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

Lucia Gonzales, Samanta Sanchez, Silvia Zambrana, Volga Iñiguez, Gudrun Wiklund, Ann Mari Svennerholm, Asa Sjölinga

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23 Scopus citations

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 CS1CS3 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.

Original languageEnglish
Pages (from-to)1219-1225
Number of pages7
JournalJournal of Clinical Microbiology
Volume51
Issue number4
DOIs
StatePublished - Apr 2013

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