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. 1997 Oct;10(4):569–584. doi: 10.1128/cmr.10.4.569

Occurrence, distribution, and associations of O and H serogroups, colonization factor antigens, and toxins of enterotoxigenic Escherichia coli.

M K Wolf 1
PMCID: PMC172934  PMID: 9336662

Abstract

Enterotoxigenic Escherichia coli (ETEC) is a leading cause of infectious diarrhea worldwide. Four categories of antigens have been commonly studied: O serogroup, H serogroup, colonization factor antigens (CFA), and toxins. A database has been complied from published reports of nearly 1,000 ETEC isolates from 18 locations and analyzed to determine the occurrence, distribution, and associations of O serogroup, H serogroup, CFA, and toxin type. Tables listing the associations of antigens are presented. This analysis documents the widespread nature and variety of ETEC. Even the most common combination of antigens, O6:H16 CFA/II LTST, accounted for only 11% of the ETEC isolates in the database. It was isolated from 12 locations. Many phenotypes occurred only once. CFA detection based on enzyme-linked antibodies with polyclonal sera is suggested as the preferred assay. A combination of CFA and toxin-based antigens is suggested as the most practical vaccine.

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Selected References

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  1. Agüero M. E., Reyes L., Prado V., Orskov I., Orskov F., Cabello F. C. Enterotoxigenic Escherichia coli in a population of infants with diarrhea in Chile. J Clin Microbiol. 1985 Oct;22(4):576–581. doi: 10.1128/jcm.22.4.576-581.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Armstrong G. L., Hollingsworth J., Morris J. G., Jr Emerging foodborne pathogens: Escherichia coli O157:H7 as a model of entry of a new pathogen into the food supply of the developed world. Epidemiol Rev. 1996;18(1):29–51. doi: 10.1093/oxfordjournals.epirev.a017914. [DOI] [PubMed] [Google Scholar]
  3. Begaud E., Mondet D., Germani Y. Molecular characterization of enterotoxigenic Escherichia coli (ETEC) isolated in New Caledonia (value of potential protective antigens in oral vaccine candidates). Res Microbiol. 1993 Nov-Dec;144(9):721–728. doi: 10.1016/0923-2508(93)90036-2. [DOI] [PubMed] [Google Scholar]
  4. Binsztein N., Jouve M. J., Viboud G. I., López Moral L., Rivas M., Orskov I., Ahrén C., Svennerholm A. M. Colonization factors of enterotoxigenic Escherichia coli isolated from children with diarrhea in Argentina. J Clin Microbiol. 1991 Sep;29(9):1893–1898. doi: 10.1128/jcm.29.9.1893-1898.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Black R. E. Epidemiology of diarrhoeal disease: implications for control by vaccines. Vaccine. 1993;11(2):100–106. doi: 10.1016/0264-410x(93)90002-f. [DOI] [PubMed] [Google Scholar]
  6. Blanco J., Blanco M., Gonzalez E. A., Blanco J. E., Alonso M. P., Garabal J. I., Jansen W. H. Serotypes and colonization factors of enterotoxigenic Escherichia coli isolated in various countries. Eur J Epidemiol. 1993 Sep;9(5):489–496. doi: 10.1007/BF00209526. [DOI] [PubMed] [Google Scholar]
  7. Blanco J., González E. A., Blanco M., Garabal J. I., Alonso M. P., Fernández S., Villanueva R., Aguilera A., Garcia M. A., Torres J. Enterotoxigenic Escherichia coli associated with infant diarrhoea in Galicia, north-western Spain. J Med Microbiol. 1991 Sep;35(3):162–167. doi: 10.1099/00222615-35-3-162. [DOI] [PubMed] [Google Scholar]
  8. Cassels F. J., Wolf M. K. Colonization factors of diarrheagenic E. coli and their intestinal receptors. J Ind Microbiol. 1995 Sep;15(3):214–226. doi: 10.1007/BF01569828. [DOI] [PubMed] [Google Scholar]
