Diffuse-Adhering Escherichia coli (DAEC) as a Putative Cause of Diarrhea in Mayan Children in Mexico

Abstract

Diarrhea is a major cause of infantile morbidity and mortality in developing countries. A community-based, case control study was conducted in a southern MexicanMayan village for 3 weeksduring the peak diarrhea period to prospectively identifythe infectiousagents associated with childhood diarrheal disease. Severalenteropathogens wereisolated from stools of 34 of 58 cases, although none was significantly associated with diarrhea. For the 24 cases from which no enteropathogens were isolated, diffuse-adhering Escherichia coli (DAEC) strains were significantly associated with diarrheal disease (P < .02; odds ratio = 6; 95% confidence limit, 1.08l–99.0). DAEC were highly heterogeneous with respect to plasmid content and serotype. Three DNA probes designed to differentiate E. coli exhibiting localized, diffuse, or aggregative adherence were compared with results from a standard HeLa cell binding assay to assess the utility of these probes in the field. This study provides evidence for the potential pathogenic capacity of DAEC and underscores the variety of diarrheal agents operating within a community.