title: Pathotypes of diarrheagenic Escherichia coli in children attending a tertiary care hospital in South India.
abstract: The prevalence of diarrheagenic Escherichia coli (DEC) in children under 5 years was studied in children with diarrhea and controls in South India. Four polymerase chain reaction (PCR) "schemes" were used to detect genes of the 6 pathotypes of DEC. In 394 children with diarrhea, 203 (52%) DEC infections were found. Among the 198 controls, 126 (63%) DEC infections were found. Enteroaggregative E. coli was the most common pathotype by multiplex PCR both in cases (58, 14.7%) and controls (47, 23.7%), followed by enteropathogenic E. coli seen in 10% cases and 8% of controls. Enterotoxigenic E. coli (ETEC), enterohemorrhagic E. coli (EHEC), enteroinvasive E. coli (EIEC), and diffusely adherent E. coli (DAEC) were found in 4.1%, 2.0%, 1.0%, and 0.5% of cases, respectively. ETEC was found in 2.5% of controls, but EHEC, EIEC, and DAEC were not detected. Overall, no single assay worked well, but by discounting genes with a pathogenicity index of less than 1, it was possible to use the PCR assays to identify DEC in 75/394 (19%) cases and 12/198 (6.1%) controls, while mixed infection could be identified in 8/394 (2%) cases and 2/198 (1%) controls.
authors.affiliation: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
authors.forename: Priya
authors.initials: P
authors.lastname: Rajendran
authors.forename: Sitara Swarna Rao
authors.initials: SS
authors.lastname: Ajjampur
authors.forename: Divya
authors.initials: D
authors.lastname: Chidambaram
authors.forename: Gunasekaran
authors.initials: G
authors.lastname: Chandrabose
authors.forename: Bhuvaneswari
authors.initials: B
authors.lastname: Thangaraj
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarkar
authors.forename: Prasanna
authors.initials: P
authors.lastname: Samuel
authors.forename: Deva Prasanna
authors.initials: DP
authors.lastname: Rajan
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology*; D054324:Enterohemorrhagic Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D054308:Enteropathogenic Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D054307:Enterotoxigenic Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D004926:Escherichia coli / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D014644:Genetic Variation; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D017720:Molecular Epidemiology; D016133:Polymerase Chain Reaction / Q000379:methods; D015995:Prevalence
chemical_list: D004269:DNA, Bacterial