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Foods as a Source of Enteropathogens Causing Childhood Diarrhea in Thailand

Laksana Rasrinaul^*, Orasa Suthienkul^*, Peter D. Echeverria, David N. Taylor, Jitvimol Seriwatana, Aroon Bangtrakulnonth AND Udom Lexomboon

^* Faculty of Public Health, Mahidol University
Armed Forces Research Institute of Medical Sciences
Department of Medical Sciences, Ministry of Public Health
Children's Hospital, Bangkok, Thailand

Foods obtained in markets in Bangkok were cultured for bacterial enteric pathogens and examined for their similarity to strains isolated from children under 5 years of age in Bangkok in 1986. Salmonella was isolated from 17%, Campylobacter from 12%, and enterotoxigenic Escherichia coli (ETEC) from 3% of 510 foods examined. Campylobacter was isolated from 13.5%, ETEC from 13%, and Salmonella from 12% of 1,230 children under 5 years of age with diarrhea. Eighty-eight percent of children infected with Salmonella were infected with serotypes isolated from foods of animal origin. Six percent of children with Salmonella were infected with the same serotype containing plasmids with identical endonuclease restriction patterns as isolates from food. Eighty-seven percent of children with Campylobacter were infected with the same serotypes and biotypes found in food of animal origin. Thirty-one percent of heat-labile enterotoxin (LT) producing ETEC from foods contained genes coding for LT II, but LT II ETEC was not isolated from children. Twenty-one percent of ETEC isolated from foods vs. 53% isolated from children were resistant to 2 or more antibiotics (P < 0.01). Salmonella and Campylobacter, but not ETEC, isolated from foods were similar to strains isolated from children. Foods of animal origin are an important source of Salmonella and Campylobacter in Thailand.

Accepted for publication November 12, 1987.