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Volume 16, Number 1—January 2010
Dispatch

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)

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Table

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
Travelers
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
E850¶
 STp/CS6
 Traveling in Guatemala
 2003 May 8
 Asymptomatic
 29 y/F
 398
Children
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.

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