  9. Changchawalit S., Echeverria P., Taylor D. N., Leksomboon U., Tirapat C., Eampokalap B., Rowe B. Colonization factors associated with enterotoxigenic Escherichia coli isolated in Thailand. Infect Immun. 1984 Aug;45(2):525–527. doi: 10.1128/iai.45.2.525-527.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Clemens J. D., Sack D. A., Harris J. R., Chakraborty J., Neogy P. K., Stanton B., Huda N., Khan M. U., Kay B. A., Khan M. R. Cross-protection by B subunit-whole cell cholera vaccine against diarrhea associated with heat-labile toxin-producing enterotoxigenic Escherichia coli: results of a large-scale field trial. J Infect Dis. 1988 Aug;158(2):372–377. doi: 10.1093/infdis/158.2.372. [DOI] [PubMed] [Google Scholar]
  11. Cravioto A., Reyes R. E., Ortega R., Fernández G., Hernández R., López D. Prospective study of diarrhoeal disease in a cohort of rural Mexican children: incidence and isolated pathogens during the first two years of life. Epidemiol Infect. 1988 Aug;101(1):123–134. doi: 10.1017/s0950268800029289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Cravioto A., Reyes R. E., Trujillo F., Uribe F., Navarro A., De La Roca J. M., Hernández J. M., Pérez G., Vázquez V. Risk of diarrhea during the first year of life associated with initial and subsequent colonization by specific enteropathogens. Am J Epidemiol. 1990 May;131(5):886–904. doi: 10.1093/oxfordjournals.aje.a115579. [DOI] [PubMed] [Google Scholar]
  13. Cárdenas L., Clements J. D. Development of mucosal protection against the heat-stable enterotoxin (ST) of Escherichia coli by oral immunization with a genetic fusion delivered by a bacterial vector. Infect Immun. 1993 Nov;61(11):4629–4636. doi: 10.1128/iai.61.11.4629-4636.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Dean A. G., Ching Y. C., Williams R. G., Harden L. B. Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhea in children in Honolulu. J Infect Dis. 1972 Apr;125(4):407–411. doi: 10.1093/infdis/125.4.407. [DOI] [PubMed] [Google Scholar]
  15. Echeverria P., Taylor D. N., Lexsomboon U., Bhaibulaya M., Blacklow N. R., Tamura K., Sakazaki R. Case-control study of endemic diarrheal disease in Thai children. J Infect Dis. 1989 Mar;159(3):543–548. doi: 10.1093/infdis/159.3.543. [DOI] [PubMed] [Google Scholar]
  16. Evans D. G., Evans D. J., Jr New surface-associated heat-labile colonization factor antigen (CFA/II) produced by enterotoxigenic Escherichia coli of serogroups O6 and O8. Infect Immun. 1978 Aug;21(2):638–647. doi: 10.1128/iai.21.2.638-647.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Evans D. G., Evans D. J., Jr, Opekun A. R., Graham D. Y. Non-replicating oral whole cell vaccine protective against enterotoxigenic Escherichia coli (ETEC) diarrhea: stimulation of anti-CFA (CFA/I) and anti-enterotoxin (anti-LT) intestinal IgA and protection against challenge with ETEC belonging to heterologous serotypes. FEMS Microbiol Immunol. 1988 Dec;1(3):117–125. doi: 10.1111/j.1574-6968.1988.tb02363.x. [DOI] [PubMed] [Google Scholar]
  18. Evans D. G., Graham D. Y., Evans D. J., Jr Administration of purified colonization factor antigens (CFA/I, CFA/II) of enterotoxigenic Escherichia coli to volunteers. Response to challenge with virulent enterotoxigenic Escherichia coli. Gastroenterology. 1984 Oct;87(4):934–940. [PubMed] [Google Scholar]
  19. Evans D. G., Silver R. P., Evans D. J., Jr, Chase D. G., Gorbach S. L. Plasmid-controlled colonization factor associated with virulence in Esherichia coli enterotoxigenic for humans. Infect Immun. 1975 Sep;12(3):656–667. doi: 10.1128/iai.12.3.656-667.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Fernández-Beros M. E., Kissel V., Agüero M. E., Figueroa G., D'Ottone K., Prado V., Cabello F. Further characterization of Escherichia coli O153:H45, an ETEC serotype disseminated in Chile. Can J Microbiol. 1988 Jan;34(1):85–88. doi: 10.1139/m88-017. [DOI] [PubMed] [Google Scholar]
