Advertisement

Diagnosisand Investigation of Diarrheagenic Escherichia coli

  • James P. Nataro
  • Juan Martinez
Part of the Methods in Molecular Medicine™ book series (MIMM, volume 15)

Abstract

Although most Escherichia coli are harmless commensals of the human intestine, certain specific, highly-adapted E. coli strains are capable of causing urinary tract, systemic or enteric/diarrheagenic infection. Diarrheagenic E coli are divided into six distinct categories, or pathotypes, each with a distinct pathogenic scheme (Table 1). Combined, diarrheagenic E coli have emerged as perhaps the most important enteric pathogens of man. In the developing world, the E coli categories account for more cases of gastroenteiltis among infants than any other cause (1) In addition, E coli are also the most common cause of traveller’s diarrhea, which afflicts more than one million travellers to the developing world annually (1). Enterohemorrhagic E coli (EHEC) are the cause of hemolytic uremic syndrome (HUS), which has become a major foodborne threat in many parts of the developed world (2).
Table 1

Categories of Diarrheagenic E. coli

Category

Toxins

Invasion

Virulence plasmid

Adhesin

Clinical syndrome

ETEC

LT, ST

Many

CFA/I, CFA/II, CFA/IV, others

Watery diarrhea

EPEC

+

60 MDa

Bundle-forming pilus

Watery diarrhea of infants

EHEC

SLT-1, SLT-2

60 MDa a

Intimin, Fimbriae a

Hemorrhagic colitis, HUS

EAEC

EAST1 a

?

65 MDa a

AAF/I, AAF/I

Watery, persistent diarrhea

EIEC

EIET a

+++

140 MDa

Ipa’s(?)

Watery diarrhea, dysentery

DAEC

?

?

?

