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Enterotoxigenic Escherichia-coli-associated diarrheal disease in Apache children
Insights
Enterotoxigenic Escherichia coli (Esch. coli) caused acute diarrhea in 16% of Apache children studied. Traditional "enteropathogenic" Esch. coli serotypes did not induce diarrhea in infant rabbit models, suggesting a redefinition is needed.
Area of Science:
- Microbiology
- Pediatrics
- Infectious Diseases
Background:
- Acute diarrhea remains a significant health concern in pediatric populations worldwide.
- Escherichia coli (Esch. coli) is a common bacterial cause of diarrheal diseases.
- The classification and pathogenic mechanisms of Esch. coli strains require further investigation.
Purpose of the Study:
- To investigate the prevalence and pathogenic potential of enterotoxigenic Escherichia coli (ETEC) in Apache children experiencing acute diarrhea.
- To evaluate the efficacy of established infant rabbit and adult rabbit ileal loop models in detecting enterotoxigenic strains.
- To assess the role of specific
Main Methods:
- Collected stool and small-bowel fluid samples from 59 Apache children during acute diarrheal episodes and convalescent phases.
- Tested Escherichia coli isolates using three established enterotoxigenicity assays: adult-rabbit ileal loop, infant rabbit model, and adrenal-cell assay.
- Compared enterotoxigenic potential of isolates with traditional "enteropathogenic" Esch. coli serotypes.
Main Results:
- Enterotoxigenic Escherichia coli strains were identified in 16% of acute diarrheal episodes, with none found in convalescent samples.
- None of the tested "enteropathogenic" Esch. coli serotypes induced fluid production in the adult-rabbit ileal loop model.
- These findings indicate a significant role for ETEC in pediatric diarrhea within this population.
Conclusions:
- Enterotoxigenic Escherichia coli is a likely cause of substantial diarrheal illness in Apache children.
- The current classification of "enteropathogenic" Escherichia coli serotypes may require re-evaluation based on their pathogenic mechanisms.
- Further research is warranted to refine the understanding and diagnosis of Esch. coli-associated diarrheal diseases.
Abstract:
A search for intestinal enterotoxigenic Escherichia coli was made in 59 Apache children hospitalized with 64 episodes of acute diarrhea. Esch. coli isolates from acute-phase and convalescent-phase specimens of small-bowel fluid and stool were tested in three currently recognized models: the adult-rabbit ileal loop; infant rabbit; and the adrenal-cell assay. Enterotoxigenic strains were isolated from 10 children during acute diarrheal episodes (16 per cent); none were isolated from convalescent-phase specimens. None of 64 "enteropathogenic" serotypes of Esch. coli from 43 children with diarrhea, however, caused fluid production in the ileal-loop model. These results suggest that enterotoxigenic Esch. coli may be the cause of considerable diarrhea in this population and that the term "enteropathogenic" as applied to serotypes of Esch. coli needs to be redefined.