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. 1989 Aug;103(1):53–62. doi: 10.1017/s0950268800030351

The association of enterotoxigenic and enteropathogenic Escherichia coli and other enteric pathogens with childhood diarrhoea in Yugoslavia.

M Cobeljić 1, D Mel 1, B Arsić 1, L Krstić 1, B Sokolovski 1, B Nikolovski 1, E Sopovski 1, M Kulauzov 1, S Kalenić 1
PMCID: PMC2249489  PMID: 2673826

Abstract

The presence of enterotoxigenic and enteropathogenic Escherichia coli (ETEC and EPEC, respectively) was investigated in stool specimens of 1082 preschool children with diarrhoea and in stools of 335 healthy controls in localities in southern Yugoslavia, as well as in 566 children with diarrhoea and in 231 controls living in northern part of the country, during the seasonal peak (August-November) of enteric diseases in 1986. ETEC were found in 114 (10.5%) children with diarrhoea and in 14 (4.2%) controls (P less than 0.001) in the southern part, and in 26 (4.6%) ill children and one (0.4%) well child (P less than 0.005) in the northern part of Yugoslavia. EPEC were isolated from stools of 85 (7.9%) children with diarrhoea and of 14 (4.2%) well children (P less than 0.05) in localities of southern Yugoslavia, and from 22 (3.9%) ill children and from 10 (4.3%) controls in northern Yugoslavia. Nineteen EPEC strains expressed localized adherence to HEp-2 tissue culture cells; all were isolated from stools of ill children. In southern Yugoslavia, where other enteropathogens were sought, the most commonly found agents in ill children were shigellae (17.5%), rotavirus (11.8%), ETEC, and EPEC. Potential pathogens were detected in 44.5% cases of sporadic diarrhoea and in 15.8% controls. This study revealed that ETEC were associated with acute diarrhoeal disease in Yugoslav preschool children. On the other hand, the diagnosis of EPEC-diarrhoea by routine determination of serogroup established the association of these agents with sporadic diarrhoea only in the 0-2 years age categories in all investigated localities. In the less developed southern part of Yugoslavia bacteria were the predominant causative agents of enteric illness during the seasonal peak of this disease.

