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

Abstract

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
Volume13
Issue number9
Pages (from-to)863-872
Number of pages10
ISSN1198-743X
DOIs
Publication statusPublished - Sep 2007
Externally publishedYes

Keywords

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

Cite this