Distribution of Escherichia coli Pathotypes along an Urban-Rural Gradient in Ecuador.
Am J Trop Med Hyg
; 109(3): 559-567, 2023 09 06.
Article
en En
| MEDLINE
| ID: mdl-37549901
ABSTRACT
Diarrheal diseases are a leading cause of mortality and morbidity in low- and middle-income countries. Diarrhea is associated with a wide array of etiological agents including bacterial, viral, and parasitic enteropathogens. Previous studies have captured between- but not within-country heterogeneities in enteropathogen prevalence and severity. We conducted a case-control study of diarrhea to understand how rates and outcomes of infection with diarrheagenic pathotypes of Escherichia coli vary across an urban-rural gradient in four sites in Ecuador. We found variability by site in enteropathogen prevalence and infection outcomes. Any pathogenic E. coli infection, coinfections, diffuse adherent E. coli (DAEC), enteroinvasive E. coli (EIEC), and rotavirus were significantly associated with acute diarrhea. DAEC was the most common pathotype overall and was more frequently associated with disease in urban areas. Enteropathogenic E. coli (EPEC) and enterotoxigenic E. coli (ETEC) were more common in rural areas. ETEC was only associated with diarrhea in one site. Phylogenetic analysis revealed that associations with disease were not driven by any single clonal complex. Higher levels of antibiotic resistance were detected in rural areas. Enteropathogen prevalence, virulence, and antibiotic resistance patterns vary substantially by site within Ecuador. The variations in E. coli pathotype prevalence and virulence in this study have important implications for control strategies by context and demonstrate the importance of capturing within-country differences in enteropathogen disease dynamics.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por Escherichia coli
/
Escherichia coli Enteropatógena
/
Escherichia coli Enterotoxigénica
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do sul
/
Ecuador
Idioma:
En
Revista:
Am J Trop Med Hyg
Año:
2023
Tipo del documento:
Article
País de afiliación:
Ecuador