Abstract
Strains of Escherichia coli, hybridising with a DNA probe for enteroaggregative E. coli (EAggEC), were isolated from patients with infectious intestinal disease (IID) or gastro-enteritis, and healthy controls during the study of IID in England. Of 3506 cases presenting with an IID, 160 (4.6%) had faecal EAgg-EC as compared with 46 (1.7%) of 2772 healthy controls, 53% of EAggEC isolated from each of the ‘case’ and the ‘control’ groups adhered in a ‘stacked-brick’ formation. Strains from cases and controls belonged to over 39 and 14 different serogroups respectively, and approximately half of the strains isolated did not react with antisera in the current somatic antigen serotyping scheme. Forty-nine cases with EAggEC (31%) had a known history of foreign travel. Over 50% of strains isolated from cases and controls were resistant to one or more of eight antimicrobials, and antimicrobial resistance was not statistically significantly more common among cases with a known history of foreign travel (p = 0.57). These data form part of the largest investigation carried out on these organisms in the UK to date and provide the most comprehensive analysis of strains of EAggEC isolated from the general population of England.
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Nataro JP, Deng Y, Maneval DR, et al. Characterisation of enteroadherent-aggregative Escherichia coli, a putative agent of diarrhoel pathogen. J Infect Dis 1988; 161: 1249–1251.
Bhan MK, Raj P, Levine MM, et al. Enteroaggregative Escherichia coli associated with persistent diarrhea in a cohort of rural children in India. J Infect Dis 1989; 159: 1061–1064.
Gomes TAT, Blake PA, Trabulsi L. Prevalence of Escherichia coli strains with localised, diffuse, and aggregative adherence to HeLa cells in infants with diarrhea and matched controls. J Clin Microbiol 1989; 27: 266–269.
Morreli R, Baldassarri L, Falbo V, et al. Detection of enteroadherent Escherichia coli associated with diarrhoea in Italy. J Med Microbiol 1994; 41: 399–404.
Chan KN, Phillips AD, Knutton S, et al. Enteroaggregative Escherichia coli: Another cause of acute and chronic diarrhoea in England? J Ped Gastroent Nut 1994; 18: 87–91.
Huppertz HI, Rutkowski S, Aleksic S, et al. Acute and chronic diarrhoea and abdominal colic associated with enteroaggregative Escherichia coli in young children living in western Europe. Lancet 1997; 349: 1660–1664.
Itoh Y, Nagano I, Kunishima M, et al. Laboratory investigation of enteroaggregative Escherichia coli O-untypeable:H10 associated with a massive outbreak of gastrointestinal illness. J Clin Microbiol 1997; 35: 2546–2550.
Gascón J, Vargas L, Quintó L, et al. Enteroaggregative Escherichia coli strains as a cause of traveler's diarrhoea: A case–control study. J Infect Dis 1998; 177: 1409–1412.
Cohen MB, Hawkins JA, Weckbach LS, et al. Colonization by enteroaggregative Escherichia coli in travelers with and without diarrhoea. J Clin Microbiol 1993; 31: 351–353.
Forestier C, Meyer M, Favre-Bonte S, et al. Enteroadherent Escherichia coli and diarrhea in children: A prospective case–control study. J Clin Microbiol 1996; 34: 2897–2903.
Vial PA, Robins-Browne R, Lior H, et al. Characterisation of enteroadherent-aggregative Escherichia coli, a putative agent of diarrhoeal disease. J Infect Dis 1988; 158: 70–79.
Roderick PJ, Wheeler JG, Cowden JM, et al. A pilot study of infectious intestinal disease in England. Epidemiol Infect 1995; 114: 277–288.
Wheeler JG, Sethi D, Cowden JM, et al. Study of infectious intestinal disease in England: Rates of the community, presenting to general practice, and reported to national surveillance. Br Med J 1999; 318: 1046–1050.
Sethi D, Wheeler JG, Cowden JM, et al. A study of infectious intestinal disease in England: Plan and methods of data collection. Comm Dis Public Health 1999; 2: 101–107.
