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Severe Protracted Diarrhea due to Multiresistant Adherent Escherichia coli FREE

Jacques Lacroix, MD; Gilles Delage, MD; Florian Gosselin, MSc; Luc Chicoine, MD
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Reprint requests to Hôpital Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, Quebec, Canada H3T 1C5 (Dr Lacroix).


Am J Dis Child. 1984;138(7):693-696. doi:10.1001/archpedi.1984.02140450075023.
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• We studied 15 cases of severe protracted diarrhea due to a strain of Escherichia coli serotype 0111:K58:H2. The clinical features of these patients were compared with those of 18 patients infected with other enteropathogenic serotypes of E coli. More patients infected with 0111:K58:H2 strains had been treated with ampicillin (six of 15 v one of 18), and more were dehydrated (nine of 15 v two of 18) and in a toxic condition (nine of 15 v three of 18). The number of stools per day (14.1 v 6.8), the total duration of the diarrhea (24.7 v 7.0 days), and the frequency of relapses (six of 15 v none of 18) were also greater in these patients. A large number had a serum sodium level below 135 mEq/L (ten of 15 v none of 18) and a serum protein level below 11 mEq/L (six of 15 v none of 18). At least two infants Infected with E coli 0111:K58:H2 manifested a urinary tract infection. All 15 strains of E coli 0111:K58:H2 studied adhered to HeLa cell lines, whereas none of the strains Isolated from the second group were adherent. None of the 0111:K58:H2 strains produced enterotoxins, and they were negative in the Serény test. All adherent strains were resistant to many antibiotics.

(AJDC 1984;138:693-696)

REFERENCES

 Bray's discovery of pathogenic Escherichia coli as a cause of infantile gastroenteritis , editorial. Arch Dis Child 1973;;48:923-926.
Rowe B:  The role of Escherichia coli in gastroenteritis . Clin Gastroenterol 1979;;8:625-644.
San Joaquin VH, Marks MI:  New agents in diarrhea . Pediatr Infect Dis 1982;;1:53-65.
Klipstein FA, Rowe B, Engert RF, et al:  Enterotoxigenicity of enteropathogenic sero-types of Escherichia coli isolated from infants with epidemic diarrhea . Infect Immun 1978;;21: 171-178.
Cantey JR, Blake RK:  Diarrhea due to Escherichia coli in the rabbit: A novel mechanism . J Infect Dis 1977;;135:454-462.
Ulshen MH, Rollo JL:  Pathogenesis of Escherichia coli gastroenteritis in man: Another mechanism . N Engl J Med 1980;;302:99-101.
Clausen CR, Christie PL:  Chronic diarrhea in infants caused by adherent enteropathogenic Escherichia coli . J Pediatr 1982;;100:358-361.
Rothbaum R, McAdams AJ, Giannella R, et al:  A clinicopathologic study of enterocyte-adherent Escherichia coli: A cause of protracted diarrhea in infants . Gastroenterology 1982;;83: 441-454.
Pai CH, Sorger RT, Lackman RN, et al:  Campylobacter gastroenteritis in children . J Pediatr 1979;;94:589-591.
Edwards PR, Ewing WH: Identification of Enterobacteriaceae . Minneapolis, Burgess Publishing Co, 1972;, pp 67-107.
Washington JA, Sutter VL:  Dilution susceptibility test: Agar and macro-broth dilution procedures , in Lenette EH, Balows A, Hausler WS Jr, et al (eds): Manual of Clinical Microbiology . Washington, DC, American Society for Microbiology, 1980;, pp 453-458.
Speirs JI, Stavric S, Konowalchuk J:  Assay of Escherichia coli heat-labile enterotoxin with VERO cells . Infect Immun 1977;;16:617-622.
Guerrant RL, Brunton LL, Schnaitman TC, et al:  Cyclic adenosine monophosphate and alteration of Chinese hamster ovary cell morphology: A rapid, sensitive in vitro assay for the enterotoxin of Vibrio cholerae and Escherichia coli . Infect Immun 1974;;10:320-327.
Dean AG, Ching Y, Williams RG, et al:  Test for Escherichia coli enterotoxin using infant mice: Application in a study of diarrhea in children in Honolulu . J Infect Dis 1972;;125:407-411.
Serény B:  Experimental Shigella conjunctivitis . Acta Microbiol Acad Sci Hung 1955;;2:293-296.
Leffler H, Svanborg-Eden C:  Glycolipid receptors for uropathic Escherichia coli on human erythrocytes and uroepithelial cells . Infect Immun 1981;;34:920-929.
Schaeffer AJ, Jones JM, Dunn JK:  Association of in vitro Escherichia coli adherence to vaginal and buccal epithelial cells with susceptibility of women to recurrent urinary tract infections . N Engl J Med 1981;;304:1062-1066.
Takeuchi A, Inman LR, O'Hanley PD, et al:  Scanning and transmission electron microscopic study of Escherichia coli 015(RDEC-1) enteric infection in rabbits . Infect Immun 1978;;19:686-694.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

