Prevalence of diarrheagenic Escherichia coli in acute childhood enteritis: A prospective controlled study - 15/08/11
, James P. Nataro, MD, PhD 2, David I. Bernstein, MD 3, Jennifer Hawkins, BA 1, Nancy Roberts, MS 3, Mary A. Staat, MD, MPH 3
Correspondence and reprint requests to: Mitchell B. Cohen, MD, Cincinnati Children's Hospital Medical Center, Gastroenterology, Hepatology and Nutrition, MLC 2010, 3333 Burnet Ave., Cincinnati, OH 45229 USA, Phone: 513 636 4953, Fax: 513 636 5581See editorial, p 11.
Résumé |
Objective |
Since diarrheagenic E. coli are not identified by common clinical laboratory techniques, we hypothesized that these organisms might be an unrecognized cause of enteritis in children in the U.S.
Study design |
1327 children with acute gastroenteritis were identified prospectively by active surveillance in the Emergency Department (ED) and the inpatient units at Cincinnati Children's Hospital Medical Center. Stool samples were evaluated for diarrheagenic E. coli using a panel of DNA probes and adherence pattern to HEp-2 cells. Stool samples from a reference group of 555 well children were studied for comparison.
Results |
Gene probe studies, but not HEp-2 cell adherence, demonstrated that enteroaggregative, diffusely adherent and enteropathogenic E. coli were associated with clinical illness. Each was isolated significantly more often from study subjects in the ED than controls. In children <1 year of age, enteroaggregative E. coli were isolated significantly more often from both inpatients (4.7%, Odds Ratio=3.4, 95% confidence intervals 1.3-9.1, p <0.03) and ED patients (10.0%, Odds Ratio=7.2, 95% confidence intervals 2.9-18.2, p <0.001) than from well children (1.4%).
Conclusions |
Diarrheagenic E. coli, especially enteroaggregative E. coli, may be an important, unrecognized cause of childhood diarrhea in the U.S.
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Plan
| Grant support: This study was supported by Awards from the National Institutes of Health N01 AI 45252 and R01 DK 47318. We thank Carolyn Gunther, Phil Chen, Lisa Brockman, Cara Kohlreiser, Tara Hamann, Lori McKenna, Karen Munson, Sara O'Cull, Jolyn Phillips, Amy Pohler, Michelle Roth, and Carla Thieman and Suzanne Davis for technical and nursing assistance. |
Vol 146 - N° 1
P. 54-61 - janvier 2005 Retour au numéro
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