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J Med Microbiol 56 (2007), 1386-1392; DOI: 10.1099/jmm.0.47161-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Virulence characteristics and the molecular epidemiology of enteroaggregative Escherichia coli isolates from travellers to developing countries

David B. Huang1,2, Jamal A. Mohamed2, James P. Nataro3, Herbert L. DuPont1,2,4,5, Zhi-Dong Jiang4 and Pablo C. Okhuysen1,2,4

1 Baylor College of Medicine, Division of Infectious Diseases, Houston, TX, USA

2 University of Texas at Houston Health Science Center, Division of Infectious Diseases, Houston, TX, USA

3 University of Maryland School of Medicine, Baltimore, MD 21201, USA

4 University of Texas at Houston School of Public Health, Houston, TX, USA

5 St Luke's Episcopal Hospital, Houston, TX, USA

Correspondence
Pablo C. Okhuysen
Pablo.C.Okhuysen{at}uth.tmc.edu

Received 10 January 2007
Accepted 12 June 2007

Enteroaggregative Escherichia coli (EAEC) is associated with diarrhoea among travellers to developing countries. EAEC virulence properties predisposing to illness are not clear. Sixty-four EAEC strains identified by a HEp-2 cell assay and isolated from faecal samples from US and European travellers to developing countries were studied for the prevalence of 11 putative virulence genes by PCR: 49 EAEC strains from adults with acute diarrhoea and 15 EAEC strains from adults without diarrhoea. E. coli strains from the stools of healthy travellers to the same region were used as controls. EAEC carrying aggR, aap, astA and set1A were identified individually more often in the stools of subjects with diarrhoea compared with those without diarrhoea (P<0.05). EAEC isolates with two or three of these genes were associated with diarrhoea compared with EAEC isolates without the presence of these genes (P<0.05). Subjects with diarrhoea who shed EAEC isolates positive for these genes were more likely than subjects shedding EAEC negative for these genes to pass stools with gross mucus (57 vs 14 %) and faecal leukocytes (40 vs 7 %) (P<0.05). This study shows the heterogeneity of gene profiles of EAEC strains found in the stools of international travellers and suggests that the presence of aggR, aap, astA or set1A, the number of genes present and stool characteristics may be markers for more virulent EAEC strains.

Abbreviations: EAEC, enteroaggregative Escherichia coli; ETEC, enterotoxigenic E. coli.




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