ENTEROPATHOGENS ASSOCIATED WITH DIARRHEA AMONG MILITARY-PERSONNEL DURING OPERATION-BRIGHT-STAR-96, IN ALEXANDRIA, EGYPT

This study investigated the microbial causes of diarrheal disease amon g U.S. troops deployed near Alexandria, Egypt, during October 1995, Ba cterial causes associated with 19 cases of diarrhea included: enteroto xigenic Escherichia coli (ETEC), 42% (21% heat-stable, 11% heat-labile , and 11% heat-stable/heat-labile producers); enteropathogenic E. coli (5.3%); and enteroadherent E. coli (42%). Four cases of diarrhea were as sociated with enteroaggregative E. coli based on probe analysis fo r enteroaggregative heat;stable enterotoxin 1. Protozoan causes includ ed: Entamoeba histolytica (11%), E. hartmanni (5%), E. nana (5%), Blas tocystis hominis (5%), Chilomastix mesnili (11%), Dientamoeba fragilis (5%), Entamoeba coli (5%), and Cryptosporidium (5%). Shigella, Aeromo nas, Plesiomonas, Vibrio, Campylobacter, and Salmonella were not detec ted. Of the eight ETEC cases,one was colonization factor antigen (CFA) /I only, one was both CFA/I and CFA/III, three were CFA/II, two were C FA/IV, and two were CFA-negative. Antibiograms of the ETEC and enteroa dherent E. coli strains showed that all isolates were susceptible to n orfloxacin, ciprofloxacin, and nalidixic acid but resistant to ampicil lin, tetracycline, chloramphenicol, and sulfamethoxazole.