DIFFUSE AND ENTEROAGGREGATIVE PATTERNS OF ADHERENCE OF ENTERIC ESCHERICHIA-COLI ISOLATED FROM ABORIGINAL CHILDREN FROM THE KIMBERLEY REGION OF WESTERN-AUSTRALIA

Escherichia coli from 138 fecal samples from aboriginal children, in whom no other enteric pathogen was isolated (including enterovirulent E. coli), were examined for HEp-2 cell adhesion. Twenty-five (36.8%) of 68 children with diarrhea and 32 (45.7%) of 70 without diarrhea had diffusely adherent isolates, which were thus not associated with diarrhea (P > .25). However, after age stratification, children greater-than-or-equal-to 18 months showed a significant association of diffusely adherent E. coli with diarrhea (P less-than-or-equal-to .05). Enteroaggregative E. coli were isolated from 12 children with diarrhea (17.6%) and 15 without diarrhea (21.4%); thus, there was no association with diarrhea (P greater-than-or-equal-to .5). Sixteen children with diarrhea (23.5%) and 6 without diarrhea (8.6%) carried isolates that caused detachment of the HEp-2 cell monolayer from the glass coverslip when examined in the adhesion assay and were significantly associated with diarrhea (P less-than-or-equal-to .05). These isolates, termed cell-detaching E. coli, were different from all recognized classes of enterovirulent E. coli.