F1845 a

Watery diarrhea

a Role in pathogenesis unproven

Keywords

Hemolytic Uremic Syndrome Molecular Diagnostic Technique EPEC Strain Fragment Probe EAEC Strain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Levine, M.M (1987) Escherichia coli that cause diarrhea enterotoxigenic,enteropathogenic, enteroinvasive, enterohemorrhagic, and enteroadherent J Infect Dis 155, 377–389PubMedGoogle Scholar
  2. 2.
    Pickering, L K., Obng, T G., and Stapleton, F. B (1994) Hemolytic-uremicsyndrome and enterohemorrhagic Escherichia coli Pediatr Infect Dis J 13, 459–476Google Scholar
  3. 3.
    Albert, M. J, Faruque, S M, Faruque, A S. G, Neogi, P. K. B, Ansaruzzaman, M, Bhuiyan, N A, Alam, K, and Akbar, M S (1995) Controlled study ofEscherichza colidiarrhea1 mfectlons in Bangladesh1 children J Clin Microbiol 33, 973–977PubMedGoogle Scholar
  4. 4.
    Levine, M. M (1985) Escherzchza coli lmfections N Engl J Med 313, 445–447PubMedCrossRefGoogle Scholar
  5. 5.
    Echevema, P., Taylor, D N., Donohue-Rolfe, A., Supawat, K., Ratchtrachenchal, O, Kaper, J., and Keusch, G T.(1987) HeLa cell adherence and cytotoxm production by enteropathogemc Escherichia coli isolated from Infants with diarrheain Thailand J Clzn Mzcrobzol 25, 1519–1523Google Scholar
  6. 6.
    Cassels, F J and Wolf, M K (1995) Colomzatlon factors of dlarrheagemc E coliand their mtestmal receptors J Indust Microbiol 15, 214–226.CrossRefGoogle Scholar
  7. 7.
    Moseley, S L, Echevema, P., Serwatana, J, Tirapat, C, Chalcumpa, W, Sakuldaipeara, T., and Falkow, S (1982) Identlfication of enterotoxlgenicEscherichia co1i by colony hybridization using three enterotoxin gene probes JInfect Dis 145, 863–869.Google Scholar
  8. 8.
    Lanata, C F, Kaper, J. B., Baldml, M. M, Black, R E., and Levme, M. M (1985) Sensltlvlty and specificity of DNA probes with the stool blot technique for detection of Escherzchza coli enterotoxins. J Infect Dis 152, 1087–1090.PubMedGoogle Scholar
  9. 9.
    Levine, M M., Ferreccio, C, Prado, V., Cayazzo, M, Abrego, P, Martinez, J., Maggl, L, Baldml, M. M, Martin, W, Maneval, D, Kay, B, Guers, L, Llor, H, Wasserman, S S., and Nataro, J. P (1993) Epldemiologlc studies of Escherzchzacoli diarrheal infections in a low socloeconomlc level pen-urban community in Santiago, Chile Am J Epzdemzol 138, 849–869Google Scholar
  10. 10.
    Rademaker, C M A., Martinez-Martmez, L., Perea, E J, Jansze, M., Fluit, A.C., Glerum, J.H., and Verhoef, J (1993) Detection of enterovirulent Escherichia coliassociated with diarrhoea in Seville, Southern Spain, with non-radtoacttve DNAprobes.J Med Microbiol 38, 87–89.PubMedCrossRefGoogle Scholar
  11. 11.
    Begaud, E and Germani, Y. (1992) Detection of enterotoxigemc Escherichia coliin faecal specimens by acetylaminofluorene-labelled DNA probes Res Microbiol 143, 315–325.PubMedCrossRefGoogle Scholar
  12. 12.
    Schultsz, C, Pool, G. J, VanKetel, R., De Wever, B., Speelman, P, and Dankert, J (1994) Detection of enterotoxtgemc Escherichia coli in stool samples by usingnonradioactively labeled oligonucleotide DNA probes and PCR J ClinMicrobiol 32, 2393–2391.Google Scholar
  13. 13.
    Stacy-Phlpps, S., Mecca, JJ, and Weiss, J B (1995) Multiplex PCR assayand simple preparation method for stool specimens detect enterotoxtgemcEscherichia coli DNA during course of infection J. Clin Microbiol 33, 1054–1059Google Scholar
  14. 14.
