Displaying publications 1 - 20 of 60 in total

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  1. Characteristics of a phage effective for colibacillosis control in poultry
    Lau GL, Sieo CC, Tan WS, Ho YW
    J Sci Food Agric, 2012 Oct;92(13):2657-63.
    PMID: 22505020 DOI: 10.1002/jsfa.5683
    Colibacillosis is one of the main causes of economic loss in the poultry industry worldwide. Although antibiotics have been used to control this infection, the emergence of antibiotic-resistant bacteria poses a threat to animal and human health. Phage therapy has been reported as one of the potential alternative methods to control bacterial infections. However, efficient phage therapy is highly dependent on the characteristics of the phage isolated. In the present study the characteristics of a lytic phage, ØEC1, which was found to be effective against the causative agent of colibacillosis in chickens in a previous in vivo study, are reported.
    Matched MeSH terms: Escherichia coli Infections/microbiology; Escherichia coli Infections/prevention & control*; Escherichia coli Infections/veterinary
  2. Fatal Leptospirosis and Escherichia coli co-infection in a post-partum woman
    Tan TL, Lee LY, Lim WC
    Med J Malaysia, 2018 12;73(6):427-429.
    PMID: 30647223
    The occurrence of Leptospirosis and Escherichia coli coinfection in the post-partum period is a novel case. This report illustrated a previously well woman from a suburban area presented with acute neurological deterioration following a two days history of fever during her puerperal period. Early interventions with fluids, broad spectrum antibiotics and intensive supportive care were given. Despite that, she deteriorated rapidly and developed pulmonary hemorrhage, disseminated intravascular coagulopathy, and multi-organ failure. She succumbed within 12 hours of admission. The knowledge about such fatal co-infections should be disseminated to medical practitioners encountering Leptospirosis infection and general public.
    Matched MeSH terms: Escherichia coli Infections/complications*; Escherichia coli Infections/microbiology
  3. Prevalence of AmpC beta-lactamase and extended spectrum beta-lactamase co-producer in Escherichia coli and Klebsiella species in a teaching hospital
    Ting SMV, Ismail Z, Hanafiah A
    Malays J Pathol, 2024 Apr;46(1):79-89.
    PMID: 38682847
    INTRODUCTION: Beta-lactamase producing bacterial infection has been on surge due to selection pressure and injudicious antibiotics usage. Organisms that co-produced more than one beta lactamase enzyme posed diagnostic challenges which may result in inadequate treatment. To date, there is no standardised guideline offering phenotypic detection of AmpC β-lactamase. The purpose of this study was to determine the prevalence of ESBLs, AmpC β-lactamase and co-producer organisms in a teaching hospital.

    MATERIALS AND METHODS: Three hundred and four isolates of E. coli and Klebsiella sp. had been selected via convenient sampling. These isolates were identified using conventional laboratory methods and their antimicrobial susceptibilities were determined using disc diffusion method. Those isolates were then proceeded with ESBL confirmatory test, cloxacillin-containing Muller Hinton confirmatory test, modified double disk synergy test and AmpC disk test.

    RESULTS: Out of 304 isolates, 159 isolates were E. coli and 145 were Klebsiella sp. The prevalence of organisms which co-produced AmpC β-lactamase and ESBL enzymes were 3.0%. Besides that, 39 cefoxitin resistant and three cefoxitin susceptible isolates (13.8%) were proven to produce AmpC β-lactamase through AmpC disk test. Through the CLSI confirmatory test, 252 (82.9%) isolates were identified as ESBLs producers and the prevalence increased slightly when cloxacillin-containing Muller Hinton were used. Only three ESBLs positive organisms were positive for modified double disk synergy test.

    CONCLUSION: Distinguishing between AmpC β-lactamase and ESBL-producing organisms has epidemiological significance as well as therapeutic importance. Moreover, AmpC β-lactamase and ESBLs co-producing organisms can lead to false negative ESBL confirmatory test. Therefore, knowing the local prevalence can guide the clinician in navigating the treatment.

    Matched MeSH terms: Escherichia coli Infections/microbiology; Escherichia coli Infections/epidemiology
  4. Fulltext The higher prevalence of extended spectrum beta-lactamases among Escherichia coli ST131 in Southeast Asia is driven by expansion of a single, locally prevalent subclone
    Chen SL, Ding Y, Apisarnthanarak A, Kalimuddin S, Archuleta S, Omar SFS, et al.
