Abstract
A case of persistent diarrhea following Escherichia coli O18ab gastroenteritis is reported. Electron microscopy of a biopsy of the small intestine showed effacement of the brush border, attachment of bacteria to the epithelial cells with pedestal formation, and bacteria within the enterocytes. The bacterial isolate was an enteropathogenic E. coli isolate which did not contain the adherence factor (EAF) but possessed the attaching-effacing eae gene, was able to invade HeLa cells in a gentamicin invasion assay, and also invaded rabbit intestinal cells. Results suggest that E. coli organisms of the O18ab serotype may cause diarrhea by an as yet unknown pathogenic mechanism, involving attaching to and effacing of enterocytes followed by invasion of the epithelial cells.
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- Bilge S. S., Clausen C. R., Lau W., Moseley S. L. Molecular characterization of a fimbrial adhesin, F1845, mediating diffuse adherence of diarrhea-associated Escherichia coli to HEp-2 cells. J Bacteriol. 1989 Aug;171(8):4281–4289. doi: 10.1128/jb.171.8.4281-4289.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bratoeva M. P., Wolf M. K., Marks J. K., Cantey J. R. A case of diarrhea, bacteremia, and fever caused by a novel strain of Escherichia coli. J Clin Microbiol. 1994 May;32(5):1383–1386. doi: 10.1128/jcm.32.5.1383-1386.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cantey J. R., Blake R. K. Diarrhea due to Escherichia coli in the rabbit: a novel mechanism. J Infect Dis. 1977 Mar;135(3):454–462. doi: 10.1093/infdis/135.3.454. [DOI] [PubMed] [Google Scholar]
- Clausen C. R., Christie D. L. Chronic diarrhea in infants caused by adherent enteropathogenic Escherichia coli. J Pediatr. 1982 Mar;100(3):358–361. doi: 10.1016/s0022-3476(82)80429-0. [DOI] [PubMed] [Google Scholar]
- Donnenberg M. S., Donohue-Rolfe A., Keusch G. T. Epithelial cell invasion: an overlooked property of enteropathogenic Escherichia coli (EPEC) associated with the EPEC adherence factor. J Infect Dis. 1989 Sep;160(3):452–459. doi: 10.1093/infdis/160.3.452. [DOI] [PubMed] [Google Scholar]
- Fagundes-Neto U., Freymuller E., Gatti M. S., Schmitz L. G., Scaletsky I. Enteropathogenic Escherichia coli O111ab:H2 penetrates the small bowel epithelium in an infant with acute diarrhoea. Acta Paediatr. 1995 Apr;84(4):453–455. doi: 10.1111/j.1651-2227.1995.tb13670.x. [DOI] [PubMed] [Google Scholar]
- Francis C. L., Jerse A. E., Kaper J. B., Falkow S. Characterization of interactions of enteropathogenic Escherichia coli O127:H6 with mammalian cells in vitro. J Infect Dis. 1991 Oct;164(4):693–703. doi: 10.1093/infdis/164.4.693. [DOI] [PubMed] [Google Scholar]
- Guerrant R. L., Moore R. A., Kirschenfeld P. M., Sande M. A. Role of toxigenic and invasive bacteria in acute diarrhea of childhood. N Engl J Med. 1975 Sep 18;293(12):567–572. doi: 10.1056/NEJM197509182931201. [DOI] [PubMed] [Google Scholar]
- Haraszti M., Czirók E. Properties of Escherichia coli serogroup O18 strains isolated from an outbreak of enteritis among newborn infants. Acta Microbiol Acad Sci Hung. 1967;14(3):299–304. [PubMed] [Google Scholar]
