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Enteroaggregative Escherichia coli associated with an outbreak of diarrhoea in a neonatal nursery ward

Published online by Cambridge University Press:  15 May 2009

M. Čobeljić ,
B. Miljković-Selimović ,
D. Paunović-Todosijević ,
Z. Veličković ,
Z. Lepšanović ,
N. Zec ,
D. Savić ,
R. Ilić ,
S. Konstantinović  and
B. Jovanović
...Show all authors
M. Čobeljić
Affiliation:
Institute of Preventive Medicine, Military Medical Academy, Crnotravska 17, 11000 Belgrade, Serbia, Yugoslavia
B. Miljković-Selimović
Affiliation:
Public Health Centre, Niš, Serbia, Yugoslavia
D. Paunović-Todosijević
Affiliation:
Public Health Centre, Niš, Serbia, Yugoslavia
Z. Veličković
Affiliation:
Public Health Centre, Niš, Serbia, Yugoslavia
Z. Lepšanović
Affiliation:
Institute of Preventive Medicine, Military Medical Academy, Crnotravska 17, 11000 Belgrade, Serbia, Yugoslavia
N. Zec
Affiliation:
Institute of Preventive Medicine, Military Medical Academy, Crnotravska 17, 11000 Belgrade, Serbia, Yugoslavia
D. Savić
Affiliation:
University Clinic Centre, Niš, Serbia, Yugoslavia
R. Ilić
Affiliation:
University Clinic Centre, Niš, Serbia, Yugoslavia
S. Konstantinović
Affiliation:
University Clinic Centre, Niš, Serbia, Yugoslavia
B. Jovanović
Affiliation:
University Clinic Centre, Niš, Serbia, Yugoslavia
V. Kostić
Affiliation:
University Clinic Centre, Niš, Serbia, Yugoslavia
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Over a 9-day period in February 1995, 16 newborn babies (age range 2–11 days) and 3 infants (24, 47 and 180 days of age) in a neonatal nursery ward developed diarrhoea accompanied by pyrexia and weight loss. Known enteropathogens were not detected in their stools but Escherichia coli displaying aggregative adherence to HEp-2 cells (enteroaggregative E. coli) were found in 12 (63%) ill infants and in none of 5 well neonates (P = 0·02). The illness lasted 3–9 days (mean 5·2) in 16 babies, whereas in 3 neonates it showed a protracted course of 18–20 days. The source of infection and the mode of transmission remained unclear. The outbreak isolates manifested properties common in this new group of diarrhoeagenic E. coli: mannose-resistant haemagglutination, haemolysis on blood agar, and clump formation in liquid culture medium. They belonged to the O4 E. coli serogroup and expressed multiple antibiotic resistance.

Type
Research Article
Information
Epidemiology & Infection , Volume 117 , Issue 1 , August 1996 , pp. 11 - 16
Copyright
Copyright © Cambridge University Press 1996