    Sci Rep, 2019 09 13;9(1):13245.
    PMID: 31519972 DOI: 10.1038/s41598-019-49467-5
    The ST131 multilocus sequence type (MLST) of Escherichia coli is a globally successful pathogen whose dissemination is increasing rates of antibiotic resistance. Numerous global surveys have demonstrated the pervasiveness of this clone; in some regions ST131 accounts for up to 30% of all E. coli isolates. However, many regions are underrepresented in these published surveys, including Africa, South America, and Asia. We collected consecutive bloodstream E. coli isolates from three countries in Southeast Asia; ST131 was the most common MLST type. As in other studies, the C2/H30Rx clade accounted for the majority of ST131 strains. Clinical risk factors were similar to other reported studies. However, we found that nearly all of the C2 strains in this study were closely related, forming what we denote the SEA-C2 clone. The SEA-C2 clone is enriched for strains from Asia, particularly Southeast Asia and Singapore. The SEA-C2 clone accounts for all of the excess resistance and virulence of ST131 relative to non-ST131 E. coli. The SEA-C2 strains appear to be locally circulating and dominant in Southeast Asia, despite the intuition that high international connectivity and travel would enable frequent opportunities for other strains to establish themselves.
    Matched MeSH terms: Escherichia coli Infections/drug therapy; Escherichia coli Infections/genetics; Escherichia coli Infections/microbiology; Escherichia coli Infections/epidemiology*
  5. Fulltext Loop-mediated isothermal amplification assay for detection of generic and verocytotoxin-producing Escherichia coli among indigenous individuals in Malaysia
    Teh CS, Chua KH, Lim YA, Lee SC, Thong KL
    ScientificWorldJournal, 2014;2014:457839.
    PMID: 24967435 DOI: 10.1155/2014/457839
    We have successfully developed a Loop-mediated isothermal amplification (LAMP) assay that could specifically detect generic Escherichia coli (E. coli). This assay was tested on 85 bacterial strains and successfully identified 54 E. coli strains (average threshold time, Tt = 21.26). The sensitivity of this assay was evaluated on serial dilutions of bacterial cultures and spiked faeces. The assay could detect 10(2) CFU/mL for bacterial culture with Tt = 33.30 while the detection limit for spiked faeces was 10(3) CFU/mL (Tt = 31.12). We have also detected 46 generic E. coli from 50 faecal samples obtained from indigenous individuals with 16% of the positive samples being verocytotoxin-producing E. coli (VTEC) positive. VT1/VT2 allele was present in one faecal sample while the ratio of VT1 to VT2 was 6 : 1. Overall, our study had demonstrated high risk of VTEC infection among the indigenous community and most of the asymptomatic infection occurred among those aged below 15 years. The role of asymptomatic human carriers as a source of dissemination should not be underestimated. Large scale screening of the VTEC infection among indigenous populations and the potential contamination sources will be possible and easy with the aid of this newly developed rapid and simple LAMP assay.
    Matched MeSH terms: Escherichia coli Infections/diagnosis; Escherichia coli Infections/microbiology*
  6. Extraintestinal pathogenic Escherichia coli (ExPEC) of human and avian origin belonging to sequence type complex 95 (STC95) portray indistinguishable virulence features
    Nandanwar N, Janssen T, Kühl M, Ahmed N, Ewers C, Wieler LH
    Int J Med Microbiol, 2014 Oct;304(7):835-42.
    PMID: 25037925 DOI: 10.1016/j.ijmm.2014.06.009
    Extraintestinal pathogenic Escherichia coli (ExPEC) strains of certain genetic lineages are frequently implicated in a wide range of diseases in humans and birds. ExPEC strains belonging to the phylogenetic lineage/sequence type complex 95 (STC95) are one such prominent lineage that is commonly isolated from extraintestinal infections such as systemic disease in poultry and urinary tract infections (UTIs), neonatal meningitis and sepsis in humans. Several epidemiological studies have indicated that ST95 strains obtained from such infections may share similar virulence genes and other genomic features. However, data on their ability to establish infections in vivo as deduced from the manifestation of similar virulence phenotypes remain elusive. In the present study, 116 STC95 ExPEC isolates comprising 55 human and 61 avian strains, possessing similar virulence gene patterns, were characterized in vitro using adhesion, invasion, biofilm formation and serum bactericidal assays. Overall, STC95 strains from both groups, namely human and birds, were equally capable of adhering to and invading the two mammalian kidney cell lines. Similarly, these strains were able to form strong biofilms in M63 medium. Furthermore, they were equally resistant to the bactericidal activity of human and avian serum. Our cumulative data reinforce the understanding that ST95 strains from poultry present a potential zoonotic risk and therefore need a One Health strategy for a successfull intervention.
