Enterotoxigenic Escherichia coli

Enterotoxigenic Escherichia coli
Classification and external resources
Specialty infectious disease
ICD-10 A04.1
ICD-9-CM 008.02

Enterotoxigenic Escherichia coli (ETEC) is a type of Escherichia coli and one of the leading bacterial causes of diarrhea in the developing world,[1] as well as the most common cause of travelers' diarrhea.[2] Insufficient data exist, but conservative estimates suggest that each year, about 157,000 deaths occur, mostly in children, from ETEC.[3][4][5] A number of pathogenic isolates are termed ETEC, but the main hallmarks of this type of bacteria are expression of one or more enterotoxins and presence of fimbriae used for attachment to host intestinal cells.

Enterotoxins

Enterotoxins produced by ETEC include heat-labile enterotoxin (LT) and heat-stable enterotoxin (ST).[6]

Presentation

Infection with ETEC can cause profuse, watery diarrhea with no blood or leukocytes and abdominal cramping. Fever, nausea with or without vomiting, chills, loss of appetite, headache, muscle aches and bloating can also occur, but are less common.[2]

Prevention and treatment

To date, no licensed vaccines specifically target ETEC, though several are in various stages of development.[1][7] Studies indicate that protective immunity to ETEC develops after natural or experimental infection, suggesting that vaccine-induced ETEC immunity should be feasible and could be an effective preventive strategy.[1][8] Prevention through vaccination is a critical part of the strategy to reduce the incidence and severity of diarrheal disease due to ETEC, particularly among children in low-resource settings. The development of a vaccine against this infection has been hampered by technical constraints, insufficient support for coordination, and a lack of market forces for research and development. Most vaccine development efforts are taking place in the public sector or as research programs within biotechnology companies.[9] ETEC is a longstanding priority and target for vaccine development for the World Health Organization.

Treatment for ETEC infection includes rehydration therapy and antibiotics, although ETEC is frequently resistant to common antibiotics.[2] Improved sanitation is also key. Since the transmission of this bacterium is fecal contamination of food and water supplies, one way to prevent infection is by improving public and private health facilities. Another simple prevention of infection is by drinking factory bottled water—this is especially important for travelers and traveling military—though it may not be feasible in developing countries, which carry the greatest disease burden.

See also

References

  1. 1 2 3 Bourgeois, A Louis; Wierzba, Thomas F; Walker, Richard I (2016). "Status of vaccine research and development for enterotoxigenic Escherichia coli". Vaccine. 34 (26): 2880–2886.
  2. 1 2 3 US Centers for Disease Control and Prevention (2014). "Enterotoxigenic E. coli (ETEC)".
  3. ↑ Lozano, Rafael; Naghavi, Mohsen; Foreman, Kyle; et al. (2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". The Lancet. 380 (9859): 2095–2128.
  4. ↑ Gupta, SK; Keck J; Ram PK; et al. (2008). "Analysis of Data Gaps Pertaining to Enterotoxigenic Escherichia coli Infections in Low and Medium Human Development Index Countries, 1984-2005". Epidemiology and Infection. 136 (6): 721–738. doi:10.1017/S095026880700934X.
  5. ↑ Kotloff, Karen L; Nataro, James P; Blackwelder, William C; et al. (2013). "Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study". The Lancet. 382 (9888): 209–222.
  6. ↑ Qadri, F.; Svennerholm, A. M.; Faruque, A. S. G.; Bradley Sack, R. (2005). "Enterotoxigenic Escherichia coli in Developing Countries: Epidemiology, Microbiology, Clinical Features, Treatment, and Prevention". Clinical Microbiology Reviews. 18 (3): 465–483. doi:10.1128/CMR.18.3.465-483.2005. PMC 1195967Freely accessible. PMID 16020685.
  7. ↑ "WHO vaccine pipeline tracker". World Health Organization. Retrieved 2016-07-21.
  8. ↑ Girard, M.; Steele, D.; Chaignat, C. L.; Kieny, M. P. (2006). "A review of vaccine research and development: human enteric infections". Vaccine. 24 (15): 2732–2750. doi:10.1016/j.vaccine.2005.10.014. PMID 16483695.
  9. ↑ PATH, bvgh (March 2011). "The Case for Investment in Enterotoxigenic Escherichia coli Vaccines" (PDF). Retrieved 2 May 2012.
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