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. 1977 Jul;17(1):78–82. doi: 10.1128/iai.17.1.78-82.1977

Diarrhea caused by Escherichia coli that produce only heat-stable enterotoxin.

M M Levine, E S Caplan, D Waterman, R A Cash, R B Hornick, M J Snyder
PMCID: PMC421084  PMID: 328397

Abstract

To determine the role of Escherichia coli heat-stable enterotoxin (ST) as a virulence factor in human diarrhea, a strain that elaborates only ST (E. coli 214-4) was fed to free-living volunteers in doses of 10(6), 10(8), and 10(10) organisms. Short-lived (1 day) mild illness consisting of abdominal cramps with vomiting or diarrhea occurred in three of five individuals fed 10(8). Typical travelers' diarrhea (loose stools, abdominal cramps, and low-grade fever for 2 to 3 days) was seen in four of five volunteers given 10(10); two had brief cholera-like purging of rice-water stools. Despite fever, there was no evidence of mucosal invasion. E. coli 214-4 became the predominant coliform in stools; coproculture isolates were uniformly negative for heat-labile enterotoxin (LT), whereas most produced ST. Ten of 13 individuals developed rises in antibody to somatic E. coli antigen, and none had rises in LT antitoxin. E. coli that elaborate only ST can cause diarrheal disease in adults.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. CAREY J. B., Jr A SIMPLIFIED GASTROINTESTINAL BIOPSY CAPSULE. Gastroenterology. 1964 May;46:550–557. [PubMed] [Google Scholar]
  2. Cash R. A., Music S. I., Libonati J. P., Snyder M. J., Wenzel R. P., Hornick R. B. Response of man to infection with Vibrio cholerae. I. Clinical, serologic, and bacteriologic responses to a known inoculum. J Infect Dis. 1974 Jan;129(1):45–52. doi: 10.1093/infdis/129.1.45. [DOI] [PubMed] [Google Scholar]
  3. 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]
  4. Donta S. T., Sack D. A., Wallace R. B., Dupont H. L., Sack R. B. Tissue-culture assay of antibodies to heat-liable Escherichia coli enterotoxins. N Engl J Med. 1974 Jul 18;291(3):117–121. doi: 10.1056/NEJM197407182910302. [DOI] [PubMed] [Google Scholar]
  5. Evans D. G., Evans D. J., Jr, Pierce N. F. Differences in the response of rabbit small intestine to heat-labile and heat-stable enterotoxins of Escherichia coli. Infect Immun. 1973 Jun;7(6):873–880. doi: 10.1128/iai.7.6.873-880.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gorbach S. L., Kean B. H., Evans D. G., Evans D. J., Jr, Bessudo D. Travelers' diarrhea and toxigenic Escherichia coli. N Engl J Med. 1975 May 1;292(18):933–936. doi: 10.1056/NEJM197505012921801. [DOI] [PubMed] [Google Scholar]
  7. Gross R. J., Scotland S. M., Rowe B. Enterotoxin testing of Escherichia coli causing epidemic infantile enteritis in the U.K. Lancet. 1976 Mar 20;1(7960):629–631. doi: 10.1016/s0140-6736(76)90429-3. [DOI] [PubMed] [Google Scholar]
  8. 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]
  9. Harris J. C., Dupont H. L., Hornick R. B. Fecal leukocytes in diarrheal illness. Ann Intern Med. 1972 May;76(5):697–703. doi: 10.7326/0003-4819-76-5-697. [DOI] [PubMed] [Google Scholar]
  10. Levine M. M., DuPont H. L., Formal S. B., Hornick R. B., Takeuchi A., Gangarosa E. J., Snyder M. J., Libonati J. P. Pathogenesis of Shigella dysenteriae 1 (Shiga) dysentery. J Infect Dis. 1973 Mar;127(3):261–270. doi: 10.1093/infdis/127.3.261. [DOI] [PubMed] [Google Scholar]
