Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea
Enteroaggregative Escherichia coli (EAEC) is frequently isolated from sporadic cases of diarrhea and in outbreaks of gastroenteritis in several regions of the world. The pathophysiology of EAEC continues to be enigmatic, and the efficacy of antibiotic treatment in EAEC-associated diarrhea has been d...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-09-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fcimb.2018.00306/full |
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| author | Betina Hebbelstrup Jensen Betina Hebbelstrup Jensen Camilla Adler Sørensen Stig Hebbelstrup Rye Rasmussen Dorthe Rejkjær Holm Alice Friis-Møller Jørgen Engberg Hengameh C. Mirsepasi-Lauridsen Carsten Struve Anette M. Hammerum Lone Jannok Porsbo Randi Føns Petersen Andreas Munk Petersen Andreas Munk Petersen Karen Angeliki Krogfelt |
| author_facet | Betina Hebbelstrup Jensen Betina Hebbelstrup Jensen Camilla Adler Sørensen Stig Hebbelstrup Rye Rasmussen Dorthe Rejkjær Holm Alice Friis-Møller Jørgen Engberg Hengameh C. Mirsepasi-Lauridsen Carsten Struve Anette M. Hammerum Lone Jannok Porsbo Randi Føns Petersen Andreas Munk Petersen Andreas Munk Petersen Karen Angeliki Krogfelt |
| author_sort | Betina Hebbelstrup Jensen |
| collection | DOAJ |
| description | Enteroaggregative Escherichia coli (EAEC) is frequently isolated from sporadic cases of diarrhea and in outbreaks of gastroenteritis in several regions of the world. The pathophysiology of EAEC continues to be enigmatic, and the efficacy of antibiotic treatment in EAEC-associated diarrhea has been discussed. Since the level of antibiotic resistance is increasing, it is essential to restrict the use of antibiotics to prevent further resistance development. We aimed to investigate EAEC strains in adult Danish patients suffering from diarrhea and from healthy controls. We examined the antibiotic resistance in EAEC strains, the clinical response to antibiotic treatment in EAEC diarrheal cases, and the distribution of virulence genes in diarrheal cases. The EAEC strains were collected from patients suffering from diarrhea in a Danish multicenter study. A medical doctor interviewed the patients by using a questionnaire regarding gastrointestinal symptoms, exposures, and use of antibiotic and over-the-counter antidiarrheal drugs. Follow-up was performed after 3–5 months to inquire about differential diagnosis to gastrointestinal disease. A multiplex polymerase chain reaction characterized virulence genes in diarrheal cases. Finally, the level of antibiotic resistance was examined by using the disc diffusion method. Asymptomatic carriage of EAEC in the adult Danish population was rare, in contrast to findings in healthy Danish children. The duration of diarrhea was not shortened by antibiotic treatment, specifically ciprofloxacin treatment, or by over-the-counter antidiarrheal drugs. Follow-up revealed no pathology in diarrheal patients apart from irritable bowel syndrome in two patients. A high number of patients suffered from long-term diarrhea, which was associated with the enterotoxin EAST-1 and a high virulence factor score. A high level of antibiotic resistance was observed and 58% of the EAEC strains were multidrug resistant. Multidrug resistance was most pronounced in cases of travelers' diarrhea, and it was seen that antibiotic treatment did not reduce the duration of diarrhea. |
| first_indexed | 2024-12-10T20:34:48Z |
| format | Article |
| id | doaj.art-8fb5e74d4cea4310a0e238381d75e9eb |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
| last_indexed | 2024-12-10T20:34:48Z |
| publishDate | 2018-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj.art-8fb5e74d4cea4310a0e238381d75e9eb2022-12-22T01:34:34ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882018-09-01810.3389/fcimb.2018.00306360838Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of DiarrheaBetina Hebbelstrup Jensen0Betina Hebbelstrup Jensen1Camilla Adler Sørensen2Stig Hebbelstrup Rye Rasmussen3Dorthe Rejkjær Holm4Alice Friis-Møller5Jørgen Engberg6Hengameh C. Mirsepasi-Lauridsen7Carsten Struve8Anette M. Hammerum9Lone Jannok Porsbo10Randi Føns Petersen11Andreas Munk Petersen12Andreas Munk Petersen13Karen Angeliki Krogfelt14Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, DenmarkThe Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, DenmarkDepartment of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, DenmarkDepartment of