A SURVEY OF ENTEROPATHOGENS AMONG UNITED-STATES MILITARY PERSONNEL DURING OPERATION-BRIGHT-STAR-94, IN CAIRO, EGYPT

Acute gastroenteritis is a potential cause of substantial morbidity in U.S. military personnel during deployment. This study was conducted t o evaluate enteric pathogens associated with diarrhea in a U.S. milita ry population on deployment in Cairo, Egypt, during November 1993. Ent eric pathogens found to be associated with cases of diarrhea included: enterotoxigenic Escherichia coli (ETEC), 27% (22% heat-stable [ST], 3 % heat-labile [LT], and 2% ST/LT producers); Campylobacter spp., 3%; a nd Salmonella spp. 3%. Other enteric pathogens, namely Shigella, Aerom onas, Plesiomonas, Vibrio spp., Bacillus cereus, and enteric parasites , were not found in any of the 36 patients. Of the 8 patients who were ETEC-positive, three expressed colonization factor antigens (CFA)/II, and two expressed putative colonization factor antigen (PCF) 0159. Al l of the latter isolates produced ST. ETEC with different surface prot ein antigens were found to have surface hydrophobicity in the range of 0.2 M to greater than 2.0 M. Plasmid profiles of the ETEC strains sho wed no correlation with toxin production. In vitro susceptibility test ing of the ETEC strain showed that 32% of the strains were resistant t o three or more antimicrobial agents, whereas 24% showed 100% suscepti bility. The enteropathogens tested were susceptible to norfloxacin, ci profloxacin, and nalidixic acid, suggesting that the quinolones might be useful for the treatment of diarrheic patients.