    Abdul, A A., Faruque, S. M., Ahmad, Q. S, Hossain, K M, Mahalanabis, D.,and Albert, M J (1994) Evaluation of a non-radtoactlve chemiluminescentmethod for using oligonucleotide and polynucleotide probes to identifyenterotoxtgenic Escherichia co1i J Dear Dis. Res 12, 113–116.Google Scholar
  15. 15.
    Jablonski, E., Moomaw, E W, Tullis, R.H, and Ruth, J. L. (1987) Prepration ofoligodeoxynucleotide-alkaline phosphatase conugates and their use ashyrbidtzation probes Nucleic Acids Res. 14, 6115–6128.CrossRefGoogle Scholar
  16. 16.
    Sommerfelt, H., Bhan, M. K., Snvastava, R, and Bhatnagar, S (1993) Evaluationof DNA-DNA hybrldtzatton for the direct detection of enterotoxigenic Escherichia coli in stool blots. Stand. J infect. Dis.25, 457–463Google Scholar
  17. 17.
    Tormeporth, N. G., John, J, Salgado, K., DeJesus, P, Latham, E., Melo, M. C.N., Gunzburg, S. T., and Riley, L. W.(1995) Differentiation of pathogenicEscherichia coli strains in Brazilian children by PCR J Clin Microbiol 33, 1371–1374.Google Scholar
  18. 18.
    Lang, A. L, Tsar, Y.-L, Mayer, C. L., Patton, K. C., and Palmer, C. J (1994) Multiplex PCR for detection of the heat-labile toxin gene and Shiga-like toxin Iand II genes in Escherichia coli isolated from natural waters. Appl Environ.Microbiol. 60, 3145–3149.PubMedGoogle Scholar
  19. 19.
    Olsvik, 0. and Strockbme, N. A. (1993) PCR detection of heat-stable, heat-labile,and Shiga-like toxin genes in Escherichia coli, in Diagnostic Molecular Microbiology Principles and Applications, (Persmg, D. H., Smith, T F., Tenover, F C.,and White, T. J., eds.), Rochester, NY, Mayo Foundation, pp. 271–276.Google Scholar
  20. 20.
    du Ton, R., Victor, T C, and Van Helden, P. D. (1993) Empirical evaluation ofcondmons influencing the polymerase chain reaction enterotoxigemc Escheri-chia co1i as a test case. Eur J Clin Chem. 31, 225–231.Google Scholar
  21. 21.
    Robins-Browne, R. M. (1987) Traditional enteropathogemc Escherichia coli ofinfantile diarrhea Rev Infect Dis 9, 28–53.PubMedCrossRefGoogle Scholar
  22. 22.
    Donnenberg, M. S and Kaper, J B. (1992) Enteropathogenic Escherichia coliInfect Immun 60, 3953–3961Google Scholar
  23. 23.
    McDaniel, T K, Jarvis, K G, Donnenberg, M S, and Kaper, J. B (1995) Agenetic locus of enterocyte effacement conserved among diverse enterobacterialpathogens Proc Nat1 Acad Sci USA 92, 1664–1668CrossRefGoogle Scholar
  24. 24.
    Giron, J A., Ho, A S Y., and Schoolink, G. K (1991) An inducible bundleforming pilus of enteropathogenic Escherdia coli Science 254, 710–713Google Scholar
  25. 25.
    Baldini, M M, Nataro, J P., and Kaper, J. B (1986) Localization of a determinant for HEp-2 adherence by enteropathogenic Escherichia cob. Infect Immun 52, 334–336.PubMedGoogle Scholar
  26. 26.
    Nataro, J P, Baldmr, M M, Kaper, J B., Black, R E, Bravo, N., and Levine, M M. (1985) Detection of an adherence factor of enteropathogenic Escherichia coliwith a DNA probe J Infect Dis 152, 560–565PubMedGoogle Scholar
  27. 27.
    Nataro, J. P, Maher, K O., Mackie, P, and Kaper, J. B (1987) Characterizationof plasmids encoding the adherence factor of enteropathogenic Escherichia coliInfect Immun 55, 2370–2377Google Scholar
  28. 28.
    Jerse, A. E, Martin, W C., Galen, J E., and Kaper, J B (1990) Oligonucleotideprobe for detection of the enteropathogenic Escherichia co1i (EPEC) adherencefactor of localized adherent EPEC.J Clin Microbiol 28, 2842–2844.PubMedGoogle Scholar
  29. 29.
    Donnenberg, M S., Giron, J A., Nataro, J P, and Kaper, J B (1992) Aplasmidencoded type IV fimbrial gene of enteropathogenic Escherichia coli associatedwith localized adherence Mol Microbiol 6, 3427–3437PubMedCrossRefGoogle Scholar
