1887

Abstract

The aim of the present study was to investigate the relative contribution of enteropathogenic (EPEC) as a cause of infectious diarrhoea in Norwegian children. Data from faecal specimens from children <2 years old with diarrhoea during the year 2001 were analysed. isolates with the attaching and effacing genotype ( ) were examined for the presence of the bundle-forming pilus () and Shiga toxin genes by PCR, and for genetic relatedness by PFGE. During the 1-year period, 598 specimens from 440 patients <2 years old were analysed. Potential enteric pathogens were identified in 124 patients (28.2 %). EPEC was the most frequently identified agent (44 patients), followed by rotavirus (41 patients), (17 patients) and adenovirus (17 patients). All other agents were detected in five patients or less. Only one of the isolates was classified as typical EPEC ( ). Among the 43 isolates that were classified as atypical EPEC ( ), eight strains belonged to EPEC serogroups, whereas the majority of strains ( = 35) were not agglutinated by EPEC antisera. None of the EPEC isolates were genetically related. This study demonstrates that atypical EPEC of non-EPEC serogroups is highly prevalent among Norwegian children with diarrhoea.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.05287-0
2003-11-01
2024-12-09
Loading full text...

Full text loading...

/deliver/fulltext/jmm/52/11/JM521112.html?itemId=/content/journal/jmm/10.1099/jmm.0.05287-0&mimeType=html&fmt=ahah

