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High turnover rate of Escherichia coli strains in the intestinal flora of infants in Pakistan

Published online by Cambridge University Press:  01 December 1998

I. ADLERBERTH
Affiliation:
Department of Clinical Immunology, University of Göteborg, Guldhedsgatan 10, S-413 46 Göteborg, Sweden
F. JALIL
Affiliation:
Department of Social and Preventive Pediatrics, King Edward Medical College, Lahore, Pakistan
B. CARLSSON
Affiliation:
Department of Clinical Immunology, University of Göteborg, Guldhedsgatan 10, S-413 46 Göteborg, Sweden
L. MELLANDER
Affiliation:
Department of Paediatrics, University of Göteborg, Sweden
L. Å. HANSON
Affiliation:
Department of Clinical Immunology, University of Göteborg, Guldhedsgatan 10, S-413 46 Göteborg, Sweden
P. LARSSON
Affiliation:
Department of Clinical Bacteriology, University of Göteborg, Sweden
K. KHALIL
Affiliation:
Department of Paediatrics, King Edward Medical College, Lahore, Pakistan
A. E. WOLD
Affiliation:
Department of Clinical Immunology, University of Göteborg, Guldhedsgatan 10, S-413 46 Göteborg, Sweden
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Abstract

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The Escherichia coli flora of infants in developed countries is dominated by one or a few strains which persist for prolonged periods of time, but no longitudinal studies have been performed in developing countries. To this end, we studied the rectal enterobacterial flora in 22 home-delivered Pakistani infants during their first 6 months of life. Three colonies were isolated and species typed on each of 11 sampling occasions. E. coli isolates were strain typed using electromorphic typing of cytoplasmic enzymes, and their O serogroups were determined. There was a very rapid turnover of enterobacterial strains in the rectal flora of individual infants. On average, 8·5 different E. coli strains were found per infant, and several biotypes of other enterobacteria. Less than 50% of the infants were colonized with E. coli from their mothers, but strains of maternal origin were four times more likely to persists in the infants' flora than other E. coli strains. Enterobacteria other than E. coli were always of non-maternal origin, and Enterobacter cloacae and Klebsiella pneumoniae biotypes recovered from contaminated feeds were later identified in the infants' rectal flora. An early colonization with klebsiella or enterobacter was significantly associated with diarrhoea during the neonatal period, although these bacteria were not likely to be the cause of the disease. The results suggest that poor hygienic conditions result in an unstable and diverse enterobacterial flora, which may influence infant health.

Type
Research Article
Copyright
© 1998 Cambridge University Press