From the Guidelines
Enteropathogenic E. coli (EPEC) infections are primarily acquired through the fecal-oral route, involving the consumption of contaminated food, water, or direct person-to-person contact. The mode of transmission for EPEC infections is multifaceted, including:
- Contaminated food and water, particularly in areas with inadequate sanitation and hygiene
- Person-to-person transmission, especially in crowded settings like daycare centers and households
- Contact with animals or their environment
- Ingestion of contaminated water 1 Key factors contributing to the spread of EPEC include:
- A low infectious dose, allowing for efficient person-to-person transmission
- The ability of the bacteria to survive on surfaces and objects (fomites), facilitating indirect transmission
- Poor sanitation and hygiene practices, which increase the risk of contamination Prevention strategies should focus on:
- Proper handwashing techniques
- Safe food preparation and handling practices
- Access to clean drinking water
- Implementation of appropriate sanitation measures It is essential to note that while the provided study 1 discusses Shiga toxin-producing E. coli, the principles of transmission and prevention can be applied to Enteropathogenic E. coli, given the similarities in their modes of transmission.
From the Research
Mode of Transmission for Enteropathogenic E. coli (EPEC) Infections
The mode of transmission for Enteropathogenic E. coli (EPEC) infections is not explicitly stated in the provided studies. However, we can infer the possible modes of transmission based on the characteristics of EPEC and its interaction with the host.
- EPEC is a gram-negative bacterial pathogen that adheres to intestinal epithelial cells, causing diarrhea 2, 3.
- The bacteria use a type-three-secretion-system (T3SS) to inject virulence factors into the host cell, leading to the formation of a characteristic pedestal structure underneath adherent bacteria 4, 3.
- EPEC can colonize the intestine and cause disease in humans, particularly in infants and young children 5, 2.
- The bacteria can be transmitted through contaminated food or water, or through person-to-person contact 2.
Epidemiology of EPEC Infections
- EPEC is a significant cause of infant mortality in developing countries 2.
- Atypical EPEC (aEPEC) are seen more frequently than typical EPEC (tEPEC) worldwide, including in both endemic diarrhea and diarrhea outbreaks 5.
- aEPEC strains are highly heterogeneous and may carry virulence determinants that compensate for their lack of bundle-forming pili (BFP) 6.
Pathogenesis of EPEC Infections
- EPEC infection induces diarrhea, intestinal damage, metabolic alterations, and increased intestinal permeability in a murine model 4.
- The bacteria subvert the host cell cytoskeleton, causing a rearrangement of cytoskeletal components into a characteristic pedestal structure underneath adherent bacteria 3.
- EPEC activates several signaling pathways that lead to tight junction disruption, inhibition of phagocytosis, altered ion secretion, and immune responses 3.