Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 16, Number 1—January 2010

Enterotoxigenic Escherichia coli Multilocus Sequence Types in Guatemala and Mexico

Matilda NicklassonComments to Author , John D. Klena, Claudia Rodas, August Louis Bourgeois, Olga Torres, Ann-Mari Svennerholm, and Åsa Sjöling
Author affiliations: University of Gothenburg, Gothenburg, Sweden (M. Nicklasson, C. Rodas, A.-M. Svennerholm, Å. Sjöling); United States Naval Medical Research Unit 3, Cairo, Egypt (J. Klena); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (A.L. Bourgeois); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (O. Torres)

Main Article


Comparison of ETEC isolates and clinical and demographic information collected during study of US travelers to Guatemala and Mexico and resident children from Guatemala*

Isolate† Toxin/CF profile Geographic origin Date of collection Severity of diarrhea‡ Age/sex MLST sequence type
E617 STp/CS6 Antigua, Guatemala 2000 Jun 19 Mild 24 y/M 182
E830 STp/CS6 Traveling in Guatemala 2002 Sep 23 Moderate–severe 30 y/M 182
E539 STp/CS6 Cuernavaca, Mexico 2000 Jul 13 Moderate–severe 36 y/F 182
E576 STp/CS6 Cuernavaca, Mexico 2000 Jul 15 Moderate–severe 50 y/M 182
E494 STp/CS6 Antigua, Guatemala 1999 Jul 3 Moderate–severe 37 y/F 182
E695 STp/CS6 Antigua, Guatemala 2001 Jan 15 Moderate–severe 44 y/M 182
E396 STp/CS6 Antigua, Guatemala 1998 Jul 30 Moderate–severe 49 y/M 726
E848 STp/CS6 Traveling in Guatemala 2003 Apr 28 Moderate–severe 27 y/M 727
E368 STp/CS6 Cuernavaca, Mexico 1999 Aug 11 Asymptomatic§ 30 y/F 278
E416 STp/CS6 Antigua, Guatemala 1999 May 30 Moderate–severe 25 y/M 278
E521 STp/CS6 Cuernavaca, Mexico 2001 Apr 8 Moderate–severe 51 y/F 278
E837 STp/CS6 Traveling in Guatemala 2002 Sep 23 Moderate-severe 30 y/M 278
E844¶ STp/CS6 Traveling in Guatemala 2003 Apr 28 Moderate–severe 29 y/F 712
E382 STp/CS6 Antigua, Guatemala 1998 Jul 1 Moderate–severe 21 y/F 398
E447 STp/CS6 Antigua, Guatemala 1999 Jun 21 Moderate–severe 46 y/F 398
E670 STp/CS6 Antigua, Guatemala 2000 Jul 17 Moderate–severe 27 y/F 398
Traveling in Guatemala
2003 May 8
29 y/F
E856 STp/CS6 SMJ, Guatemala 2002 Jun 21 Persistent moderate–severe 10 mo/M 398
E861 STp/CS6 SMJ, Guatemala 2002 Jul 4 Persistent moderate–severe 34 mo/M 398
E870 STp/CS6 SMJ, Guatemala 2002 Jul 26 Moderate 11 mo/M 398
E871 STp/CS6 SMJ, Guatemala 2002 Aug 1 Moderate 22 mo/F 398
E872 STp/CS6 SMJ, Guatemala 2002 Aug 7 Moderate 12 mo/F 398
E879 STp/CS6 SMJ, Guatemala 2002 Aug 23 Moderate 26 mo/F 398
E874 STh/CS6 SMJ, Guatemala 2002 Aug 19 Moderate 18 mo/F 443

*ETEC, enterotoxigenic Escherichia coli; CF, colonization factor; MLST, multilocus sequence typing; SMJ, Santa María de Jesús.
†World Health Organization Collaborating Centre for Research on Enterotoxigenic Escherichia coli strain collection number.
‡Classification of diarrheal disease severity in travelers was based on the study case definition of travelers’ diarrhea with an associated gastrointestinal symptom rated as mild, moderate, or severe (5). Moderate symptoms interfered with daily activity, and severe symptoms prevented normal daily activity. Disease classification in children was based on the number of diarrheal stools in a 24-hour period (3/24 h, mild; 4–5/24 h, moderate; >6/24 h, severe). Diarrhea accompanied by vomiting was classified as severe; diarrhea lasting >14 days was classified as persistent.
§Not travelers’ diarrhea.
¶Strains E844 and E850 were isolated from the same person participating in the antimicrobial drug treatment study. Strain E850 was isolated after completion of a course of antimicrobial drugs.

Main Article

  1. Qadri  F, Svennerholm  A-M, Faruque  AS, Sack  RB. Enterotoxigenic Escherichia coli in developing countries: epidemiology, microbiology, clinical features, treatment, and prevention. Clin Microbiol Rev. 2005;18:46583. DOIPubMedGoogle Scholar
  2. Wolf  MK. Occurence, distribution, and associations of O and H serogroups, colonization factor antigens, and toxins of enterotoxigenic Escherichia coli. Clin Microbiol Rev. 1997;10:56984.PubMedGoogle Scholar
  3. Bölin  I, Wiklund  G, Qadri  F, Torres  O, Bourgeois  AL, Savarino  S, Enterotoxigenic Escherichia coli with STh and STp genotypes is associated with diarrhea both in children in areas of endemicity and in travelers. J Clin Microbiol. 2006;44:38727. DOIPubMedGoogle Scholar
  4. Gaastra  W, Svennerholm  A-M. Colonization factors of human enterotoxigenic Escherichia coli (ETEC). Trends Microbiol. 1996;4:44452. DOIPubMedGoogle Scholar
  5. Sack  DA, Shimko  J, Torres  O, Bourgeois  AL, Francia  DS, Gustafsson  B, Randomised, double-blind, safety and efficacy of a killed oral vaccine for enterotoxigenic E. coli diarrhoea of travellers to Guatemala and Mexico. Vaccine. 2007;25:4392400. DOIPubMedGoogle Scholar
  6. Shaheen  HI, Abdel Messih  IA, Klena  JD, Mansour  A, El-Wakkeel  Z, Wierzba  TF, Phenotypic and genotypic analysis of enterotoxigenic Escherichia coli in samples obtained from Egyptian children presenting to referral hospitals. J Clin Microbiol. 2009;47:18997. DOIPubMedGoogle Scholar
  7. Qadri  F, Saha  A, Ahmed  T, Al Tarique  A, Ara Begum  Y, Svennerholm  A-M. Disease burden due to enterotoxigenic Escherichia coli in the first 2 years of life in an urban community in Bangladesh. Infect Immun. 2007;75:39618. DOIPubMedGoogle Scholar
  8. Bourgeois  AL, Halpern  J, Gustafsson  B, Svennerholm  A-M, Torres  O, Belkind-Gerson  J, Protective efficacy of an oral killed vaccine (OKV) for enterotoxigenic E. coli (ETEC) in adult travelers to Guatemala (GU) and Mexico (MX). 45th Annual Meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy. 2005.
  9. Taylor  DN, Bourgeois  AL, Ericsson  CD, Steffen  R, Jiang  ZD, Halpern  J, A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers’ diarrhea. Am J Trop Med Hyg. 2006;74:10606.PubMedGoogle Scholar
  10. Sjöling  Å, Wiklund  G, Savarino  SJ, Cohen  DI, Svennerholm  A-M. Comparative analyses of phenotypic and genotypic methods for detection of enterotoxigenic Escherichia coli (ETEC) toxins and colonisation factors. J Clin Microbiol. 2007;45:3295301. DOIPubMedGoogle Scholar
  11. Wirth  T, Falush  D, Lan  R, Colles  F, Mensa  P, Wieler  LH, Sex and virulence in Escherichia coli: an evolutionary perspective. Mol Microbiol. 2006;60:113651. DOIPubMedGoogle Scholar
  12. Hall  TA. BioEdit: a user-friendly biological sequence alignment editor and analysis program for Windows 95/98/NT. Nucleic Acids Symp Ser. 1999;41:958.
  13. Kumar  S, Tamura  K, Nei  M. MEGA3: Integrated software for Molecular Evolutionary Genetics Analysis and sequence alignment. Brief Bioinform. 2004;5:15063. DOIPubMedGoogle Scholar
  14. Nicklasson  M, Sjöling  Å, Lebens  M, Tobias  J, Janzon  A, Brive  L, Mutations in the periplasmic chaperone leading to loss of surface expression of the colonization factor CS6 in enterotoxigenic Escherichia coli (ETEC) clinical isolates. Microb Pathog. 2008;44:24654. DOIPubMedGoogle Scholar
  15. Wolf  MK, de Haan  LA, Cassels  FJ, Willshaw  GA, Warren  R, Boedeker  EC, The CS6 colonization factor of human enterotoxigenic Escherichia coli contains two heterologous major subunits. FEMS Microbiol Lett. 1997;148:3542. DOIPubMedGoogle Scholar

Main Article

Page created: March 31, 2011
Page updated: March 31, 2011
Page reviewed: March 31, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.