  21. Fujii Y., Okamuro Y., Hitotsubashi S., Saito A., Akashi N., Okamoto K. Effect of alterations of basic amino acid residues of Escherichia coli heat-stable enterotoxin II on enterotoxicity. Infect Immun. 1994 Jun;62(6):2295–2301. doi: 10.1128/iai.62.6.2295-2301.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Giannella R. A. Escherichia coli heat-stable enterotoxins, guanylins, and their receptors: what are they and what do they do? J Lab Clin Med. 1995 Feb;125(2):173–181. [PubMed] [Google Scholar]
  23. Girón J. A., Viboud G. I., Sperandio V., Gómez-Duarte O. G., Maneval D. R., Albert M. J., Levine M. M., Kaper J. B. Prevalence and association of the longus pilus structural gene (lngA) with colonization factor antigens, enterotoxin types, and serotypes of enterotoxigenic Escherichia coli. Infect Immun. 1995 Oct;63(10):4195–4198. doi: 10.1128/iai.63.10.4195-4198.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Gomes T. A., Rassi V., MacDonald K. L., Ramos S. R., Trabulsi L. R., Vieira M. A., Guth B. E., Candeias J. A., Ivey C., Toledo M. R. Enteropathogens associated with acute diarrheal disease in urban infants in São Paulo, Brazil. J Infect Dis. 1991 Aug;164(2):331–337. doi: 10.1093/infdis/164.2.331. [DOI] [PubMed] [Google Scholar]
  25. Gonzalez E. A., Blanco J., Garabal I., Blanco M. Biotypes, antibiotic resistance and plasmids coding for CFA/I and STa in enterotoxigenic Escherichia coli strains of serotype O153:H45 isolated in Spain. J Med Microbiol. 1991 Feb;34(2):89–95. doi: 10.1099/00222615-34-2-89. [DOI] [PubMed] [Google Scholar]
  26. Gothefors L., Ahrén C., Stoll B., Barua D. K., Orskov F., Salek M. A., Svennerholm A. M. Presence of colonization factor antigens on fresh isolates of fecal Escherichia coli: a prospective study. J Infect Dis. 1985 Dec;152(6):1128–1133. doi: 10.1093/infdis/152.6.1128. [DOI] [PubMed] [Google Scholar]
  27. Guth B. E., Aguiar E. G., Griffin P. M., Ramos S. R., Gomes T. A. Prevalence of colonization factor antigens (CFAs) and adherence to HeLa cells in enterotoxigenic Escherichia coli isolated from feces of children in São Paulo. Microbiol Immunol. 1994;38(9):695–701. doi: 10.1111/j.1348-0421.1994.tb01844.x. [DOI] [PubMed] [Google Scholar]
  28. Harville B. A., Dreyfus L. A. Involvement of 5-hydroxytryptamine and prostaglandin E2 in the intestinal secretory action of Escherichia coli heat-stable enterotoxin B. Infect Immun. 1995 Mar;63(3):745–750. doi: 10.1128/iai.63.3.745-750.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Holmgren J., Czerkinsky C., Lycke N., Svennerholm A. M. Strategies for the induction of immune responses at mucosal surfaces making use of cholera toxin B subunit as immunogen, carrier, and adjuvant. Am J Trop Med Hyg. 1994;50(5 Suppl):42–54. [PubMed] [Google Scholar]
  30. Jann B., Shashkov A. A., Kochanowski H., Jann K. Structural comparison of the O6 specific polysaccharides from E. coli O6:K2:H1, E. coli O6:K13:H1, and E. coli O6:K54:H10. Carbohydr Res. 1994 Oct 17;263(2):217–225. doi: 10.1016/0008-6215(94)00167-7. [DOI] [PubMed] [Google Scholar]
  31. Jansson P. E., Lindberg B., Lönngren J., Ortega C., Svenson S. B. Structural studies of the Escherichia coli O-antigen 6. Carbohydr Res. 1984 Aug 15;131(2):277–283. doi: 10.1016/0008-6215(84)85250-7. [DOI] [PubMed] [Google Scholar]
  32. Jansson P. E., Lindberg B., Widmalm G., Leontein K. Structural studies of the Escherichia coli O78 O-antigen polysaccharide. Carbohydr Res. 1987 Jul 15;165(1):87–92. doi: 10.1016/0008-6215(87)80080-0. [DOI] [PubMed] [Google Scholar]
