Enterotoxigenic Escherichia coli and other enteropathogens in paediatric diarrhoea in Addis Ababa

This study was performed during two weeks among 86 paediatric outpatients of poor socio-economic background. A control group comprised 60 healthy children. Enterotoxigenic Escherichia coli (ETEC) was the most common diarrhoeal agent isolated (26%). Strains of ETEC producing heat-labile (LT) only or LT and heat-stable (ST) enterotoxin were isolated from 11% each and ETEC producing ST only from 4% of the patients. ETEC was also found not infrequently among controls (10%). ETEC with O-antigens 78, 6 and 8 were shown to harbour colonization factors. Enterotoxigenic bacteria were found as contaminants in 5 of 24 feeding bottles investigated. Enteropathogenic Escherichia coli (EPEC) and Shigella species were isolated from 8% each and rotavirus from 24% of the patients. Twelve patients infected with ETEC only were compared to 66 patients not infected with ETEC. Patients infected with ETEC had a relatively mild disease and it was not possible by clinical findings to distinguish those patients infected with ETEC, LT and/or ST producing, carrying or not carrying colonization factors from those infected with other agents. This study underlines the need for extended studies of the clinical significance of ETEC infection in developing countries.