The prevalence and virulence characteristics of enteroaggregative at an urgent-care clinic in the USA: a case–control study Free

Abstract

This case–control study examined the prevalence of enteroaggregative (EAEC), its genes and elicited inflammatory response, and the stool characteristics of adult patients with and without acute diarrhoeal illness presenting to an urgent-care clinic in the USA. A total of 1004 individual stool specimens (253 from patients with acute diarrhoeal illness and 751 from patients without diarrhoeal illness) were collected between 1 June 2003 and 30 June 2008. EAEC was identified as the sole cause of acute diarrhoeal illness in 6 % (=15) of patients and in 2 % (=15) without diarrhoeal illness. Control patients (=15) were similar to case patients (=15) for age, gender and co-morbidities. The EAEC genes , , , and/or were identified more frequently in case patients compared with control patients ( <0.05). -positive EAEC elicited higher levels of interleukin (IL)-1ra, IL-6, IL-8 and tumour necrosis factor- compared with -negative EAEC during co-incubation with HCT-8 cells. Patients with EAEC diarrhoea and isolates with the genes , , , or had stools characterized by gross mucus and the presence of faecal leukocytes ( <0.05). These results indicate that EAEC is a potential cause of acute diarrhoeal illness affecting patients presenting to an acute-care clinic in the USA and suggest that , aa, , and may be markers for virulence.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.005793-0
2009-04-01
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/jmm/58/4/403.html?itemId=/content/journal/jmm/10.1099/jmm.0.005793-0&mimeType=html&fmt=ahah

