Circulation of enterotoxigenic Escherichia coli (ETEC) isolates expressing CS23 from the environment to clinical settings

Enterotoxigenic Escherichia coli (ETEC) is one of the leading causes of infant diarrhea in low- and middle-income countries (LMICs). Although most diarrheal pathogens are transmitted through environmental reservoirs, it is unknown what predominant bacterial strains are transmitted between the human-environment interphases. Therefore whole genome sequencing of 30 Bolivian ETEC strains (19 isolated from filtered river water from the Choqueyapu River in La Paz and 11 isolates from diarrheal stool samples from hospitalized children) was conducted to investigate circulating ETEC isolates. Bioinformatic and phenotypic analysis was used to describe the antibiotic resistance and virulence factor profiles of the isolates. The adherence and biofilm formation ability and the cytotoxicity of the ETEC isolates were analysed. Furthermore, the ability to discriminate between circulating ETEC clones using the bacterial biochemical fingerprinting (PhenePlates) methodology versus phylogenetic analysis was compared.