ENTEROAGGREGATIVE ESCHERICHIA-COLI AS A POTENTIAL CAUSE OF DIARRHEAL DISEASE IN ADULTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

Stools of 68 human immunodeficiency virus (HIV)-infected adults with d iarrhea and 60 without diarrhea were examined for enteroaggregative Es cherichia coli (EAggEc) by Her.a cell adherence assay. EAggEc were pre sent in stools of 30 patients with and 18 without diarrhea (P = .05), CD4 cell counts of patients with EAggEc and diarrhea were significantl y lower than those of patients with EAggEc without diarrhea (P = .02). There was no difference in the mean duration of diarrheal symptoms or in the number of stools per day between patients with EAggEc and thos e without. None of the EAggEc strains were positive by polymerase chai n reaction for adherence fimbria, but 11 strains were positive for:EAg gEc heat-stable toxin EAST/1, Of the EAggEc strains, 51% were resistan t to trimethoprim-sulfamethoxazole and 65% were resistant to ampicilli n, EAggEc may be a pathogen in HIV-infected patients with diarrhea; HI V-infected patients with EAggEc appear to be more symptomatic when HIV disease is more advanced.