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

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.

journal_name

J Am Coll Nutr

authors

Fagundes-Neto U,Freymüller E,Gandolfi Schimitz L,Scaletsky I

doi

10.1080/07315724.1996.10718586

subject

Has Abstract

pub_date

1996-04-01 00:00:00

pages

180-5

issue

2

eissn

0731-5724

issn

1541-1087

journal_volume

15

pub_type

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