Volume 76, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Enteroinvasive (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 and genes of enterotoxigenic (ETEC), the gene of enteropathogenic (EPEC), and the gene of both enteroinvasive and Shigellae. The pathogenic 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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. DuPont HL, Formal SB, Hornick RB, Snyder MJ, Libonati JP, Sheahan DG, LaBrec EH, Kolas JP, 1971. Pathogenesis of Escherichia coli diarrhea. N Engl J Med 285 : 1–9. [Google Scholar]
  2. Akinyemi KO, Oyefolu AO, Opere B, Otunba-Payne VA, Oworu AO, 1998. Escherichia coli in patients with acute gastroenteritis in Lagos, Nigeria. East Afr Med J 75 : 512–515. [Google Scholar]
  3. Katouli M, Jaafari A, Farhoudi-Moghaddam AA, Ketabi GR, 1990. Aetiological studies of diarrhoeal diseases in infants and young children in Iran. J Trop Med Hyg 93 : 22–27. [Google Scholar]
  4. Kim KH, Suh IS, Kim JM, Kim CW, Cho YJ, 1989. Etiology of childhood diarrhea in Korea. J Clin Microbiol 27 : 1192–1196. [Google Scholar]
  5. Lee CL, Chiou SI, Liu TP, Pan TM, 1997. Pathogenic strains of Escherichia coli in Taiwan. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 30 : 55–59. [Google Scholar]
  6. Okeke IN, Lamikanra A, Steinruck H, Kaper JB, 2000. Characterization of Escherichia coli strains from cases of childhood diarrhea in provincial southwestern Nigeria. J Clin Microbiol 38 : 7–12. [Google Scholar]
  7. Orlandi PP, Silva T, Magalhaes GF, Alves F, de Almeida Cunha RP, Durlacher R, da Silva LH, 2001. Enteropathogens associated with diarrheal disease in infants of poor urban areas of Porto Velho, Rondonia: a preliminary study. Mem Inst Oswaldo Cruz 96 : 621–625. [Google Scholar]
  8. Pabst WL, Altwegg M, Kind C, Mirjanic S, Hardegger D, Nadal D, 2003. Prevalence of enteroaggregative Escherichia coli among children with and without diarrhea in Switzerland. J Clin Microbiol 41 : 2289–2293. [Google Scholar]
  9. Rappelli P, Folgosa E, Solinas ML, Dacosta JL, Pisanu C, Sidat M, Melo J, Cappuccinelli P, Colombo MM, 2005. Pathogenic enteric Escherichia coli in children with and without diarrhea in Maputo, Mozambique. FEMS Immunol Med Microbiol 43 : 67–72. [Google Scholar]
  10. Regua-Mangia AH, Gomes TA, Vieira MA, Andrade JR, Irino K, Teixeira LM, 2004. Frequency and characteristics of diarrhoeagenic Escherichia coli strains isolated from children with and without diarrhoea in Rio de Janeiro, Brazil. J Infect 48 : 161–167. [Google Scholar]
  11. Shehabi AA, Bulos NK, Hajjaj KG, 2003. Characterization of diarrhoeagenic Escherichia coli isolates in Jordanian children. Scand J Infect Dis 35 : 368–371. [Google Scholar]
  12. Sunthadvanich R, Chiewsilp D, Seriwatana J, Sakazaki R, Echeverria P, 1990. Nationwide surveillance program to identify diarrhea-causing Escherichia coli in children in Thailand. J Clin Microbiol 28 : 469–472. [Google Scholar]
  13. Taylor DN, Houston R, Shlim DR, Bhaibulaya M, Ungar BL, Echeverria P, 1988. Etiology of diarrhea among travelers and foreign residents in Nepal. JAMA 260 : 1245–1248. [Google Scholar]
  14. Teng LJ, Hsueh PR, Liaw SJ, Ho SW, Tsai JC, 2004. Genetic detection of diarrheagenic Escherichia coli isolated from children with sporadic diarrhea. J Microbiol Immunol Infect 37 : 327–334. [Google Scholar]
  15. Tornieporth NG, John J, Salgado K, de Jesus P, Latham E, Melo MC, Gunzburg ST, Riley LW 1995. Differentiation of pathogenic Escherichia coli strains in Brazilian children by PCR. J Clin Microbiol 33 : 1371–1374. [Google Scholar]
