{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:36:51Z","timestamp":1785148611538,"version":"3.55.0"},"reference-count":23,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1991,2]]},"abstract":"<jats:p>Enteropathogenic Escherichia coli (EPEC) infection is not generally thought to cause severe diarrhoea after the neonatal period. Patients admitted to Queen Elizabeth Hospital for Children over the three years (1984-7) with diarrhoea and EPEC infection were reviewed. Clinical details, features of small intestinal mucosa, and treatment were recorded in those who developed chronic diarrhoea with failure to thrive. Twenty six children with EPEC required hospital admission for diarrhoea and six of these (23%) developed chronic diarrhoea. In contrast only two (5%) of 42 with other serogroups of E coli (p less than 0.01) and 28 (4%) of 764 children without EPEC admitted with acute diarrhoea developed chronic symptoms (p less than 0.01). EPEC serogroups detected in the stool of the six children with chronic diarrhoea were 0128 in three, 0114 in two, and 0119 in one. The patients' clinical characteristics were: previous good health, no significant immunodeficiency, age 4-10 months, foreign travel (three of six), severe life threatening secretory diarrhoea from 0.5 to 1.5 1 per day (four of six), small intestinal enteropathy (five of six) three of whom showed mucosal adherent, non-invasive E coli of the same serotype as that in the stool, in association with microvillous loss and pedestal formation. All were treated with hypoallergenic feeds, two with parenteral nutrition, and three with parenteral antibiotics. All eventually recovered. EPEC infection is a common treatable cause of life threatening chronic diarrhoea in infancy.<\/jats:p>","DOI":"10.1136\/gut.32.2.154","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"154-158","source":"Crossref","is-referenced-by-count":69,"title":["Enteropathogenic Escherichia coli and life threatening chronic diarrhoea."],"prefix":"10.1136","volume":"32","author":[{"given":"S M","family":"Hill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A D","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J A","family":"Walker-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1991,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1016\/S0140-6736(87)91267-0","article-title":"Bacterial diarrhoea and its treatment","volume":"ii:","author":"Gorbach, S.L.","year":"1987","unstructured":"Gorbach SL. Bacterial diarrhoea and its treatment. Lancet 1987; ii: 1378-82.","journal-title":"Lancet"},{"key":"ref_2","first-page":"208","article-title":"Traveller's diarrhoea with a vengeance in children of UK immigrants visiting their parental homeland","volume":"3","author":"Hutchins, P.; Hindocha, P.; Phillips, A.; Walker-Smith, J.A.","year":"1982","unstructured":"Hutchins P, Hindocha P, Phillips A, Walker-Smith JA. Traveller's diarrhoea with a vengeance in children of UK immigrants visiting their parental homeland. Arch Dis Child 1982; 3:208-11.","journal-title":"Arch Dis Child"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/02724936.1988.11748564","article-title":"Travellers diarrhoea among children returning to the United Kingdom from visits abroad","volume":"8","author":"Msengi, A.E.; Phillips, A.D.; Risdon, R.A.; Walker-Smith, J.A.","year":"1988","unstructured":"Msengi AE, Phillips AD, Risdon RA, Walker-Smith JA. Travellers diarrhoea among children returning to the United Kingdom from visits abroad. Ann Trop Paediatr 1988; 8: 173-80.","journal-title":"Ann Trop Paediatr"},{"key":"ref_4","first-page":"771","article-title":"Use ofantibiotics in E coli gastroenteritis","volume":"i:","author":"Hill, S.M.; Phillips, A.D.; Walker-Smith, J.A.; Sanderson, I.R.; Milla, P.J.","year":"1988","unstructured":"Hill SM, Phillips AD, Walker-Smith JA, Sanderson IR, Milla PJ. Use ofantibiotics in E coli gastroenteritis. Lancet 1988; i: 771-2.","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1056\/NEJM198001103020207","article-title":"Pathogenesis ofEscherichia coli gastroenteritis in man - another mechanism","volume":"302","author":"Ulshen, M.H.; Rollo, J.L.","year":"1980","unstructured":"Ulshen MH, Rollo JL. Pathogenesis ofEscherichia coli gastroenteritis in man - another mechanism. N EnglJ Med 1980; 302: 99-101.","journal-title":"N EnglJ Med"},{"key":"ref_6","first-page":"441","article-title":"Clinicopathologic study of enterocyte-adherent Escherichia coli: a cause of protracted","volume-title":"diarrhoea in infants. Gastroenterology 1982; 83","author":"Rothbaum, R.; McAdams, A.J.; Giannella, R.; Partin, J.C.","unstructured":"Rothbaum R, McAdams AJ, Giannella R, Partin JC. Clinicopathologic study of enterocyte-adherent Escherichia coli: a cause of protracted diarrhoea in infants. Gastroenterology 1982; 83: 441-54."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/00005176-198601000-00013","article-title":"Ultrastructural and biochemical changes in human jejunal mucosa associated with enteropathogenic Escherichia coli (0111) infection","volume":"5","author":"Taylor, C.J.; Hart, A.; Bat, R.M.; McDougall, C.; Mclean, L.","year":"1986","unstructured":"Taylor CJ, Hart A, Bat RM, McDougall C, Mclean L. Ultrastructural and biochemical changes in human jejunal mucosa associated with enteropathogenic Escherichia coli (0111) infection.J Pediatr Gastroenterol Nutr 1986; 5: 70-3.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/oxfordjournals.epirev.a036274","article-title":"Enteropathogenic Escherichia coli of classic serotypes associated with infant diarrhoea: epidemiology and pathogenesis","volume":"6","author":"Levin, M.M.; Edelman, R.","year":"1984","unstructured":"Levin MM, Edelman R. Enteropathogenic Escherichia coli of classic serotypes associated with infant diarrhoea: epidemiology and pathogenesis. 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Edinburgh: Churchill Livingstone 1988: 318-52."}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.32.2.154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T06:38:36Z","timestamp":1765607916000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.32.2.154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,2]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1991,2,1]]},"published-print":{"date-parts":[[1991,2]]}},"alternative-id":["10.1136\/gut.32.2.154"],"URL":"https:\/\/doi.org\/10.1136\/gut.32.2.154","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1991,2]]}}}