Political Sciences and Public Management, University of Southern Denmark, Odense, DenmarkDepartment of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, DenmarkDepartment of Clinical Microbiology, Hvidovre Hospital, Copenhagen, DenmarkDepartment of Clinical Microbiology, Slagelse Hospital, Slagelse, DenmarkDepartment of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, DenmarkDepartment of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, DenmarkDepartment of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, DenmarkNational Food Institute, Technical University of Denmark, Copenhagen, DenmarkDepartment of Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, DenmarkDepartment of Clinical Microbiology, Hvidovre Hospital, Copenhagen, DenmarkDepartment of Gastroenterology, Hvidovre Hospital, Copenhagen, DenmarkDepartment of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, DenmarkEnteroaggregative Escherichia coli (EAEC) is frequently isolated from sporadic cases of diarrhea and in outbreaks of gastroenteritis in several regions of the world. The pathophysiology of EAEC continues to be enigmatic, and the efficacy of antibiotic treatment in EAEC-associated diarrhea has been discussed. Since the level of antibiotic resistance is increasing, it is essential to restrict the use of antibiotics to prevent further resistance development. We aimed to investigate EAEC strains in adult Danish patients suffering from diarrhea and from healthy controls. We examined the antibiotic resistance in EAEC strains, the clinical response to antibiotic treatment in EAEC diarrheal cases, and the distribution of virulence genes in diarrheal cases. The EAEC strains were collected from patients suffering from diarrhea in a Danish multicenter study. A medical doctor interviewed the patients by using a questionnaire regarding gastrointestinal symptoms, exposures, and use of antibiotic and over-the-counter antidiarrheal drugs. Follow-up was performed after 3–5 months to inquire about differential diagnosis to gastrointestinal disease. A multiplex polymerase chain reaction characterized virulence genes in diarrheal cases. Finally, the level of antibiotic resistance was examined by using the disc diffusion method. Asymptomatic carriage of EAEC in the adult Danish population was rare, in contrast to findings in healthy Danish children. The duration of diarrhea was not shortened by antibiotic treatment, specifically ciprofloxacin treatment, or by over-the-counter antidiarrheal drugs. Follow-up revealed no pathology in diarrheal patients apart from irritable bowel syndrome in two patients. A high number of patients suffered from long-term diarrhea, which was associated with the enterotoxin EAST-1 and a high virulence factor score. A high level of antibiotic resistance was observed and 58% of the EAEC strains were multidrug resistant. Multidrug resistance was most pronounced in cases of travelers' diarrhea, and it was seen that antibiotic treatment did not reduce the duration of diarrhea.https://www.frontiersin.org/article/10.3389/fcimb.2018.00306/fullEnteroaggregative Escherichia coliEAECdiarrheaantibiotic resistancemultidrug resistance |
| spellingShingle | Betina Hebbelstrup Jensen Betina Hebbelstrup Jensen Camilla Adler Sørensen Stig Hebbelstrup Rye Rasmussen Dorthe Rejkjær Holm Alice Friis-Møller Jørgen Engberg Hengameh C. Mirsepasi-Lauridsen Carsten Struve Anette M. Hammerum Lone Jannok Porsbo Randi Føns Petersen Andreas Munk Petersen Andreas Munk Petersen Karen Angeliki Krogfelt Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea Frontiers in Cellular and Infection Microbiology Enteroaggregative Escherichia coli EAEC diarrhea antibiotic resistance multidrug resistance |
| title | Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea |
| title_full | Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea |
| title_fullStr | Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea |
| title_full_unstemmed | Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea |
| title_short | Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea |
| title_sort | characterization of diarrheagenic enteroaggregative escherichia coli in danish adults antibiotic treatment does not reduce duration of diarrhea |
| topic | Enteroaggregative Escherichia coli EAEC diarrhea antibiotic resistance multidrug resistance |
| url | https://www.frontiersin.org/article/10.3389/fcimb.2018.00306/full |
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