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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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          <p class="first" id="P1">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( <i>pagC</i>), Module 2( <i>senA, nleB</i> and <i>nleE</i>) and Module 3( <i>lifA/efa-1</i>). 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 <i>nleE</i>(37.7%), <i>senA</i>(34.6%) and <i>nleB</i>(37.5%), with similar prevalence among diarrhea and control samples. However, <i>lifA/efa-1</i> was more common among diarrhea cases than healthy control cases (30.5% vs. 21.1%, p&lt;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&lt;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. </p>

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          International Journal of Medical Microbiology
          International Journal of Medical Microbiology
          Elsevier BV
          June 2016
          June 2016
          : 306
          : 4
          : 231-236
          © 2016


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