2-YEAR STUDY OF ENDEMIC ENTERIC PATHOGENS ASSOCIATED WITH ACUTE DIARRHEA IN NEW-CALEDONIA

A longitudinal study of diarrheal disease among patients of all ages w ith acute diarrhea was carried out in New Caledonia from January 1990 to December 1991. Stool samples from 2,088 diarrheal patients were exa mined for parasites, rotavirus, and bacterial pathogens. Potential sou rces of contamination (drinking water, seawater and bovine and porcine feces) were investigated. One or more enteric pathogens were identifi ed in 41.8 and 40.6% of the persons with diarrhea, in 1990 and 1991, r espectively. Salmonella spp., Shigella spp., HEp-2 cell adherent Esche richia coli (diffuse adherent and enteroaggregative), enteropathogenic E. coli (EPEC) (EPEC adherence factor-positive strains belonging to c lassical serotypes), localized adherent E. coli (non-EPEC), and entero toxigenic E. coli were the frequently identified enteropathogenic bact eria. Other major enteropathogens were Entamoeba histolytica and Giard ia lamblia. Campylobacter jejuni, Closthridium difficile, Clostridium perfringens, Yersinia enterocolitica, and rotavirus were isolated from only a few patients. No Vibrio spp., Aeromonas spp., Plesiomonas spp. , Shiga-like-toxin-producing E. coli, enterohemorrhagic E. coli, or en teroinvasive E. coli were identified. Shiga-like toxin I-producing E. coli were present in adult bovines and calves, and heat-stable enterot oxin II-producing enterotoxigenic E. coli were found in pigs.