  16. Torres ME, Pirez MC, Schelotto F, Varlea G, Parodi V, Allende F, Falconi E, Dell’Acqua L, Gaione P, Mendez MV, Ferrari AM, Montano A, Zanetta E, Acuna AM, Chiparelli H, Ingold E, 2001. Etiology of children’s diarrhea in Montevideo, Uruguay: associated pathogens and unusual isolates. J Clin Microbiol 39 : 2134–2139. [Google Scholar]
  17. Valentiner-Branth P, Steinsland H, Fischer TK, Perch M, Scheutz F, Aaby P, Molbak K, Sommerfelt H, 2003. Cohort study of Guinean children: incidence, pathogenicity, conferred protection, and attributable risk for enteropathogens during the first 2 years of life. J Clin Microbiol 41 : 4238–4245. [Google Scholar]
  18. Youssef M, Shurman A, Bougnoux M, Rawashdeh M, Bretagne S, Strockbine N, 2000. Bacterial, viral and parasitic enteric pathogens associated with acute diarrhea in hospitalized children from northern Jordan. FEMS Immunol Med Microbiol 28 : 257–263. [Google Scholar]
  19. Kain KC, Barteluk RL, Kelly MT, He X, de Hua G, Ge YA, Proctor EM, Byrne S, Stiver HG, 1991. Etiology of childhood diarrhea in Beijing, China. J Clin Microbiol 29 : 90–95. [Google Scholar]
  20. Taylor DN, Echeverria P, Sethabutr O, Pitarangsi C, Leksomboon U, Blacklow NR, Rowe B, Gross R, Cross J, 1988. Clinical and microbiologic features of Shigella and enteroinvasive Escherichia coli infections detected by DNA hybridization. J Clin Microbiol 26 : 1362–1366. [Google Scholar]
  21. Faundez G, Figueroa G, Troncoso M, Cabello FC, 1988. Characterization of enteroinvasive Escherichia coli strains isolated from children with diarrhea in Chile. J Clin Microbiol 26 : 928–932. [Google Scholar]
  22. Altwegg M, Perschil I, Gruner E, 1997. Molecular biology detection and antibiotic sensitivities of Shigella spp. and entero-invasive Escherichia coli (EIEC) in patients returning from the tropics. Schweiz Rundsch Med Prax 86 : 348–351. [Google Scholar]
  23. Gassama-Sow A, Sow PS, Gueye M, Gueye-N’diaye A, Perret JL, M’boup S, Aidara-Kane A, 2004. Characterization of pathogenic Escherichia coli in human immunodeficiency virus-related diarrhea in Senegal. J Infect Dis 189 : 75–78. [Google Scholar]
  24. Meqdam MM, Youssef MT, Rawashdeh MO, Al-khdour MS. 1997. Non-seasonal viral and bacterial episode of diarrhoea in the Jordan Valley, West of Jordan. FEMS Immunol Med Microbiol 18 : 133–138. [Google Scholar]
  25. Cortes-Ortiz IA, Rodriguez-Angeles G, Moreno-Escobar EA, Tenorio-Lara JM, Torres-Mazadiego BP, Montiel-Vazquez E, 2002. Outbreak caused by Escherichia coli in Chalco, Mexico. Salud Publica Mex 44 : 297–302. [Google Scholar]
  26. Nguyen TV, Le Van P, Le Huy C, Gia KN, Weintraub A, 2005. Detection and characterization of diarrheagenic Escherichia coli from young children in Hanoi, Vietnam. J Clin Microbiol 43 : 755–760. [Google Scholar]
  27. Ratchtrachenchai OA, Subpasu S, Hayashi H, Ba-Thein W, 2004. Prevalence of childhood diarrhoea-associated Escherichia coli in Thailand. J Med Microbiol 53 : 237–243. [Google Scholar]
  28. Svenungsson B, Lagergren A, Ekwall E, Evengard B, Hedlund KO, Karnell A, Lofdahl S, Svensson L, Weiantraub A, 2000. Enteropathogens in adult patients with diarrhea and healthy control subjects: a 1-year prospective study in a Swedish clinic for infectious diseases. Clin Infect Dis 30 : 770–778. [Google Scholar]
  29. Rival L, 2003. The meanings of forest governance in Esmeraldas, Ecuador. Oxf Dev Stud 31 : 479–501. [Google Scholar]
  30. Sierra R, 1999. Traditional resource-use systems and tropical deforestation in a multi-ethnic region in North-west Ecuador. Environ Conserv 26 : 136–145. [Google Scholar]
