Diarrheagenic Escherichia coli Infection in Baltimore, Maryland, and New Haven, Connecticut

• Published in: Clinical infectious diseases Vol. 43; no. 4; pp. 402 - 407
• Main Authors: Nataro, James P., Mai, Volker, Johnson, Judith, Blackwelder, William C., Heimer, Robert, Tirrell, Shirley, Edberg, Stephen C., Braden, Christopher R., Morris, J. Glenn, Hirshon, Jon Mark
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.08.2006; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Age groups; Articles and Commentaries; Bacteriology; Baltimore - epidemiology; Biological and medical sciences; Child; Child, Preschool; Connecticut - epidemiology; Developing countries; Diarrhea; Dysentery - epidemiology; Dysentery - microbiology; E coli; Emergency departments; Epidemiology; Escherichia coli; Escherichia coli - isolation & purification; Escherichia coli - pathogenicity; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Escherichia coli O157; Etiology; Humans; Infant; Infant, Newborn; Infections; Infectious diseases; Medical sciences; Middle Aged; Pathogens; Pathology; Prospective Studies; United States; North America; Maryland; America; Connecticut; Baltimore; New Haven Connecticut; Baltimore Maryland; Infection; Bacteriosis; Bacteria; Colibacillosis; Escherichia coli; Enterobacteriaceae
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/505867

Background. Diarrhea remains a common complaint among US patients who seek medical attention. Methods. We performed a prospective study to determine the etiology of diarrheal illness among patients and control subjects of all ages presenting to the emergency departments and outpatient clinics of 2 large academic hospitals in Baltimore, Maryland, and New Haven, Connecticut. We used molecular methods to detect the presence of diarrheagenic Escherichia coli pathotypes, including enteroaggregative E. coli (EAEC), as well as Shiga toxin–producing, cytodetaching, enterotoxigenic and enteropathogenic E. coli. Results. Of the pathotypes sought, only EAEC was found in an appreciable proportion (4.5%) of case patients, and it was found more frequently among case patients than control subjects (P < .02). Surprisingly, EAEC was the most common bacterial cause of diarrhea in our population. EAEC was common in all age strata and was not associated with foreign travel or immunodeficiency. EAEC infection is frequently accompanied by fever and abdominal pain, though this did not happen more frequently in patients with EAEC infection than in patients with diarrhea due to other causes. Conclusions. Our data suggest that EAEC infection should be considered among persons with diarrhea that does not yield another known etiologic agent.