  30. 30.
    Zhang, H.-Z, Lory, S, and Donnenberg, M. S (1994) A plasmid-encoded prepilinpeptidase gene from enteropathogenic Escherichia coli.J Bacteriol 176, 6885–6891.PubMedGoogle Scholar
  31. 31.
    Gtron, J. A, Donnenberg, M. S, Martin, W C, Jarvis, K G, and Kaper, J B (1993) Distribution of the bundle-forming pilus structural gene (bfpA) amongenteropathogenic Escherichia coli. J Infect Dis 168, 1037–1041.Google Scholar
  32. 32.
    Jerse, A. E, Gicquelais, K, and Kaper, J. B. (1991) Plasmid and chromosomalelements involved in the pathogenesis of attaching and effacing Escherichia coliInfect Immun 59, 3869–3815Google Scholar
  33. 33.
    Schmidt, H., Russmann, H, and Karch, H. (1993) Virulence determinants innontoxinogenic Escherichia coli O157 strains that cause infantile diarrhea Infect immun 61, 4894–4898PubMedGoogle Scholar
  34. 34.
    Schmtdt, H, Russman, H, Schwarzkopf, A., Aleksic, S, Heesemen, J, and Karch, H (1994) Prevalence of attaching and effacing Escherichia coli in stool samples from patients and controls. Int J Med Microbiol Virol Parasitol Infect. Dis 281, 201–213Google Scholar
  35. 35.
    Franke, J., Franke, S., Schmtdt, H., Schwarzkopf, A., Wieler, L H., BalJer, G, Beutm, L., and Karch, H (1994) Nucleotide sequence analysis of enteropathogenicEscherichia coli (EPEC) adherence factor probe and development of PCR for rapiddetection of EPEC harboring virulence plasmids J Clin Microbiol 32, 2460–2463PubMedGoogle Scholar
  36. 36.
    Gunzberg, S T, Tornieporth, N G, and Riley, L W (1995) Identification ofenteropathogenic Escherichia co1i by PCR-based detection of the bundle-formingpilus gene J Clin Microbiol 33, 1375–1377Google Scholar
  37. 37.
    Donnenberg, M. S., Tzipori, S., McKee, M. L., O’Brien, A. D., Alroy, J, and Kaper,J. B (1993) The role of the eae gene of enterohemorrhagic Escherichia colin in intimate attachment in vitro and in a porcine model J. Clin Invest 92, 1418–1424.PubMedCrossRefGoogle Scholar
  38. 38.
    O’Brien, A D, Tesh, V. L, Donohue-Rolfe, A., Jackson, M P, Olsnes, S.,Sandvig, K., Lindberg, A A, and Keusch, G T (1992) Shiga toxin Biochemistry, genetics, mode of action, and role in pathogenesis Curr Top MicrobiolImmunol 180, 65–94Google Scholar
  39. 39.
    Karch, H, Heesemann, J, Laufs, R., O’Brien, A D, Tacket, C O, and Levine, M M (1987) A plasmid of Enterohemorrhagic Escherichia coli O157″H7 isrequired for expression of a new fimbrial antigen and for adhesion to epithelialcells Infect Immun. 55, 455–461PubMedGoogle Scholar
  40. 40.
    Karch, H. and Meyer, T (1989) Evaluation of ohgonucleotide probes for tdentification of Shiga-like-toxin-producing Escherichia coli. J Clin Microbiol 27, 1180–1186.PubMedGoogle Scholar
  41. 41.
    Levine, M M., Xu, J, Kaper, J B, Lior, H, Prado, V, Tall, B, Nataro, J, Karch, H, and Wachsmuth, K (1987) A DNA probe to identify EnterohemorrhagicEscherichia coliof 0157 H7 and other serotypes that cause hemorrhagic coltisand hemolytic uremic syndrome J Infect Dis 156, 175–182PubMedGoogle Scholar
  42. 42.
    Gunzer, F., Bohm, H., Russman, H, Bitzan, M., Aleksic, S., and Karch, H (1992) Molecular detection of sorbitol-fermenting Escherichia coli 0157 in patients withhemolytic-uremic syndrome J Clin Microbiol 30, 1807–1810PubMedGoogle Scholar
  43. 43.
    Schmidt, H, Karch, H, and Beutin, L (1994) The large-sized plasmids of enterohemorrhagic Escherichia coli 0157 strains encode hemolysins which are presumably members of the E cali-hemolysin family. FEMS Microbiol Lett 117, 189–196PubMedGoogle Scholar