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Selected References

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  1. Black R. E., Merson M. H., Rahman A. S., Yunus M., Alim A. R., Huq I., Yolken R. H., Curlin G. T. A two-year study of bacterial, viral, and parasitic agents associated with diarrhea in rural Bangladesh. J Infect Dis. 1980 Nov;142(5):660–664. doi: 10.1093/infdis/142.5.660. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brunton J., Hinde D., Langston C., Gross R., Rowe B., Gurwith M. Enterotoxigenic Escherichia coli in central Canada. J Clin Microbiol. 1980 Apr;11(4):343–348. doi: 10.1128/jcm.11.4.343-348.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chatkaeomorakot A., Echeverria P., Taylor D. N., Bettelheim K. A., Blacklow N. R., Sethabutr O., Seriwatana J., Kaper J. HeLa cell-adherent Escherichia coli in children with diarrhea in Thailand. J Infect Dis. 1987 Oct;156(4):669–672. doi: 10.1093/infdis/156.4.669. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. Donta S. T., Wallace R. B., Whipp S. C., Olarte J. Enterotoxigenic Escherichia coli and diarrheal disease in Mexican children. J Infect Dis. 1977 Mar;135(3):482–485. doi: 10.1093/infdis/135.3.482. [DOI] [PubMed] [Google Scholar]
  6. Echeverria P., Seriwatana J., Taylor D. N., Yanggratoke S., Tirapat C. A comparative study of enterotoxigenic Escherichia coli, Shigella, Aeromonas, and Vibrio as etiologies of diarrhea in northeastern Thailand. Am J Trop Med Hyg. 1985 May;34(3):547–554. doi: 10.4269/ajtmh.1985.34.547. [DOI] [PubMed] [Google Scholar]
  7. Echeverria P., Taylor D. N., Donohue-Rolfe A., Supawat K., Ratchtrachenchai O., Kaper J., Keusch G. T. HeLa cell adherence and cytotoxin production by enteropathogenic Escherichia coli isolated from infants with diarrhea in Thailand. J Clin Microbiol. 1987 Aug;25(8):1519–1523. doi: 10.1128/jcm.25.8.1519-1523.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Evans D. J., Jr, Evans D. G., DuPont H. L. Hemagglutination patterns of enterotoxigenic and enteropathogenic Escherichia coli determined with human, bovine, chicken, and guinea pig erythrocytes in the presence and absence of mannose. Infect Immun. 1979 Feb;23(2):336–346. doi: 10.1128/iai.23.2.336-346.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gross R. J., Rowe B. Escherichia coli diarrhoea. J Hyg (Lond) 1985 Dec;95(3):531–550. doi: 10.1017/s0022172400060666. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Guerrant R. L., Brunton L. L., Schnaitman T. C., Rebhun L. I., Gilman A. G. Cyclic adenosine monophosphate and alteration of Chinese hamster ovary cell morphology: a rapid, sensitive in vitro assay for the enterotoxins of Vibrio cholerae and Escherichia coli. Infect Immun. 1974 Aug;10(2):320–327. doi: 10.1128/iai.10.2.320-327.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Guerrant R. L., Kirchhoff L. V., Shields D. S., Nations M. K., Leslie J., de Sousa M. A., Araujo J. G., Correia L. L., Sauer K. T., McClelland K. E. Prospective study of diarrheal illnesses in northeastern Brazil: patterns of disease, nutritional impact, etiologies, and risk factors. J Infect Dis. 1983 Dec;148(6):986–997. doi: 10.1093/infdis/148.6.986. [DOI] [PubMed] [Google Scholar]
  12. Hughes J. M., Rouse J. D., Barada F. A., Guerrant R. L. Etiology of summer diarrhea among the Navajo. Am J Trop Med Hyg. 1980 Jul;29(4):613–619. doi: 10.4269/ajtmh.1980.29.613. [DOI] [PubMed] [Google Scholar]
  13. Kapikian A. Z., Kim H. W., Wyatt R. G., Cline W. L., Arrobio J. O., Brandt C. D., Rodriguez W. J., Sack D. A., Chanock R. M., Parrott R. H. Human reovirus-like agent as the major pathogen associated with "winter" gastroenteritis in hospitalized infants and young children. N Engl J Med. 1976 Apr 29;294(18):965–972. doi: 10.1056/NEJM197604292941801. [DOI] [PubMed] [Google Scholar]
  14. Karch H., Heesemann J., Laufs R. Phage-associated cytotoxin production by and enteroadhesiveness of enteropathogenic Escherichia coli isolated from infants with diarrhea in West Germany. J Infect Dis. 1987 Apr;155(4):707–715. doi: 10.1093/infdis/155.4.707. [DOI] [PubMed] [Google Scholar]
  15. Konowalchuk J., Speirs J. I., Stavric S. Vero response to a cytotoxin of Escherichia coli. Infect Immun. 1977 Dec;18(3):775–779. doi: 10.1128/iai.18.3.775-779.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Koopman J. S., Turkish V. J., Monto A. S., Gouvea V., Srivastava S., Isaacson R. E. Patterns and etiology of diarrhea in three clinical settings. Am J Epidemiol. 1984 Jan;119(1):114–123. doi: 10.1093/oxfordjournals.aje.a113712. [DOI] [PubMed] [Google Scholar]
  17. Leksomboon U., Echeverria P., Suvongse C., Duangmani C. Viruses and bacteria in pediatric diarrhea in Thailand: a study of multiple antibiotic-resistant enteric pathogens. Am J Trop Med Hyg. 1981 Nov;30(6):1281–1290. doi: 10.4269/ajtmh.1981.30.1281. [DOI] [PubMed] [Google Scholar]
  18. Levine M. M. Escherichia coli that cause diarrhea: enterotoxigenic, enteropathogenic, enteroinvasive, enterohemorrhagic, and enteroadherent. J Infect Dis. 1987 Mar;155(3):377–389. doi: 10.1093/infdis/155.3.377. [DOI] [PubMed] [Google Scholar]
  19. Mathewson J. J., Johnson P. C., DuPont H. L., Satterwhite T. K., Winsor D. K. Pathogenicity of enteroadherent Escherichia coli in adult volunteers. J Infect Dis. 1986 Sep;154(3):524–527. doi: 10.1093/infdis/154.3.524. [DOI] [PubMed] [Google Scholar]
  20. Mathewson J. J., Oberhelman R. A., Dupont H. L., Javier de la Cabada F., Garibay E. V. Enteroadherent Escherichia coli as a cause of diarrhea among children in Mexico. J Clin Microbiol. 1987 Oct;25(10):1917–1919. doi: 10.1128/jcm.25.10.1917-1919.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. 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]
  22. Nataro J. P., Kaper J. B., Robins-Browne R., Prado V., Vial P., Levine M. M. Patterns of adherence of diarrheagenic Escherichia coli to HEp-2 cells. Pediatr Infect Dis J. 1987 Sep;6(9):829–831. doi: 10.1097/00006454-198709000-00008. [DOI] [PubMed] [Google Scholar]
  23. Nataro J. P., Scaletsky I. C., Kaper J. B., Levine M. M., Trabulsi L. R. Plasmid-mediated factors conferring diffuse and localized adherence of enteropathogenic Escherichia coli. Infect Immun. 1985 May;48(2):378–383. doi: 10.1128/iai.48.2.378-383.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Robins-Browne R. M. Traditional enteropathogenic Escherichia coli of infantile diarrhea. Rev Infect Dis. 1987 Jan-Feb;9(1):28–53. doi: 10.1093/clinids/9.1.28. [DOI] [PubMed] [Google Scholar]
  25. 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]
  26. Spencer H. C., Wells J. G., Gary G. W., Sondy J., Puhr N. D., Feldman R. A. Diarrhea in a non-hospitalized rural Salvadoran population: the role of enterotoxigenic Escherichia coli and rotavirus. Am J Trop Med Hyg. 1980 Mar;29(2):246–253. doi: 10.4269/ajtmh.1980.29.246. [DOI] [PubMed] [Google Scholar]
  27. Stintzing G., Bäck E., Tufvesson B., Johnsson T., Wadström T., Habte D. Seasonal fluctuations in the occurrence of enterotoxigenic bacteria and rotavirus in paediatric diarrhoea in Addis Ababa. Bull World Health Organ. 1981;59(1):67–73. [PMC free article] [PubMed] [Google Scholar]
  28. de Mol P., Brasseur D., Hemelhof W., Kalala T., Butzler J. P., Vis H. L. Enteropathogenic agents in children with diarrhoea in rural Zaire. Lancet. 1983 Mar 5;1(8323):516–518. doi: 10.1016/s0140-6736(83)92202-x. [DOI] [PubMed] [Google Scholar]

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