Departamento de Propedêutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, 30130-100, Belo Horizonte, MG, Brazil.
Trans R Soc Trop Med Hyg. 2012 Jan;106(1):43-7. doi: 10.1016/j.trstmh.2011.09.009. Epub 2011 Nov 17.
This 3.5-year prospective study was conducted to ascertain the level of attaching and effacing Escherichia coli (AEEC) associated diarrhoea in children from Teresina, a northeastern state of Brazil. Passed faecal specimens from 400 patients (250 with and 150 without diarrhoea) up to 60 months of age attending from 2004 to 2007 at two public hospitals were investigated. Conventional microbiology methods and PCR were employed. Escherichia coli was isolated from 390 children, 240 of them with diarrhoea. A total of 117 AEEC strains were cultivated from specimens from 63 children, 37 with and 26 without diarrhoea. No association between AEEC and diarrhoea was observed. Atypical enteropathogenic E. coli (a-EPEC) (79.4%) was more commonly found than typical EPEC (t-EPEC). Association between EPEC and EPEC subtypes and diarrhoea was not detected. Mixed infection by t-EPEC and a-EPEC and infection by Shiga toxin-producing E. coli (STEC) were rare. Enteropathogenic E. coli was more common in males and in children aged less than 12 months. Correlation between serotyping and PCR results was 0.19. High resistance rates of AEEC to ampicillin, cephalotin, and trimethoprim-sulfamethoxazole were found. In conclusion, EPEC is very common in children with diarrhoea and controls in the population we studied, with a-EPEC predominating. This diarrhoeagenic E. coli (DEC) pathotype is more common in infant males and is resistant to drugs frequently used in clinical practice.
本为期 3.5 年的前瞻性研究旨在确定巴西东北部特蕾西纳儿童中附着和破坏大肠杆菌 (AEEC) 相关腹泻的水平。从 2004 年至 2007 年，对来自两家公立医院的 400 名患者（250 名腹泻患者和 150 名无腹泻患者）的粪便标本进行了研究。采用常规微生物学方法和 PCR 进行检测。从 390 名儿童中分离出大肠杆菌，其中 240 名腹泻患儿。从 63 名儿童的标本中培养出 117 株 AEEC 株，其中 37 名腹泻患儿和 26 名无腹泻患儿。未观察到 AEEC 与腹泻之间存在关联。非典型肠致病性大肠杆菌 (a-EPEC)（79.4%）比典型肠致病性大肠杆菌 (t-EPEC)更为常见。未发现 EPEC 与 EPEC 亚型和腹泻之间存在关联。t-EPEC 和 a-EPEC 的混合感染以及产志贺毒素大肠杆菌 (STEC)的感染较为罕见。肠致病性大肠杆菌在男性和年龄小于 12 个月的儿童中更为常见。血清分型和 PCR 结果之间的相关性为 0.19。AEEC 对氨苄西林、头孢噻肟和甲氧苄啶-磺胺甲噁唑的耐药率很高。综上所述，在我们研究的人群中，腹泻患儿和对照组中 EPEC 非常常见，其中 a-EPEC 占优势。这种腹泻性大肠杆菌 (DEC) 病原体在婴儿男性中更为常见，并且对临床实践中常用的药物具有耐药性。
