Skip to main content
    • Aa
    • Aa

Enteroaggregative Escherichia coli associated with an outbreak of diarrhoea in a neonatal nursery ward

  • M. Čobeljić (a1), B. Miljković-Selimović (a2), D. Paunović-Todosijević (a2), Z. Veličković (a2), Z. Lepšanović (a1), N. Zec (a1), D. Savić (a3), R. Ilić (a3), S. Konstantinović (a3), B. Jovanović (a3) and V. Kostić (a3)...

Over a 9-day period in February 1995, 16 newborn babies (age range 2–11 days) and 3 infants (24, 47 and 180 days of age) in a neonatal nursery ward developed diarrhoea accompanied by pyrexia and weight loss. Known enteropathogens were not detected in their stools but Escherichia coli displaying aggregative adherence to HEp-2 cells (enteroaggregative E. coli) were found in 12 (63%) ill infants and in none of 5 well neonates (P = 0·02). The illness lasted 3–9 days (mean 5·2) in 16 babies, whereas in 3 neonates it showed a protracted course of 18–20 days. The source of infection and the mode of transmission remained unclear. The outbreak isolates manifested properties common in this new group of diarrhoeagenic E. coli: mannose-resistant haemagglutination, haemolysis on blood agar, and clump formation in liquid culture medium. They belonged to the O4 E. coli serogroup and expressed multiple antibiotic resistance.

Hide All
1. JP Nataro , JB Kaper , R Robins-Browne , V Prado , MM Levine . Pattern of adherence of diarrheagenic Escherichia coli to HEp-2 cells. Pediatr Infect Dis J 1987; 6: 829–31.

4. MK Bhan , P Raj , MM Levine , Enteroaggregative Escherichia coli associated with persistent diarrhea in a cohort of rural children in India. J Infect Dis 1989; 159: 1061–4.

8. P Echeverria , O Serichantalerg , S Changchawalit , Tissue culture adherent Escherichia coli in infantile diarrhea. J Infect Dis 1992; 165: 141–3.

9. S Bhatnagar , MK Bhan , H Sommerfelt , S Sazawal , R Kumar , S. Seini Enteroaggregative Escherichia coli may be a new pathogen causing acute and persistent diarrhea. Scand J Infect Dis 1993; 25: 579–83.

14. MA Karmali . Laboratory diagnosis of verotoxin-producing Escherichia coli infections. Clin Microbiol Newslett 1987; 9: 6570.

16. SM Scotland , HR Smith , GA Willshaw , T Cheasty , B Rowe . Identification of enteropathogenic Escherichia coli isolated in Britain as enteroaggregative or as members of a subclass of attaching-and-effacing E. coli not hybridizing with the EPEC adherence-factor probe. J Med Microbiol 1991; 35: 278–83.

19. HR Smith , SM Scotland , GA Willshaw , B Rowe , A Cravioto , C. Eslava Isolates of Escherichia coli O44:H18 of diverse origin are enteroaggregative. J Infect Dis 1994; 170: 1610–3.

21. SM Scotland , GA Willshaw , T Cheasty , B Rowe , JE Hassal . Association of enteroaggregative Escherichia coli with traveller's diarrhoea. J Infect 1994; 29: 115–6.

23. JP Nataro , D Yikang , S Cookson , Heterogeneity of enteroaggregative Escherichia coli virulence demonstrated in volunteers. J Infect Dis 1995; 171: 465–8.

24. PA Vial , R Robins-Browne , H Lior , Characterization of enteroadherent-aggregative Escherichia coli, a putative agent of diarrheal disease. J Infect Dis 1988; 158: 70–9.

33. RW Ryder , IK Wachsmuth , AE Buxton , Infantile diarrhea produced by heat-stable enterotoxigenic Escherichia coli. N Engl J Med 1976; 295: 849–53.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 2 *
Loading metrics...

Abstract views

Total abstract views: 89 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 26th September 2017. This data will be updated every 24 hours.