From the Guidelines
Enteroaggregative Escherichia (E. coli) diarrhea is caused by the adherence of E. coli to intestinal cells and the production of toxins that trigger inflammation and fluid secretion, leading to diarrhea. The exact mechanisms of this process are complex and involve various virulence factors, but the end result is the disruption of normal intestinal function and the onset of diarrhea [1].
Key Factors Contributing to E. coli Diarrhea
- Adherence to intestinal cells: E. coli adheres to the intestinal mucosa, which is a critical step in the pathogenesis of the disease [1].
- Production of toxins: The production of toxins by E. coli contributes to the inflammation and fluid secretion that characterize the disease [1].
- Inflammation and fluid secretion: The toxins produced by E. coli trigger an inflammatory response and increase fluid secretion in the intestine, leading to diarrhea [1].
Prevention and Management
Prevention of Enteroaggregative E. coli diarrhea involves practicing good hand hygiene, consuming safe food and water, and avoiding potentially contaminated food sources, especially when traveling to regions where E. coli is common [1]. Management of the disease typically involves supportive care, including oral rehydration therapy and, in some cases, antibiotic treatment [1].
Important Considerations
- The burden of acute gastroenteritis, including that caused by E. coli, has been reduced since the implementation of rotavirus vaccines [1].
- General measures, such as hand hygiene and proper food preparation and storage, can help reduce the incidence of acute infectious diarrhea [1].
- Appropriate use of antimicrobial agents is crucial to prevent increasing resistance and worsening illness [1].
From the Research
Cause of Enteroaggregative Escherichia (E. coli) Diarrhea
The cause of Enteroaggregative Escherichia (E. coli) diarrhea can be attributed to the following factors:
- Adherence to the intestinal mucosa: EAEC pathogenesis involves the adherence to the intestinal mucosa, which is the first stage of infection 2.
- Increased production and deposition of a mucus biofilm: The second stage of EAEC pathogenesis is the increased production and deposition of a mucus biofilm, leading to mucosal toxicity 2.
- Mucosal toxicity due to inflammation and cytokine release: The third stage of EAEC pathogenesis is the mucosal toxicity due to inflammation and cytokine release, resulting in diarrhea 2.
- Infection with EAEC strains that produce biofilm: Many putative virulence genes and EAEC strains that produce biofilm have been identified, which may contribute to the development of diarrhea 3.
- Host susceptibility: A -251 AA single nucleotide polymorphism (SNP) in the interleukin (IL)-8 promoter region is reported to increase host susceptibility to EAEC diarrhea 3.
Key Findings
Key findings on the cause of Enteroaggregative Escherichia (E. coli) diarrhea include:
- EAEC is an emerging pathogen that causes enteric and food-borne infectious diseases 2, 4, 3.
- EAEC infection can result in watery diarrhea, which is often persistent and can be inflammatory 4.
- EAEC has been implicated in sporadic diarrhea in children and adults, in both developing and developed countries 4.
- EAEC has been identified as the cause of several outbreaks worldwide 4, 3.