References

1.Nataro, JP, Kaper, JB, Robins-Browne, R, Prado, V, Levine, MM. Pattern of adherence of diarrheagenic Escherichia coli to HEp-2 cells. Pediatr Infect Dis J 1987; 6: 829–31.CrossRefGoogle ScholarPubMed
2.Nataro, JP, Deng, Y, Maneval, DR, German, AL, Martin, WC, levine, MM. Aggregative adherence fimbriae I of enteroaggregative Escherichia coli mediate adherence to HEp-2 cells and hemagglutination of human erythrocytes. Infect Immun 1992; 60: 2297–304.CrossRefGoogle ScholarPubMed
3.Gomes, TA, Blake, PA, Trabulsi, LR. Prevalence of Escherichia coli strains with localized, diffuse, and aggregative adherence to HeLa cells in infants with diarrhea and matched controls. J Clin Microbiol 1989; 27: 266–9.CrossRefGoogle ScholarPubMed
4.Bhan, MK, Raj, P, Levine, MM, et al. Enteroaggregative Escherichia coli associated with persistent diarrhea in a cohort of rural children in India. J Infect Dis 1989; 159: 1061–4.CrossRefGoogle Scholar
5.Čobeljić, M, Stojiljković, I, Budišin, A, Lepšanović, Z, Lerš, N. Lack of association of Escherichia coli exhibiting both mannose-resistant haemagglutination and diffuse adherence to HEp-2 cells with acute diarrhoea in children. Epidemiol Infect 1990; 104: 127–33.CrossRefGoogle ScholarPubMed
6.Giron, JA, Jones, T, Millan-Velasco, F, et al. Diffuseadhering Escherichia coli (DAEC) as a putative cause of diarrhea in Mayan children in Mexico. J Infect Dis 1991; 163; 507–13.Google ScholarPubMed
7.Cravioto, A, Tello, A, Navarro, A, et al. Association of Escherichia coli HEp-2 adherence patterns with type and duration of diarrhoea. Lancet 1991; i: 262–4.Google Scholar
8.Echeverria, P, Serichantalerg, O, Changchawalit, S, et al. Tissue culture adherent Escherichia coli in infantile diarrhea. J Infect Dis 1992; 165: 141–3.CrossRefGoogle ScholarPubMed
9.Bhatnagar, S, Bhan, MK, Sommerfelt, H, Sazawal, S, Kumar, R, Seini, S.Enteroaggregative Escherichia coli may be a new pathogen causing acute and persistent diarrhea. Scand J Infect Dis 1993; 25: 579–83.CrossRefGoogle ScholarPubMed
10.Levine, MM, Ferreccio, C, Prado, V, et al. Epidemiologic studies of Escherichia coli diarrheal infections in a low socioeconomic level peri-urban community in Santiago, Chile. Am J Epidemiol 1993; 138: 849–69.CrossRefGoogle Scholar
11.World Health Organization. Manual for laboratory investigation of acute enteric infections. Geneva: WHO, WHO/CDD/83.3, 1983.Google Scholar
12.Edwards, PR, Ewing, WH. Identification of Enterobacteriaceae, 3rd ed. Burgess Publishing Company, 1972.Google Scholar
13.Čobeljić, M, Mel, D, Arsić, B, et al. The association of enterotoxigenic and enteropathogenic Escherichia coli and other enteric pathogens with childhood diarhhoea in Yugoslavia. Epidemiol Infect 1989; 103: 53–62.CrossRefGoogle Scholar
14.Karmali, MA. Laboratory diagnosis of verotoxin-producing Escherichia coli infections. Clin Microbiol Newslett 1987; 9: 65–70.CrossRefGoogle Scholar
15.Sereny, G.Experimental Shigella keratoconjunctivitis: a preliminary report. Acta Microbiol Acad Sci Hung 1955; 2: 293.Google ScholarPubMed
16.Scotland, SM, Smith, HR, Willshaw, GA, Cheasty, T, Rowe, B. Identification of enteropathogenic Escherichia coli isolated in Britain as enteroaggregative or as members of a subclass of attaching-and-effacing E. coli not hybridizing with the EPEC adherence-factor probe. J Med Microbiol 1991; 35: 278–83.CrossRefGoogle Scholar
17.Bauer, AW, Kirby, WMM, Sherris, JC, Tuck, M.Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966; 45: 493–6.Google Scholar
18.Maniatis, T, Fritsch, EF, Sembrook, J.Molecular cloning: a laboratory manual. Cold Spring Harbor, New York: Cold Spring Harbor Laboratory, 1986.Google Scholar
19.Smith, HR, Scotland, SM, Willshaw, GA, Rowe, B, Cravioto, A, Eslava, C.Isolates of Escherichia coli O44:H18 of diverse origin are enteroaggregative. J Infect Dis 1994; 170: 1610–3.Google Scholar
20.Eslava, C, Villaseca, J, Morales, R, Navarro, A, Cravioto, A.Identification of a protein with toxigenic activity produced by enteroaggregative Eschericia coli. In: Proceedings of the 93rd Annual meeting of the American Society for Microbiology (Atlanta)Washington, DC:1993.Google Scholar
21.Scotland, SM, Willshaw, GA, Cheasty, T, Rowe, B, Hassal, JE. Association of enteroaggregative Escherichia coli with traveller's diarrhoea. J Infect 1994; 29: 115–6.CrossRefGoogle Scholar
22.Haberberger, ZRL, Mikhail, IA, Tharwat, FI. Enteritis due to multiresistant enteroadherent Escherichia coli. Lancet 1991; 1: 235–6.CrossRefGoogle Scholar
23.Nataro, JP, Yikang, D, Cookson, S, et al. Heterogeneity of enteroaggregative Escherichia coli virulence demonstrated in volunteers. J Infect Dis 1995; 171: 465–8.Google Scholar
24.Vial, PA, Robins-Browne, R, Lior, H, et al. Characterization of enteroadherent-aggregative Escherichia coli, a putative agent of diarrheal disease. J Infect Dis 1988; 158: 70–9.CrossRefGoogle ScholarPubMed
25.Tzipori, S, Montanaro, J, Robins-Browne, RM, Vial, P, Gibson, R, Levine, MM. Studies with enteroaggregative Escherichia coli in the gnotobiotic piglet gastroenteritis model. Infect Immun 1992; 60: 5302–6.Google Scholar
26.Qadri, F, Haque, A, Faruque, SM, Bettelheim, KA, Robins-Browne, R, Albert, J.Hemagglutinating properties of enteroaggregative Escherichia coli. J Clin Microbiol 1994; 32: 510–4.CrossRefGoogle ScholarPubMed
27.Knutton, S, Shaw, RK, Bhan, MK, et al. Ability of enteroaggregative Escherichia coli strains to adhere in vitro to human intestinal mucosa. Infect Immun 1992; 60: 2083–91.CrossRefGoogle ScholarPubMed
28.Haque, MA, Ohki, K, Kikuchi, M, Kohashi, O. Contact hemolysin production by strains of enteroaggregative Escherichia coli isolated from children with diarrhea. J Clin Microbiol 1994; 32: 1109–11.CrossRefGoogle ScholarPubMed
29.Yamamoto, T, Endo, S, Yokota, T, Echeverria, P.Characteristics of adherence of enteroaggregative Escherichia coli to human and animal mucosa. Infect Immun 1991; 59: 3722–39.CrossRefGoogle ScholarPubMed
30.Gross, RJ, Scotland, SM, Rowe, B.Enterotoxin testing of Escherichia coli causing epidemic infantile enteritis in the U.K. Lancet 1976; i: 629–31.CrossRefGoogle Scholar
31.Boyer, KM, Petersen, NJ, Iraj Farzaneh, SM, Pattison, CP, Hart, MC, Maynard, JE.An outbreak of gastroenteritis due to E. coli O142 in a neonatal nursery. J Pediatr 1975; 86: 919–27.Google Scholar
32.Senerwa, D, Olsvik, O, Mutanda, LN, Gathuma, JM, Wachsmuth, K.Colonization of neonates in a nursery ward with enteropathogenic Escherichia coli and correlation to the clinical histories of the children. J Clin Microbiol 1989; 27: 2539–43.CrossRefGoogle Scholar
33.Ryder, RW, Wachsmuth, IK, Buxton, AE, et al. Infantile diarrhea produced by heat-stable enterotoxigenic Escherichia coli. N Engl J Med 1976; 295: 849–53.CrossRefGoogle ScholarPubMed