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

VL - 27

SP - 614

EP - 630

JO - Clinical Microbiology Reviews

JF - Clinical Microbiology Reviews

SN - 0893-8512

IS - 3

ER -