Abstract
This review examines the association of strains of Escherichia coli with sudden infant death syndrome (SIDS) and the possible role these bacteria play in this enigmatic condition. The review addresses evidence for E. coli in SIDS infants, potential sources of E. coli in the environment, colonization by commensal and pathogenic strains, the variety of currently accepted pathotypes, and how these pathotypes could compromise intestinal integrity and induce inflammation. Both intestinal and extraintestinal pathotypes are compared in relation to the apparent liability in which virulence traits can be gained or lost by strains of E. coli. The way in which E. coli infections fit with current views on infant sleeping position and other SIDS risk factors is highlighted.
Highlights
This review examines the association of strains of Escherichia coli with sudden infant death syndrome (SIDS) and the possible role these bacteria play in this enigmatic condition
While Escherichia coli and “coliform” bacteria are considered part of the normal microbiome of the human intestinal tract, they have been identified in studies of infants who died suddenly and unexpectedly, infants classified either as sudden infant death syndrome (SIDS) and more recently sudden unexpected death in infancy (SUDI) [1,2,3]
Until 1940s, pathogenic E. coli were not identified; they could not be distinguished by techniques available from non-pathogenic commensal E. coli
Summary
Discipline of Paediatrics, School of Paediatrics and Reproductive Health, University of Adelaide, North Adelaide, SA, Australia. This review examines the association of strains of Escherichia coli with sudden infant death syndrome (SIDS) and the possible role these bacteria play in this enigmatic condition. The review addresses evidence for E. coli in SIDS infants, potential sources of E. coli in the environment, colonization by commensal and pathogenic strains, the variety of currently accepted pathotypes, and how these pathotypes could compromise intestinal integrity and induce inflammation. Both intestinal and extraintestinal pathotypes are compared in relation to the apparent liability in which virulence traits can be gained or lost by strains of E. coli. Specialty section: This article was submitted to Inflammation, a section of the journal
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