Affiliation:
1. Department of Pharmaceutics, Obafemi Awolowo University, Ile-Ife, Nigeria
2. Department of Microbiology and Immunology and Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland 21201
Abstract
ABSTRACT
Stool specimens from 113 adult outpatients with diarrhea in southwestern Nigeria and 63 controls were examined for bacterial and parasitic enteric pathogens. Enterohemorrhagic
Escherichia coli
(EHEC) (
P
< 0.02), enteroaggregative
E. coli
(EAEC) (
P
< 0.02), and
Entamoeba histolytica
(
P
< 0.0002) were significantly associated with diarrhea.
Salmonella
,
Shigella
, nontoxigenic
Vibrio cholerae
, other categories of diarrheagenic
E. coli
, as well as a variety of helminths were recovered more frequently from the stools of patients than from the stools of controls but did not show a significant association with disease. Multiple pathogens were recovered from 36.3% of specimens, and bloody diarrhea was commonly associated with
E. histolytica
and diarrheagenic
E. coli
infections. The majority of EHEC isolates were non-O157 strains that carried the
stx
2
gene. Of the 23 EHEC-infected patients, 12 (52.2%) presented during the 10th week of the study. EHEC strains isolated within this cluster were more likely to hybridize with the enterohemolysin gene probe, to be nonmotile and sorbitol positive, and to fail to agglutinate O157 antisera. Pulsed-field gel electrophoresis demonstrated that the only strains with
Xba
I profiles that occurred more than once were isolated during the 10th and 11th weeks of the study, suggesting an outbreak. The study has demonstrated that
E. histolytica
, EHEC, and EAEC are important diarrheal pathogens within the study area and that sporadic and epidemic EHEC infections occur in developing as well as developed countries. Routine surveillance for diarrheagenic
E. coli
, even only at the tertiary-care level, would be useful in identifying outbreaks and assist in identifying environmental reservoirs and transmission routes.
Publisher
American Society for Microbiology
Reference43 articles.
1. Akinyemi, K. O., A. O. Oyefolu, B. Opere, V. A. Otunba-Payne, and A. O. Oworu. 1998. Escherichia coli in patients with acute gastroenteritis in Lagos, Nigeria. East Afr. Med. J.75:512-515.
2. Armitage P. and G. Berry. 1987. Statistical methods in medical research. Blackwell Scientific Publications Oxford United Kingdom.
3. Barrow G. and R. Feltham. 1993. Cowan and Steel's manual for the identification of medical bacteria 3rd ed. Cambridge University Press Cambridge United Kingdom.
4. Baudry, B., S. J. Savarino, P. Vial, J. B. Kaper, and M. M. Levine. 1990. A sensitive and specific DNA probe to identify enteroaggregative Escherichia coli, a recently discovered diarrheal pathogen. J. Infect. Dis.161:1249-1251.
5. Molecular characterization of a fimbrial adhesin, F1845, mediating diffuse adherence of diarrhea-associated Escherichia coli to HEp-2 cells
Cited by
62 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献