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      Pathogenicity Island O-122 in enteropathogenic Escherichia coli strains is associated with diarrhea severity in children from Lima Peru

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          Abstract

          EPEC is an attaching and effacing diarrheal pathogen that carries a large pathogenicity island, locus for enterocyte effacement (LEE). Recently, the pathogenicity island PAI O-122 was described among non-LEE effectors and found to be associated with diarrhea among atypical EPEC strains. It is unknown if incomplete PAI O-122 could be associated with diarrhea duration and severity. To identify these virulence determinants we analyzed 379 EPEC strains isolated from Peruvian children. EPEC was diagnosed by PCR(eae+, stx−) and classified as typical(t-EPEC) or atypical(a-EPEC). To characterize PAI O-122 we amplified three modules by PCR: Module 1( pagC), Module 2( senA, nleB and nleE) and Module 3( lifA/efa-1). To characterize the large ORF lifA/efa-1 we amplified the regions known as efa-N, efa-M and efa-C. Clinical information was obtained from the cohort study. A total of 379 EPEC strains were able to analyze PAI O-122 genes, 128 (10.4%) EPEC strains were isolated from 1235 diarrhea episodes and 251(9.2%) from 2734 healthy controls. t-EPEC strains were isolated from 14.8% (19/128) of children with diarrhea and 25/251(10.0%) from healthy controls. The most frequent PAI O-122 genes were nleE(37.7%), senA(34.6%) and nleB(37.5%), with similar prevalence among diarrhea and control samples. However, lifA/efa-1 was more common among diarrhea cases than healthy control cases (30.5% vs. 21.1%, p<0.05). The presence of complete PAI O-122 was associated with diarrhea episodes of higher severity among single pathogen infection (33.3% vs. 1.8%, p<0.05) mainly due to the presence of a complete lifA/efa-1 gene. In summary, the gene lifA/efa-1 is significantly associated with diarrheal episodes of higher severity, suggesting to be an important virulent factor.

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          Author and article information

          Journal
          100898849
          1331
          Int J Med Microbiol
          Int. J. Med. Microbiol.
          International journal of medical microbiology : IJMM
          1438-4221
          1618-0607
          28 May 2016
          10 May 2016
          June 2016
          01 June 2017
          : 306
          : 4
          : 231-236
          Affiliations
          [a ]Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
          [b ]ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
          [c ]University of Texas School of Public Health, Houston, Texas, USA
          Author notes
          [* ] Address correspondence to Theresa Ochoa, theresa.j.ochoa@ 123456uth.tmc.edu , Theresa J. Ochoa, MD, Instituto de Medicina Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porras, Lima 33, Perú, Phone 51-1-482-3910, Fax: 51-1-482-3404, Theresa.J.Ochoa@ 123456uth.tmc.edu
          Article
          PMC4900456 PMC4900456 4900456 nihpa790479
          10.1016/j.ijmm.2016.05.005
          4900456
          27236730
          49ae007a-f8f4-446f-a617-0721f6fa7a14
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