Enteropathogenic Escherichia coli (EPEC) and enterotoxigenic (ETEC) related diarrhoeal disease in a neonatal unit

In an outbreak of summer diarrhoea in the neonatal unit, King Edward VIII Hospital, Durban, 25 (69%) of the 36 infants had organisms demonstrated in their stools. Four (11%) had EPEC alone, six (17%) ETEC alone, six (17%) EPEC plus rotavirus and nine (25%) all three organisms. Eleven (30%) infants had no organisms in their stools. Rotavirus alone was not present in any of the stools. Seven infants had septicaemia. The overall mortality was 22% and 62.5% of the deaths occurred in low birthweight infants. In a study of 41 infants without diarrhoea during the following winter and summer periods 55% of winter, 43% of summer controls, and four of 12 (33%) mothers had rotavirus. Only two (4.8%) of 41 infants had E. coli (EPEC). The findings suggest that E. coli (EPEC strain 044/K74[c], and ETEC) was the major cause of the outbreak and it was associated with a high mortality.