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J Med Microbiol 55 (2006), 1303-1311; DOI: 10.1099/jmm.0.46674-0
© 2006 Society for General Microbiology
ISSN 1473-5644

Review

A review of an emerging enteric pathogen: enteroaggregative Escherichia coli

David B. Huang1, Alakananda Mohanty2, Herbert L. DuPont1,2,3,4, Pablo C. Okhuysen2,3 and Tom Chiang5

1 Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, 535EE, Houston, TX 77030, USA

2 University of Texas at Houston School of Public Health, 1200 Herman Pressler - E50, Houston, TX 77030, USA

3 University of Texas at Houston Medical School, 6431 Fannin Street, Houston, TX 77030, USA

4 St. Luke's Episcopal Hospital, 6720 Bertner Avenue, MC 1-164, Houston, TX 77030, USA

5 New Jersey Veterans Affairs Medical Center, 385 Tremont Avenue, East Orange, NJ 07018-1023, USA

Correspondence
David B. Huang
dhuang82{at}hotmail.com


Enteroaggregative Escherichia coli (EAEC) is an increasingly recognized enteric pathogen. It is a cause of both acute and persistent diarrhoea among children, adults and HIV-infected persons, in both developing and developed countries. In challenge studies, EAEC has caused diarrhoeal illness with the ingestion of 1010 c.f.u. Outbreaks of diarrhoeal illness due to EAEC have been reported, and linked to the ingestion of contaminated food. Diarrhoeal illness due to EAEC is the result of a complex pathogen–host interaction. Some infections due to EAEC result in diarrhoeal illness and elicit an inflammatory response, whereas other infections do not result in a symptomatic infection. Many putative virulence genes and EAEC strains that produce biofilm have been identified; however, the clinical significance of these genes and of biofilm production has yet to be defined. A –251 AA single nucleotide polymorphism (SNP) in the interleukin (IL)-8 promoter region is reported to increase host susceptibility to EAEC diarrhoea. Ciprofloxacin and rifaximin continue to be an effective treatment in persons infected with EAEC. This review is intended to provide an updated review for healthcare workers on EAEC, an emerging enteric pathogen.

Abbreviations: ABC, ATP-binding cassette; AAF, aggregative adherence fimbriae; CI, confidence interval; DAEC, diffusely adherent E. coli; EAEC, enteroaggregative E. coli; EHEC, enterohaemorrhagic E. coli; EPEC, enteropathogenic E. coli; ETEC, enterotoxigenic E. coli; IL, interleukin; OMP, outer-membrane protein; OR, odds ratio.




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