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Outbreak of infantile enteritis caused by enterotoxigenic Escherichia coli O6.H16
Insights
A special-care baby unit outbreak of enteritis was investigated. Enterotoxigenic Escherichia coli O6.H16, not common pathogens, was identified as the likely cause in infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Neonatal intensive care units are vulnerable to infectious outbreaks.
- Enteritis in infants can lead to severe complications.
- Traditional enteropathogens were not detected during a recent outbreak.
Purpose of the Study:
- To identify the causative agent of an enteritis outbreak in a special-care baby unit.
- To investigate the role of Escherichia coli serotypes in infant enteritis.
Main Methods:
- Epidemiological investigation of an outbreak in a special-care baby unit.
- Microbiological analysis of stool samples from affected infants and staff.
- Serotyping and enterotoxin analysis of Escherichia coli isolates.
Main Results:
- Ten of 18 at-risk infants developed enteritis.
- Common bacterial pathogens (Salmonella, Shigella) and viruses were not identified.
- Escherichia coli O6.H16 was isolated from 6 infants (5 with diarrhea, 1 without).
- All E. coli O6.H16 isolates were enterotoxigenic (heat-labile and heat-stable toxins).
Conclusions:
- Enterotoxigenic Escherichia coli O6.H16 is implicated as the cause of the infant enteritis outbreak.
- This E. coli serotype has previously been linked to adult enteritis outbreaks.
- Surveillance for specific enterotoxigenic E. coli strains is crucial in neonatal settings.
Abstract:
Ten out of 18 babies at risk developed enteritis in an outbreak in a special-care baby unit. Salmonella, Shigella, and Escherichia coli belonging to the traditional infantile enteropathogenic serogroups were not found in faeces from the babies and the staff, and no virus particles were found by electron microscopy. Detailed serotyping of E. coli showed that five of the 10 babies with diarrhoea and one of the eight without diarrhoea were excreting E. coli O6.H16. All six isolates of this serotype produced both heat-labile and heat-stable enterotoxin. Enterotoxigenic strains of E. coli O6.H16 have caused outbreaks of enteritis in adults in the USA and Japan.