  31. Whitten NE, 1974. Black Frontiersmen: A South American Case. Cambridge, MA: Schenkman Pub. Co.
  32. Zhang Y, Yakrus MA, Graviss EA, Williams-Bouyer N, Turenne C, Kabani A, Wallace RJ, Jr, 2004. Pulsed-field gel electrophoresis study of Mycobacterium abscessus isolates previously affected by DNA degradation. J Clin Microbiol 42 : 5582–5587. [Google Scholar]
  33. Gordillo ME, Reeve GR, Pappas J, Mathewson JJ, DuPont HL, Murray BE, 1992. Molecular characterization of strains of enteroinvasive Escherichia coli O143, including isolates from a large outbreak in Houston, Texas. J Clin Microbiol 30 : 889–893. [Google Scholar]
  34. Harris JR, Mariano J, Wells JG, Payne BJ, Donnell HD, Cohen ML, 1985. Person-to-person transmission in an outbreak of enteroinvasive Escherichia coli. Am J Epidemiol 122 : 245–252. [Google Scholar]
  35. Ozbonfil D, Cohen D, Ohad E, Sechter I, 1990. An outbreak of enteritis associated with enteroinvasive E. coli in an Israeli military base. Public Health Rev 18 : 171–177. [Google Scholar]
  36. She SL, 1989. An outbreak of diarrhoea in newborns caused by EIEC. Zhonghua Liu Xing Bing Xue Za Zhi 10 : 333–336. [Google Scholar]
  37. Sobotkova J, Hausner O, Aldova E, Jiskrova R, Maskova L, 1984. An epidemic of diarrhea caused by enteroinvasive sero-types of Escherichia coli O28 ac (Ca 792). Cesk Epidemiol Mikrobiol Imunol 33 : 315. [Google Scholar]
  38. Marier R, Wells JG, Swanson RC, Dalthan W, Mehlman IJ, 1973. An outbreak of enteropathogenic Escherichia coli foodborne disease traced to imported French cheese. Lancet ii : 1376–1378. [Google Scholar]
  39. Snyder JD, Wells JG, Yashuk J, Puhr N, Blake PA, 1984. Outbreak of invasive Escherichia coli gastroenteritis on a cruise ship. Am J Trop Med Hyg 33 : 281–284. [Google Scholar]
  40. Yamamura K, Sumi N, Egashira Y, Fukuoka I, Motomura S, Tsuchida R, 1992. Food poisoning caused by enteroinvasive Escherichia coli (O164:H−)—a case in which the causative agent was identified. Kansenshogaku Zasshi 66 : 761–768. [Google Scholar]
  41. Yang SZ, 1986. An outbreak of food poisoning due to enteroinvasive E. coli. Zhonghua Liu Xing Bing Xue Za Zhi 7 : 129–131. [Google Scholar]
  42. Beutin L, Gleier K, Kontny I, Echeverria P, Scheutz F, 1997. Origin and characteristics of enteroinvasive strains of Escherichia coli (EIEC) isolated in Germany. Epidemiol Infect 118 : 199–205. [Google Scholar]
  43. Llovet T, Coll P, March F, Montserrat I, Atela I, Mirelis B, Prats G, 1995. Comparison of macrorestriction analysis of genomic DNA by pulsed-field gel electrophoresis and ribotyping with conventional methods for differentiation of Escherichia coli O124 isolates. Clin Microbiol Infect 1 : 127–133. [Google Scholar]
  44. Jallat C, Livrelli V, Darfeuille-Michaud A, Rich C, Joly B, 1993. Escherichia coli strains involved in diarrhea in France: high prevalence and heterogeneity of diffusely adhering strains. J Clin Microbiol 31 : 2031–2037. [Google Scholar]
  45. Pupo GM, Lan R, Reeves PR, 2000. Multiple independent origins of Shigella clones of Escherichia coli and convergent evolution of many of their characteristics. Proc Natl Acad Sci USA 97 : 10567–10572. [Google Scholar]
  46. Nataro JP, Kaper JB, 1998. Diarrheagenic Escherichia coli. Clin Microbiol Rev 11 : 142–201. [Google Scholar]
  47. Sarantuya J, Nishi J, Wakimoto N, Erdene S, Nataro JP, Sheikh J, Iwashita M, Mango K, Tokuda K, Yoshinaga M, Miyata K, Kawano Y, 2004. Typical enteroaggregative Escherichia coli is the most prevalent pathotype among E. coli strains causing diarrhea in Mongolian children. J Clin Microbiol 42 : 133–139. [Google Scholar]
  48. DuPont HL, Levine MM, Hornick RB, Formal SB, 1989. Inoculum size in shigellosis and implications for expected mode of transmission. J Infect Dis 159 : 1126–1128. [Google Scholar]
  49. Hsia RC, Small PL, Bavoil PM, 1993. Characterization of virulence genes of enteroinvasive Escherichia coli by TnphoA mutagenesis: identification of invX, a gene required for entry into HEp-2 cells. J Bacteriol 175 : 4817–4823. [Google Scholar]
  50. Niyogi SK, 2005. Shigellosis. J Microbiol 43 : 133–143. [Google Scholar]

Data & Media loading...

  • Received : 10 Oct 2006
  • Accepted : 07 Nov 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error