A CASE-CONTROL STUDY OF DIARRHEA IN CHILDREN CAUSED BY ESCHERICHIA-COLI PRODUCING HEAT-STABLE ENTEROTOXIN (EAST-1)

Escherichia coli strains associated with diarrhoeal disease have been classified into several types according to the pathogenic mechanism. A mong these, enteroaggregative E. coli strains (EAggEC) have been assoc iated with persistent childhood diarrhoea, Some strains of EAggEC prod uce a heat-stable toxin (EAST-1) that differs from others described pr eviously, The main goal of this case-control study was to determine th e prevalence of EAggEC and EAST-1-producing E, coli strains as a cause of diarrhoea in children in Spain and to study their in-vitro suscept ibility to 21 antimicrobial agents. In the case group (115 children) 2 2 (19%) isolates and four (3.5%) isolates were EAST-1-producing E, col i and EAggEC, respectively, whereas in the control group (79 children) four (5%) isolates produced EAST-1 (p=0.005) and three (3.8%) isolate s were EAggEC, The present study suggests that EAST-1-producing E, col i strains are associated with diarrhoeal diseases in Spanish children, whereas EAggEC strains are not. Moreover, EAST-1-producing E, coli st rains showed a high susceptibility to all the antimicrobial agents tes ted except for ampicillin.