  11. Merson M. H., Morris G. K., Sack D. A., Wells J. G., Feeley J. C., Sack R. B., Creech W. B., Kapikian A. Z., Gangarosa E. J. Travelers' diarrhea in Mexico. A prospective study of physicians and family members attending a congress. N Engl J Med. 1976 Jun 10;294(24):1299–1305. doi: 10.1056/NEJM197606102942401. [DOI] [PubMed] [Google Scholar]
  12. Nalin D. R., Bhattacharjee A. K., Richardson S. H. Cholera-like toxic effect of culture filtrates of Escherichia coli. J Infect Dis. 1974 Dec;130(6):595–607. doi: 10.1093/infdis/130.6.595. [DOI] [PubMed] [Google Scholar]
  13. Nalin D. R. Enterotoxigenic E. coli in Bangladesh. Lancet. 1976 Jun 12;1(7972):1300–1300. doi: 10.1016/s0140-6736(76)91774-8. [DOI] [PubMed] [Google Scholar]
  14. Nalin D. R., McLaughlin J. C., Rahaman M., Yunus M., Curlin G. Enterotoxigenic Escherichia coli and idiopathic diarrhoea in Bangladesh. Lancet. 1975 Dec 6;2(7945):1116–1119. doi: 10.1016/s0140-6736(75)91005-3. [DOI] [PubMed] [Google Scholar]
  15. Nalin D. R., al-Mahmud A., Curlin G., Ahmed A., Peterson J. Cholera toxoid boosts serum Escherichia coli antitoxin in humans. Infect Immun. 1974 Oct;10(4):747–749. doi: 10.1128/iai.10.4.747-749.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Ryder R. W., Sack D. A., Kapikian A. Z., McLaughlin J. C., Chakraborty J., Mizanur Rahman A. S., Merson M. H., Wells J. G. Enterotoxigenic Escherichia coli and Reovirus-like agent in rural Bangladesh. Lancet. 1976 Mar 27;1(7961):659–663. doi: 10.1016/s0140-6736(76)92776-8. [DOI] [PubMed] [Google Scholar]
  17. 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]
  18. Sack D. A., Merson M. H., Wells J. G., Sack R. B., Morris G. K. Diarrhoea associated with heat-stable enterotoxin-producing strains of Escherichia coli. Lancet. 1975 Aug 9;2(7928):239–241. doi: 10.1016/s0140-6736(75)90958-7. [DOI] [PubMed] [Google Scholar]
  19. Sack D. A., Sack R. B. Test for enterotoxigenic Escherichia coli using Y-1 adrenal cells in miniculture. Infect Immun. 1975 Feb;11(2):334–336. doi: 10.1128/iai.11.2.334-336.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Sack R. B., Hirschborn N., Woodward W. E., Sack D. A., Cash R. A. Antibodies to heat-labile Escherichia coli enterotoxin in Apaches in Whiteriver, Arizona. Infect Immun. 1975 Dec;12(6):1475–1477. doi: 10.1128/iai.12.6.1475-1477.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Sack R. B., Hirschhorn N., Brownlee I., Cash R. A., Woodward W. E., Sack D. A. Enterotoxigenic Escherichia-coli-associated diarrheal disease in Apache children. N Engl J Med. 1975 May 15;292(20):1041–1045. doi: 10.1056/NEJM197505152922001. [DOI] [PubMed] [Google Scholar]
  22. Sack R. B. Human diarrheal disease caused by enterotoxigenic Escherichia coli. Annu Rev Microbiol. 1975;29:333–353. doi: 10.1146/annurev.mi.29.100175.002001. [DOI] [PubMed] [Google Scholar]
  23. Smith H. W., Halls S. Observations by the ligated intestinal segment and oral inoculation methods on Escherichia coli infections in pigs, calves, lambs and rabbits. J Pathol Bacteriol. 1967 Apr;93(2):499–529. doi: 10.1002/path.1700930211. [DOI] [PubMed] [Google Scholar]

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