Etiology of childhood diarrhea in the northeast of Brazil: significant emergent diarrheal pathogens.
In a study conducted in João Pessoa, northeast of Brazil, 2344 Escherichia coli isolated from 290 infants with diarrhea and 290 healthy matched controls were analyzed for virulence traits. Enteroaggregative E. coli (EAEC) was the most prevalent pathogen associated to acute diarrhea. Based on the results of colony blot hybridization, serotyping, and HEp-2 cell adherence assays, strains were separated in categories as typical enteropathogenic E. coli (EPEC) (1.7%), atypical EPEC (a-EPEC) (9.3%), EAEC (25%), enterotoxigenic E. coli (10%), and enteroinvasive E. coli (EIEC) (1.4%). No enterohemorrhagic E. coli strains were isolated. Other enteropathogens were found, including Salmonella (7.9%), Shigella spp. (4.1%), thermophilic Campylobacter spp. (2.4%), Giardia lamblia (9.3%), and Entamoeba histolytica (5.8%). All enteropathogens were associated with diarrhea (P < 0.01). However, the association was lower for EPEC and EIEC (P < 0.03). Different pathogens associated with diarrhea may have been changing in Brazil where EAEC and a-EPEC seem to be the most prevalent pathogens among them.
Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP 05508-900, Brazil.
Ana Carolina Ramos
AC
Moreno
Antônio Fernandes
AF
Filho
Tânia do Amaral Tardelli
Tdo A
Gomes
Sônia T S
ST
Ramos
Liana P G
LP
Montemor
Vanessa C
VC
Tavares
Lauro Dos Santos
Ldos S
Filho
Kinue
K
Irino
Marina Baquerizo
MB
Martinez
D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002448:Cell Adhesion; D045744:Cell Line, Tumor; D016009:Chi-Square Distribution; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000382:microbiology*; D054308:Enteropathogenic Escherichia coli / Q000145:classification* / Q000235:genetics; D004926:Escherichia coli / Q000145:classification / Q000235:genetics; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000145:classification / Q000235:genetics; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007223:Infant; D015995:Prevalence; D012703:Serotyping; D014774:Virulence