Attaching and effacing Escherichia coli isolates from Danish children: Clinical significance and microbiological characteristics

C. Jensen, S. Ethelberg, B. Olesen, P. Schiellerup, K. E.P. Olsen, F. Scheutz, E. M. Nielsen, J. Neimann, B. Høgh, P. Gerner-Smidt, Kåre Mølbak, K. A. Krogfelt*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review


This study describes the prevalence, clinical manifestations and microbiological characteristics of attaching and effacing Escherichia coli isolates, i.e., enteropathogenic E. coli (EPEC) belonging to the classical EPEC serotypes, non-EPEC attaching and effacing E. coli (A/EEC) and verocytotoxin-producing E. coli (VTEC), isolated in a case-control study of Danish children aged <5 years. Among 424 children with diarrhoea and 866 healthy controls, EPEC and VTEC were more prevalent in cases (2.4% and 2.6%, respectively) than in controls (0.7% and 0.7%, respectively). There was a high frequency of A/EEC isolates (n = 121), but these were equally prevalent in cases (11.3%) and controls (12.5%), and comprised a heterogeneous distribution of O:H serotypes. The intimin (eae) subtypes in A/EEC isolates showed an even distribution; the eae-γ subtype predominated in classical EPEC cases. The virulence genes encoding the bundle-forming pilus (bfpA) and enteroaggregative heat-stable enterotoxin (astA) were rare among all isolates, and seemed to be of limited pathogenic importance in this population. Virulence characterisation of A/EEC isolates did not reveal any significant differences between cases and controls. Colonisation of children with A/EEC was associated with contact with sheep or goats (OR 2.2). The role of A/EEC, not being VTEC or belonging to the classical EPEC serotypes, requires further clarification, but serotyping is useful in discriminating between EPEC and A/EEC strains.

Original languageEnglish
JournalClinical Microbiology and Infection
Issue number9
Pages (from-to)863-872
Number of pages10
Publication statusPublished - Sep 2007
Externally publishedYes


  • Attaching and effacing E. coli
  • Diarrhoea
  • EPEC
  • Escherichia coli
  • Intimin subtypes
  • Virulence factors

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