ENTEROAGGREGATIVE ESCHERICHIA-COLI STRAINS AS A CAUSE OF TRAVELERS DIARRHEA - A CASE-CONTROL STUDY

To elucidate the importance of enteroaggregative Escherichia coli (EAg gEC) strains as a cause of traveler's diarrhea in Spanish travelers, a prospective case-control 1:1 study was done in a university hospital clinic for travelers. EAggEC strains were isolated from 23 of 165 case -patients and from 4 of 165 controls (P = .0003), In 16 patients, this was the only isolate recovered. Six of the EAggEC-positive isolates f rom the case-patients and 2 from the controls were positive for the en teroaggregative stable toxin type 1 gene, Other enteropathogens were a lso isolated. Shigella and enterotoxigenic E, coli strains showed sign ificant differences between cases and controls (P =.0023 and P < .0001 , respectively). Geographic distribution of the EAggEC strains was hom ogeneous, and the clinical symptom, secretory diarrhea, did not differ statistically with that for the enterotoxigenic E. coli strains. EAgg EC strains are a cause of secretory diarrhea in Spaniards traveling to developing countries.