• 1

    Okeke IN, Lamikanra A, Czeczulin J, Dubovsky F, Kaper JB, Nataro JP, 2000. Heterogeneous virulence of enteroaggregative Escherichia coli strains isolated from children in southwest Nigeria. J Infect Dis 181 :252–260.

    • Search Google Scholar
    • Export Citation
  • 2

    Thea DM, St Louis ME, Atido U, Kanjinga K, Kembo B, Matondo M, Tshiamala T, Kamenga C, Davachi F, Brown C, 1993. A prospective study of diarrhea and HIV-1 infection among 429 Zairian infants. N Engl J Med 329 :1696–1702.

    • Search Google Scholar
    • Export Citation
  • 3

    Mayer HB, Wanke CA, 1995. Enteroaggregative Escherichia coli as a possible cause of diarrhea in an HIV-infected patient. N Engl J Med 332 :273–274.

    • Search Google Scholar
    • Export Citation
  • 4

    Mathewson JJ, Johnson PC, DuPont HL, Morgan DR, Thornton SA, Wood LV, Ericsson CD, 1985. A newly recognized cause of travelers’ diarrhea: enteroadherent Escherichia coli.J Infect Dis 151 :471–475.

    • Search Google Scholar
    • Export Citation
  • 5

    Nataro JP, Kaper JB, 1998. Diarrheagenic Escherichia coli.Clin Microbiol Rev 11 :142–201.

  • 6

    Nataro JP, Deng Y, Cookson S, Cravioto A, Savarino SJ, Guers LD, Levine MM, Tacket CO, 1995. Heterogeneity of enteroaggregative Escherichia coli virulence demonstrated in volunteers. J Infect Dis 171 :465–468.

    • Search Google Scholar
    • Export Citation
  • 7

    Jiang ZD, Lowe B, Verenkar MP, Ashley D, Steffen R, Tornieporth N, von Sonnenburg F, Waiyaki P, DuPont HL, 2002. Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya (Mombasa), India (Goa), or Jamaica (Montego Bay). J Infect Dis 185 :497–502.

    • Search Google Scholar
    • Export Citation
  • 8

    Murray BE, Mathewson JJ, DuPont HL, Hill WE, 1987. Utility of oligodeoxyribonucleotide probes for detecting enterotoxigenic Escherichia coli.J Infect Dis 155 :809–811.

    • Search Google Scholar
    • Export Citation
  • 9

    Miqdady MS, Jiang ZD, Nataro JP, DuPont HL, 2002. Detection of enteroaggregative Escherichia coli with formalin-preserved HEp-2 cells. J Clin Microbiol 40 :3066–3067.

    • Search Google Scholar
    • Export Citation
  • 10

    Czeczulin JR, Whittam TS, Henderson IR, Navarro-Garcia F, Nataro JP, 1999. Phylogenetic analysis of enteroaggregative and diffusely adherent Escherichia coli.Infect Immun 67 :2692–2699.

    • Search Google Scholar
    • Export Citation
  • 11

    Jiang ZD, Greenberg D, Nataro JP, Steffen R, DuPont HL, 2002. Rate of occurrence and pathogenic effect of enteroaggregative Escherichia coli virulence factors in international travelers. J Clin Microbiol 40 :4185–4190.

    • Search Google Scholar
    • Export Citation
  • 12

    Czeczulin JR, Balepur S, Hicks S, Phillips A, Hall R, Kothary MH, Navarro-Garcia F, Nataro JP, 1997. Aggregative adherence fimbria II, a second fimbrial antigen mediating aggregative adherence in enteroaggregative Escherichia coli.Infect Immun 65 :4135–4145.

    • Search Google Scholar
    • Export Citation
  • 13

    Adachi JA, Ericsson CD, Jiang ZD, DuPont MW, Pallegar SR, DuPont HL, 2002. Natural history of enteroaggregative and enterotoxigenic Escherichia coli infection among US travelers to Guadalajara, Mexico. J Infect Dis 185 :1681–1683.

    • Search Google Scholar
    • Export Citation
  • 14

    Rich C, Favre-Bonte S, Sapena F, Joly B, Forestier C, 1999. Characterization of enteroaggregative Escherichia coli isolates. FEMS Microbiol Lett 173 :55–61.

    • Search Google Scholar
    • Export Citation
  • 15

    Baudry B, Savarino SJ, Vial P, Kaper JB, Levine MM, 1990. A sensitive and specific DNA probe to identify enteroaggregative Escherichia coli, a recently discovered diarrheal pathogen. J Infect Dis 161 :1249–1251.

    • Search Google Scholar
    • Export Citation
  • 16

    Bouzari S, Jafari A, Azizi A, Oloomi M, Nataro JP, 2001. Short report: characterization of enteroaggregative Escherichia coli isolates from Iranian children. Am J Trop Med Hyg 65 :13–14.

    • Search Google Scholar
    • Export Citation

 

 

 

 

ASSOCIATION OF VIRULENCE FACTOR-POSITIVE AND -NEGATIVE ENTEROAGGREGATIVE ESCHERICHIA COLI AND OCCURRENCE OF CLINICAL ILLNESS IN TRAVELERS FROM THE UNITED STATES TO MEXICO

View More View Less
  • 1 Department of Medicine, Baylor College of Medicine, Houston, Texas; Center for Infectious Diseases, University of Texas-Houston School of Public Health and Medical School, Houston, Texas; St. Luke’s Episcopal Hospital, Houston, Texas

The objective of the study was to determine if the presence or absence of virulence factor-positive and -negative enteroaggregative Escherichia coli (EAEC) determined the occurrence of illness or sub-clinical EAEC infection in travelers from the United States to Mexico. Sixty-five newly arrived college students from the United States submitted weekly stool samples for a four-week period of time. Among EAEC-infected subjects, diarrhea occurred in those with a defined virulence factor with the following frequency: aggA, 5 of 15 (33%); aggR, 3 of 11 (27%); aafA, 3 of 8 (38%); and aspU, 1 of 6 (17%). Twenty-two of 31 students (71%) had two or more EAEC infections. After the initial EAEC infection, only 4 (11%) of 31 students had a subsequent symptomatic EAEC infection. Our study suggests that clinical illness by EAEC is not explained by presence of a defined EAEC virulence factors, and we provide suggestive evidence that EAEC infection protects against future symptomatic infection.

Save