Isolation and Characterization of an Escherichia albertii Strain Producing Three Different Toxins from a Child with Diarrhea.

Here, we report a bacterium-isolated as the sole pathogen from a child with diarrhea-harboring eae and 2 different cytolethal distending toxin genes (cdt) that are homologous to Escherichia coli cdt-I and cdt-II. The bacterium was originally identified as atypical E. coli by conventional biochemical testing, but was finally identified as E. albertii by multilocus sequence analysis, which is the only method that can currently differentiate E. albertii from E. coli. The Shiga toxin 2f (stx2f) genes were also detected in the strain. Production of these 3 toxins was confirmed by western blotting and/or a cytotoxicity assay using eukaryotic cell lines. This is the first report showing the biological activity of CDT-I, CDT-II, and Stx2f in E. albertii.

High Prevalence of Diarrheagenic Escherichia coli among Children with Diarrhea in Kenya.

Diarrheagenic Escherichia coli (DEC) is an important agent of endemic and epidemic diarrhea worldwide, particularly in developing countries. DEC cannot be differentiated from commensal E. coli on selective media, although there are a few exceptions. Most studies use the colony isolation method, which cannot detect low numbers of DEC, and therefore, these studies might underestimate the incidence of DEC. In the present study, we employed a colony sweep method with real-time PCR targeting virulence genes of 5 categories of DEC; this technique can detect very low numbers of DEC among hundreds of commensal E. coli. DEC was detected in 171 (55.9%) of 306 children with diarrhea in Kenya. The prevalence of DEC in Kenya was notably higher than that (30 in 143, 21.0%) in Indonesia. Occurrences of multiple DEC infection in Kenya were frequent (69 in 306, 23.2%), suggesting that the source of DEC infection may be related to grossly contaminated food and water. In contrast, only 9 (6.0%) of 150 healthy adults in Kenya carried DEC. Considering that healthy adults naturally harbor non-DEC, it is interesting how children exclude DEC but not non-DEC as they grow up. Several mechanisms, such as mucosal immunity and intestinal microbiota, might be involved in the exclusion of DEC.