ENTEROADHERENT ESCHERICHIA-COLI AND DIARRHEA IN CHILDREN - A PROSPECTIVE CASE-CONTROL STUDY

The relative contribution of diarrheagenic Escherichia coli was examin ed during a 1-year prospective study of hospitalized children in Clerm ont-Ferrand, France, including 220 case patients (with diarrhea) and 2 11 matched controls. Fecal isolates were characterized by means of the ir pattern of adherence to HEp-2 cells and by colony hybridization wit h DNA probes specific for the six categories of diarrheagenic E. coli. No enteroinvasive or enterotoxigenic E. coli isolates were isolated. Twenty-eight (6.5%) eae-positive isolates and 39 (9%) enteroaggregativ e E. coli isolates characterized with the aggregative adherence probe and/or by their adherence pattern were detected; they were equally dis tributed among the patients and the controls. Diffusely adhering E. co li was the predominant pathotype: 30.7% were detected by their adheren ce pattern and 13.7% were detected with the daaC probe. They were isol ated with similar frequencies from the patients and the controls, ther eby showing no association with diarrhea. However, daaC-positive strai ns were significantly associated with a past record of urinary tract i nfections. These results suggest that the diffusely adhering E. coli o rganisms isolated in the present study are not true intestinal pathoge ns but may be regarded as resident colonic strains.