Abstract
Previous studies have demonstrated the potentiality of E. coli to induce diarrhea either by enterotoxin production or by intestinal cell penetration. Both qualities have not been systematically explored in children with diarrheal disease. In this study we investigated 40 infants and children with acute diarrhea and 19 controls. From each patient's rectal swab culture 10 colonies of E. coli, randomly chosen from the EMB plate, were tested for enterotoxin production by intragastric inoculation in suckling mice and screened for cell penetration with HEP-2 cells. Colonies demonstrating invasiveness in HEP-2 cells were further tested by inoculation into guinea pig conjunctivae (Sereny test).
Salmonella or Shigella strains were isolated from 42.5% of the patients with diarrhea. Enterotoxin-producing strains of E. coli were found in 82% of the diarrhea group and in 42% of controls. Strains with capability to invade cells were found in 27.5% of the diarrhea group and in 10% of controls. Some strains of E. coli demonstrated both enterotoxin production and invasiveness; this has not been previously reported. In an overall view, considering Salmonella, Shigella, and enteroinvasive or enterotoxigenie E. coli, a definitive etiology was demonstrated in 95% of infants with diarrheal disease.
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Rudoy, R., Nelson, J. ENTEROINVASIVE AND ENTEROTOXIGENIC E. COLI IN DIARRHEAL DISEASE. Pediatr Res 8, 428 (1974). https://doi.org/10.1203/00006450-197404000-00528
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DOI: https://doi.org/10.1203/00006450-197404000-00528