Toxins and colonization factor antigens of enterotoxigenic Escherichia coli among residents of Jakarta, Indonesia

Infection caused by enterotoxigenic Escherichia coli (ETEC) poses a serious health problem among children and adults in developing countries. Coloniza tion of the small intestinal mucosa by ETEC strains is mediated by antigeni cally specific fimbriae, also known as colonization factor antigens (CFA). The significance of this study arises from reports that active and passive immunization with ETEC strains harboring CFAs has previously been shown to induce protective immunity against diarrhea in animal models. The aim of th is study was to determine toxin-associated CFAs of ETEC isolated from a dia rrheal disease case-control study in Jakarta, Indonesia. Thirteen hundred a nd twenty-three diarrheic and control patients with lactose-fermenting colo nies were screened by ganglioside GM1-enzyme-linked immunosorbent assay (GM 1-ELISA) for heat-labile (LT) and heat-stable (ST) toxins. Two hundred and forty-six (19%) ETEC isolates identified by GM1-ELISA for the LT/ST toxins were screened for CFAs by Dot blot assay using monoclonal antibodies agains t CFA/I, II, and IV and against the putative colonization antigens (PCF) PC FO159, PCFO166, CS7, and CS17 Of the 246 ETEC isolates, 177 (72%) elaborate d ST, 56 (23%) produced LT, while 13 (5%) elicited both the ST and LT toxin s. CFA testing of the 246 ETEC isolates showed that 21 (8%) expressed CFA/I , 3 (1%) exhibited CFA/II, 14 (6%) elaborated CFA/IV, while 7 (3%) expresse d PCFO159 and PCFO159 plus CS5. No CFAs or PCFs could be associated with 20 1 (82%) of the ETEC strains. This report documents the types of CFAs associ ated with ETEC strains in Jakarta, Indonesia. These data may help cur-rent research efforts on the development of CFA-based vaccines for humans agains t ETEC and provide additional information for future ETEC vaccine trials in Southeast Asia.