ArticlePLoS neglected tropical diseases2015
Diarrheagenic Escherichia coli carrying supplementary virulence genes are an important cause of moderate to severe diarrhoeal disease in Mexico.
Article in PLoS neglected tropical diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Burden of Shigella among children with diarrhea in the Americas: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2025Pooled it
- EnteroaggregativeEcoSal Plus · 2025Review
- Association of DiarrheagenicMicroorganisms · 2025Article
- Cytolethal distending toxin-producing Escherichia coli clinical isolates from Mexican children harbor different cdt types causing CDT-induced epithelial pathological phenotypes.Medical microbiology and immunology · 2025Article
- Two Novel Bacteriophage Species Against Hybrid Intestinal PathogenicPHAGE (New Rochelle, N.Y.) · 2024Article
- Article
- Adhesin related genes as potential markers for the enteroaggregativeFrontiers in cellular and infection microbiology · 2022Article
- Epidemiological investigations of diarrhea in children in Praia city, Cape Verde.Frontiers in microbiology · 2022Article
- A Novel Adult Murine Model of Typical EnteroaggregativeFrontiers in cellular and infection microbiology · 2022Article
- Studies on the Mechanism of the Volatile Oils from Caoguo-4 Decoction in Regulating Spleen Deficiency Diarrhea by Adjusting Intestinal Microbiota.Oxidative medicine and cellular longevity · 2022Article
- Prevalence of Cyclomodulin-PositivePathogens (Basel, Switzerland) · 2021Article
- Occurrence of Hybrid DiarrhoeagenicMicroorganisms · 2021Article
- A One Health Perspective for Defining and DecipheringComparative medicine · 2021Review
- Household food sources and diarrhoea incidence in poor urban communities, Accra Ghana.PloS one · 2021Article
- Characterization and antibiotic resistance pattern of diffusely adherentNew microbes and new infections · 2020Article
- Low frequency of enterohemorrhagic, enteroinvasive and diffusely adherent Escherichia coli in children under 5 years in rural Mozambique: a case-control study.BMC infectious diseases · 2020Article
- Shiga Toxin-Producing and Enteroaggregative Escherichia coli in Animal, Foods, and Humans: Pathogenicity Mechanisms, Detection Methods, and Epidemiology.Current microbiology · 2020Review
- New Insights Into DAEC and EAEC Pathogenesis and Phylogeny.Frontiers in cellular and infection microbiology · 2020Article
- Pathotyping and Antibiotic Resistance Profiling ofBioMed research international · 2020Article
- Draft Genome Sequence of Escherichia albertii Strain Mex-12/320a, Isolated from an Infant with Diarrhea and Harboring Virulence Genes Associated with Diarrheagenic Strains of Enteropathogenic Escherichia coli.Microbiology resource announcements · 2019Article
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
Diarrheagenic Escherichia coli (DEC) cause acute and persistent diarrhoea worldwide, but little is known about their epidemiology in Mexico. We determined the prevalence of bacterial enteropathogens in 831 children with acute diarrhoea over a four-year period in Yucatan, Mexico. Six DEC supplementary virulence genes (SVG), mainly associated with enteroaggregative E. coli (EAEC), were sought in 3100 E. coli isolates. DEC was the most common bacterial enteropathogen (28%), surpassing Salmonella (12%) and Shigella (9%). Predominant DEC groups were diffusely adherent E. coli (DAEC) (35%), EAEC (24%), and enteropathogenic E. coli (EPEC) (19%). Among children with DEC infections, 14% had severe illness mainly caused by EPEC (26%) and DAEC (18%); 30% had moderate diarrhoea mainly caused by DAEC (36%), mixed DEC infections (33%) and EAEC (32%). DAEC was most prevalent during spring, while ETEC, EAEC and EPEC predominated in summer. EAEC was more frequent in children 6-24 months old than in those younger than 6 months of age (P = 0.008, OR = 4.2, 95% CI, 1.3-13.9). The presence of SVG dispersin, (aatA), dispersin-translocator (aatA), enteroaggregative heat-stable toxin 1 (astA), plasmid encoded toxin (pet), cytolethal distending toxin (cdt) was higher in DEC than non-DEC strains, (36% vs 26%, P <0.0001, OR = 1.5, 95% CI, 1.3-1.8). 98% of EAEC-infected children harboured strains with SVG; 85% carried the aap-aatA gene combination, and 33% of these also carried astA. 28% of both EPEC and ETEC, and 6% of DAEC patients had strains with SVG. 54% of EPEC patients carried pet-positive strains alone or in combination with astA; only this DEC group harboured cdt-positive isolates. All ETEC patients carried astA- or astA-aap-positive strains. astA and aap were the most common SVG in DAEC (3% and 2%) and non-DEC strains (21% and 13%). DEC carrying SVG are an important cause of moderate to severe bacterial diarrhoea in Mexican children.
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