title: Enterotoxigenic Escherichia coli infections and diarrhea in a cohort of young children in Guinea-Bissau.
abstract: In an effort to describe the natural history of enterotoxigenic Escherichia coli (ETEC) infection and diarrhea, 200 children in Guinea-Bissau, West Africa, were followed up from birth until up to age 2 years with weekly stool specimen collection, regardless of whether the children had diarrhea. ETEC isolates were tested for the presence of the porcine and human heat-stable toxins (STp and STh), the heat-labile toxin (LT), and 18 of 21 known colonization factors (CFs). The rate of primary infections increased substantially after age 3 or 6 months (depending on the type of ETEC causing the infection). The pathogenicity of STh-containing ETEC was substantially higher than that of STp-containing ETEC, and STp and STh were associated with separate sets of CFs. Small epidemics were observed, mainly caused by STh-containing ETEC. The difference in epidemic propensity, CF association, and pathogenicity suggests that STh- and STp-containing ETEC represent 2 different groups of human ETEC. Vaccines should primarily target STh-containing ETEC.
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Hans
authors.initials: H
authors.lastname: Steinsland
authors.forename: Palle
authors.initials: P
authors.lastname: Valentiner-Branth
authors.forename: Michael
authors.initials: M
authors.lastname: Perch
authors.forename: Francisco
authors.initials: F
authors.lastname: Dias
authors.forename: Thea K
authors.initials: TK
authors.lastname: Fischer
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
authors.forename: Kåre
authors.initials: K
authors.lastname: Mølbak
authors.forename: Halvor
authors.initials: H
authors.lastname: Sommerfelt
mesh_terms: D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks; D004768:Enterotoxins / Q000032:analysis*; D004926:Escherichia coli / Q000302:isolation & purification* / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D036781:Fimbriae Proteins / Q000032:analysis; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D012621:Seasons
chemical_list: D004768:Enterotoxins; C022924:colonization factor antigens; D036781:Fimbriae Proteins