Tompkins DS, Hudson MJ, Smith HR, et al. A study of infectious intestinal disease in England: Microbiological findings in cases and controls. Comm Dis Public Health 1999; 2: 108–113.
Baudry B, Savarino SJ, Vial P, et al. A sensitive and speci.c DNA probe to identify enteroaggregative Escherichia coli, a recently discovered diarrheal pathogen. J Infect Dis 1990; 161: 1249–1251.
Gross RJ, Rowe B, In: The Serotyping of Escherichia coli Sussman M (ed.) London: Society of General Microbiology, 1985 (The Virulence of Escherichia coli), 345–363.
Frost JA. Testing for Resistance to Antimicrobial Drugs. In: Chart H (ed.) Methods in Practical Laboratory Bacteriology. Boca Raton: CRC Press, 1994; 73–82.
Cravioto A, Gross RJ, Scotland SM, et al. An adhesive factor found in strains of Escherichia coli belonging to the traditional infantile enteropathogenic serotypes. Curr Microbiol 1979; 3: 95–99.
Chart H, Scotland SM, Willshaw GA, et al. HEp-2 adhesion and the expression of a 94 kDa outer-membrane protein by strains of Escherichia coli belonging to entero-pathogenic serotypes. J Gen Microbiol 1989; 134: 1315–1321.
Law D, Chart H. Enteroaggregative Escherichia coli. J Appl Microbiol 1998; 84: 685–697.
Knutton S, Shaw RK, Bahn MK. et al. Ability of Enteroaggregative Escherichia coli strains of adhere in vitro to human mucosa. Infect Immun 1992; 2083–2091.
Knutton S, Shaw R, Phillips AD. et al. Phenotypic and genotypic analysis of diarrhea-associated Escherichia coli isolated from children in the United Kingdom. J Pediatr Gastroenterol Nutr 2001; 33: 32–40.
Spencer J, Chart H, Smith HR, Rowe B. Improved detection of enteroaggregative Escherichia coli using formalin-fixed HEp-2 cells. Letts Appl Microbiol 1997; 25: 325–326.
Spencer J, Smith HR, Chart H. Characterization of enteroaggregative Escherichia coli isolated from outbreaks of diarrhoeal disease in England. Epidemiol Infect 1999; 123: 413–421.
Chart H, Smith HR, Rowe B. Antigenic cross-reactions between fimbriae expressed by Salmonella enteritidis, S. dublin and an 18 kDa outer membrane-associated protein expressed by Escherichia coli O126:H27. FEMS Microbiol Letts 1994; 121: 19–24.
Chart H, Smith HR, Rowe B. Enteroaggregative strains of Escherichia coli belonging to serotypes O126:H27 and O44:H18 express antigenically similar 18 kDa outer membrane-associated proteins. FEMS Microbiol Letts 1995; 132: 17–22.
Savarino SJ, Fasano A, Robertson DC, Levine MM. Enteroaggregative Escherichia coli elaborate a heatstable enterotoxin demonstrable in an in vitro rabbit intestinal model. J Clin Invest 1991; 87: 1450–1455.
Eslava C, Navarro-Garcia F, Czeczulin JR. et al. Pet, an autotransporter enterotoxin from enteroaggregative Escherichia coli. Infect Immun 1998; 66: 3155–3163. Address for correspondence: Dr Henrik Chart. Laboratory of Enteric Pathogens, CPHL, 61 Colindale Avenue, London, NW9 5HT, UK Phone: +44–208–200–4400; Fax: +44–208–905–9929 E-mail: hchart@phls.org.uk 1130
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Wilson, A., Evans, J., Chart, H. et al. Characterisation of strains of enteroaggregative Escherichia coli isolated during the infectious intestinal disease study in England. Eur J Epidemiol 17, 1125–1130 (2001). https://doi.org/10.1023/A:1021224915322
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DOI: https://doi.org/10.1023/A:1021224915322