    Matched MeSH terms: Escherichia coli Infections/microbiology*; Escherichia coli Infections/veterinary*
  7. Fulltext An atypical case of retropharyngeal abscess with long blind tract treated with Ryle's tube drainage
    Tang ML, Lee SC, Phoon MP
    Med J Malaysia, 2011 Dec;66(5):501-3.
    PMID: 22390112
    A 10 year-old Iban girl presented with severe odynophagia for 4 days and subcutaneous emphysema. Clinically, her neck was tender with crepitus. Lateral neck radiograph showed multiple linear radiolucent shadows at retropharyngeal space. Flexible nasopharyngolaryngoscope revealed a tunnel behind upper oesophagus with slough and there was pooling of saliva at pyriform sinus. Feeding via nasogastric tube was started and empirical treatment for fungal and bacterial infection was commenced. Subsequent computed tomography of neck and thorax showed a 15-long blind tract at subglottic region posterior to oesophagus (prevertebral region), extending to superior mediastinum just before carina at T3/T4 level, represent abscess. Hourly suctioning of the remaining abscess in the blind tract with 10ml-syringe was done.
    Matched MeSH terms: Escherichia coli Infections/diagnosis; Escherichia coli Infections/therapy*
  8. Emergence of mcr-1-mediated colistin resistance in Escherichia coli in Malaysia
    Yu CY, Ang GY, Chin PS, Ngeow YF, Yin WF, Chan KG
    Int J Antimicrob Agents, 2016 Jun;47(6):504-5.
    PMID: 27208898 DOI: 10.1016/j.ijantimicag.2016.04.004
    Matched MeSH terms: Escherichia coli Infections/microbiology*; Escherichia coli Infections/veterinary*
  9. Fulltext Chitosan Nanoparticles as Carriers for the Delivery of ΦKAZ14 Bacteriophage for Oral Biological Control of Colibacillosis in Chickens
    Adamu Ahmad K, Sabo Mohammed A, Abas F
    Molecules, 2016 Mar 14;21(3):256.
    PMID: 26985885 DOI: 10.3390/molecules21030256
    The use of chitosan as a delivery carrier has attracted much attention in recent years. In this study, chitosan nanoparticles (CS-NP) and chitosan-ΦKAZ14 bacteriophage-loaded nanoparticles (C-ΦKAZ14 NP) were prepared by a simple coercavation method and characterized. The objective was to achieve an effective protection of bacteriophage from gastric acids and enzymes in the chicken gastrointestinal tract. The average particle sizes for CS-NP and C-ΦKAZ14 NP were 188 ± 7.4 and 176 ± 3.2 nm, respectively. The zeta potentials for CS-NP and C-ΦKAZ14 NP were 50 and 60 mV, respectively. Differential scanning calorimetry (DSC) of C-ΦKAZ14 NP gave an onset temperature of -17.17 °C with a peak at 17.32 °C and final end set of 17.41 °C, while blank chitosan NP had an onset of -20.00 °C with a peak at -19.78 °C and final end set at -20.47. FT-IR spectroscopy data of both CS-NP and C-ΦKAZ14 NP were the same. Chitosan nanoparticles showed considerable protection of ΦKAZ14 bacteriophage against degradation by enzymes as evidenced in gel electrophoresis, whereby ΦKAZ14 bacteriophage encapsulated in chitosan nanoparticles were protected whereas the naked ΦKAZ14 bacteriophage were degraded. C-ΦKAZ14 NP was non-toxic as shown by a chorioallantoic membrane (CAM) toxicity assay. It was concluded that chitosan nanoparticles could be a potent carrier of ΦKAZ14 bacteriophage for oral therapy against colibacillosis in poultry.
    Matched MeSH terms: Escherichia coli Infections/prevention & control; Escherichia coli Infections/veterinary*
  10. ENTEROAGGREGATIVE ESCHERICHIA COLI O104 FROM THAI AND IMPORTED MALAYSIAN RAW BEEF
    Wameadesa N, Sae-lim A, Hayeebilan F, Rattanachuay P, Sukhumungoon P
    Southeast Asian J Trop Med Public Health, 2017 Mar;48(2):338-50.
    PMID: 29642296
    Local Thai and imported Malaysian beef in southern Thailand area carry
    several Shiga toxin-producing Escherichia coli (STEC) serotypes. STEC O104 is an
    important pathogen capable of causing outbreaks with considerable morbidity
    and mortality. This study investigated the presence of E. coli O104 from local Thai
    and imported Malaysian beef obtained from markets in Hat Yai City, Songkhla
    Province during August 2015 - February 2016. Thirty-one E. coli O104 strains
    were isolated from 12 beef samples (16% and 23% Thai and imported Malaysian,
    respectively). Thirty strains possessed aggA (coding for a major component of
    AAF/I fimbriae), a gene associated with enteroaggregative E. coli (EAEC) pathotype,
    and all strains carried fimH (encoding Type 1 fimbriae). Thirty strains
    belonged to phylogenetic group B1 and one strain (from Malaysian beef) to group
    A. Agglutination of yeast cells was observed among 29 E. coli O104 strains. Investigation
    of stx2 phage occupancy loci demonstrated that sbcB was occupied in 12
    strains. Antimicrobial susceptibility assay revealed that 7 strains were resistant
    to at least one antimicrobial agent and two were multi-drug resistant. One strain
    carried extended spectrum β-lactamase gene blaCTX-M and three carried blaTEM. PFGE-generated DNA profiling showed identical DNA pattern between that of
    one EAEC O104 strain from Thai beef and another from Malaysian beef, indicating
    that these two strains originated from the same clone. This is the first report
    in Thailand describing the presence of EAEC O104 from both Thai and imported
    Malaysian beef and their transfer between both countries. Thorough surveillance
    of this pathogen in fresh meats and vegetables should help to prevent any possible
    outbreak of E. coli O104.
    Matched MeSH terms: Escherichia coli Infections/microbiology; Escherichia coli Infections/epidemiology*
  11. Fulltext Prevalence and characterization of verotoxigenic-Escherichia coli isolates from pigs in Malaysia
    Ho WS, Tan LK, Ooi PT, Yeo CC, Thong KL
    BMC Vet Res, 2013;9:109.
    PMID: 23731465 DOI: 10.1186/1746-6148-9-109
    Postweaning diarrhea caused by pathogenic Escherichia coli, in particular verotoxigenic E. coli (VTEC), has caused significant economic losses in the pig farming industry worldwide. However, there is limited information on VTEC in Malaysia. The objective of this study was to characterize pathogenic E. coli isolated from post-weaning piglets and growers with respect to their antibiograms, carriage of extended-spectrum beta-lactamases, pathotypes, production of hemolysins and fimbrial adhesins, serotypes, and genotypes.
    Matched MeSH terms: Escherichia coli Infections/microbiology; Escherichia coli Infections/epidemiology; Escherichia coli Infections/veterinary*
  12. Immune-stimulating properties of 80% methanolic extract of Ludwigia octovalvis against Shiga toxin-producing E. coli O157:H7 in Balb/c mice following experimental infection
    Kadum Yakob H, Manaf Uyub A, Fariza Sulaiman S
    J Ethnopharmacol, 2015 Aug 22;172:30-7.
    PMID: 26091966 DOI: 10.1016/j.jep.2015.06.006
    Ludwigia octovalvis is an aquatic plant widely distributed throughout the tropical and sub-tropical regions. It is commonly consumed as a health drink and traditionally used for treating various ailments such as dysentery, diarrhea, diabetes, nephritisn and headache. No information is available on its in vivo antibacterial activity against an important foodborne pathogen, Shiga toxin producing Escherichia coli O157:H7.
    Matched MeSH terms: Escherichia coli Infections/immunology*; Escherichia coli Infections/metabolism; Escherichia coli Infections/microbiology*
  13. Isolation of verotoxin-producing Escherichia coli associated with diarrhoea in Malaysia containing plasmids showing homology with biotinylated Shiga-like toxin DNA gene probes
    Son R, Ansary A, Rusul G, Karim MI
    World J Microbiol Biotechnol, 1996 May;12(3):243-6.
