Attaching and effacing Escherichia coli isolates from Danish children: clinical significance and microbiological characteristics.

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  • C Jensen
  • S Ethelberg
  • B Olesen
  • P Schiellerup
  • K E P Olsen
  • F Scheutz
  • E M Nielsen
  • J Neimann
  • Høgh, Birthe
  • P Gerner-Smidt
  • K Mølbak
  • K A Krogfelt
This study describes the prevalence, clinical manifestations and microbiological characteristics of attaching and effacing Escherichia coli isolates, i.e., enteropathogenic E. coli (EPEC) belonging to the classical EPEC serotypes, non-EPEC attaching and effacing E. coli (A/EEC) and verocytotoxin-producing E. coli (VTEC), isolated in a case-control study of Danish children aged <5 years. Among 424 children with diarrhoea and 866 healthy controls, EPEC and VTEC were more prevalent in cases (2.4% and 2.6%, respectively) than in controls (0.7% and 0.7%, respectively). There was a high frequency of A/EEC isolates (n = 121), but these were equally prevalent in cases (11.3%) and controls (12.5%), and comprised a heterogeneous distribution of O:H serotypes. The intimin (eae) subtypes in A/EEC isolates showed an even distribution; the eae-gamma subtype predominated in classical EPEC cases. The virulence genes encoding the bundle-forming pilus (bfpA) and enteroaggregative heat-stable enterotoxin (astA) were rare among all isolates, and seemed to be of limited pathogenic importance in this population. Virulence characterisation of A/EEC isolates did not reveal any significant differences between cases and controls. Colonisation of children with A/EEC was associated with contact with sheep or goats (OR 2.2). The role of A/EEC, not being VTEC or belonging to the classical EPEC serotypes, requires further clarification, but serotyping is useful in discriminating between EPEC and A/EEC strains.
Original languageEnglish
JournalClinical Microbiology and Infection
Volume13
Issue number9
Pages (from-to)863-72
Number of pages9
ISSN1198-743X
DOIs
Publication statusPublished - 2007

ID: 34098510