Prospective study of enteropathogens in children with diarrhea in Houston and Mexico.
During a 22-month period, 595 children with diarrhea and 210 age-matched controls attending clinics in Houston (367 children) and Mexico (438) were prospectively evaluated for enteric pathogens. Enteropathogens associated with disease were Shigella (18%), rotavirus (14%), Salmonella (9%), toxigenic Escherichia coli (6%), and others (12%), including 14 Proteus isolates that caused rounding of adrenal cells. Enteropathogens were isolated from a greater (P less than 0.001) number of children with diarrhea (59%) than from asymptomatic controls (6%). Paired sera tested for antibody to heat-labile toxin of E. coli rarely demonstrated a fourfold rise during episodes of diarrhea. This study demonstrates: (1) more striking illness in children from Mexico; (2) more common occurrence of Shigella in Houston, and of rotavirus and Salmonella in Mexico; (3) lack of seasonal occurrence of rotavirus isolation in either population and a summertime occurrence of Shigella in Houston; (4) lack of toxigenic E. coli isolation in endemic diarrhea of either population; and (5) a significant (P less than 0.001) age-related acquisition of E. coli LT antibodies.
D000907:Antibodies, Bacterial / Q000032:analysis; D001427:Bacterial Toxins; D002675:Child, Preschool; D003967:Diarrhea / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000302:isolation & purification*; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico; D011446:Prospective Studies; D012401:Rotavirus / Q000302:isolation & purification; D012475:Salmonella / Q000302:isolation & purification; D012760:Shigella / Q000302:isolation & purification; D013781:Texas; D013997:Time Factors
D000907:Antibodies, Bacterial; D001427:Bacterial Toxins