[Clinical and epidemiological characteristics of acute diarrhea by classical enteropathogenic Escherichia coli]

Acute diarrhea is usually considered as a self limited disease, but under certain circumstances, mainly owing to the age of the patient, the nutritional status and the enteropathogenic agent the illness can evolve for a protracted evolution.

In the present study we report the clinical and epidemiological features of a group of infants under two years of age with acute diarrhea caused by serogroups of enteropathogenic Escherichia coli (EPEC).

During a two year period 200 infants under two years of age, mean 8.2 months, with acute diarrhea less than 5 days duration, were consecutively studied. A control group of 40 healthy infants matched for age was also made up. The nutritional status was determined and the occurrence of food intolerance was also monitored. The patients were followed up for 4 weeks after been discharged from the hospital. Stool samples were obtained for research of bacterial, viral and protozoan enteropathogenic agents.

EPEC was isolated in the stools of 84 (42.0%) infants, as a sole enteropathogenic agent in 55 (27.5%) and in the remaining 29 (14.5%) infants associated with some other agent. EPEC was isolated in the stools of 9 (22.5%) infants of the control group (p < 0.05). Food intolerance was the main digestive complication and also the most important factor that caused perpetuation of diarrhea. The mean duration of the disease was 11.2 days, varying from 2 to 40 days. In 53 (71.6%) infants the disease lasted less than 14 days, while in the remaining 21 (28.4%) it lasted more than 14 days, and all these infants presented with food intolerance.

Enteric infections caused by EPEC serogroups, particularly O111 and O119, are more prevalent in weaned infants under 1 year of age belonging to families of low income rates. These infants present heavy fluid and electrolyte losses in the stools associated to high rates of food intolerance.