title: Prevalence of enterotoxigenic Escherichia coli (ETEC) in hospitalized acute diarrhea patients in Denpasar, Bali, Indonesia.
abstract: The relationship between enterotoxigenic Escherichia coli (ETEC) and hospitalized patients with acute diarrhea was examined in a study conducted in two hospitals from June 2000 to May 2001 in Denpasar, Bali, Indonesia. A total of 489 hospitalized patients with acute diarrhea were enrolled, and their rectal swabs were screened for enteric bacterial pathogens. Toxins, colonization factor antigens (CFAs), in vitro antimicrobial susceptibility and seasonal distribution patterns associated with ETEC were ascertained. The diagnosis of ETEC infection and CFAs association were performed with GM-1 ELISA and Dot blot immunoassays. Enterotoxigenic Escherichia coli was isolated from the rectal swabs of 14.9% of the patients. The distribution of toxins among the ETEC strains found was ST in 51 (69.9%), while LT and ST/LT were found in 28.8% and 1.3% respectively. The highest isolation rate for ETEC was found among children between the ages of 1 and 15 years. Colonization factor antigens were identified in 28.8% of the ETEC strains. A high prevalence of CFA was found among the rectal swabs of patients with ST isolates. High frequency of resistance to ampicillin, trimethoprim/sulfamethoxazole, chloramphenicol, tetracycline and cephalothin was displayed among the ETEC strains. All ETEC strains were susceptible to norfloxacin, ciprofloxacin and nalidixic acid. The results of this study document the prevalence of ETEC in hospitalized patients with acute diarrhea in Denpasar, Bali, Indonesia. Data generated in this study depicts the prevalence of ETEC diarrhea and CFA types among diarrhea patients in the tourist city of Denpasar, Bali, Indonesia.
authors.affiliation: U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.
authors.forename: D S
authors.initials: DS
authors.lastname: Subekti
authors.forename: M
authors.initials: M
authors.lastname: Lesmana
authors.forename: P
authors.initials: P
authors.lastname: Tjaniadi
authors.forename: N
authors.initials: N
authors.lastname: Machpud
authors.lastname: Sriwati
authors.lastname: Sukarma
authors.forename: J C
authors.initials: JC
authors.lastname: Daniel
authors.forename: W K
authors.initials: WK
authors.lastname: Alexander
authors.forename: J R
authors.initials: JR
authors.lastname: Campbell
authors.forename: A L
authors.initials: AL
authors.lastname: Corwin
authors.forename: H James
authors.initials: HJ
authors.lastname: Beecham
authors.forename: C
authors.initials: C
authors.lastname: Simanjuntak
authors.forename: B A
authors.initials: BA
authors.lastname: Oyofo
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001427:Bacterial Toxins / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D004768:Enterotoxins / Q000378:metabolism*; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D029968:Escherichia coli Proteins; D005260:Female; D036781:Fimbriae Proteins / Q000378:metabolism; D006760:Hospitalization; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D012007:Rectum / Q000382:microbiology; D012621:Seasons; D013048:Specimen Handling / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004768:Enterotoxins; D029968:Escherichia coli Proteins; C022924:colonization factor antigens; C034151:heat stable toxin (E coli); D036781:Fimbriae Proteins; C027538:heat-labile enterotoxin, E coli