title: Diffusely adherent Escherichia coli as a cause of acute diarrhea in young children in Northeast Brazil: a case-control study.
abstract: In a prospective study carried out in two urban centers in northeastern Brazil, 195 HEp-2-adherent Escherichia coli strains were isolated; 110 were identified as the only pathogen in stools of children with diarrhea, and 85 were from controls. Enteropathogenic E. coli isolates were identified in 21 children with diarrhea (8.9%) and 7 children without diarrhea (3.0%), and they were significantly associated with diarrhea (P < 0.01). Enteroaggregative E. coli strains were isolated from 40 children with diarrhea (16.9%) and 38 children without diarrhea (16.4%) and showed no correlation with diarrhea (P > 0.5). In 49 children with diarrhea (20.7%) and 40 children without diarrhea (17.3%), diffusely adherent E. coli (DAEC) isolates were detected and were not found to be associated with diarrhea (P = 0.41). However, after stratification, for children older than 12 months of age a significant correlation between DAEC infection and diarrhea was detected (P = 0.01). These results suggest that DAEC isolates should be considered potential pathogens in northeastern Brazil and also confirm the association of DAEC with age-dependent diarrhea.
authors.affiliation: Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil. scaletsky@ecb.epm.br
authors.forename: Isabel C A
authors.initials: IC
authors.lastname: Scaletsky
authors.forename: Sandra H
authors.initials: SH
authors.lastname: Fabbricotti
authors.forename: Rozane L B
authors.initials: RL
authors.lastname: Carvalho
authors.forename: Claudia R
authors.initials: CR
authors.lastname: Nunes
authors.forename: Helcio S
authors.initials: HS
authors.lastname: Maranhão
authors.forename: Mauro B
authors.initials: MB
authors.lastname: Morais
authors.forename: Ulysses
authors.initials: U
authors.lastname: Fagundes-Neto
mesh_terms: D001422:Bacterial Adhesion; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D004926:Escherichia coli / Q000302:isolation & purification* / Q000472:pathogenicity* / Q000502:physiology; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies