A new study by SHARP Joint Action Work Package 7 partner Instituto de Salud Carlos III (ISCIII) shows that high-income countries host enteroaggregative E. coli (EAEC) strains that have similar pathogenic potential as those most often found in developing countries.
The Enteroaggregative Escherichia coli (EAEC) pathogen causes intestinal infections including diarrhoea, fever and abdominal pain. It is an increasingly recognized cause of diarrhoea in children in developing countries, has been particularly associated with persistent diarrhoea (of more than 14 days), where severe cases can lead to bloody diarrhoea, dehydration or even kidney failure.
This means that EAEC infection is an important domestic source of diarrhoea, and not merely linked to food importation or international travel.
While the role of EAEC as etiological agent in travellers’ diarrhoea and childhood diarrhoea in developing countries is well understood, there is little research into its role in endemic diarrhoea in high-income/industrialized countries. This new study reveals that EAEC also causes endemic diarrhoea in high-income countries.
The results demonstrate the need for improved detection and monitoring in high-income settings. On a practical level, health care professionals should more frequently request stool specimens in cases of diarrhoea regardless of prior travel in developing countries. Samples from children under the age of five should be routinely tested for EAEC.
This study produced the most complete characterisation of EAEC strains acquired in high-income settings and recommends further action
The EAEC subtypes found in this study are markedly different from the ones circulating in developing countries. While the study focussed on Spain, these same subtypes, with similar pathogenic potential, appear to circulate in other industrialised countries. Therefore, further research is needed to develop tools for detection, monitoring, assessment and reporting of these infectious agents.
Moreover, it’s important to establish an internationally recognized molecular definition of the pathogen so that the tools and methods used for diagnosis and surveillance can be harmonized.
This study contributes to that end with the most complete characterisation to date of EAEC strains circulating in industrialised countries. The diagnostic and surveillance tools used in this study are applicable to other cross-border outbreaks and can also be accessed online for free.
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ORIGINAL RESEARCH article in Frontiers in Microbiology, the largest and most cited microbiology journal which advances our understanding of the role microbes play in addressing global challenges such as healthcare, food security, and climate change.
Front. Microbiol., 20 March 2023
Sec. Infectious Agents and Disease
Volume 14 – 2023 | https://doi.org/10.3389/fmicb.2023.1120285
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