Jpn. J. Infect. Dis., 55, 14-18, 2002

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Original Article

Prevalence of Escherichia coli Possessing the eaeA Gene of Enteropathogenic E. coli (EPEC) or the aggR Gene of Enteroaggregative E. coli (EAggEC) in Traveler's Diarrhea Diagnosed in Those Returning to Tama, Tokyo from Other Asian Countries

Kazue Ogata¹, Rei Kato¹, Kenichiro Ito³ and Sumio Yamada^1,2*

1Tama Branch Laboratory, Tokyo Metropolitan Research Laboratory of Public Health, Shibazaki-cho 3-16-25, Tachikawa-shi, Tokyo 190-0023, 2Office of Quality Assurance, Tokyo Metropolitan Research Laboratory of Public Health, Hyakunin-cho 3-24-1, Shinjuku-ku, Tokyo 169-0073 and 3National Institute of Public Health, Shirokanedai 4-6-1, Minato-ku, Tokyo 108-8638, Japan

(Received June 11, 2001. Accepted January 29, 2001)

SUMMARY: To elucidate the importance of enteropathogenic Escherichia coli (EPEC) and enteroaggregative E. coli (EAggEC) as etiological agents in traveler's diarrhea, the detection of the eaeA and aggR gene in E. coli strains isolated from overseas travelers with diarrhea in Tama, Tokyo was carried out using a PCR method. Of 192 travelers who were mostly adults and had visited Asian countries from April 1998 to March 1999, aggR-positive E. coli strains were detected in 26 (13.5%). These strains represent the second predominant enteropathogen following enterotoxigenic E. coli (ETEC), whereas eaeA-positive E. coli strains were confirmed in seven subjects (3.6%). In 13 cases with aggR and four cases with eaeA, the organisms were detected in stool samples of patients as the only potential enteric pathogen. The clinical symptoms of these patients were similar to those in patients with ETEC; however, the severity of illness was milder than that associated with ETEC alone. Three strains with eaeA and five strains with aggR were typed as six different kinds of O serogroups, of which four strains belonged to the classical EPEC serogroups (O55, O114, O119, and O127a). These findings suggest that aggR-positive E. coli (EAggEC) is a significant causative agent in traveler's diarrhea. In addition, it was demonstrated that eaeA-positive E. coli (EPEC) is markedly correlated with diarrhea in adults.

*Corresponding author: Mailing address: Office of Quality Assurance, Tokyo Metropolitan Research Laboratory of Public Health, Hyakunin-cho 3-24-1, Shinjuku-ku, Tokyo 169-0073. Tel: +81-3-3363-3231, Fax: +81-3-3368-4060, E-mail: yamada@tokyo-eiken.go.jp

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