    PMID: 24415231 DOI: 10.1007/BF00360921
    Three strains of verotoxin-producing Escherichia coli isolated from patients with haemorrhagic colitis harboured plasmids ranging in size from 2.7 kb to 91.2 kb. Those plasmids ranging from 2.7 kb to 6.8 kb hybridized to Shiga-like toxin I and Shiga-like toxin II gene probes.
    Matched MeSH terms: Escherichia coli Infections
  14. Fulltext Draft Genome Sequence of the Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolate INF13/18/A, Recovered from Kelantan, Malaysia
    Wan Makhtar WR, Mohd Azlan M, Hassan NH, Aziah I, Samsurizal NH, Yusof NY
    Microbiol Resour Announc, 2020 Aug 13;9(33).
    PMID: 32817162 DOI: 10.1128/MRA.01497-19
    We describe here the draft genome sequence and basic characteristics of Escherichia coli isolate INF13/18/A, which was isolated from Universiti Sains Malaysia (USM) Hospital. This isolate was identified as an extended-spectrum β-lactamase-producing Escherichia coli strain harboring the antimicrobial resistance genes TEM, CTX-M-1, and CTX-M-9.
    Matched MeSH terms: Escherichia coli Infections
  15. Fulltext Detection and characterization of ESBL-producing Enterobacteriaceae from the gut of healthy chickens, Gallus gallus domesticus in rural Nepal: Dominance of CTX-M-15-non-ST131 Escherichia coli clones
    Hosuru Subramanya S, Bairy I, Nayak N, Amberpet R, Padukone S, Metok Y, et al.
    PLoS One, 2020;15(5):e0227725.
    PMID: 32469888 DOI: 10.1371/journal.pone.0227725
    The surge in the prevalence of drug-resistant bacteria in poultry is a global concern as it may pose an extended threat to humans and animal health. The present study aimed to investigate the colonization proportion of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Enterobacteriaceae (EPE and CPE, respectively) in the gut of healthy poultry, Gallus gallus domesticus in Kaski district of Western Nepal. Total, 113 pooled rectal swab specimens from 66 private household farms and 47 commercial poultry farms were collected by systematic random sampling from the Kaski district in western Nepal. Out of 113 pooled samples, 19 (28.8%) samples from 66 backyard farms, and 15 (31.9%) from 47 commercial broiler farms were positive for EPE. Of the 38 EPE strains isolated from 34 ESBL positive rectal swabs, 31(81.6%) were identified as Escherichia coli, five as Klebsiella pneumoniae (13.2%), and one each isolate of Enterobacter species and Citrobacter species (2.6%). Based on genotyping, 35/38 examined EPE strains (92.1%) were phylogroup-1 positive, and all these 35 strains (100%) had the CTX-M-15 gene and strains from phylogroup-2, and 9 were of CTX-M-2 and CTX-M-14, respectively. Among 38 ESBL positive isolates, 9 (23.7%) were Ambler class C (Amp C) co-producers, predominant were of DHA, followed by CIT genes. Two (6.5%) E. coli strains of ST131 belonged to clade C, rest 29/31 (93.5%) were non-ST131 E. coli. None of the isolates produced carbapenemase. Twenty isolates (52.6%) were in-vitro biofilm producers. Univariate analysis showed that the odd of ESBL carriage among commercial broilers were 1.160 times (95% CI 0.515, 2.613) higher than organically fed backyard flocks. This is the first study in Nepal, demonstrating the EPE colonization proportion, genotypes, and prevalence of high-risk clone E. coli ST131 among gut flora of healthy poultry. Our data indicated that CTX-M-15 was the most prevalent ESBL enzyme, mainly associated with E. coli belonging to non-ST131clones and the absence of carbapenemases.
    Matched MeSH terms: Escherichia coli Infections/drug therapy*; Escherichia coli Infections/genetics; Escherichia coli Infections/microbiology
  16. Fulltext Characteristics of childhood diarrhea associated with enterotoxigenic Escherichia coli in Malaysia
    Samuel S, Vadivelu J, Parasakthi N
    Southeast Asian J Trop Med Public Health, 1997 Mar;28(1):114-9.
