Attaching and effacing Escherichia coli isolates from Danish children: clinical significance and microbiological characteristics

Clin Microbiol Infect. 2007 Sep;13(9):863-72. doi: 10.1111/j.1469-0691.2007.01773.x.

Abstract

This study describes the prevalence, clinical manifestations and microbiological characteristics of attaching and effacing Escherichia coli isolates, i.e., enteropathogenic E. coli (EPEC) belonging to the classical EPEC serotypes, non-EPEC attaching and effacing E. coli (A/EEC) and verocytotoxin-producing E. coli (VTEC), isolated in a case-control study of Danish children aged <5 years. Among 424 children with diarrhoea and 866 healthy controls, EPEC and VTEC were more prevalent in cases (2.4% and 2.6%, respectively) than in controls (0.7% and 0.7%, respectively). There was a high frequency of A/EEC isolates (n = 121), but these were equally prevalent in cases (11.3%) and controls (12.5%), and comprised a heterogeneous distribution of O:H serotypes. The intimin (eae) subtypes in A/EEC isolates showed an even distribution; the eae-gamma subtype predominated in classical EPEC cases. The virulence genes encoding the bundle-forming pilus (bfpA) and enteroaggregative heat-stable enterotoxin (astA) were rare among all isolates, and seemed to be of limited pathogenic importance in this population. Virulence characterisation of A/EEC isolates did not reveal any significant differences between cases and controls. Colonisation of children with A/EEC was associated with contact with sheep or goats (OR 2.2). The role of A/EEC, not being VTEC or belonging to the classical EPEC serotypes, requires further clarification, but serotyping is useful in discriminating between EPEC and A/EEC strains.

MeSH terms

  • Adhesins, Bacterial / genetics*
  • Adhesins, Bacterial / metabolism
  • Child
  • Child, Preschool
  • Diarrhea / microbiology*
  • Escherichia coli / genetics*
  • Escherichia coli / isolation & purification
  • Escherichia coli / pathogenicity*
  • Escherichia coli Proteins / metabolism
  • Feces / microbiology
  • Fimbriae Proteins / genetics
  • Fimbriae Proteins / physiology*
  • Fimbriae, Bacterial / physiology
  • Humans
  • Infant
  • Intestinal Mucosa / microbiology
  • Microbial Sensitivity Tests
  • Virulence / genetics

Substances

  • Adhesins, Bacterial
  • Escherichia coli Proteins
  • eaeA protein, E coli
  • Fimbriae Proteins