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Phenotypic profiles of enterotoxigenic Escherichia coli associated with early childhood diarrhea in rural Egypt

Artikel i vetenskaplig tidskrift
Författare H. I. Shaheen
S. B. Khalil
Malla Rao
R. Abu Elyazeed
Thomas Wierzba
L. F., Jr. Peruski
S. Putnam
A. Navarro
B. Z. Morsy
A. Cravioto
John Clemens
Ann-Mari Svennerholm
Stephen Savarino
Publicerad i J Clin Microbiol
Volym 42
Nummer/häfte 12
Sidor 5588-95
Publiceringsår 2004
Publicerad vid Institutionen för medicinsk mikrobiologi och immunologi
Sidor 5588-95
Språk en
Länkar dx.doi.org/10.1128/JCM.42.12.5588-5...
Ämnesord Anti-Bacterial Agents/pharmacology, Child, Preschool, Diarrhea/epidemiology/*microbiology, Egypt/epidemiology, Escherichia coli/*classification/drug effects/isolation &, purification/pathogenicity, Escherichia coli Infections/epidemiology/*microbiology, Humans, Infant, Infant, Newborn, Microbial Sensitivity Tests, Phenotype, Population Surveillance, *Rural Population, Serotyping, Virulence
Ämneskategorier Medicin och Hälsovetenskap


Enterotoxigenic Escherichia coli (ETEC) causes substantial diarrheal morbidity and mortality in young children in countries with limited resources. We determined the phenotypic profiles of 915 ETEC diarrheal isolates derived from Egyptian children under 3 years of age who participated in a 3-year population-based study. For each strain, we ascertained enterotoxin and colonization factor (CF) expression, the O:H serotype, and antimicrobial susceptibility. Sixty-one percent of the strains expressed heat-stable enterotoxin (ST) only, 26% expressed heat-labile enterotoxin (LT) alone, and 12% expressed both toxins. The most common CF phenotypes were colonization factor antigen I (CFA/I) (10%), coli surface antigen 6 (CS6) (9%), CS14 (6%), and CS1 plus CS3 (4%). Fifty-nine percent of the strains did not express any of the 12 CFs included in our test panel. Resistance of ETEC strains to ampicillin (63%), trimethoprim-sulfamethoxazole (52%), and tetracycline (43%) was common, while resistance to quinolone antibiotics was rarely detected. As for the distribution of observed serotypes, there was an unusually wide diversity of O antigens and H types represented among the 915 ETEC strains. The most commonly recognized composite ETEC phenotypes were ST CS14 O78:H18 (4%), ST (or LTST) CFA/I O128:H12 (3%), ST CS1+CS3 O6:H16 (2%), and ST CFA/I O153:H45 (1.5%). Temporal plots of diarrheal episodes associated with ETEC strains bearing common composite phenotypes were consistent with discrete community outbreaks either within a single or over successive warm seasons. These data suggest that a proportion of the disease that is endemic to young children in rural Egypt represents the confluence of small epidemics by clonally related ETEC strains that are transiently introduced or that persist in a community reservoir.

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