  44. 44.
    Brown, J. E, Sethabutr, O, Jackson, M P, Lolekha, S, and Echeverria, P (1989) Hybridization of Escherichia coli producing Shiga-like toxin I, Shtga-like toxinII, and a variant of Shiga-like toxin II with synthetic oligonucleotide probes InfectImmun 57, 281l–2814.Google Scholar
  45. 45.
    Karch, H, Janetzkt-Mittman, C., Aleksic, S., and Datz, M (1996) Isolation ofenterohemorrhagic Escherichia co1i 0157 strains from patients with hemolyttcuremic syndrome by usmg immunomagnetic separation, DNA-based methods, anddirect culture J Clin Microbiol 34, 516–519PubMedGoogle Scholar
  46. 46.
    Brian, M J., Frosolono, M., Murray, B., Miranda, A, Lopez, E. L., Gomez, H F, and Cleary, TG (1992) Polymerase chain reaction for dtagnosis ofenterohemorrhagic Escherichia coliinfectton and hemolytic uremic syndrome. JClin Microbiol 30, 1801–1806Google Scholar
  47. 47.
    Gannon, V. P J, Rashed, M, King, R. K., and Thomas, E J G (1993) Detectionand characterization of the eae gene of shiga-like toxin-producing Escherichiacoli using polymerase chain reaction. J Clin Microbiol 31, 1268–1274PubMedGoogle Scholar
  48. 48.
    Fratamico, P M, Sachtey, S K., Wiedmann, M., and Deng, M. Y (1995) Detectionof Escherichia coli 0157 ∶H7 by multiplex PCR. J. Clin Microbiol 33, 2188–2191PubMedGoogle Scholar
  49. 49.
    Savarino, S. J. (1993) Enteroadherent Escherichia coli: A heterogeneous group ofE coliimplicated as diarrhoeal pathogens Trans Roy Soc Trop. Med Hyg 87 Suppl. 3, 49–53CrossRefGoogle Scholar
  50. 50.
    Smith, H R, Scotland, S M, Willshaw, G A., Rowe, B, Cravioto, A, and Eslava, C. (1994) Isolates of Escherichia coli O44 H18 of diverse origin areenteroaggregative J infect Dis 170, 1610–1613PubMedGoogle Scholar
  51. 51.
    Wanke, C A, Schorling, J. B, Barrett, L J., Desouza, M. A, and Guerrant, R L (1991) Potential role of adherence traits of Escherichia coli in persistent diarrheain an urban Brazilian slum.Pediatr Infect Dis J 10, 746–751PubMedCrossRefGoogle Scholar
  52. 52.
    Cravioto, A Tello, A, Navarro, A, Ruiz, J., Villafan, H., Uribe, F, and Eslava, C. (1991) Association of Escherichia coli HEp-2 adherence patterns with typeand duration of diarrhoea Lancet 337, 262–264PubMedCrossRefGoogle Scholar
  53. 53.
    Eslava, C, Villaseca, J, Morales, R., Navarro, A, and Cravioto, A (1993) Identification of a protein with toxlgenic activity produced by enteroaggregative?? Escherichia coli Abstr Gen Meet Amer Sot Microbiol B105, 44. (Abstract)Google Scholar
  54. 54.
    Savarino, S J, Fasano, A, Watson, J, Martin, B M., Levine, M. M, Guandalini, S., and Guerry, P. (1993) Enteroaggregative Escherichia coli heat-stable enterotoxin 1 represents another subfamily of E coli heat-stable toxin Proc Natl Acad Sci USA 90, 3093–3097.PubMedCrossRefGoogle Scholar
  55. 55.
    Savarino, S. J., Fasano, A., Robertson, D C., and Levme, M M (1991) Enteroaggregative Escherichia coli elaborate a heat-stable enterotoxin demonstrable in an i vitro rabbit Intestinal model J Clin Invest 87, 1450–1455PubMedCrossRefGoogle Scholar
  56. 56.
    Nataro, J. P, Yikang, D, Cookson, S, Cravloto, A., Savarino, S J, Guers, L D, Levine, M M, and Tacket, C 0 (1995) Heterogeneity of enteroaggregativeEscherichia coli virulence demonstrated in volunteers. J Infect Dis 171, 465–468PubMedGoogle Scholar
  57. 57.
