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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Pathogenicity and phenotypic characterization of enterotoxigenic Escherichia coli isolates from a birth cohort of children in rural Egypt
Journal of Clinical Microbiology, Volume 52, No. 2, Year 2014
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Description
Enterotoxigenic Escherichia coli (ETEC) has consistently been the predominant bacterial cause of diarrhea in many birth cohort-and hospital-based studies conducted in Egypt. We evaluated the pathogenicity of ETEC isolates in a birth cohort of children living in a rural community in Egypt. Between 2004 and 2007, we enrolled and followed 348 children starting at birth until their second year of life. A stool sample and two rectal swabs were collected from children during twice-weekly visits when they presented with diarrhea and were collected every 2 weeks if no diarrhea was reported. From routine stool cultures, five E. Colilike colonies were screened for ETEC enterotoxins using a GM1 enzyme-linked immunosorbent assay (ELISA). The isolates were screened against a panel of 12 colonization factor antigens (CFAs) by a dot blot assay. A nested case-control study evaluated the association between initial or repeat excretion of ETEC and the occurrences of diarrhea. The pathogenicity of ETEC was estimated in symptomatic children compared to that in asymptomatic controls. ETEC was significantly associated with diarrhea (crude odds ratio, 1.37; 95% confidence interval [CI], 1.24 to 1.52). The distribution of ETEC enterotoxins varied between the symptomatic children (44.2% heat-labile toxin [LT], 38.5% heat-stable toxin [ST], and 17.3% LT/ST) and asymptomatic children (55.5% LT, 34.6% ST, and 9.9% LT/ST) (P<0.001). The CFAs CFA/I (n=61), CS3 (n=8), CS1 plus CS3 (n=24), CS2 plus CS3 (n=18), CS6 (n=45), CS5 plus CS6 (n=11), CS7 (n=25), and CS14 (n=32) were frequently detected in symptomatic children, while CS6 (n=66), CS12 (n=51), CFA/I (n=43), and CS14 (n=20) were detected at higher frequencies among asymptomatic children. While all toxin phenotypes were associated with diarrheal disease after the initial exposure, only ST and LT/ST-expressing ETEC isolates (P<0.0001) were associated with disease in repeat infections. The role of enterotoxins and pathogenicity during repeat ETEC infections appears to be variable and dependent on the coexpression of specific CFAs. Copyright © 2014, American Society for Microbiology. All Rights Reserved.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3911313/bin/supp_52_2_587__index.html
https://efashare.b-cdn.net/share/pmc/articles/PMC3911313/bin/JCM.01639-13_zjm999093158so6.pdf
Authors & Co-Authors
Mansour, Adel Mahmoud
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Shaheen, Hind Ibrahim
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Amine, Mohamed
Egypt, Cairo
Egyptian Ministry of Health and Population
Hassan, Khaled E.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Sanders, John Walton
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
United States, Silver Spring
Naval Medical Research Center
Riddle, Mark S.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
United States, Silver Spring
Naval Medical Research Center
Armstrong, Adam W.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
United States, Bethesda
Navy Bloodborne Infection Management Center
Svennerholm, Ann Mari L.
Sweden, Gothenburg
Göteborgs Universitet
Sebeny, Peter J.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Klena, John David
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
China, Beijing
International Emerging Infections Program
Young, Sylvia Y.N.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
United States
Navy Environmental and Preventive Medicine
Frenck, Robert W.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
United States, Cincinnati
Cincinnati Children's Hospital Medical Center
Statistics
Citations: 18
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1128/JCM.01639-13
ISSN:
00951137
e-ISSN:
1098660X
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study
Study Locations
Egypt