Enterotoxigenic Escherichia coli infections and diarrhea in a cohort of young children in Guinea-Bissau.
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.
Steinsland
Hans
H
Centre for International Health, University of Bergen, Bergen, Norway.
Valentiner-Branth
Palle
P
Perch
Michael
M
Dias
Francisco
F
Fischer
Thea K
TK
Aaby
Peter
P
Mølbak
Kåre
K
Sommerfelt
Halvor
H
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
D004768:Enterotoxins; C022924:colonization factor antigens; D036781:Fimbriae Proteins