Enterotoxic Escherichia coli
| Classification according to ICD-10 | |
|---|---|
| A04 | Other intestinal bacterial infections |
| A04.1 | Intestinal infection by enterotoxin-producing Escherichia coli |
| ICD-10 online (WHO version 2019) | |
Enterotoxic Escherichia coli ( ETEC ) are certain disease-causing strains of the intestinal bacterium Escherichia coli (E. coli) , the enterotoxin of which causes massive watery diarrhea . It mostly affects small children in developing countries or travelers (traveler's diarrhea ). They are responsible for 100 million infections and tens of thousands of deaths each year. Frequent triggers are contaminated food or drinking water.
Pathogenesis
ETEC strains have additional plasmid genes . In order to adhere to the epithelial cells in the intestine, ETEC strains have special fimbriae , also called colonizing factors (CFA), which prevent them from being expelled by intestinal peristalsis . They also have three eponymous toxins: a heat-labile enterotoxin LT, which is very similar to cholera toxin , and two toxins STa and STb that are heat-stable up to 100 ° C. STa stimulates guanylate cyclase , which inhibits the absorption of Na + and promotes the secretion of Cl - .
prophylaxis
Oral administration of an oral WC / rBS vaccine against cholera reduces the risk of travelers' diarrhea for a few months. Oral administration of recombinantly produced CtB, which contains five strains of formalin- killed ETEC cells, is more successful, but this does not work well in small children. Another combination preparation consists of live attenuated Shigella with vectors for expressing ETEC antigens for fimbriae and LT. In addition, a preparation against ETEC and typhoid is in development.
Individual evidence
- ^ A b Fritz H. Kayser: Medical Microbiology . Thieme, 2005, ISBN 978-1-60406-122-2 , p. 293 .
- ↑ a b Diarrheal Diseases (Updated February 2009). Enterotoxigenic Escherichia coli (ETEC). WHO , archived from the original on October 14, 2013 ; accessed on March 4, 2012 (English).