title: Serotype-specific prevalence of Escherichia coli strains with EPEC adherence factor genes in infants with and without diarrhea in São Paulo, Brazil.
abstract: To examine interrelationships of classic enteropathogenic Escherichia coli (EPEC) serotypes, EPEC adherence factor (EAF) genes, and diarrheal disease, E. coli were studied from stools of 500 infants less than 1 y of age with acute diarrhea and 500 age-matched controls. EAF-containing (EAF+) E. coli of three common classic EPEC serotypes (O111:H-, odds ratio [OR] 36.0; O111:H2, OR 55.0; O119:H6, OR 3.7) were individually strongly associated with diarrhea, as were EAF+ strains of less common classic serotypes combined (OR 5.3). Among EPEC serogroups, neither EAF+ strains of nonclassic serotypes (OR 1.8) nor EAF-strains of classic (OR 2.2) or nonclassic (OR 1.4) serotypes were significantly associated with diarrhea. At least one EAF+ non-EPEC serogroup serotype (O88:H25) may represent an unrecognized EPEC serotype. Serotype-specific variation in the association of EAF+ E. coli with diarrhea suggests that other factors are also important in determining virulence; thus, both EAF detection and E. coli serotyping are desirable in studying the etiology of diarrheal disease.
authors.affiliation: Department of Microbiology, Immunology, and Parasitology, Escola Paulista de Medicina, São Paulo, Brazil.
authors.forename: T A
authors.initials: TA
authors.lastname: Gomes
authors.forename: M A
authors.initials: MA
authors.lastname: Vieira
authors.forename: I K
authors.initials: IK
authors.lastname: Wachsmuth
authors.forename: P A
authors.initials: PA
authors.lastname: Blake
authors.forename: L R
authors.initials: LR
authors.lastname: Trabulsi
mesh_terms: D000208:Acute Disease; D018830:Adhesins, Escherichia coli; D001422:Bacterial Adhesion; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics*; D001938:Brazil; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000382:microbiology*; D004926:Escherichia coli / Q000145:classification / Q000235:genetics* / Q000378:metabolism; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D014644:Genetic Variation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012703:Serotyping
chemical_list: D018830:Adhesins, Escherichia coli; D001425:Bacterial Outer Membrane Proteins