    Nataro, J. P., Deng, Y, Maneval, D. R., German, A. L, Martin, W C, and Levine, M M (1992) Aggregative adherence fimbriae I of enteroaggregative Escherichia coli mediate adherence to HEp-2 cells and hemagglutination of human erythrocytes Infect Immun 60, 2297–2304PubMedGoogle Scholar
  58. 58.
    Fang, G. D., Lima, A. M., Martin, C C, Barrett, L J, Nataro, J P, and Guerrant, R. L (1992) Aggregative HEp-2 cell adherent Escherichia coli andCryptosporidium Important pathogens in hospitalzed children with persistentdiarrhea in Northeast Brazil Abstr 32nd Intersci Conf Antimicrob AgentsChemother Abstr 686, (Abstract)Google Scholar
  59. 59.
    Baudry, B, Savarino, S. J, Vial, P., Kaper, J. B., and Levine, M M (1990) Asensitive and specific DNA probe to identify enteroaggregative Escherichia coli,a recently discovered diarrhea1 pathogen J Infect Dis 161, 1249–1251PubMedGoogle Scholar
  60. 60.
    Vial, P A, Robins Browne, R, Lior, H, Prado, V, Kaper, J B, Nataro, J P, Maneval, D, Elsayed, A, and Levine, M M (1988) Characterization ofenteroadherent-aggregative Escherichia coli, a putative agent of dlarrheal disease J Infect Dis 158, 70–79.PubMedGoogle Scholar
  61. 61.
    Kang, G, Mathan, M.M., and Mathan, V. I (1995) Evaulation of a simplifiedHEp-2 cell adherence assay for Escherichia coli isolated from south Indian children with acute diarrhea and controls. J Clin. Microbiol 33, 2204–2205PubMedGoogle Scholar
  62. 62.
    Schmidt, H, Knop, C, Franke, S, Aleksic S, Heeseman, J, and Karch, H. (1995) Development of PCR for screening of enteroaggregative Escherichia coli J Clin.Microbiol 33, 701–705Google Scholar
  63. 63.
    Acheson, D W. K. and Keusch, G T. (1995) Shigella and enteroinvasive Escherichiacoli, in Infections of the Gastrointestinal Tract,(Blaser, M. J., Srmth, P. D., Ravdin, J I, Greenberg, H. B, and Guerrant, R L, eds.), New York, Raven, pp. 763–784Google Scholar
  64. 64.
    Goldberg, M B and Sansonetti, P J. (1993) Shigella subversion of the cellularcytoskeleton a strategy for epithelial colonization. Innfect. Immun 61, 4941–4946Google Scholar
  65. 65.
    Gomes, T, A. T., Toledo, R F, Trabulsi, L. R., Wood, P.K, and Morrrs, J G (1987) DNA probes for identification of enteroinvasive Escherichia coli. J. ClinMicrobiol 25, 2025–2027.Google Scholar
  66. 66.
    Wood, P.K., Morris, J. G, Small, P L., Sethabutr, O, Toledo, M R, Trabulsi, L., and Kaper, J B. (1986) Comparison of DNA probes and the Sereny test foridentification of invasive Shigella and Escherichia co1i strains. J Clin Microbiol 24, 498–500PubMedGoogle Scholar
  67. 67.
    Schoolnik, G.K. (1993) PCR detection of Shigella species and enteroinvasiveEscherichia coli, in Diagnostic Molecular Microbiology. Principles and Applications, (Persmg, D H, Smith, T F, Tenover, F. C, and White, T. J., eds.), Rochester, NY, Mayo Foundation, pp.277–281.Google Scholar
  68. 68.
    Small, P. L. and Falkow, S. (1986) Development of a DNA probe for the virulence plasmid of Shigella spp. and enteroinvasive Escherichia coli, in Microbiology-1986, (Lieve, L, Bonventre, P. F., Morello, J A., Silver, SD., and Wu, WC., eds.), Washington, DC, American Society for Micrrobiology, pp 12l–124Google Scholar
  69. 69.
    Frankel, G, Riley, L, Giron, J. A., Valmassoi, J., Friedman, A., Strockbine, N., Falkow, S, and Schoolnik, G A (1990) Detection of Shigella in feces using DNAamplification. J Infect Dis 161, 1252–1256.PubMedGoogle Scholar
  70. 70.
    Frankel, G, Giron, J. A., Vlamossoi, J, and Schoolnik, G (1989) Multi-geneamplification: simultaneous detection of three virulence genes in diarrhea1 stool Mol Microbiol 3, 1729–1734.PubMedCrossRefGoogle Scholar
