title: Enteropathogens associated with diarrhea among military personnel during Operation Bright Star 96, in Alexandria, Egypt.
abstract: This study investigated the microbial causes of diarrheal disease among U.S. troops deployed near Alexandria, Egypt, during October 1995. Bacterial causes associated with 19 cases of diarrhea included: enterotoxigenic Escherichia coli (ETEC), 42% (21% heat-stable, 11% heat-labile, and 11% heat-stable/ heat-labile producers); enteropathogenic E. coli (5.3%); and enteroadherent E. coli (42%). Four cases of diarrhea were associated with enteroaggregative E. coli based on probe analysis for enteroaggregative heat-stable enterotoxin 1. Protozoan causes included; Entamoeba histolytica (11%), E. hartmanni (5%), E. nana (5%), Blastocystis hominis (5%), Chilomastix mesnili (11%), Dientamoeba fragilis (5%), Entamoeba coli (5%), and Cryptosporidium (5%). Shigella, Aeromonas, Plesiomonas, Vibrio, Campylobacter, and Salmonella were not detected. Of the eight ETEC cases, one was colonization factor antigen (CFA)/I only, one was both CFA/I and CFA/III, three were CFA/II, two were CFA/IV, and two were CFA-negative. Antibiograms of the ETEC and enteroadherent E. coli strains showed that all isolates were susceptible to norfloxacin, ciprofloxacin, and nalidixic acid but resistant to ampicillin, tetracycline, chloramphenicol, and sulfamethoxazole.
authors.affiliation: Research Science Department, United States Naval Medical Research Unit No. 3, FPO AE 09835-0007, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Oyofo
authors.forename: L F
authors.initials: LF
authors.lastname: Peruski
authors.forename: T F
authors.initials: TF
authors.lastname: Ismail
authors.forename: S H
authors.initials: SH
authors.lastname: el-Etr
authors.forename: A M
authors.initials: AM
authors.lastname: Churilla
authors.forename: M O
authors.initials: MO
authors.lastname: Wasfy
authors.forename: B P
authors.initials: BP
authors.lastname: Petruccelli
authors.forename: M E
authors.initials: ME
authors.lastname: Gabriel
mesh_terms: D000668:Ampicillin Resistance; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000032:analysis; D001426:Bacterial Proteins / Q000032:analysis; D016776:Blastocystis Infections / Q000175:diagnosis; D016845:Blastocystis hominis / Q000302:isolation & purification; D002702:Chloramphenicol Resistance; D002939:Ciprofloxacin / Q000627:therapeutic use; D003457:Cryptosporidiosis / Q000175:diagnosis; D003967:Diarrhea / Q000382:microbiology* / Q000469:parasitology; D004030:Dientamoebiasis / Q000175:diagnosis; D004404:Dysentery, Amebic / Q000175:diagnosis; D004534:Egypt; D004747:Entamoeba / Q000145:classification; D004748:Entamoeba histolytica / Q000302:isolation & purification; D004926:Escherichia coli / Q000145:classification / Q000276:immunology; D004927:Escherichia coli Infections / Q000175:diagnosis; D056890:Eukaryota; D036781:Fimbriae Proteins; D006801:Humans; D008889:Military Personnel; D009268:Nalidixic Acid / Q000627:therapeutic use; D009643:Norfloxacin / Q000627:therapeutic use; D018933:Pili, Sex / Q000276:immunology; D011528:Protozoan Infections / Q000175:diagnosis; D013753:Tetracycline Resistance; D014481:United States
chemical_list: D000890:Anti-Infective Agents; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C022924:colonization factor antigens; D036781:Fimbriae Proteins; D009268:Nalidixic Acid; D002939:Ciprofloxacin; D009643:Norfloxacin