was also added to the monolayers before and after EPEC infection, and the number of adherent EPEC was determined by plate counting. RESULTS: EPEC-induced neutrophil migration and EPEC binding to monolayers were inhibited by viable L. plantarum but only when added to the monolayers before EPEC. Culture supernatants failed to inhibit the neutrophil migration. CONCLUSIONS: These results suggest that L. plantarum is beneficial in inhibiting neutrophil migration induced by EPEC, but only when preincubated with host epithelia. Rather than an indirect effect through a secreted substance produced by the probiotic agent, its effect is direct and requires the presence of the bacterium.     

Molecular epidemiology of Escherichia coli diarrhoea in children in Tehran

From July to December 2003, four categories of diarrhoeagenic Escherichia coli were investigated in Tehranian children with acute diarrhoea. Stool specimens of children under 5 years of age with diarrhoea (n=200) and matched controls (n=200) without diarrhoea were studied for the presence of entero-aggregative (EAEC), enteropathogenic (EPEC), enterotoxigenic (ETEC) and Shiga toxin-producing (STEC) E. coli by PCR identification of six different genes of diarrhoeagenic E. coli. STEC isolates were typed by O157 and H7 antisera. EAEC was the most prevalent category and was found in 24% of patients with diarrhoea and 8% of controls (p<0.0001). ETEC was isolated in 15.5% of patients with diarrhoea but not in any controls ( p<0.0001), STEC in 15% of patients and 2% of controls (p<0.0001) and EPEC in 6% of patients and 5% of controls. Of 30 STEC isolates from patients with diarrhoea, seven were O157:H7 and 23 were non-O157:H7.     

Heat-stable enterotoxigenic Escherichia coli and necrotizing enterocolitis: lack of an association.

During an outbreak of diarrhea in a special care nursery caused by heat-stable enterotoxigenic Escherichia coli (serotype 078:H11:K80), nine (4.3%) of the 205 infants in the nursery developed necrotizing enterocolitis. Cases of necrotizing enterocolitis were not significantly more common in infants colonized or infected with these organisms; heat-stable enterotoxigenic E. coli was isolated from 5(56%) of nine cases of necrotizing ecterocolitis and from 27(38%) of the 71 infants without necrotizing enterocolitis who were also cultured. Our findings suggest that caution should be taken in implicating enterotoxigenic E. coli as a cause of necrotizing enterocolitis.