[A thermostable toxin-producing E. coli and infantile diarrhea]

Area of Science:

• Microbiology
• Pediatrics
• Infectious Diseases

Background:

• Enterotoxigenic Escherichia coli (ETEC) strains, particularly serogroup 0153 producing thermostable toxin (ST), were historically considered rare worldwide.
• Recent reports indicate a rising prevalence of ETEC 0153 (ST) strains as a significant cause of infantile diarrhea outbreaks in Spain over the past two years.

Purpose of the Study:

• To report the first documented case of infantile diarrhea caused by an ETEC 0153 (ST) strain in Israel.
• To highlight the emergence of this specific ETEC strain as a potential cause of infant gastroenteritis.

Main Methods:

• Stool samples from infants with diarrhea were analyzed for bacterial pathogens.
• Isolation and characterization of the E. coli strain, including serogrouping and toxin analysis (ST production).
• Identification of co-infections with other enteric pathogens such as rotavirus, Plesiomonas, and Shigella sonnei.

Main Results:

• An E. coli strain belonging to serogroup 0153 and producing only thermostable toxin (ETEC 0153; ST) was isolated from 9 infants with diarrhea.
• Four of the affected infants were premature and experienced frequent fluid stools.
• Co-infections with other pathogens were detected in 5 of the 9 infants.

Conclusions:

• The isolation of ETEC 0153 (ST) from infants in Israel marks the first reported instance of this pathogen in the region.
• The findings suggest a potential shift in the epidemiology of infantile diarrhea, with ETEC 0153 (ST) emerging as a notable cause.
• Continued surveillance is warranted to monitor the prevalence and impact of ETEC strains in infantile gastroenteritis globally.