    PMID: 9322293
    Amongst 107 diarrheal cases studied a bacterial agent was isolated from 71 (66%) cases of which 60 (85%) were due to a single agent and the remaining 11 (15%) were of mixed infections. Enterotoxigenic Escherichia coli (ETEC) was isolated from 65 cases. Other pathogens isolated included Salmonella spp, Shigella spp and rotavirus. There was a higher isolation rate of ETEC from females and rotavirus from males. The infection rate was found to higher for the 0-2 year age group as compared to the 3-5 year age group. Amongst the ETEC isolated the STa 2 toxotype was the predominant type.
    Matched MeSH terms: Escherichia coli Infections/diagnosis; Escherichia coli Infections/microbiology*; Escherichia coli Infections/epidemiology
  17. The influence of antibiotic resistance gene carriage on biofilm formation by two Escherichia coli strains associated with urinary tract infections
    Teh AH, Wang Y, Dykes GA
    Can J Microbiol, 2014 Feb;60(2):105-11.
    PMID: 24498987 DOI: 10.1139/cjm-2013-0633
    Urinary tract infections (UTI) caused by uropathogenic Escherichia coli are one of the most common forms of human disease. In this study, the effect of the presence of newly acquired antibiotic resistance genes on biofilm formation of UTI-associated E. coli strains was examined. Two clinical UTI-associated E. coli strains (SMC18 and SMC20) carrying different combinations of virulence genes were transformed with pGEM-T, pGEM-T::KmΔAmp, or pGEM-T::Km to construct ampicillin-resistant (Km(S)Amp(R)), kanamycin-resistant (Km(R)Amp(S)), or ampicillin- and kanamycin-resistant (Km(R)Amp(R)) strains. Transformed and wild-type strains were characterized for biofilm formation, bacterial surface hydrophobicity, auto-aggregation, morphology, and attachment to abiotic surfaces. Transformation with a plasmid carrying an ampicillin resistance gene alone decreased (p < 0.05) biofilm formation by SMC18 (8 virulence marker genes) but increased (p < 0.05) biofilm formation by SMC20 (5 virulence marker genes). On the other hand, transformation with a plasmid carrying a kanamycin resistance gene alone or both ampicillin and kanamycin resistance genes resulted in a decrease (p < 0.05) in biofilm formation by SMC18 but did not affect (p > 0.05) the biofilm formation by SMC20. Our results suggest that transformation of UTI-associated E. coli with plasmids carrying different antibiotic resistance gene(s) had a significant impact on biofilm formation and that these effects were both strain dependent and varied between different antibiotics.
    Matched MeSH terms: Escherichia coli Infections/microbiology
  18. Fulltext Long-term trends in the epidemiology of human enteropathogens in Malaysia
    Shunmugam P, Kanapathy S, Chan SE, Singh KK
    Braz J Infect Dis, 2012 Nov-Dec;16(6):603-4.
    PMID: 23158263 DOI: 10.1016/j.bjid.2012.07.005
    Matched MeSH terms: Escherichia coli Infections/epidemiology*
  19. The bacterial causes of diarrhoea in Malaysia
    Jegathesan M, Singh RB, Kanaganayagi M, Soon LE
    Med J Malaysia, 1976 Sep;31(1):46-56.
    PMID: 799233
    Matched MeSH terms: Escherichia coli Infections/complications
  20. Fulltext Colonisation factors amongst clinical isolates of enterotoxigenic Escherichia coli
    Iyer L, Vadivelu J, Parasakthi N
    Singapore Med J, 1995 Oct;36(5):495-7.
    PMID: 8882532
    The production of heat-labile (LT) and heat-stable (ST) enterotoxins, colonisation factor antigens (CFAs) and haemagglutinins was investigated amongst 310 Escherichia coli (E. coli) isolates obtained from 62 children under the age of five, with diarrhoea. Twenty-one isolates were found to produce enterotoxins, of which fifteen (71%) isolates produced ST only, 2 (10%) produced LT only and 4 (19%) produced both LT and ST. However, none of the isolates demonstrated any of the common CFAs identified to date, but 8 out of the 21 isolates demonstrated haemagglutination with rabbit, sheep or human group A erythrocytes, suggesting the presence of putative CFAs, yet unidentified.
    Matched MeSH terms: Escherichia coli Infections/immunology*
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