References

  1. Avendaño P, Matson D. O, Long J, Whitney S, Matson C. C, Pickering L. K. 1993; Costs associated with office visits for diarrhea in infants and toddlers. Pediatr Infect Dis J 12:897–902 [CrossRef]
    [Google Scholar]
  2. Bokete T. N, Whittam T. S, Wilson R. A, Clausen C. R, O'Callahan C. M, Moseley S. L, Fritsche T. R, Tarr P. I. 1997; Genetic and phenotypic analysis of Escherichia coli with enteropathogenic characteristics isolated from Seattle children. J Infect Dis 175:1382–1389 [CrossRef]
    [Google Scholar]
  3. Brian M. J, Frosolono M, Murray B. E, Miranda A, Lopez E. L, Gomez H. F, Cleary T. G. 1992; Polymerase chain reaction for diagnosis of enterohemorrhagic Escherichia coli infection and hemolytic-uremic syndrome. J Clin Microbiol 30:1801–1806
    [Google Scholar]
  4. Caeiro J. P, Mathewson J. J, Smith M. A, Jiang Z. D, Kaplan M. A, Dupont H. L. 1999; Etiology of outpatient pediatric nondysenteric diarrhea: a multicenter study in the United States. Pediatr Infect Dis J 18:94–97 [CrossRef]
    [Google Scholar]
  5. Forestier C, Meyer M, Favre-Bonte S, Rich C, Malpuech G, Le Bouguenec C, Sirot J, Joly B, De Champs C. 1996; Enteroadherent Escherichia coli and diarrhea in children: a prospective case-control study. J Clin Microbiol 34:2897–2903
    [Google Scholar]
  6. Gannon V. P, Rashed M, King R. K, Thomas E. J. 1993; Detection and characterization of the eae gene of Shiga-like toxin-producing Escherichia coli using polymerase chain reaction. J Clin Microbiol 31:1268–1274
    [Google Scholar]
  7. Giammanco A, Maggio M, Giammanco G, Morelli R, Minelli F, Scheutz F, Caprioli A. 1996; Characteristics of Escherichia coli strains belonging to enteropathogenic E.coli serogroups isolated in Italy from children with diarrhea. J Clin Microbiol 34:689–694
    [Google Scholar]
  8. Gunzburg S. T, Tornieporth N. G, Riley L. W. 1995; Identification of enteropathogenic Escherichia coli by PCR-based detection of the bundle-forming pilus gene. J Clin Microbiol 33:1375–1377
    [Google Scholar]
  9. Hedberg C. W, Savarino S. J, Besser J. M. 7 other authors 1997; An outbreak of foodborne illness caused by Escherichia coli O39 : NM, an agent not fitting into the existing scheme for classifying diarrheogenic E.coli . J Infect Dis 176:1625–1628 [CrossRef]
    [Google Scholar]
  10. Keskimäki M, Eklund M, Pesonen H, Heiskanen T, Siitonen A. 2001; EPEC, EAEC and STEC in stool specimens: prevalence and molecular epidemiology of isolates.The Study Group. Diagn Microbiol Infect Dis 40:151–156 [CrossRef]
    [Google Scholar]
  11. Knutton S, Phillips A. D, Smith H. R, Gross R. J, Shaw R, Watson P, Price E. 1991; Screening for enteropathogenic Escherichia coli in infants with diarrhea by the fluorescent-actin staining test. Infect Immun 59:365–371
    [Google Scholar]
  12. Knutton S, Shaw R, Phillips A. D, Smith H. R, Willshaw G. A, Watson P, Price E. 2001; Phenotypic and genetic analysis of diarrhea-associated Escherichia coli isolated from children in the United Kingdom. J Pediatr Gastroenterol Nutr 33:32–40 [CrossRef]
    [Google Scholar]
  13. Levine M. M, Edelman R. 1984; Enteropathogenic Escherichia coli of classic serotypes associated with infant diarrhea: epidemiology and pathogenesis. Epidemiol Rev 6:31–51
    [Google Scholar]
  14. Levine M. M, Nataro J. P, Karch H, Baldini M. M, Kaper J. B, Black R. E, Clements M. L, O'Brien A. D. 1985; The diarrheal response of humans to some classic serotypes of enteropathogenic Escherichia coli is dependent on a plasmid encoding an enteroadhesive factor. J Infect Dis 152:550–559 [CrossRef]
    [Google Scholar]
  15. Morelli R, Baldassarri L, Falbo V, Donelli G, Caprioli A. 1994; Detection of enteroadherent Escherichia coli associated with diarrhoea in Italy. J Med Microbiol 41:399–404 [CrossRef]
    [Google Scholar]
  16. Nataro J. P, Kaper J. B. 1998; Diarrheagenic Escherichia coli . Clin Microbiol Rev 11:142–201
    [Google Scholar]
  17. Paciorek J. 2002; Virulence properties of Escherichia coli faecal strains isolated in Poland from healthy children and strains belonging to serogroups O18, O26, O44, O86, O126 and O127 isolated from children with diarrhoea. J Med Microbiol 51:548–556
    [Google Scholar]
  18. Pedroso M. Z, Freymuller E, Trabulsi L. R, Gomes T. A. 1993; Attaching-effacing lesions and intracellular penetration in HeLa cells and human duodenal mucosa by two Escherichia coli strains not belonging to the classical enteropathogenic E.coli serogroups. Infect Immun 61:1152–1156
