Ahmad Owais M, Rukh Seeme, Dos Santos Pereira Samuel, Saran Ankita, Chandran Vijay I, Muneeb Alina, Banderas Echeverry Waldyr M, Shoyoye Muyiwa, Akintunde Damilare M, Hassan Damilola, Morani Zoya, Masood Lalain
Internal Medicine, Charles University, Hradec Kralove , CZE.
Internal Medicine, Malik Haider Hospital, Gujrat, PAK.
Cureus. 2025 May 4;17(5):e83475. doi: 10.7759/cureus.83475. eCollection 2025 May.
is a rod-shaped gram-negative bacterium that includes the diarrheagenic strains, an identical group of intestinal pathogens. diarrhea is transmitted through the feco-oral route, through contaminated food and water. (EPEC)is one of the leading causes of diarrhea in the pediatric age group in developing and developed countries. Depending on the absence or presence of adherence factor plasmids, they are classified as typical or atypical isolates. The distinguishing feature of EPEC's pathology is the attaching and effacing lesions, which facilitate localized damage by tightly adhering to intestinal epithelial cells, disarranging their surfaces, and effacing microvilli. Typical EPEC possess the locus of enterocyte effacement (LEE), a pathogenicity island, encoding adherence factors, including the Type III Secretion System (T3SS), a needle-like structure injecting effector proteins into host cells. EPEC also have other effector genes like or encoded by non-LEE pathogenicity islands, which enable destruction of tight junctions in the host cell. Another key virulence factor is bundle-forming pili (BFP), which aids in the first attachment to enterocytes. Methods like quantitative PCR exist to diagnose EPEC accurately. As of today, no licensed vaccine exists to prevent EPEC infections. Virulence factors for attachment, such as bfpA and intimin, and immunogenic carriers can be potential candidates for vaccine development. Moreover, studies are required to better understand the interaction of EPECwith the intestinal microbiome and immune evasion strategies. This article is aimed at providing a comprehensive review of the epidemiology, transmission, virulence factors, challenges in studying EPEC virulence factors, pathogenesis, host-pathogen interaction, mechanism of intestinal injury, diagnosis, treatment, antibiotic resistance, and vaccination strategy for EPEC, and future research implications. We conducted a comprehensive literature search using credible sources such as PubMed, Google Scholar, and Scopus. We refined our keywords, applied database filters, and assessed citations in the included studies. No meta-analysis, statistical aggregation, or formal evaluation of risk bias was carried out as this review consolidates the literature narratively. High-quality English articles published in reputable peer-reviewed journals from 2010 to 2025 were analyzed, and their findings have been summarized in this comprehensive review.
是一种杆状革兰氏阴性菌，包括致腹泻菌株，这是一组相同的肠道病原体。腹泻通过粪-口途径传播，通过受污染的食物和水传播。（肠致病性大肠埃希菌）是发展中国家和发达国家儿童年龄组腹泻的主要原因之一。根据是否存在黏附因子质粒，它们被分类为典型或非典型分离株。肠致病性大肠埃希菌病理学的显著特征是黏附和消除性病变，通过紧密黏附于肠上皮细胞、扰乱其表面并消除微绒毛来促进局部损伤。典型的肠致病性大肠埃希菌拥有肠细胞消除位点（LEE），这是一个致病岛，编码黏附因子，包括III型分泌系统（T3SS），一种将效应蛋白注入宿主细胞的针状结构。肠致病性大肠埃希菌还具有其他效应基因，如由非LEE致病岛编码的或，这使得宿主细胞中的紧密连接被破坏。另一个关键的毒力因子是束状菌毛（BFP），它有助于首次黏附于肠细胞。存在定量PCR等方法来准确诊断肠致病性大肠埃希菌。截至目前，尚无预防肠致病性大肠埃希菌感染的许可疫苗。黏附的毒力因子，如bfpA和intimin，以及免疫原性载体可能是疫苗开发的潜在候选物。此外，需要进行研究以更好地了解肠致病性大肠埃希菌与肠道微生物群的相互作用以及免疫逃避策略。本文旨在全面综述肠致病性大肠埃希菌的流行病学、传播、毒力因子、研究肠致病性大肠埃希菌毒力因子的挑战、发病机制、宿主-病原体相互作用、肠道损伤机制、诊断、治疗、抗生素耐药性和疫苗接种策略，以及未来的研究意义。我们使用PubMed、谷歌学术和Scopus等可靠来源进行了全面的文献检索。我们优化了关键词，应用了数据库筛选器，并评估了纳入研究中的引用。由于本综述以叙述方式整合文献，因此未进行荟萃分析、统计汇总或风险偏倚的正式评估。分析了2010年至2025年在著名同行评审期刊上发表的高质量英文文章，并在本全面综述中总结了它们的研究结果。