References

  1. Adachi J. A., Jiang Z. D., Mathewson J. J., Verenka M. P., Thompson S., Martinez-Sandoval F., Steffen R., Ericsson C. D., DuPont H. L. 2001; Enteroaggregative Escherichia coli as a major etiologic agent in traveler's diarrhea in 3 regions of the world. Clin Infect Dis 32:1706–1709 [CrossRef]
    [Google Scholar]
  2. Behrens M., Sheikh J., Nataro J. P. 2002; Regulation of the overlapping pic / set locus in Shigella flexneri and enteroaggregative Escherichia coli . Infect Immun 70:2915–2925 [CrossRef]
    [Google Scholar]
  3. Borish L. C., Steinke J. W. 2003; Cytokines and chemokines. J Allergy Clin Immunol 111:S460–S475 [CrossRef]
    [Google Scholar]
  4. Bouckenooghe A. R., Dupont H. L., Jiang Z. D., Adachi J., Mathewson J. J., Verenkar M. P., Rodrigues S., Steffen R. 2000; Markers of enteric inflammation in enteroaggregative Escherichia coli diarrhea in travelers. Am J Trop Med Hyg 62:711–713
    [Google Scholar]
  5. Cho S. H., Shin H. H., Choi Y. H., Park M. S., Lee B. K. 2008; Enteric bacteria isolated from acute bacterial diarrheal patients in the republic of Korea between the year 2004 and 2006. J Microbiol 46:325–330 [CrossRef]
    [Google Scholar]
  6. Cohen M. B., Nataro J. P., Bernstein D. I., Hawkins J., Roberts N., Staat M. A. 2005; Prevalence of diarrheagenic Escherichia coli in acute childhood enteritis: a prospective controlled study. J Pediatr 146:54–61 [CrossRef]
    [Google Scholar]
  7. Donnenberg M. S., Nataro J. P. 1995; Methods for studying adhesion of diarrheagenic Escherichia coli . Methods Enzymol 253:324–336
    [Google Scholar]
  8. Greenberg D. E., Jiang Z. D., Steffen R., Verenker M. P., DuPont H. L. 2002; Markers of inflammation in bacterial diarrhea among travelers, with a focus on enteroaggregative Escherichia coli pathogenicity. J Infect Dis 185:944–949 [CrossRef]
    [Google Scholar]
  9. Harrington S. M., Strauman M. C., Abe C. M., Nataro J. P. 2005; Aggregative adherence fimbriae contribute to the inflammatory response of epithelial cells infected with enteroaggregative Escherichia coli . Cell Microbiol 7:1565–1578 [CrossRef]
    [Google Scholar]
  10. Huang D. B., Okhuysen P. C., Jiang Z. D., DuPont H. L. 2004; Enteroaggregative Escherichia coli : an emerging enteric pathogen. Am J Gastroenterol 99:383–389 [CrossRef]
    [Google Scholar]
  11. Huang D. B., Nataro J. P., DuPont H. L., Kamat P. P., Mhatre A. D., Okhuysen P. C., Chiang T. 2006; Enteroaggregative Escherichia coli is a cause of acute diarrheal illness: a meta-analysis. Clin Infect Dis 43:556–563 [CrossRef]
    [Google Scholar]
  12. Huang D. B., Mohamed J. A., Nataro J. P., DuPont H. L., Jiang Z. D., Okhuysen P. C. 2007; Virulence characteristics and the molecular epidemiology of enteroaggregative Escherichia coil isolated from travellers to developing countries. J Med Microbiol 56:1386–1392 [CrossRef]
    [Google Scholar]
  13. Jiang Z. D., Smith M. A., Kelsey K. E., Cortez C. P., DuPont H. L., Mathewson J. J. 1994; Effect of storage time and temperature on fecal leukocytes and occult blood in the evaluation of travelers' diarrhea. J Travel Med 1:184–186 [CrossRef]
    [Google Scholar]
  14. Jiang Z. D., Greenberg D. E., Nataro J. P., Steffen R., DuPont H. L. 2002; Rate of occurrence and pathogenic effect of enteroaggregative Escherichia coli virulence factors in international travelers. J Clin Microbiol 40:4185–4190 [CrossRef]
    [Google Scholar]
  15. Kojima S., Kageyama T., Fukushi S., Hoshino F. B., Shinohara M., Uchida K., Natori K., Takeda N., Katayama K. 2002; Genogroup-specific PCR primers for detection of Norwalk-like viruses. J Virol Methods 100:107–114 [CrossRef]
    [Google Scholar]
  16. Mohamed J. A., Huang D. B., Jiang Z. D., DuPont H. L., Nataro J. P., Belkind-Gerson J., Okhuysen P. C. 2007; Association of putative enteroaggregative Escherichia coli virulence genes and biofilm production in isolates from travelers to developing countries. J Clin Microbiol 45:121–126 [CrossRef]
    [Google Scholar]
  17. Nataro J. P. 2005; Enteroaggregative Escherichia coli pathogenesis. Curr Opin Gastroenterol 21:4–8
    [Google Scholar]
  18. Nataro J. P., Mai V., Johnson J., Blackwelder W. C., Heimer R., Tirrell S., Edberg S. C., Braden C. R., Glenn Morris J. Jr, Hirshon J. M. 2006; Diarrheagenic Escherichia coli infection in Baltimore, Maryland, and New Haven, Connecticut. Clin Infect Dis 43:402–407 [CrossRef]
    [Google Scholar]
  19. Pereira A. L., Ferraz L. R., Silva R. S. N., Giugliano L. G. 2007; Enteroaggregative Escherichia coli virulence markers: positive association with distinct clinical characteristics and segregation into 3 enteropathogenic E. coli serogroups. J Infect Dis 195:366–374 [CrossRef]
    [Google Scholar]
  20. Scavia G., Staffolani M., Fisichella S., Striano G., Colletta S., Ferri G., Escher M., Minelli F., Capriol F. 2008; Enteroaggregative Escherichia coli associated with a foodborne outbreak of gastroenteritis. J Med Microbiol 57:1141–1146 [CrossRef]
    [Google Scholar]
  21. Vila J., Vargas M., Henderson I. R., Gascon J., Nataro J. P. 2000; Enteroaggregative Escherichia coli virulence factors in traveler's diarrhea strains. J Infect Dis 182:1780–1783 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.005793-0
Loading
/content/journal/jmm/10.1099/jmm.0.005793-0
Loading

Data & Media loading...

Most cited Most Cited RSS feed