To assess the role of enterotoxigenic (ETEC) in infantile diarrhoea, 482 children with diarrhoea and 103 healthy controls, from three localities of Galicia, northwestern Spain, were investigated between 1985 and 1988. Rotavirus (37.3%) and spp. (12.8%) were the most common causal agents, followed by ETEC (3.9%), (2.3%), spp. (0.9%) and (0.5%). ETEC were significantly more frequently isolated from children with diarrhoea who were under 1 month of age (26.5%) than from older diarrhoeic children (2.2%) (p <0.001) or from healthy children who were under 1 month of age (0%) (p < 0.05). Among children who harboured ETEC, five of the nine children under 1 month of age developed diarrhoea in hospital, whereas none of the 10 children over 1 month of age did so. Seventeen ETEC isolates produced heat-stable enterotoxin (STa) only, four produced only heat-labile enterotoxin (LT), and two produced both toxins. Colonisation factor antigens CFA/I and CFA/II were detected in 11 (55.0%) of the 20 ETEC isolates that remained enterotoxigenic after maintenance in the laboratory. Most ETEC isolates belonged to serotypes O153:K-:H45 (nine STa CFA/I isolates), O27:K-: H7 (three STa isolates) or O6:K15:H16 (two LT STa CFA/II isolates). Our results suggest that ETEC constitute an important cause of neonatal diarrhoea in this part of Spain.


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