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HIGH PREVALENCE OF ENTEROINVASIVE ESCHERICHIA COLI ISOLATED IN A REMOTE REGION OF NORTHERN COASTAL ECUADOR

Enteroinvasive Escherichia coli (EIEC) causes dysentery; however, it is less widely reported than other etiological agents in studies of diarrhea worldwide. Between August 2003 and July 2005, stool samples were collected in case-control studies in 22 rural communities in northwestern Ecuador. Infection was assessed by PCR specific for LT and STa genes of enterotoxigenic E. coli (ETEC), the bfp gene of enteropathogenic E. coli (EPEC), and the ipaH gene of both enteroinvasive E. coli and Shigellae. The pathogenic E. coli most frequently identified were EIEC (3.2 cases/100 persons) and Shigellae (1.5 cases/100 persons), followed by ETEC (1.3 cases/100 persons), and EPEC (0.9 case/100 persons). EIEC exhibited similar risk-factor relationships with other pathotypes analyzed but different age-specific infection rates. EIEC was the predominant diarrheagenic bacteria isolated in our community-based study, a unique observation compared with other regions of the world.

Received October 10, 2006. Accepted for publication November 7, 2006.

Acknowledgments: The authors thank the EcoDESS field team for their invaluable contribution in collecting the data.

Financial support: This study was supported by a grant from the National Institute of Allergy and Infectious Disease (NIAID; grant RO1-AI050038).

^* Address correspondence to Joseph N. S. Eisenberg, PhD, MPH, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI. E-mail: jnse{at}umich.edu

Authors’ addresses: Nadia Vieira, Karina Ponce, William Cevallos, and Gabriel Trueba, Universidad San Francisco de Quito, Vía Interoceánica, Círculo Cumbayá, Quito, Ecuador. Sarah J. Bates, Rebecca Howsmon, and Lee Riley, School of Public Health, University of California Berkeley, Berkeley, CA. Owen D. Solberg, Department of Integrative Biology, University of California Berkeley, Berkeley, CA. Joseph N. S. Eisenberg, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, Telephone: +1 (734) 615-1625, Fax: +1 (734) 998-6837, E-mail: jnse{at}umich.edu.

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