  33. Jansson P. E., Lönngren J., Widmalm G., Leontein K., Slettengren K., Svenson S. B., Wrangsell G., Dell A., Tiller P. R. Structural studies of the O-antigen polysaccharides of Klebsiella O5 and Escherichia coli O8. Carbohydr Res. 1985 Dec 15;145(1):59–66. doi: 10.1016/s0008-6215(00)90412-9. [DOI] [PubMed] [Google Scholar]
  34. Kapur V., White D. G., Wilson R. A., Whittam T. S. Outer membrane protein patterns mark clones of Escherichia coli O2 and O78 strains that cause avian septicemia. Infect Immun. 1992 Apr;60(4):1687–1691. doi: 10.1128/iai.60.4.1687-1691.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Knutton S., McConnell M. M., Rowe B., McNeish A. S. Adhesion and ultrastructural properties of human enterotoxigenic Escherichia coli producing colonization factor antigens III and IV. Infect Immun. 1989 Nov;57(11):3364–3371. doi: 10.1128/iai.57.11.3364-3371.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. McConnell M. M., Hibberd M. L., Penny M. E., Scotland S. M., Cheasty T., Rowe B. Surveys of human enterotoxigenic Escherichia coli from three different geographical areas for possible colonization factors. Epidemiol Infect. 1991 Jun;106(3):477–484. doi: 10.1017/s0950268800067522. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. McConnell M. M., Rowe B. Prevalence of the putative colonization factors CFA/III and PCFO159:H4 in enterotoxigenic Escherichia coli. J Infect Dis. 1989 Mar;159(3):582–586. doi: 10.1093/infdis/159.3.582. [DOI] [PubMed] [Google Scholar]
  38. McConnell M. M., Smith H. R., Willshaw G. A., Field A. M., Rowe B. Plasmids coding for colonization factor antigen I and heat-stable enterotoxin production isolated from enterotoxigenic Escherichia coli: comparison of their properties. Infect Immun. 1981 May;32(2):927–936. doi: 10.1128/iai.32.2.927-936.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. McConnell M. M., Thomas L. V., Day N. P., Rowe B. Enzyme-linked immunosorbent assays for the detection of adhesion factor antigens of enterotoxigenic Escherichia coli. J Infect Dis. 1985 Dec;152(6):1120–1127. doi: 10.1093/infdis/152.6.1120. [DOI] [PubMed] [Google Scholar]
  40. Moens S., Vanderleyden J. Functions of bacterial flagella. Crit Rev Microbiol. 1996;22(2):67–100. doi: 10.3109/10408419609106456. [DOI] [PubMed] [Google Scholar]
  41. Murray B. E., Evans D. J., Jr, Penãranda M. E., Evans D. G. CFA/I-ST plasmids: comparison of enterotoxigenic Escherichia coli (ETEC) of serogroups O25, O63, O78, and O128 and mobilization from an R factor-containing epidemic ETEC isolate. J Bacteriol. 1983 Jan;153(1):566–570. doi: 10.1128/jb.153.1.566-570.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Nandi A., Mathew R., Visweswariah S. S. Expression of the extracellular domain of the human heat-stable enterotoxin receptor in Escherichia coli and generation of neutralizing antibodies. Protein Expr Purif. 1996 Sep;8(2):151–159. doi: 10.1006/prep.1996.0087. [DOI] [PubMed] [Google Scholar]
  43. Ozaki H., Sato T., Kubota H., Hata Y., Katsube Y., Shimonishi Y. Molecular structure of the toxin domain of heat-stable enterotoxin produced by a pathogenic strain of Escherichia coli. A putative binding site for a binding protein on rat intestinal epithelial cell membranes. J Biol Chem. 1991 Mar 25;266(9):5934–5941. [PubMed] [Google Scholar]
  44. Pacheco A. B., Guth B. E., de Almeida D. F., Ferreira L. C. Characterization of enterotoxigenic Escherichia coli by random amplification of polymorphic DNA. Res Microbiol. 1996 Mar-Apr;147(3):175–182. doi: 10.1016/0923-2508(96)80217-8. [DOI] [PubMed] [Google Scholar]
  45. Peltola H., Siitonen A., Kyrönseppä H., Simula I., Mattila L., Oksanen P., Kataja M. J., Cadoz M. Prevention of travellers' diarrhoea by oral B-subunit/whole-cell cholera vaccine. Lancet. 1991 Nov 23;338(8778):1285–1289. doi: 10.1016/0140-6736(91)92590-x. [DOI] [PubMed] [Google Scholar]