    [Google Scholar]
  19. Pelayo J. S, Scaletsky I. C. A, Pedroso M. Z, Sperandio V, Girón J. A, Frankel G, Trabulsi L. R. 1999; Virulence properties of atypical EPEC strains. J Med Microbiol 48:41–49 [CrossRef]
    [Google Scholar]
  20. Rademaker C. M. A, Fluit A. C, Jansze M, Jansen W. H, Glerum J. H, Verhoef J. 1993; Frequency of enterovirulent Escherichia coli in diarrhoeal disease in The Netherlands. Eur J Clin Microbiol Infect Dis 12:93–97 [CrossRef]
    [Google Scholar]
  21. Scaletsky I. C. A, Michalski J, Kaper J. 2002; Identification of novel adherence genes found in atypical enteropathogenic Escherichia coli (EPEC) strains. In Abstract Book of the 3rd International EPEC Symposium abstract no. S2.5: October 2002 Puerto Vallarta; Mexico:
    [Google Scholar]
  22. Schoolnik G. K. 1993; PCR detection of Shigella species and enteroinvasive Escherichia coli . In Diagnostic Molecular MicrobiologyPrinciples and Applications pp 277–281 Edited by Persing D. H., Smith T. F., Tenover F. C., White T. J. Washington, DC: American Society for Microbiology;
    [Google Scholar]
  23. Scotland S. M, Smith H. R, Said B, Willshaw G. A, Cheasty T, Rowe B. 1991; Identification of enteropathogenic Escherichia coli isolated in Britain as enteroaggregative or as members of a subclass of attaching-and-effacing E.coli not hybridising with the EPEC adherence-factor probe. J Med Microbiol 35:278–283 [CrossRef]
    [Google Scholar]
  24. Scotland S. M, Smith H. R, Cheasty T, Said B, Willshaw G. A, Stokes N, Rowe B. 1996; Use of gene probes and adhesion tests to characterise Escherichia coli belonging to enteropathogenic serogroups isolated in the United Kingdom. J Med Microbiol 44:438–443 [CrossRef]
    [Google Scholar]
  25. Svenungsson B, Lagergren Å, Ekwall E, Evengård B, Hedlund K. O, Kärnell A, Löfdahl S, Svensson L, Weintraub A. 2000; Enteropathogens in adult patients with diarrhea and healthy control subjects: a 1-year prospective study in a Swedish clinic for infectious diseases. Clin Infect Dis 30:770–778 [CrossRef]
    [Google Scholar]
  26. Tenover F. C, Arbeit R. D, Goering R. V, Mickelsen P. A, Murray B. E, Persing D. H, Swaminathan B. 1995; Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239
    [Google Scholar]
  27. Tompkins D. S, Hudson M. J, Smith H. R. 8 other authors 1999; A study of infectious intestinal disease in England: microbiological findings in cases and controls. Commun Dis Public Health 2:108–113
    [Google Scholar]
  28. Trabulsi L. R, Keller R, Tardelli Gomes T. A. 2002; Typical and atypical enteropathogenic Escherichia coli . Emerg Infect Dis 8:508–513 [CrossRef]
    [Google Scholar]
  29. Vallance B. A, Finlay B. B. 2000; Exploitation of host cells by enteropathogenic Escherichia coli . Proc Natl Acad Sci U S A 97:8799–8806 [CrossRef]
    [Google Scholar]
  30. Vieira M. A. M, Andrade J. R. C, Trabulsi L. R, Rosa A. C. P, Dias A. M. G, Ramos S. R. T. S, Frankel G, Gomes T. A. T. 2001; Phenotypic and genotypic characteristics of Escherichia coli strains of non-enteropathogenic E.coli (EPEC) serogroups that carry eae and lack the EPEC adherence factor and Shiga toxin DNA probe sequences. J Infect Dis 183:762–772 [CrossRef]
    [Google Scholar]
  31. Viljanen M. K, Peltola T, Junnila S. Y, Olkkonen L, Järvinen H, Kuistila M, Huovinen P. 1990; Outbreak of diarrhoea due to Escherichia coli O111 : B4 in schoolchildren and adults: association of Vi antigen-like reactivity. Lancet 336:831–834 [CrossRef]
    [Google Scholar]
  32. World Health Organization 1987; Programme for control of diarrheal diseases (CDD/83.3 Rev1). In Manual for Laboratory Investigations of Acute Enteric Infections p– 27 Geneva: WHO;
    [Google Scholar]
  33. World Health Organization 1995; Bridging the Gaps . The World Health Report (http://www.who.int/whr2001/2001/archives/1995/ index.htm)
  34. World Health Organization 2002; Reducing Risks, Promoting Healthy Life . The World Health Report (http://www.who.int/whr/en/)
  35. Yatsuyanagi J, Saito S, Sato H, Miyajima Y, Amano K, Enomoto K. 2002; Characterization of enteropathogenic and enteroaggregative Escherichia coli isolated from diarrheal outbreaks. J Clin Microbiol 40:294–297 [CrossRef]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.05287-0
Loading
/content/journal/jmm/10.1099/jmm.0.05287-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error