  71. 71.
    Gunzburg, S. T., Chang, B J, Elliott, S. J, Burke, V., and Gracey, M (1993) Diffuse and enteroaggregative patterns of adherence of enteric Escherichia coliisolated from aboriginal children from the Kimberley region of Western Australia J Infect Dis 167, 755–758.PubMedGoogle Scholar
  72. 72.
    Bilge, S S., Apostol, J M, Jr, Aldape, M A., and Moseley, S L (1993) mRNAprocessing Independent of RNase III and RNase E in the expression of the F1845fimbrial adhesin of Escherichia coli Proc. Natl. Acad Sei USA 90, 1455–1459CrossRefGoogle Scholar
  73. 73.
    Yamamoto, T., Kaneko, M, Changchawalt, S., Serichantalergs, o, IJum, S., and Echeverria, P. (1994) Actin accumulation associated with clustered and localizedadherence in Escherichia coli isolated from patients with diarrhea Infect Immun 62, 2917–2929.PubMedGoogle Scholar
  74. 73.
    Nataro, J. P., Kaper, J B, Robins Browne, R, Prado, V., Vial, P., and Levine, M M (1987) Patterns of adherence of diarrheagenic Escherichia coli to HEp-2 cells Pediatr Infect Dis J 6, 829–831.PubMedCrossRefGoogle Scholar
  75. 74.
    Bilge, S. S., Apostol, J. M., Jr, Fullner, K. J., and Moseley, S L (1993) Tran-scriptional organization of the F1845 fimbrial adhesin determinant of Escherichiacoli Mol Microbiol. 7, 993–1006.CrossRefGoogle Scholar
  76. 75.
    Nataro, J. P (1995) Enteroaggregative and diffusely adherent Escherichiacoli, in Infections of the Gastrointestinal Tract, (Blaser, M J, Smith, P D, Ravdin, J. I, Greenberg, H B, and Guerrant, R. L., eds), New York, Raven, pp 727–737Google Scholar
  77. 76.
    Taylor, D N and Echeverria, P (1993) Diarrhoeal disease current concepts and future chellenges. Molecular biological approaches to the epidedemiology of drarrhoealdiseases in developing countries (Review). Tras Roy Soc Trop Med Hyg 87, 3–5CrossRefGoogle Scholar
  78. 78.
    Levine, M M., Nataro, J P., Karch, H, Baldini, M M, Kaper, J B, Black, R E, Clements, M. L, and O’Brien, A D (1985) The diarrhea1 response of humans tosome classtc serotypes of enteropathogenic Escherichia coli is dependent on aplasmid encoding an enteroadhesiveness factor J Infect Dis 152, 550–559PubMedGoogle Scholar
  79. 79.
    Gicquelais, K G., Baldini, M. M, Martinez, J., Maggi, L, Martin, W C, Prado, V, Kaper, J B., and Levine, M M (1990) Practical and economical method forusing biotinylated DNA probes with bacterial colony blots to identify diarrheacausing Escherichia-Coli J Cli Microbiol 28, 2485–2490.Google Scholar
  80. 80.
    Murray, B E., Mathewson, J J., DuPont, H L, and Hill, W E. (1987) Utility ofoligodeoxyribonucleotide probes for detecting enterotoxigenic Escherichia coliJ Infect Dis 155, 809–811Google Scholar
  81. 81.
    Willshaw, G A, Scotland, S M, Smith, H. R., Cheasty, T., Thomas, A, and Rowe, B. (1994) Hybidization of strains of Escherichia coli 0157 with probesderived from the eaeA gene of enteropathogenic E. colt and the eaeA homologfrom a Vero cytotoxin-producing strain of E co1i 0157 J Clin Microbiol 32, 897–902.PubMedGoogle Scholar
  82. 82.
    Newland, J. W and Neill, R J (1988) DNA probes for Shiga-like toxins I and II and for toxin-converting bacteriophages. J Clin Microbiol 26, 1292–1297PubMedGoogle Scholar

Copyright information

© Humana Press Inc. 1998

Authors and Affiliations

  • James P. Nataro
    • 1
  • Juan Martinez
    • 1
  1. 1.Center for Vaccine DevelopmentUniversity of Maryland, School of MedicineBaltimore

Personalised recommendations