- Hill S. M., Phillips A. D., Walker-Smith J. A. Enteropathogenic Escherichia coli and life threatening chronic diarrhoea. Gut. 1991 Feb;32(2):154–158. doi: 10.1136/gut.32.2.154. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jerse A. E., Gicquelais K. G., Kaper J. B. Plasmid and chromosomal elements involved in the pathogenesis of attaching and effacing Escherichia coli. Infect Immun. 1991 Nov;59(11):3869–3875. doi: 10.1128/iai.59.11.3869-3875.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Knutton S., Baldwin T., Williams P. H., McNeish A. S. Actin accumulation at sites of bacterial adhesion to tissue culture cells: basis of a new diagnostic test for enteropathogenic and enterohemorrhagic Escherichia coli. Infect Immun. 1989 Apr;57(4):1290–1298. doi: 10.1128/iai.57.4.1290-1298.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Knutton S., Phillips A. D., Smith H. R., Gross R. J., Shaw R., Watson P., Price E. Screening for enteropathogenic Escherichia coli in infants with diarrhea by the fluorescent-actin staining test. Infect Immun. 1991 Jan;59(1):365–371. doi: 10.1128/iai.59.1.365-371.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maas R. An improved colony hybridization method with significantly increased sensitivity for detection of single genes. Plasmid. 1983 Nov;10(3):296–298. doi: 10.1016/0147-619x(83)90045-8. [DOI] [PubMed] [Google Scholar]
- Moon H. W., Whipp S. C., Argenzio R. A., Levine M. M., Giannella R. A. Attaching and effacing activities of rabbit and human enteropathogenic Escherichia coli in pig and rabbit intestines. Infect Immun. 1983 Sep;41(3):1340–1351. doi: 10.1128/iai.41.3.1340-1351.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nataro J. P., Baldini M. M., Kaper J. B., Black R. E., Bravo N., Levine M. M. Detection of an adherence factor of enteropathogenic Escherichia coli with a DNA probe. J Infect Dis. 1985 Sep;152(3):560–565. doi: 10.1093/infdis/152.3.560. [DOI] [PubMed] [Google Scholar]
- Orskov F., Orskov I. Escherichia coli serotyping and disease in man and animals. Can J Microbiol. 1992 Jul;38(7):699–704. [PubMed] [Google Scholar]
- Rothbaum R., McAdams A. J., Giannella R., Partin J. C. A clinicopathologic study of enterocyte-adherent Escherichia coli: a cause of protracted diarrhea in infants. Gastroenterology. 1982 Aug;83(2):441–454. [PubMed] [Google Scholar]
- Ryder R. W., Wachsmuth I. K., Buxton A. E., Evans D. G., DuPont H. L., Mason E., Barrett F. F. Infantile diarrhea produced by heat-stable enterotoxigenic Escherichia coli. N Engl J Med. 1976 Oct 14;295(16):849–853. doi: 10.1056/NEJM197610142951601. [DOI] [PubMed] [Google Scholar]
- Scaletsky I. C., Silva M. L., Trabulsi L. R. Distinctive patterns of adherence of enteropathogenic Escherichia coli to HeLa cells. Infect Immun. 1984 Aug;45(2):534–536. doi: 10.1128/iai.45.2.534-536.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Siitonen A., Takala A., Ratiner Y. A., Pere A., Mäkelä P. H. Invasive Escherichia coli infections in children: bacterial characteristics in different age groups and clinical entities. Pediatr Infect Dis J. 1993 Jul;12(7):606–612. doi: 10.1097/00006454-199307000-00012. [DOI] [PubMed] [Google Scholar]
- Staley T. E., Jones E. W., Corley L. D. Attachment and penetration of Escherichia coli into intestinal epithelium of the ileum in newborn pigs. Am J Pathol. 1969 Sep;56(3):371–392. [PMC free article] [PubMed] [Google Scholar]
- Ulshen M. H., Rollo J. L. Pathogenesis of escherichia coli gastroenteritis in man--another mechanism. N Engl J Med. 1980 Jan 10;302(2):99–101. doi: 10.1056/NEJM198001103020207. [DOI] [PubMed] [Google Scholar]