Association of untypeable enteropathogenic Escherichia coli (EPEC) strains with persistent diarrhea in children from the region of Lower Silesia in Poland
Anna Duda - Madej, Grażyna Gościniak, Barbara Andrzejewska, Anna Krystyna Duda, Beata Magdalena Sobieszczańska Pol J Microbiol 2013; 62 (4): ICID: 1087852 Article type: Original article IC™ Value: 10.00
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In the study nontypeable typical and atypical enteropathogenic Escherichia coli carrying virulence factors characteristic to other pathogenic E. coli i.e. diffusely adhering and enteroaggregative E. coli were isolated from 24 (43.6%) of 55 children >10 years old with persistent diarrhea. Isolated enteropathogenic E. coli carried the eae gene encoding intimin and were able to induce specific to the pathotype attaching and effacing of enterocytes lesions in the intestinal epithelial cell. Based on the presence of the bfpA gene encoding bundle forming pili, 18 (75%) out of the 24 eae–positive E. coli were categorized as typical enteropathogenic E. coli. The remaining 6 (25%) eae–positive, but bfp–negative strains were considered atypical enteropathogenic E. coli. The afaD and daaA genes encoding adhesins specific to diffusely adhering E. coli were associated with 10 (41.7%) and 3 (12.5%) of the 24 eaeA–positive E. coli, respectively. Less commonly, enteropathogenic E. coli examined carried genes characteristic to enteroaggregative E. coli i.e. aggB and aggR that were present in 6 (25%) and 8 (33.3%) isolates, respectively. These results indicated that nontypeable typical and atypical enteropathogenic E. coli can contribute to chronic intestinal infections in teenagers in the region of Lower Silesia in Poland. The results of the study also raises the difficulties to the diagnosis of infections caused by nontypeable enteropathogenic E. coli strains based only on the serologic determination of enteropathogenic E. coli O serogroups, as without detection of virulence factors these pathogens are missed leading to incorrect diagnosis.