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Diffuse-adhering Escherichia coli (DAEC) as a putative cause of diarrhea in Mayan children in Mexico
J A Girón1, T Jones, F Millán-Velasco
1Department of Microbiology and Immunology, Stanford University, CA 94305.
Abstract:
Diarrhea is a major cause of infantile morbidity and mortality in developing countries. A community-based, case control study was conducted in a southern Mexican Mayan village for 3 weeks during the peak diarrhea period to prospectively identify the infectious agents associated with childhood diarrheal disease. Several enteropathogens were isolated from stools of 34 of 58 cases, although none was significantly associated with diarrhea. For the 24 cases from which no enteropathogens were isolated, diffuse-adhering Escherichia coli (DAEC) strains were significantly associated with diarrheal disease (P less than .02; odds ratio = 6; 95% confidence limit, 1.08-99.0). DAEC were highly heterogeneous with respect to plasmid content and serotype. Three DNA probes designed to differentiate E. coli exhibiting localized, diffuse, or aggregative adherence were compared with results from a standard HeLa cell binding assay to assess the utility of these probes in the field. This study provides evidence for the potential pathogenic capacity of DAEC and underscores the variety of diarrheal agents operating within a community.
Insights
Diffuse-adhering Escherichia coli (DAEC) was identified as a significant cause of childhood diarrhea in a Mexican village. This finding highlights DAEC
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Diarrheal diseases represent a critical global health challenge, particularly impacting infant morbidity and mortality in developing nations.
- Identifying the specific infectious agents responsible for childhood diarrhea is crucial for effective public health interventions.
Purpose of the Study:
- To prospectively identify infectious agents associated with childhood diarrheal disease in a southern Mexican Mayan village.
- To investigate the role of diffuse-adhering Escherichia coli (DAEC) in cases where other enteropathogens were not detected.
Main Methods:
- A community-based, case-control study was conducted over three weeks during the peak diarrhea season.
- Stool samples were analyzed for enteropathogens, and a HeLa cell binding assay was used alongside DNA probes to assess E. coli adherence patterns.
Main Results:
- While several enteropathogens were isolated, none were significantly associated with diarrhea in the studied population.
- Diffuse-adhering Escherichia coli (DAEC) strains showed a significant association with diarrheal disease (P < .02, OR = 6) in cases where no other pathogens were identified.
- DAEC strains exhibited considerable heterogeneity in plasmid content and serotype.
Conclusions:
- This study provides evidence for the pathogenic potential of DAEC in childhood diarrhea.
- The findings underscore the diverse range of diarrheal agents present within a community and the importance of considering DAEC in etiological investigations.