title: Genotypic and phenotypic features of enteropathogenic Escherichia coli isolated in industrialized and developing countries.
abstract: BACKGROUND
  Typical EPEC are considered a leading cause of diarrhoea in developing countries, while atypical EPEC have been isolated more frequently in developed areas. The actual geographic distribution of the two EPEC subgroups is controversial, since data can be highly influenced by laboratory resources. This study aimed to compare the distribution of typical and atypical EPEC among children in developed and developing countries, and to characterize the bacterial isolates, using a unique methodological approach.
  
  
  METHODS
  A total of 1,049 E. coli were isolated from faeces of children with acute diarrhoea in Mozambique, Angola and Italy, and processed by PCR to assess the presence of a large panel of virulence genes. All isolates classified as EPEC were further characterized by evaluating adherence and capability to induce actin rearrangement on Hep-2 cells.
  
  
  RESULTS
  Overall we isolated 59 EPEC, likewise distributed in the three countries, representing the 5.04%, 4.44% and 6.97% of all Mozambican, Angolan and Italian isolates, respectively. Nevertheless, the geographic distribution of the two EPEC subgroups was not homogeneous: in Italy we isolated 28 aEPEC but no tEPEC, while in Angola and Mozambique the percentage of the two subgroups was comparable. Twelve atypical EPEC were FAS positive and able to induce localized-like adherence on Hep-2 cells, but no correlation with the geographic origin of isolates was observed.
  
  
  CONCLUSIONS
  Atypical EPEC are present in sub-Saharan areas in a percentage similar to that of typical strains, and are not mainly restricted to industrialized countries, as it was previously supposed.
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Sassari, Italy. simo.santona@tiscali.it
authors.forename: Simona
authors.initials: S
authors.lastname: Santona
authors.forename: Nicia
authors.initials: N
authors.lastname: Diaz
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Fiori
authors.forename: Moises
authors.initials: M
authors.lastname: Francisco
authors.forename: Mohsin
authors.initials: M
authors.lastname: Sidat
authors.forename: Piero
authors.initials: P
authors.lastname: Cappuccinelli
authors.forename: Paola
authors.initials: P
authors.lastname: Rappelli
mesh_terms: D000199:Actins / Q000378:metabolism; D000810:Angola / Q000453:epidemiology; D001422:Bacterial Adhesion; D002460:Cell Line; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics; D019049:Developed Countries; D003906:Developing Countries; D054308:Enteropathogenic Escherichia coli / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity / Q000502:physiology; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D005838:Genotype; D022781:Hepatocytes / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D017720:Molecular Epidemiology; D009073:Mozambique / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000199:Actins; D004269:DNA, Bacterial; D037521:Virulence Factors