Nutritional impact and ultrastructural intestinal alterations in severe infections due to enteropathogenic Escherichia coli strains in infants

Nutritional impact and ultrastructural intestinal alterations in severe infections due to enteropathogenic Escherichia coli strains in infants

Author Fagundes Neto, Ulysses Autor UNIFESP Google Scholar
Freymüller-Haapalainen, Edna Autor UNIFESP Google Scholar
Schimitz, Lenora Gandolfi Autor UNIFESP Google Scholar
Scaletsky, Isabel Cristina Affonso Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: Enteropathogenic Escherichia coli (EPEC) strains are able to adhere to human intestinal tissue inducing a typical lesion causing dissolution of the brush border membrane and loss of microvillus structure at sites of bacterial attachment. The presence of these lesions can provoke perpetuation of diarrhea associated with malabsorption of the nutrients and nutritional aggravation. In this paper we report the nutritional impact of severe EPEC gastroenteritis in infants in a small bowel ultrastructural study.Methods and Results: Two infants aged 3 months and one 4 month old infant with profuse watery diarrhea lasting less than 6 days were studied. After rehydration therapy, the patients were fed a cow's milk formula and since food intolerance was diagnosed, a protein-hydrolisate, lactose-free formula was introduced. This dietary modification was successful, diarrhea ceased, the patients were discharged and followed up for 30 days. The following EPEC strains were identified in the stools and in the jejunal secretion: O111ab:H2, O119:H6 and O18ab:H14. A small bowel biopsy was performed and the electron microscopic study revealed bacteria tightly adhered to the apical portion of the enterocyte and effacement of the microvilli. These lesions were more prominent in the areas where bacteria were present.Conclusion: The patients underwent an acute nutritional aggravation due to food intolerance, but the introduction of a protein-hydrolisate, lactose-free formula, allowed prompt cessation of diarrhea and nutritional recovery.
Keywords enteropathogenic Escherichia coli
acute diarrhea
malnutrition
nutritional aggravation
food intolerance
lactose intolerance
small bowel ultrastructural abnormalities
Language English
Date 1996-04-01
Published in Journal Of The American College Of Nutrition. New York: Amer Coll Nutrition, v. 15, n. 2, p. 180-185, 1996.
ISSN 0731-5724 (Sherpa/Romeo, impact factor)
Publisher Amer Coll Nutrition
Extent 434-438
Origin http://dx.doi.org/10.1080/07315724.1996.10718586
Access rights Closed access
Type Article
Web of Science ID WOS:A1996UE78800014
URI http://repositorio.unifesp.br/11600/44724

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