 Bray's discovery of pathogenic Escherichia coli as a cause of infantile gastroenteritis , editorial. Arch Dis Child 1973;;48:923-926.
Rowe B:  The role of Escherichia coli in gastroenteritis . Clin Gastroenterol 1979;;8:625-644.
San Joaquin VH, Marks MI:  New agents in diarrhea . Pediatr Infect Dis 1982;;1:53-65.
Klipstein FA, Rowe B, Engert RF, et al:  Enterotoxigenicity of enteropathogenic sero-types of Escherichia coli isolated from infants with epidemic diarrhea . Infect Immun 1978;;21: 171-178.
Cantey JR, Blake RK:  Diarrhea due to Escherichia coli in the rabbit: A novel mechanism . J Infect Dis 1977;;135:454-462.
Ulshen MH, Rollo JL:  Pathogenesis of Escherichia coli gastroenteritis in man: Another mechanism . N Engl J Med 1980;;302:99-101.
Clausen CR, Christie PL:  Chronic diarrhea in infants caused by adherent enteropathogenic Escherichia coli . J Pediatr 1982;;100:358-361.
Rothbaum R, McAdams AJ, Giannella R, et al:  A clinicopathologic study of enterocyte-adherent Escherichia coli: A cause of protracted diarrhea in infants . Gastroenterology 1982;;83: 441-454.
Pai CH, Sorger RT, Lackman RN, et al:  Campylobacter gastroenteritis in children . J Pediatr 1979;;94:589-591.
Edwards PR, Ewing WH: Identification of Enterobacteriaceae . Minneapolis, Burgess Publishing Co, 1972;, pp 67-107.
Washington JA, Sutter VL:  Dilution susceptibility test: Agar and macro-broth dilution procedures , in Lenette EH, Balows A, Hausler WS Jr, et al (eds): Manual of Clinical Microbiology . Washington, DC, American Society for Microbiology, 1980;, pp 453-458.
Speirs JI, Stavric S, Konowalchuk J:  Assay of Escherichia coli heat-labile enterotoxin with VERO cells . Infect Immun 1977;;16:617-622.
Guerrant RL, Brunton LL, Schnaitman TC, et al:  Cyclic adenosine monophosphate and alteration of Chinese hamster ovary cell morphology: A rapid, sensitive in vitro assay for the enterotoxin of Vibrio cholerae and Escherichia coli . Infect Immun 1974;;10:320-327.
Dean AG, Ching Y, Williams RG, et al:  Test for Escherichia coli enterotoxin using infant mice: Application in a study of diarrhea in children in Honolulu . J Infect Dis 1972;;125:407-411.
Serény B:  Experimental Shigella conjunctivitis . Acta Microbiol Acad Sci Hung 1955;;2:293-296.
Leffler H, Svanborg-Eden C:  Glycolipid receptors for uropathic Escherichia coli on human erythrocytes and uroepithelial cells . Infect Immun 1981;;34:920-929.
Schaeffer AJ, Jones JM, Dunn JK:  Association of in vitro Escherichia coli adherence to vaginal and buccal epithelial cells with susceptibility of women to recurrent urinary tract infections . N Engl J Med 1981;;304:1062-1066.
Takeuchi A, Inman LR, O'Hanley PD, et al:  Scanning and transmission electron microscopic study of Escherichia coli 015(RDEC-1) enteric infection in rabbits . Infect Immun 1978;;19:686-694.

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