Entry of Enteropathogenic Escherichia coli into Host Cells

Abstract

The enteropathogenic Escherichia coli (EPEC) are a class of diarrheagenic E. coli strains that induce a characteristic “attaching and effacing” effect on the host cell cytoskeleton and membrane, but do not produce high levels of Shiga-like toxins. EPEC strains are also distinguished by the “localized adherence” pattern by which they form discrete microcolonies on the surface of tissue culture cells. EPEC strains are a leading cause of diarrhea worldwide, affecting primarily infants in developing countries (COBELJIC et al. 1989; CRAVIOTO et al. 1991; KAIN et al. 1991; GOMES et al. 1991; ECHEVERRIA et al. 1991; LEVINE et al. 1988). In some countries EPEC are the number one cause of infantile diarrhea, exceeding even rotavirus in incidence (GOMES et al. 1991; ROBINS-BROWNE et al. 1980; CRAVIOTO et al. 1988). EPEC diarrhea is typically watery, often with associated vomiting and low-grade fever (GOMES et al. 1991). Diarrhea due to EPEC may be severe and protracted and may require hospitalization, intravenous rehydration, and total parental nutrition (FAGUNDES NETO et al. 1989; HILL et al. 1991). EPEC are thought to be transmitted primarily from person to person (Wu and PENG, 1992), but common-source food and water outbreaks have been described (VILJANEN et al. 1990; SCHTOEDER et al. 1968). In developed countries outbreaks in child daycare centers have occurred (PAULOZZI et al. 1986; BOWER et al. 1989). Mortality due to EPEC infection continues to be a problem in developing countries (SENERWA et al. 1989).