Enteropathogenic Escherichia coli—A Summary of the Literature

Anca Delia Mare,Valeriu Moldovan,Bianca Tudor,Cristina Nicoleta Ciurea,Felicia Toma,Luminița Decean,Adrian Man

doi:10.3390/gastroent12010004

Anca Delia Mare, Valeriu Moldovan + Show 5 more

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https://doi.org/10.3390/gastroent12010004

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Abstract

Diarrheal disease is still a major public health concern, as it is still considered an important cause of death in children under five years of age. A few decades ago, the detection of enteropathogenic E. coli was made by detecting the O, H, and K antigens, mostly by agglutination. The recent protocols recommend the molecular methods for diagnosing EPEC, as they can distinguish between typical and atypical EPEC by identifying the presence/absence of specific virulence factors. EPEC are defined as diarrheagenic strains of E. coli that can produce attaching and effacing lesions on the intestinal epithelium while being incapable of producing Shiga toxins and heat-labile or heat-stable enterotoxins. The ability of these strains to produce attaching and effacing lesions enable them to cause localized lesions by attaching tightly to the surface of the intestinal epithelial cells, disrupting the surfaces of the cells, thus leading to the effacement of the microvilli. EPEC are classified on typical and atypical isolates, based on the presence or absence of E. coli adherence factor plasmids. All the EPEC strains are eae positive; typical EPEC strains are eae+, bfpA+, while atypical strains are eae+, bfpA−. No vaccines are currently available to prevent EPEC infections.

Highlights

Diarrheal disease is still a major health problem, and it is considered an important cause of morbidity and mortality, especially in infants and children under five years old. the disease primarily affects populations from developing countries, where sanitation, water supplies, and the medical addressability rate are inadequate, there are still reported cases in developed countries [1,2,3,4]
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E. coli is a versatile microorganism, and even if the invasive infections are those that are more likely to evolve with life threatening complications, the diarrheagenic strains of E. coli are still important pathogens, especially in the pediatric departments

Summary

Introduction

Diarrheal disease is still a major health problem, and it is considered an important cause of morbidity and mortality, especially in infants and children under five years old. E. coli is a versatile microorganism, and even if the invasive infections are those that are more likely to evolve with life threatening complications, the diarrheagenic strains of E. coli are still important pathogens, especially in the pediatric departments Among these strains, Enteropathogenic E. coli (EPEC) is a important one, as it is a bacterial etiological agent in a pathology that is dominated by viruses, making it easy to be “forgotten” or not taken into consideration, especially in the case of infantile diarrhea. Enteropathogenic E. coli (EPEC) is a important one, as it is a bacterial etiological agent in a pathology that is dominated by viruses, making it easy to be “forgotten” or not taken into consideration, especially in the case of infantile diarrhea The fact that these strains present multiple phenotypic differences, that they possess different, multiple virulence factors (some of them belonging to other pathotypes), and that they are still evolving, makes them a group of bacteria that will always be of interest for physicians from different medical departments. Heat-labile and heat-stable toxins, CFAs (colonization factors) elt, est Traveler’s diarrhea vomiting

EPEC Definition and Classification

Virulence Factors

Pathogenesis

Clinical Aspects

Findings

Epidemiology