TY - JOUR
T1 - Epidemiology and clinical manifestations of enteroaggregative Escherichia coli
AU - Hebbelstrup Jensen, Betina
AU - Olsen, Katharina E. P.
AU - Struve, Carsten
AU - Krogfelt, Karen Angeliki
AU - Petersen, Andreas Munk
N1 - Copyright © 2014, American Society for Microbiology. All Rights Reserved.
PY - 2014
Y1 - 2014
N2 - Enteroaggregative Escherichia coli (EAEC) represents a heterogeneous group of E. coli strains. The pathogenicity and clinical relevance of these bacteria are still controversial. In this review, we describe the clinical significance of EAEC regarding patterns of infection in humans, transmission, reservoirs, and symptoms. Manifestations associated with EAEC infection include watery diarrhea, mucoid diarrhea, low-grade fever, nausea, tenesmus, and borborygmi. In early studies, EAEC was considered to be an opportunistic pathogen associated with diarrhea in HIV patients and in malnourished children in developing countries. In recent studies, associations with traveler's diarrhea, the occurrence of diarrhea cases in industrialized countries, and outbreaks of diarrhea in Europe and Asia have been reported. In the spring of 2011, a large outbreak of hemolytic-uremic syndrome (HUS) and hemorrhagic colitis occurred in Germany due to an EAEC O104:H4 strain, causing 54 deaths and 855 cases of HUS. This strain produces the potent Shiga toxin along with the aggregative fimbriae. An outbreak of urinary tract infection associated with EAEC in Copenhagen, Denmark, occurred in 1991; this involved extensive production of biofilm, an important characteristic of the pathogenicity of EAEC. However, the heterogeneity of EAEC continues to complicate diagnostics and also our understanding of pathogenicity.
AB - Enteroaggregative Escherichia coli (EAEC) represents a heterogeneous group of E. coli strains. The pathogenicity and clinical relevance of these bacteria are still controversial. In this review, we describe the clinical significance of EAEC regarding patterns of infection in humans, transmission, reservoirs, and symptoms. Manifestations associated with EAEC infection include watery diarrhea, mucoid diarrhea, low-grade fever, nausea, tenesmus, and borborygmi. In early studies, EAEC was considered to be an opportunistic pathogen associated with diarrhea in HIV patients and in malnourished children in developing countries. In recent studies, associations with traveler's diarrhea, the occurrence of diarrhea cases in industrialized countries, and outbreaks of diarrhea in Europe and Asia have been reported. In the spring of 2011, a large outbreak of hemolytic-uremic syndrome (HUS) and hemorrhagic colitis occurred in Germany due to an EAEC O104:H4 strain, causing 54 deaths and 855 cases of HUS. This strain produces the potent Shiga toxin along with the aggregative fimbriae. An outbreak of urinary tract infection associated with EAEC in Copenhagen, Denmark, occurred in 1991; this involved extensive production of biofilm, an important characteristic of the pathogenicity of EAEC. However, the heterogeneity of EAEC continues to complicate diagnostics and also our understanding of pathogenicity.
KW - Anti-Bacterial Agents/pharmacology
KW - Child
KW - Coinfection
KW - Developed Countries
KW - Developing Countries
KW - Diarrhea/drug therapy
KW - Disease Outbreaks
KW - Disease Reservoirs/microbiology
KW - Drug Resistance, Multiple, Bacterial
KW - Escherichia coli/drug effects
KW - Escherichia coli Infections/diagnosis
KW - HIV Infections
KW - Humans
KW - Travel
KW - Urinary Tract Infections/epidemiology
U2 - 10.1128/cmr.00112-13
DO - 10.1128/cmr.00112-13
M3 - Review
C2 - 24982324
SN - 0893-8512
VL - 27
SP - 614
EP - 630
JO - Clinical Microbiology Reviews
JF - Clinical Microbiology Reviews
IS - 3
ER -
