Enteropatogena Escherichia coli (EPEC) – ett vanligt fynd i halländska fecesprover

Abstract

Background: Enteropathogenic Escherichia coli (EPEC) is known for causing gastroenteritis, especially in children in developing countries, but in a Swedish context the bacteria are less studied and described. In Halland, a new method for analyzing stool samples for suspected infectious diarrhoea was introduced in April 2024. The analysis is a multiplex PCR that includes EPEC. Positive test results regarding EPEC have created uncertainty among the clinics.

Research questions: What does the patient population with EPEC look like in Halland in terms of age, gender and seasonality? How does it differ from the patient population with Campylobacter in Halland? Materials and methods: A retrospective cohort study was conducted by collecting data from positive stool samples for EPEC and Campylobacter. The study subjects are people who from April 24, 2024, to January 31, 2025, were positive for EPEC and/or Campylobacter jejuni/coli/upsaliensis in stool samples analyzed at Clinical Microbiology in Halland.

Results: About 10% of all samples analyzed were positive for EPEC. 29,8% of the EPEC cohort tested positive for other intestinal pathogens at the time of sampling, which was significantly different from the Campylobacter cohort (12.6% p <0.001). The mean age for EPEC and Campylobacter, respectively, was 41.4 years and 49.3 years (p <0.02). More than 50% of the samples in both cohorts were taken at a health care center, but the proportion of samples taken in a hospital ward were larger for EPEC than for Campylobacter (13.4% vs 2.7%). Conclusion: EPEC was common in stool samples from Halland. In the EPEC cohort, patients tested positive for additional pathogens more often, but otherwise the cohorts did not differ much. Implications: Further investigation of EPEC is needed to understand the virulence and clinical relevance in a Swedish context.