Diarrheagenic Escherichia coli and acute and persistent diarrhea in returned travelers

To determine the role of diarrheagenic Escherichia coli in acute and persis tent diarrhea in returned travelers, a case control study was performed, En terotoxigenic E, coli (ETEC) was detected in stool samples from 18 (10.7%) of 169 patients and 4 (3.7%) of 108 controls. Enteroaggregative E, call (EA ggEC) was detected in 16 (9.5%) patients and 7 (6.5%) controls, Diffuse adh erent E, coli strains were commonly present in both patients (13%) and cont rols (13.9), Campylobacter and Shigella species were the other bacterial en teropathogens most commonly isolated (10% of patients, 2% of controls), Mul tivariate analysis showed that the presence of ETEC was associated with acu te diarrhea (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.5 to 29. 1; P = 0.005), but not with persistent diarrhea (OR 1.6; 95% CI 0.4 to 7.4) . EAggEC was significantly more often present in patients with acute diarrh ea than in controls (P = 0.009), but no significant association remained af ter multivariate analysis, ETEC and EAggEC are frequently detected in retur ned travelers with diarrhea, The presence of ETEC strains is associated wit h acute but not with persistent diarrhea.