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A clinicopathologic study of enterocyte-adherent Escherichia coli: a cause of protracted diarrhea in infants

R Rothbaum, A J McAdams, R Giannella

    Gastroenterology
    |August 1, 1982
    PubMed

    Insights

    Enteropathogenic Escherichia coli serotype 0119:B14 caused severe, prolonged diarrhea in infants. This nontoxigenic bacteria adhered to the gut, damaging enterocytes and leading to dehydration and poor growth.

    Area of Science:

    • Pediatric Gastroenterology
    • Microbiology
    • Infectious Diseases

    Background:

    • Infants can suffer severe diarrhea, dehydration, and poor growth.
    • Persistent watery stools necessitate intensive nutritional support and hospitalization.

    Purpose of the Study:

    • To identify the causative agent of protracted diarrhea in infants.
    • To investigate the pathological mechanisms of enteropathogenic Escherichia coli 0119:B14 infection.

    Main Methods:

    • Clinical case series of 15 infants with severe diarrhea.
    • Microbiological stool and intestinal fluid cultures for Escherichia coli 0119:B14.
    • Jejunal or rectal mucosal biopsies for light and electron microscopy.
    • Toxin assays for heat-labile, heat-stable, and vero cell toxins.

    Main Results:

    • Enteropathogenic Escherichia coli 0119:B14 was identified in all patients.
    • Histopathology revealed severe enterocyte damage, villous atrophy, and epithelial vacuolization.
    • Ultrastructural analysis showed bacteria adhering to mucosal cells, microvilli effacement, and intracellular damage.
    • Escherichia coli isolates were negative for common virulence toxins.

    Conclusions:

    • Adherent, nontoxigenic Escherichia coli 0119:B14 can cause severe, protracted diarrhea in infants.
    • Damage to enterocytes and villi by this pathogen leads to significant clinical manifestations.
    • Oral neomycin and nutritional support improved outcomes and cleared the bacteria.

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