Previous Article | Next Article ![]()
Journal of Clinical Microbiology, January 2000, p. 27-31, Vol. 38, No. 1
International Centre for Diarrhoeal Disease
Research, Bangladesh, Dhaka 1000, Bangladesh1;
Department of International Health, The Johns Hopkins
University, Baltimore, Maryland2; and
Department of Medical Microbiology and Immunology,
Göteborg University, S-413 46 Göteborg,
Sweden3
Received 26 July 1999/Returned for modification 8 September
1999/Accepted 22 September 1999
The prevalence of toxin types and colonization factors (CFs) of
enterotoxigenic Escherichia coli (ETEC) was prospectively studied with fresh samples (n = 4,662) obtained from a
2% routine surveillance of diarrheal stool samples over 2 years, from
September 1996 to August 1998. Stool samples were tested by
enzyme-linked immunoassay techniques and with specific monoclonal
antibodies for the toxins and CFs. The prevalence of ETEC was 14%
(n = 662), with over 70% of the strains isolated from
children 0 to 5 years of age, of whom 93% were in the 0- to 3-year-old
age range. Of the total ETEC isolates, 49.4% were positive for the
heat-stable toxin (ST), 25.4% were positive for the heat-labile toxin
(LT) only, and 25.2% were positive for both LT and ST. The rate of ETEC isolation peaked in the hot summer months of May to September and
decreased in winter. About 56% of the samples were positive for 1 or
more of the 12 CFs that were screened for. The coli surface antigens
CS4, CS5, and/or CS6 of the colonization factor antigen (CFA)/IV
complex were most prevalent (incidence, 31%), followed by CFA/I
(23.5%) and coli surface antigens CS1, CS2, and CS3 of CFA/II (21%).
In addition, other CFs detected in decreasing order were CS7 (8%),
CS14 (PCFO166) (7%), CS12 (PCFO159) (4%), CS17 (3%), and CS8
(CFA/III) (2.7%). The ST- or LT- and ST-positive ETEC isolates
expressed the CFs known to be the most prevalent (i.e., CFA/I, CFA/II,
and CFA/IV), while the strains positive for LT only did not. Among
children who were infected with ETEC as the single pathogen, a trend of
relatively more severe disease in children infected with ST-positive
(P < 0.001) or LT- and ST-positive (P < 0.001) ETEC isolates compared to the severity of
the disease in children infected with LT only-positive ETEC isolates
was seen. This study supports the fact that ETEC is still a major cause of childhood diarrhea in Bangladesh, especially in children up to 3 years of age, and that measures to prevent such infections are needed
in developing countries.
0095-1137/0/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Prevalence of Toxin Types and Colonization Factors
in Enterotoxigenic Escherichia coli Isolated during a
2-Year Period from Diarrheal Patients in Bangladesh
*
Corresponding author. Mailing address: Laboratory
Sciences Division, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. Phone: 880 2 871751 to 880 2 871760. Fax: 880 2 872529, 880 2 883116, or 880 2 886050. E-mail: fqadri{at}icddrb.org.
This article has been cited by other articles:
| Antimicrob. Agents Chemother. | Clin. Microbiol. Rev. |
|---|---|
| Clin. Vaccine Immunol. | ALL ASM JOURNALS |
|---|