Volume 83, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



More than 5,000 diarrheal cases per year receive medical care at the National Children's Hospital of Costa Rica, and nearly 5% of them require hospitalization. A total of 173 strains isolated from children with diarrhea were characterized at the molecular, serologic, and phenotypic level. Multiplex and duplex polymerase chain reactions were used to detect the six categories of diarrheagenic . Thirty percent (n = 52) of the strains were positive, indicating a high prevalence among the pediatric population. Enteropathogenic and enteroinvasive pathotypes were the most prevalent (21% and 19%, respectively). Pathogenic strains were distributed among the four phylogenetic groups A, B1, B2, and D, with groups A and B1 the most commonly found. This study used molecular typing to evaluate the prevalence of diarrheagenic reported in Costa Rica and demonstrated the importance of these pathotypes in the pediatric population.


Article metrics loading...

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

Full text loading...



  1. Nataro JP, Kaper JB, , 1998. Diarrheagenic Escherichia coli . Clin Microbiol Rev 11: 142201. [Google Scholar]
  2. McDaniel TK, Jarvis KG, Donnenberg MS, Kaper JB, , 1995. A genetic locus of enterocyte effacement conserved among diverse enterobacterial pathogens. Proc Natl Acad Sci USA 92: 16641668.[Crossref] [Google Scholar]
  3. Elliot SJ, Wainwright LA, McDaniel TK, Jarvis KG, Deng YK, Lai LC, MacNamara BP, Donnenberg MS, Kaper JB, , 1998. The complete sequence of the locus of enterocyte effacement (LEE) from enteropathogenic Escherichia coli E2348/69. Mol Microbiol 28: 14.[Crossref] [Google Scholar]
  4. Black RE, , 1990. Epidemiology of traveler's diarrhea and relative importance of various pathogens. Rev Infect Dis 12: S73S79.[Crossref] [Google Scholar]
  5. Qadri F, Svennerholm AM, Faruque AS, Sack DA, , 2005. Enterotoxigenic Escherichia coli in developing countries: epidemiology, microbiology, clinical features, treatment and prevention. Clin Microbiol Rev 18: 465483.[Crossref] [Google Scholar]
  6. Evans DG, Silver RP, Evans DJ, Chase DG, Gorbach SL, , 1975. Plasmid-controlled colonization factor associated with virulence in Esherichia coli enterotoxigenic for humans. Infect Immun 12: 656667. [Google Scholar]
  7. Evans DG, Evans DJ, DuPont HL, , 1977. Virulence factors of enterotoxigenic Escherichia coli . J Infect Dis 136: S118S123.[Crossref] [Google Scholar]
  8. Karmali MA, Steele BT, Petric M, Lim C, , 1983. Sporadic cases of haemolytic uremic syndrome associated with faecal cytotoxin and cytotoxin producing Escherichia coli in stools. Lancet 1: 619620.[Crossref] [Google Scholar]
  9. O'Brien AD, Lively TA, Chen ME, Rothman SW, Formal SB, , 1983. Escherichia coli O157:H7 strains associated with haemorrhagic colitis in the United States produce a Shigella dysenteriae 1 (shiga) like cytotoxin. Lancet 1: 702.[Crossref] [Google Scholar]
  10. Tesh VL, O'Brien AD, , 1991. The pathogenic mechanisms of shiga toxin and the shiga-like toxins. Mol Microbiol 5: 18171822.[Crossref] [Google Scholar]
  11. Brenner DJ, Fanning GR, Miklos GV, Steigerwalt AG, , 1973. Polynucleotide sequence relatedness among Shigella species. Int J Syst Bacteriol 23: 17.[Crossref] [Google Scholar]
  12. Sasakawa C, Buysse JM, Watanabe H, , 1992. The large virulence plasmid of Shigella . Curr Top Microbiol Immunol 180: 2144.[Crossref] [Google Scholar]
  13. Weintraub A, , 2007. Enteroaggregative Escherichia coli: epidemiology, virulence and detection. J Med Microbiol 56: 48.[Crossref] [Google Scholar]
  14. Huang DB, Mohamed JA, Nataro JP, DuPont HL, Jiang Z, Okhuysen PC, , 2007. Virulence characteristics and the molecular epidemiology of enteroaggregative Escherichia coli isolates from travellers to developing countries. J Med Microbiol 56: 13861392.[Crossref] [Google Scholar]
  15. Bilge SS, Clausen CR, Lau W, Moseley S, , 1989. Molecular characterization of a fimbrial adhesin, F1845, mediating diffuse adherence of diarrhea-associated Escherichia coli to HEp-2 cells. J Bacteriol 171: 42814289.[Crossref] [Google Scholar]
  16. Lopes LM, Fabbricotti SH, Ferreira A, Kato M, Michalski J, Scaletsky I, , 2005. Heterogeneity among strains of diffusely adherent Escherichia coli isolated in Brazil. J Clin Microbiol 43: 19681972.[Crossref] [Google Scholar]
  17. Gomez-Duarte OG, Bai J, Newell E, , 2009. Detection of Escherichia coli, Salmonella spp., Shigella spp., Yersinia enterocolitica, Vibrio cholerae, and Campylobacter spp. enteropathogens by 3-reaction multiplex polymerase chain reaction. Diagn Microbiol Infect Dis 63: 19.[Crossref] [Google Scholar]
