Molecular characterization of enterotoxigenic Escherichia coli isolates recovered from children with diarrhea during a 4-year period (2007 to 2010) in Bolivia

J Clin Microbiol. 2013 Apr;51(4):1219-25. doi: 10.1128/JCM.02971-12. Epub 2013 Feb 6.

Abstract

Enterotoxigenic Escherichia coli (ETEC) is an important cause of childhood diarrhea. This study aimed to characterize ETEC strains isolated from Bolivian children aged <5 years according to enterotoxin profile, colonization factors (CFs), suggested virulence genes, and severity of disease. A total of 299 ETEC isolates recovered from children with diarrhea and 55 ETEC isolates from children without diarrhea (controls) were isolated over a period of 4 years. Strains expressing heat-labile toxin (LT) or heat-stable toxin (ST) alone were about equally common and twice as common as ETEC producing both toxins (20%). ETEC strains expressing human ST (STh) were more common in children aged <2 years, while ETEC strains expressing LT plus STh (LT/STh) were more frequent in 2- to 5-year-old children. Severity of disease was not related to the toxin profile of the strains. CF-positive isolates were more frequently identified in diarrheal samples than in control samples (P = 0.02). The most common CFs were CFA/I and CS14. CFA/I ETEC strains were more frequent in children aged <2 years than CS1+CS3 isolates and CS14 isolates, which were more prevalent in 2- to 5-year-old children. The presence of suggested ETEC virulence genes (clyA, eatA, tia, tibC, leoA, and east-1) was not associated with disease. However, east-1 was associated with LT/STh strains (P < 0.001), eatA with STh strains (P < 0.001), and tia with LT/STh strains (P < 0.001). A minor seasonal peak of ETEC infections was identified in May during the cold-dry season and coincided with the peak of rotavirus infections; this pattern is unusual for ETEC and may be important for vaccination strategies in Bolivia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Toxins / genetics
  • Bolivia / epidemiology
  • Child, Preschool
  • Diarrhea / epidemiology*
  • Diarrhea / microbiology*
  • Diarrhea / pathology
  • Enterotoxigenic Escherichia coli / classification*
  • Enterotoxigenic Escherichia coli / genetics*
  • Enterotoxigenic Escherichia coli / isolation & purification
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology*
  • Escherichia coli Infections / pathology
  • Escherichia coli Proteins / genetics
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Molecular Epidemiology
  • Seasons
  • Virulence Factors / genetics

Substances

  • Bacterial Toxins
  • Escherichia coli Proteins
  • Virulence Factors