Enteropathogenic Escherichia coli identification in pediatric patients hospitalized for acute gastroenteritis

Background. Most of childhood diarrheal disease is caused by pathogens not recognized in routine clinical testing; we had reason to suspect that diarrheagenic Escherichia coli might be some of the most important emerging pathogens that cause enteric and food-borne infectious diseases. The aim of the present study is to estimate the incidence and investigate the epidemiology and pathogenesis of enteropathogenic E. coli from faecal specimens in pediatric patients hospitalized for gastroenteritis. Materials. Between November 2003 and December 2004 we stored and analysed the stools of 150 patients admitted in our hospital for acute gastroenteritis, aged between 6 months and 15 years, born at term, appropriate for gestational age, without any chronic gastrointestinal or metabolic disease. Methods. Trained operators took the stool samples from the first evacuation after the admission in hospital; cultures were incubated overnight at 37 ◦C, then the colonies were analysed by multiplex-PCR and electrophoresis with API20E [1,2]. Results. E. coli were isolated in 81 samples (54.9%); 11 samples among these 81 (corresponding to 7.3% of the overall collected samples) had been positively recognised for genes related to pathogenesis (eaeA, slt-I, slt-II, lt). Conclusions. From our finding we can observe that enteropathogenic E. coli are an important cause of childhood gastrointestinal disease, not only in developing countries but also in the developed ones, such as Italy. This data provide an interesting epidemiologic survey of enteropathogenic E. coli, which usually are not detected, although they have potential clinical implications.