Enteroaggregative Escherichia coli strains as a cause of traveler's diarrhea: a case-control study.
To elucidate the importance of enteroaggregative Escherichia coli (EAggEC) strains as a cause of traveler's diarrhea in Spanish travelers, a prospective case-control 1:1 study was done in a university hospital clinic for travelers. EAggEC strains were isolated from 23 of 165 case-patients and from 4 of 165 controls (P = .0003). In 16 patients, this was the only isolate recovered. Six of the EAggEC-positive isolates from the case-patients and 2 from the controls were positive for the enteroaggregative stable toxin type 1 gene. Other enteropathogens were also isolated. Shigella and enterotoxigenic E. coli strains showed significant differences between cases and controls (P = .0023 and P < .0001, respectively). Geographic distribution of the EAggEC strains was homogeneous, and the clinical symptom, secretory diarrhea, did not differ statistically with that for the enterotoxigenic E. coli strains. EAggEC strains are a cause of secretory diarrhea in Spaniards traveling to developing countries.
Gascón
J
J
Servei Microbiologia i Parasitologia, Unitat Epidemiologia, Hospital Clínic, University of Barcelona, School of Medicine, Spain.
Vargas
M
M
Quintó
L
L
Corachán
M
M
Jimenez de Anta
M T
MT
Vila
J
J
D016022:Case-Control Studies; D003710:Demography; D003967:Diarrhea / Q000382:microbiology* / Q000503:physiopathology; D004926:Escherichia coli / Q000145:classification* / Q000302:isolation & purification / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000382:microbiology* / Q000503:physiopathology; D006801:Humans; D016133:Polymerase Chain Reaction; D012760:Shigella / Q000302:isolation & purification; D013030:Spain; D014195:Travel