title: Enterotoxins and adhesins of enterotoxigenic Escherichia coli: are they risk factors for acute diarrhea in the community?
abstract: A cohort of 228 Mexican children less than 5 years old was followed during the enterotoxigenic Escherichia coli(ETEC) season. The incidence of ETEC diarrhea-associated and asymptomatic infections was determined, and E. coli strains isolated from stool samples were tested for heat-labile and heat-stable toxins and for expression of colonization factor antigens (CFA). Of the children, 61% had at least one ETEC infection. Children with ETEC isolated from stools were more likely to have diarrhea than were ETEC-free age-matched control children (odds ratio [OR] = 4.5; 95% confidence interval [CI] = 2.9-7.0). Strains carrying CFA/IV, CFA/I, or CFA/II were found in 23%, 18%, and 5% of ETEC infections, respectively. The risk of having diarrhea associated with a CFA-expressing versus a CFA-negative ETEC strain was the same (age-adjusted OR = 0.8; 95% CI = 0.4-1.6). These data should be considered in the development of a diarrhea vaccine containing only CFAs.
authors.affiliation: Department of Infectious Diseases, Instituto Nacional de la Nutrición, Tlalpan, Mexico.
authors.forename: Y
authors.initials: Y
authors.lastname: López-Vidal
authors.forename: J J
authors.initials: JJ
authors.lastname: Calva
authors.forename: A
authors.initials: A
authors.lastname: Trujillo
authors.forename: A
authors.initials: A
authors.lastname: Ponce de León
authors.forename: A
authors.initials: A
authors.lastname: Ramos
authors.forename: A M
authors.initials: AM
authors.lastname: Svennerholm
authors.forename: G M
authors.initials: GM
authors.lastname: Ruiz-Palacios
mesh_terms: D018830:Adhesins, Escherichia coli; D000942:Antigens, Bacterial / Q000032:analysis; D001425:Bacterial Outer Membrane Proteins / Q000032:analysis*; D001427:Bacterial Toxins / Q000032:analysis; D002675:Child, Preschool; D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology*; D004768:Enterotoxins / Q000032:analysis*; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000209:etiology*; D029968:Escherichia coli Proteins; D005243:Feces / Q000382:microbiology; D036781:Fimbriae Proteins; D006801:Humans; D015994:Incidence; D007223:Infant; D008800:Mexico / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons
chemical_list: D018830:Adhesins, Escherichia coli; D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; D029968:Escherichia coli Proteins; C022924:colonization factor antigens; C034151:heat stable toxin (E coli); D036781:Fimbriae Proteins; C027538:heat-labile enterotoxin, E coli