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1 February 2007

Volume 195, Number 3
The Journal of Infectious Diseases 2007;195:366–374
© 2006 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2007/19503-0010$15.00
DOI: 10.1086/510538
MAJOR ARTICLE

Enteroaggregative Escherichia coli Virulence Markers: Positive Association with Distinct Clinical Characteristics and Segregation into 3 Enteropathogenic E. coli Serogroups

Alex L. Pereira,1

Lúcia R. Ferraz,2

Rejane S. N. Silva,2 and

Loreny G. Giugliano1

1Laboratório de Microbiologia, Departamento de Biologia Celular, Universidade de Brasília, and 2Laboratório Central de Saúde Pública do Distrito Federal, Brasilia, Brazil

Background.Enteroaggregative Escherichia coli (EAEC) are a heterogeneous category of emerging pathogens associated with acute and persistent diarrhea.

Methods.We performed a case‐control study to evaluate the association of EAEC strains and their virulence markers with infantile diarrhea in Brasília, Brazil.

Results.Of the EAEC markers that were tested, only EAEC heat‐stable toxin (EAST1), protein involved in colonization (Pic), and the CVD432 sequence showed positive correlation with diarrhea; however, these virulence traits presented associations with distinct clinical characteristics. Although CVD432‐positive strains were associated with persistent diarrhea, EAST1‐positive strains were statistically correlated with acute diarrhea only in children >6 months of age. Typical EAEC strains were found with equal frequency in case patients and control subjects. O antigens of enteropathogenic E. coli (EPEC) were also sought, and the data showed that the EAEC markers are frequently segregated into 3 EPEC serogroups: O126, O128, and O158.

Conclusions.The presence of EPEC O antigens along with EAEC markers influenced the positive association of E. coli strains with diarrhea. Concerning the detection of the AA phenotype, the CVD432 sequence presented a low positive predictive value, regardless of its high specificity as a marker.

Received 6 July 2006; accepted 20 September 2006; electronically published 20 December 2006.

Reprints or correspondence: Dr. Loreny G. Giugliano, Laboratório de Microbiologia, Departamento de Biologia Celular, Instituto de Biologia, Universidade de Brasília, 70910‐900, Brasília‐DF ().

Cited by

D. Cennimo, A. Abbas, D. B. Huang, T. Chiang. (2009) The prevalence and virulence characteristics of enteroaggregative Escherichia coli at an urgent-care clinic in the USA: a case-control study. Journal of Medical Microbiology 58:4, 403-407
Online publication date: 1-May-2009.
CrossRef
Jose Flores, Pablo C Okhuysen. (2009) Enteroaggregative Escherichia coli infection. Current Opinion in Gastroenterology 25:1, 8-11
Online publication date: 1-Feb-2009.
CrossRef
ZA Bhutta, EA Nelson, WS Lee, PI Tarr, R Zablah, KB Phua, K Lindley, D Bass, A Phillips. (2008) Recent Advances and Evidence Gaps in Persistent Diarrhea. Journal of Pediatric Gastroenterology and Nutrition 47:2, 260-265
Online publication date: 1-Sep-2008.
CrossRef
C. Jenkins, H. Chart, G. A. Willshaw, T. Cheasty, D. S. Tompkins. (2007) Association of putative pathogenicity genes with adherence characteristics and fimbrial genotypes in typical enteroaggregative Escherichia coli from patients with and without diarrhoea in the United Kingdom. European Journal of Clinical Microbiology & Infectious Diseases 26:12, 901-906
Online publication date: 7-Dec-2007.
CrossRef

  • Potential conflicts of interest: none reported.

    Financial support: Conselho Nacional de Desenvolvimento Científico e Tecnológico–CNPq (grants 520674/99‐5).

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