Severe protracted diarrhea due to multiresistant adherent Escherichia coli.
We studied 15 cases of severe protracted diarrhea due to a strain of Escherichia coli serotype 0111: K58 :H2. The clinical features of these patients were compared with those of 18 patients infected with other enteropathogenic serotypes of E coli. More patients infected with 0111: K58 :H2 strains had been treated with ampicillin (six of 15 v one of 18), and more were dehydrated (nine of 15 v two of 18) and in a toxic condition (nine of 15 v three of 18). The number of stools per day (14.1 v 6.8), the total duration of the diarrhea (24.7 v 7.0 days), and the frequency of relapses (six of 15 v none of 18) were also greater in these patients. A large number had a serum sodium level below 135 mEq/L (ten of 15 v none of 18) and a serum protein level below 11 mEq/L (six of 15 v none of 18). At least two infants infected with E coli 0111: K58 :H2 manifested a urinary tract infection. All 15 strains of E coli 0111: K58 :H2 studied adhered to HeLa cell lines, whereas none of the strains isolated from the second group were adherent. None of the 0111: K58 :H2 strains produced enterotoxins, and they were negative in the Ser eny test. All adherent strains were resistant to many antibiotics.
D000268:Adhesiveness; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003968:Diarrhea, Infantile / Q000209:etiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004768:Enterotoxins / Q000096:biosynthesis; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000502:physiology; D004927:Escherichia coli Infections / Q000150:complications* / Q000382:microbiology; D005759:Gastroenteritis / Q000150:complications* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D012008:Recurrence; D012703:Serotyping
D000900:Anti-Bacterial Agents; D004768:Enterotoxins