  18. López-Saucedo C, Cerna JF, Villegas-Sepulveda N, Thompson R, Velásquez FR, Torres J, Tarr PI, Estrada-García T, , 2003. Single multiplex polymerase chain reaction to detect diverse loci associated with diarrheagenic Escherichia coli . Emerg Infect Dis 9: 127131.[Crossref] [Google Scholar]
  19. Escobar-Páramo P, Clermont O, Blanc-Potard A, Bui H, Le Bouguénec C, Denamur E, , 2004. A specific background is required for adquisition and expression of virulence factors in Escherichia coli . Mol Biol Evol 21: 10851094.[Crossref] [Google Scholar]
  20. Hommais F, Pereira S, Acquaviva C, Escobar-Páramo P, Denamur E, , 2005. Single nucleotide polymorphism phylotyping of Escherichia coli . Appl Environ Microbiol 71: 47844792.[Crossref] [Google Scholar]
  21. Clermont O, Cordevant C, Bonacorsi S, Marecat A, Lange M, Bingen E, , 2001. Automated ribotyping provides rapid phylogenetic subgroup affiliation of clinical extraintestinal pathogenic Escherichia coli strains. J Clin Microbiol 39: 45494553.[Crossref] [Google Scholar]
  22. Nataro JP, Deng Y, Maneval DR, German AL, Martin WC, Levine MM, , 1992. Aggregative adherence fimbria I of enteroaggregative Escherichia coli mediate adherence to HEp-2 cells and hemagglutination of human erythrocytes. Infect Immun 60: 22972304. [Google Scholar]
  23. Knutton S, Baldwin T, Williams PH, McNeish AS, , 1989. Actin accumulation at sites of bacterial adhesion to tissue culture cells: basis of a new diagnostic test for enteropathogenic and enterohemorrhagic Escherichia coli . Infect Immun 57: 12901298. [Google Scholar]
  24. Gunzburg ST, Tornieporth NG, Riley LW, , 1995. Identification of enteropathogenic Escherichia coli by PCR-based detection of the bundle-forming pilus gene. J Clin Microbiol 33: 13751377. [Google Scholar]
  25. Paton AW, Paton JC, , 1998. Detection and characterization of shiga toxigenic Escherichia coli by using multiplex PCR assays for stx1, stx2, eaeA, enterohemorrhagic E. coli hlyA, rfb0111, and rfb0157. J Clin Microbiol 36: 598602. [Google Scholar]
  26. Stacy-Phipps S, Mecca JJ, Weiss JB, , 1995. Multiplex PCR assay and simple preparation method for stool specimens detect enterotoxigenic Escherichia coli DNA during the course of infection. J Clin Microbiol 33: 10541059. [Google Scholar]
  27. Toma C, Lu Y, Higa N, Nakasone N, Chinen I, Baschkier A, Rivas M, Iwanaga M, , 2003. Multiplex PCR assay for identification of human diarrheagenic Escherichia coli . J Clin Microbiol 41: 26692671.[Crossref] [Google Scholar]
  28. Vidal M, Kruger E, Durán C, Lagos R, Levine M, Prado V, Toro C, Vidal R, , 2005. Single multiplex PCR assay to identify simultaneously the six categories of diarrheagenic Escherichia coli associated with enteric infections. J Clin Microbiol 43: 53625365.[Crossref] [Google Scholar]
  29. Clermont O, Bonacorsi S, Bingen E, , 2000. Rapid and simple determination of the Escherichia coli phylogenetic group. Appl Environ Microbiol 66: 45554558.[Crossref] [Google Scholar]
  30. Durso LM, Bono JM, Keen JE, , 2005. Molecular serotyping of Escherichia coli O26:H11. Appl Environ Microbiol 71: 49414944.[Crossref] [Google Scholar]
  31. Cravioto A, Gross RJ, Scotland SM, Rowe B, , 1979. An adhesive factor found in strains of Escherichia coli belonging to the traditional infantile enteropathogenic serotypes. Curr Microbiol 3: 9599.[Crossref] [Google Scholar]
  32. Afset JE, Bevanger L, Romundstad P, Bergh K, , 2004. Association of atypical enteropathogenic Escherichia coli (EPEC) with prolonged diarrhea. J Med Microbiol 53: 11371144.[Crossref] [Google Scholar]
  33. Heczko U, Carthy CM, O'Brien BA, Finlay BB, , 2001. Decreased apoptosis in the ileum and ileal Peyer's patches: a feature after infection with rabbit enteropathogenic Escherichia coli O103. Infect Immun 69: 45804589.[Crossref] [Google Scholar]
  34. Hill SM, Phillips AD, Walker-Smith JA, , 1991. Enteropathogenic Escherichia coli and life threatening chronic diarrhoea. Gut 32: 154158.[Crossref] [Google Scholar]
  35. Nguyen RN, Taylor LS, Tauschek M, Robins-Browne RM, , 2006. Atypical enteropathogenic Escherichia coli infection and prolonged diarrhea in children. Emerg Infect Dis 12: 597603.[Crossref] [Google Scholar]
  36. Nguyen TV, Van Le P, Huy Le C, Weintraub A, , 2005. Antibiotic resistance in diarrheagenic Escherichia coli and Shigella strains isolated from children in Hanoi, Vietnam. Antimicrob Agents Chemother 49: 816819.[Crossref] [Google Scholar]
  37. World Health Organization, 2005. The Treatment of Diarrhea: A Manual for Physicians and Other Senior Health Workers. Geneva: World Health Organization. [Google Scholar]

Data & Media loading...

  • Received : 20 Jul 2009
  • Accepted : 16 May 2010
  • Published online : 05 Aug 2010

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