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Journal of Clinical Microbiology, November 2006, p. 3872-3877, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.00790-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Enterotoxigenic Escherichia coli with STh and STp Genotypes Is Associated with Diarrhea Both in Children in Areas of Endemicity and in Travelers{triangledown}

Ingrid Bölin,1* Gudrun Wiklund,1 Firdausi Qadri,2 Olga Torres,3 A. Louis Bourgeois,4 Stephen Savarino,5 and Ann-Mari Svennerholm1

Department of Microbiology and Immunology, and Göteborg Vaccine Research Institute (GUVAX), Göteborg University, Göteborg, Sweden,1 Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh,2 Laboratorios de Microbiologia INCAP, Ciudad de Guatemala, Guatemala,3 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,4 Enteric Diseases Department, Naval Medical Research Center, Silver Spring, Maryland5

Received 13 April 2006/ Returned for modification 11 June 2006/ Accepted 13 August 2006

Enterotoxigenic Escherichia coli (ETEC) is an important cause of diarrhea among children in developing countries and in travelers to areas of ETEC endemicity. ETEC strains isolated from humans may produce a heat-labile enterotoxin (LT) and two types of the heat-stable enterotoxin STa, called STh and STp, encoded by the estA gene. Two commonly used assay methods for the detection of STa, the infant mouse assay or different enzyme-linked immunosorbent assays, are unable to distinguish between the two subtypes of ST. Different genotypic methods, such as DNA probes or PCR assays, may, however, allow such discrimination. Using gene probes, it has recently been reported that ETEC strains producing STp as the only enterotoxin are not associated with diarrhea. In this study, we have used highly specific PCR methods, including newly designed primers for STh together with previously described STp primers, to compare the relative distribution of STh and STp in ETEC isolated from children with diarrhea in three different geographically distinct areas, i.e., Bangladesh, Egypt, and Guatemala, and from travelers to Mexico and Guatemala. It was found that ETEC strains producing STp were as commonly isolated from cases of diarrhea as strains producing STh both in Egypt and Guatemala, whereas STp strains were considerably less common in Bangladesh. No difference was found in the relative distribution of STh and STp in ETEC strains isolated from travelers with diarrhea and from asymptomatic carriers. Irrespective of ST genotype, the disease symptoms were also similar in both children and travelers.

* Corresponding author. Mailing address: Dep. Microbiology and Immunology, Sahlgrenska Academy, Göteborg University, P.O. Box 435, SE-405 30 Göteborg, Sweden. Phone: 46 31 7736211. Fax: 46 31 7736210. E-mail: ingrid.bolin{at}microbio.gu.se.

{triangledown} Published ahead of print on 30 August 2006.

Journal of Clinical Microbiology, November 2006, p. 3872-3877, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.00790-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Rodas, C., Iniguez, V., Qadri, F., Wiklund, G., Svennerholm, A.-M., Sjoling, A. (2009). Development of Multiplex PCR Assays for Detection of Enterotoxigenic Escherichia coli Colonization Factors and Toxins. J. Clin. Microbiol. 47: 1218-1220 [Abstract] [Full Text]  
  • Sjoling, A., Wiklund, G., Savarino, S. J., Cohen, D. I., Svennerholm, A.-M. (2007). Comparative Analyses of Phenotypic and Genotypic Methods for Detection of Enterotoxigenic Escherichia coli Toxins and Colonization Factors. J. Clin. Microbiol. 45: 3295-3301 [Abstract] [Full Text]  


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