Enterotoxigenic Escherichia coli as cause of diarrhea among Mexican adults and US travelers in Mexico.
BACKGROUND
Enterotoxigenic Escherichia coli (ETEC) is the most common pathogen identified in travelers to Mexico with diarrhea. There have been few recent studies looking at the etiology of diarrhea in travelers compared with the local resident population.


METHODS
We compared enteric pathogens isolated in two populations experiencing acute diarrhea acquired in Guadalajara, Mexico and also compared clinical illness caused by the principal pathogen, ETEC.


RESULTS
A single and 2 enteropathogens were detected in 107 (23%) and 8 (2%), respectively, of 457 Mexicans in 1995 and 1997, and 37 (29%) and 2 (2%), respectively, of 127 US adults in 1997. The most common pathogen was ETEC in both groups (11% of Mexican, 19% of US adults), although more common in the US travelers group (p =.0017). Shigella spp and Cryptosporidium spp were less common in the Mexican (<1% and <1%, respectively) than in the travelers group (6% and 3%, respectively) (p <.001 and p =.002, respectively). Entamoeba histolytica was more often found in the Mexican group (4% Mexican, 0% US adults; p =.027).


CONCLUSIONS
ETEC is the most common pathogen among travelers and Mexican residents in this study. The duration of untreated diarrhea due to ETEC was significantly shorter among Mexicans (49 hours in Mexican, 94 hours in US adults; p =.0004), as was the average number of unformed stools passed over 4 days (Mexicans 8.8 versus travelers 17.9 stools; p =.0009
Bouckenooghe
Alain R
AR
Veterans Affairs Medical Center, Baylor College of Medicine, and University of Texas Medical School and School of Public Health, Houston, Texas, USA.
Jiang
Zhi Dong
ZD
De La Cabada
Francisco J
FJ
Ericsson
Charles D
CD
DuPont
Herbert L
HL
D000328:Adult; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology*; D004768:Enterotoxins / Q000032:analysis*; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D006801:Humans; D015994:Incidence; D008800:Mexico / Q000453:epidemiology; D014195:Travel / Q000706:statistics & numerical data*; D014481:United States / Q000208:ethnology
D004768:Enterotoxins