Enterotoxigenic Escherichia coli

Specialty| Infectious disease

Enterotoxigenic Escherichia coli (ETEC) is a type of Escherichia coli and one of the leading bacterial causes of diarrhea in the developing world,[1] as well as the most common cause of travelers' diarrhea.[2] Insufficient data exists, but conservative estimates suggest that each year, about 157,000 deaths occur, mostly in children, from ETEC.[3][4][5] A number of pathogenic isolates are termed ETEC, but the main hallmarks of this type of bacterium are expression of one or more enterotoxins and presence of fimbriae used for attachment to host intestinal cells. The bacterium was identified by the Bradley Sack lab in Kolkata in 1968.

## Contents

* 1 Signs and symptoms
* 2 Enterotoxins
* 3 Prevention
* 4 Management
* 5 See also
* 6 References
* 7 External links

## Signs and symptoms

Infection with ETEC can cause profuse, watery diarrhea with no blood or leukocytes and abdominal cramping. Fever, nausea with or without vomiting, chills, loss of appetite, headache, muscle aches and bloating can also occur, but are less common.[2]

## Enterotoxins

Enterotoxins produced by ETEC include heat-labile enterotoxin (LT) and heat-stable enterotoxin (ST).[6]

## Prevention

To date, no licensed vaccines specifically target ETEC, though several are in various stages of development.[1][7] Studies indicate that protective immunity to ETEC develops after natural or experimental infection, suggesting that vaccine-induced ETEC immunity should be feasible and could be an effective preventive strategy.[1][8] Prevention through vaccination is a critical part of the strategy to reduce the incidence and severity of diarrheal disease due to ETEC, particularly among children in low-resource settings. The development of a vaccine against this infection has been hampered by technical constraints, insufficient support for coordination, and a lack of market forces for research and development. Most vaccine development efforts are taking place in the public sector or as research programs within biotechnology companies.[9] ETEC is a longstanding priority and target for vaccine development for the World Health Organization.[citation needed]

## Management

Treatment for ETEC infection includes rehydration therapy and antibiotics, although ETEC is frequently resistant to common antibiotics.[2] Improved sanitation is also key. Since the transmission of this bacterium is fecal contamination of food and water supplies, one way to prevent infection is by improving public and private health facilities. Another simple prevention of infection is by drinking factory bottled water—this is especially important for travelers and traveling military—though it may not be feasible in developing countries, which carry the greatest disease burden.[citation needed]

## See also

* Gastroenteritis

## References

1. ↑ 1.0 1.1 1.2 Bourgeois, A Louis; Wierzba, Thomas F; Walker, Richard I (2016). "Status of vaccine research and development for enterotoxigenic Escherichia coli". Vaccine 34 (26): 2880–2886. doi:10.1016/j.vaccine.2016.02.076. PMID 26988259.
2. ↑ 2.0 2.1 2.2 US Centers for Disease Control and Prevention (2014). "Enterotoxigenic E. coli (ETEC)". https://www.cdc.gov/ecoli/etec.html.
3. ↑ Lozano, Rafael et al. (2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". The Lancet 380 (9859): 2095–2128. doi:10.1016/S0140-6736(12)61728-0. PMID 23245604. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61728-0/fulltext.
4. ↑ Gupta, SK et al. (2008). "Analysis of Data Gaps Pertaining to Enterotoxigenic Escherichia coli Infections in Low and Medium Human Development Index Countries, 1984-2005". Epidemiology and Infection 136 (6): 721–738. doi:10.1017/S095026880700934X. PMID 17686197.
5. ↑ Kotloff, Karen L et al. (2013). "Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study". The Lancet 382 (9888): 209–222. doi:10.1016/s0140-6736(13)60844-2. PMID 23680352. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60844-2/fulltext.
6. ↑ Qadri, F.; Svennerholm, A. M.; Faruque, A. S. G.; Bradley Sack, R. (2005). "Enterotoxigenic Escherichia coli in Developing Countries: Epidemiology, Microbiology, Clinical Features, Treatment, and Prevention". Clinical Microbiology Reviews 18 (3): 465–483. doi:10.1128/CMR.18.3.465-483.2005. PMID 16020685.
7. ↑ "WHO vaccine pipeline tracker" (in en-GB). https://www.who.int/immunization/research/vaccine_pipeline_tracker_spreadsheet/en/.
8. ↑ Girard, M.; Steele, D.; Chaignat, C. L.; Kieny, M. P. (2006). "A review of vaccine research and development: human enteric infections". Vaccine 24 (15): 2732–2750. doi:10.1016/j.vaccine.2005.10.014. PMID 16483695.
9. ↑ PATH, bvgh (March 2011). The Case for Investment in Enterotoxigenic Escherichia coli Vaccines. http://www.path.org/publications/files/VAC-etec-investment-rpt.pdf. Retrieved 2 May 2012.