  46. Peñaranda M. E., Evans D. G., Murray B. E., Evans D. J., Jr ST:LT:CFA/II plasmids in enterotoxigenic Escherichia coli belonging to serogroups O6, O8, O80, O85, and O139. J Bacteriol. 1983 May;154(2):980–983. doi: 10.1128/jb.154.2.980-983.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Polotsky Y. u., Dragunsky E., Khavkin T. h. Morphologic evaluation of the pathogenesis of bacterial enteric infections. Crit Rev Microbiol. 1994;20(3):161–208. doi: 10.3109/10408419409114553. [DOI] [PubMed] [Google Scholar]
  48. Ratnayake S., Weintraub A., Widmalm G. Structural studies of the enterotoxigenic Escherichia coli (ETEC) O153 O-antigenic polysaccharide. Carbohydr Res. 1994 Dec 2;265(1):113–120. doi: 10.1016/0008-6215(94)00220-7. [DOI] [PubMed] [Google Scholar]
  49. Reis M. H., Heloiza M., Affonso T., Trabulsi L. R., Mazaitis A. J., Maas R., Maas W. K. Transfer of a CFA/I-ST plasmid promoted by a conjugative plasmid in a strain of Escherichia coli of serotype O128ac:H12. Infect Immun. 1980 Jul;29(1):140–143. doi: 10.1128/iai.29.1.140-143.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Sanchez J., Argotte R., Buelna A. Engineering of cholera toxin A-subunit for carriage of epitopes at its amino end. FEBS Lett. 1997 Jan 13;401(1):95–97. doi: 10.1016/s0014-5793(96)01445-7. [DOI] [PubMed] [Google Scholar]
  51. Sanchez J., Johansson S., Löwenadler B., Svennerholm A. M., Holmgren J. Recombinant cholera toxin B subunit and gene fusion proteins for oral vaccination. Res Microbiol. 1990 Sep-Oct;141(7-8):971–979. doi: 10.1016/0923-2508(90)90137-f. [DOI] [PubMed] [Google Scholar]
  52. Sato T., Ozaki H., Hata Y., Kitagawa Y., Katsube Y., Shimonishi Y. Structural characteristics for biological activity of heat-stable enterotoxin produced by enterotoxigenic Escherichia coli: X-ray crystallography of weakly toxic and nontoxic analogs. Biochemistry. 1994 Jul 26;33(29):8641–8650. doi: 10.1021/bi00195a004. [DOI] [PubMed] [Google Scholar]
  53. Sears C. L., Kaper J. B. Enteric bacterial toxins: mechanisms of action and linkage to intestinal secretion. Microbiol Rev. 1996 Mar;60(1):167–215. doi: 10.1128/mr.60.1.167-215.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Selander R. K., Caugant D. A., Ochman H., Musser J. M., Gilmour M. N., Whittam T. S. Methods of multilocus enzyme electrophoresis for bacterial population genetics and systematics. Appl Environ Microbiol. 1986 May;51(5):873–884. doi: 10.1128/aem.51.5.873-884.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Sen D., Ganguly U., Saha M. R., Bhattacharya S. K., Datta P., Datta D., Mukherjee A. K., Chakravarty R., Pal S. C. Studies on Escherichia coli as a cause of acute diarrhoea in Calcutta. J Med Microbiol. 1984 Feb;17(1):53–58. doi: 10.1099/00222615-17-1-53. [DOI] [PubMed] [Google Scholar]
  56. Skelton N. J., Garcia K. C., Goeddel D. V., Quan C., Burnier J. P. Determination of the solution structure of the peptide hormone guanylin: observation of a novel form of topological stereoisomerism. Biochemistry. 1994 Nov 22;33(46):13581–13592. doi: 10.1021/bi00250a010. [DOI] [PubMed] [Google Scholar]
  57. Smith H. R., Scotland S. M., Rowe B. Plasmids that code for production of colonization factor antigen II and enterotoxin production in strains of Escherichia coli. Infect Immun. 1983 Jun;40(3):1236–1239. doi: 10.1128/iai.40.3.1236-1239.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Smith H. W., Linggood M. A. Observations on the pathogenic properties of the K88, Hly and Ent plasmids of Escherichia coli with particular reference to porcine diarrhoea. J Med Microbiol. 1971 Nov;4(4):467–485. doi: 10.1099/00222615-4-4-467. [DOI] [PubMed] [Google Scholar]