## External links

Classification|

* ICD-10: A04.1
* ICD-9-CM: 008.02

|

* US Centers for Disease Control and Prevention: Enterotoxigenic Escherichia coli
* Vaccine Resource Library: Shigellosis and enterotoxigenic Escherichia coli (ETEC)

* v
* t
* e

* Infectious diseases
* Bacterial disease: ProteobacterialG−]]
* primarily A00–A79, 001–041, 080–109

| Rickettsiales|

| Rickettsiaceae/
(Rickettsioses)|

| Typhus|

* Rickettsia typhi
* Murine typhus
* Rickettsia prowazekii
* Epidemic typhus, Brill–Zinsser disease, Flying squirrel typhus

|

Spotted
fever|

| Tick-borne|

* Rickettsia rickettsii
* Rocky Mountain spotted fever
* Rickettsia conorii
* Boutonneuse fever
* Rickettsia japonica
* Japanese spotted fever
* Rickettsia sibirica
* North Asian tick typhus
* Rickettsia australis
* Queensland tick typhus
* Rickettsia honei
* Flinders Island spotted fever
* Rickettsia africae
* African tick bite fever
* Rickettsia parkeri
* American tick bite fever
* Rickettsia aeschlimannii
* Rickettsia aeschlimannii infection

|

Mite-borne|

* Rickettsia akari
* Rickettsialpox
* Orientia tsutsugamushi
* Scrub typhus

Flea-borne|

* Rickettsia felis
* Flea-borne spotted fever

Anaplasmataceae|

* Ehrlichiosis: Anaplasma phagocytophilum
* Human granulocytic anaplasmosis, Anaplasmosis
* Ehrlichia chaffeensis
* Human monocytotropic ehrlichiosis
* Ehrlichia ewingii
* Ehrlichiosis ewingii infection

Rhizobiales|

| Brucellaceae|

* Brucella abortus
* Brucellosis

|

Bartonellaceae|

* Bartonellosis: Bartonella henselae
* Cat-scratch disease
* Bartonella quintana
* Trench fever
* Either B. henselae or B. quintana
* Bacillary angiomatosis
* Bartonella bacilliformis
* Carrion's disease, Verruga peruana

| Neisseriales|

| M+|

* Neisseria meningitidis/meningococcus
* Meningococcal disease, Waterhouse–Friderichsen syndrome]], Meningococcal septicaemia

|

M−|

* Neisseria gonorrhoeae/gonococcus
* Gonorrhea

ungrouped:|

* Eikenella corrodens/Kingella kingae
* HACEK
* Chromobacterium violaceum
* Chromobacteriosis infection

Burkholderiales|

* Burkholderia pseudomallei
* Melioidosis
* Burkholderia mallei
* Glanders
* Burkholderia cepacia complex
* Bordetella pertussis/Bordetella parapertussis
* Pertussis

| Enterobacteriales
(OX−)|

| Lac+|

* Klebsiella pneumoniae
* Rhinoscleroma, Pneumonia
* Klebsiella granulomatis
* Granuloma inguinale
* Klebsiella oxytoca

* Escherichia coli: Enterotoxigenic
* Enteroinvasive
* Enterohemorrhagic
* O157:H7
* O104:H4
* Hemolytic-uremic syndrome

* Enterobacter aerogenes/Enterobacter cloacae

|

Slow/weak|

* Serratia marcescens
* Serratia infection
* Citrobacter koseri/Citrobacter freundii

Lac−|

| H2S+|

* Salmonella enterica
* Typhoid fever, Paratyphoid fever, Salmonellosis

|

H2S−|

* Shigella dysenteriae/sonnei/flexneri]]/boydii
* Shigellosis, Bacillary dysentery
* Proteus mirabilis/Proteus vulgaris
* Yersinia pestis
* Plague/Bubonic plague
* Yersinia enterocolitica
* Yersiniosis
* Yersinia pseudotuberculosis
* Far East scarlet-like fever

Pasteurellales|

| Haemophilus:|

* H. influenzae
* Haemophilus meningitis
* Brazilian purpuric fever
* H. ducreyi
* Chancroid
* H. parainfluenzae
* HACEK

|

Pasteurella multocida|

* Pasteurellosis
* Actinobacillus
* Actinobacillosis

Aggregatibacter actinomycetemcomitans|

* HACEK

Legionellales|

* Legionella pneumophila/Legionella longbeachae
* Legionnaires' disease
* Coxiella burnetii
* Q fever

Thiotrichales|

* Francisella tularensis
* Tularemia

Vibrionaceae|

* Vibrio cholerae
* Cholera
* Vibrio vulnificus
* Vibrio parahaemolyticus
* Vibrio alginolyticus
* Plesiomonas shigelloides

Pseudomonadales|

* Pseudomonas aeruginosa
* Pseudomonas infection
* Moraxella catarrhalis
* Acinetobacter baumannii

Xanthomonadaceae|

* Stenotrophomonas maltophilia

Cardiobacteriaceae|

* Cardiobacterium hominis
* HACEK

Aeromonadales|

* Aeromonas hydrophila/Aeromonas veronii
* Aeromonas infection

| Campylobacterales|

* Campylobacter jejuni
* Campylobacteriosis, Guillain–Barré syndrome]]
* Helicobacter pylori
* Peptic ulcer, MALT lymphoma, Gastric cancer
* Helicobacter cinaedi
* Helicobacter cellulitis

|

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