  59. Smyth C. J. Two mannose-resistant haemagglutinins on enterotoxigenic Escherichia coli of serotype O6:K15:H16 or H-isolated from travellers' and infantile diarrhoea. J Gen Microbiol. 1982 Sep;128(9):2081–2096. doi: 10.1099/00221287-128-9-2081. [DOI] [PubMed] [Google Scholar]
  60. Snider D. P. The mucosal adjuvant activities of ADP-ribosylating bacterial enterotoxins. Crit Rev Immunol. 1995;15(3-4):317–348. doi: 10.1615/critrevimmunol.v15.i3-4.70. [DOI] [PubMed] [Google Scholar]
  61. So M., Heffron F., McCarthy B. J. The E. coli gene encoding heat stable toxin is a bacterial transposon flanked by inverted repeats of IS1. Nature. 1979 Feb 8;277(5696):453–456. doi: 10.1038/277453a0. [DOI] [PubMed] [Google Scholar]
  62. Spangler B. D. Structure and function of cholera toxin and the related Escherichia coli heat-labile enterotoxin. Microbiol Rev. 1992 Dec;56(4):622–647. doi: 10.1128/mr.56.4.622-647.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  63. Svennerholm A. M., Holmgren J., Sack D. A. Development of oral vaccines against enterotoxinogenic Escherichia coli diarrhoea. Vaccine. 1989 Jun;7(3):196–198. doi: 10.1016/0264-410x(89)90228-4. [DOI] [PubMed] [Google Scholar]
  64. Thomas L. V., Cravioto A., Scotland S. M., Rowe B. New fimbrial antigenic type (E8775) that may represent a colonization factor in enterotoxigenic Escherichia coli in humans. Infect Immun. 1982 Mar;35(3):1119–1124. doi: 10.1128/iai.35.3.1119-1124.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Thomas L. V., McConnell M. M., Rowe B., Field A. M. The possession of three novel coli surface antigens by enterotoxigenic Escherichia coli strains positive for the putative colonization factor PCF8775. J Gen Microbiol. 1985 Sep;131(9):2319–2326. doi: 10.1099/00221287-131-9-2319. [DOI] [PubMed] [Google Scholar]
  66. Thomas L. V., Rowe B., McConnell M. M. In strains of Escherichia coli O167 a single plasmid encodes for the coli surface antigens CS5 and CS6 of putative colonization factor PCF8775, heat-stable enterotoxin, and colicin Ia. Infect Immun. 1987 Aug;55(8):1929–1931. doi: 10.1128/iai.55.8.1929-1931.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. Thomas L. V., Rowe B. The occurrence of colonisation factors (CFA/I, CFA/II and E8775) in enterotoxigenic Escherichia coli from various countries in South East Asia. Med Microbiol Immunol. 1982;171(2):85–90. doi: 10.1007/BF02124915. [DOI] [PubMed] [Google Scholar]
  68. Willshaw G. A., Cheasty T., Rowe B., Smith H. R., Faithfull-Davies D. N., Brooks T. G. Isolation of enterotoxigenic Escherichia coli from British troops in Saudi Arabia. Epidemiol Infect. 1995 Dec;115(3):455–463. doi: 10.1017/s0950268800058611. [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Wolf M. K., Taylor D. N., Boedeker E. C., Hyams K. C., Maneval D. R., Levine M. M., Tamura K., Wilson R. A., Echeverria P. Characterization of enterotoxigenic Escherichia coli isolated from U.S. troops deployed to the Middle East. J Clin Microbiol. 1993 Apr;31(4):851–856. doi: 10.1128/jcm.31.4.851-856.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Wood L. V., Wolfe W. H., Ruiz-Palacios G., Foshee W. S., Corman L. I., McCleskey F., Wright J. A., DuPont H. L. An outbreak of gastroenteritis due to a heat-labile enterotoxin-producing strain of Escherichia coli. Infect Immun. 1983 Sep;41(3):931–934. doi: 10.1128/iai.41.3.931-934.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Zaki A. M., DuPont H. L., el Alamy M. A., Arafat R. R., Amin K., Awad M. M., Bassiouni L., Imam I. Z., el Malih G. S., el Marsafie A. The detection of enteropathogens in acute diarrhea in a family cohort population in rural Egypt. Am J Trop Med Hyg. 1986 Sep;35(5):1013–1022. doi: 10.4269/ajtmh.1986.35.1013. [DOI] [PubMed] [Google Scholar]

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