Studies on an outbreak of neonatal diarrhea caused by EPEC 0127:H6 with plasmid analysis restriction analysis and outer membrane protein determination

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Abstract
An outbreak of enteropathogenic Escherichia coli (EPEC) 0127:H6 diarrhea occurred at two nurseries for the newborn in Chongqing in May 1987. Sixty‐nine neonates had diarrhea; two deaths resulted. The epidemic strains, carrying 1.5 and 60 Md plasmid DNA, had an identical restriction digest profile and the same outer membrane protein pattern and could produce localized adherence to HeLa, HEp‐2 and FL cells. The rates of contamination with EPEC 0127:H6 on medical staff's hands in these two nurseries were 11.8% and 8.7%, respectively, whereas 85 samples from milk, air and other sources were all negative for EPEC. The source of infection was the index case's mother who had had watery stools. Transmission of EPEC 0127:H6 from infant to infant took place by way of the fecal‐oral route, most likely via the hands of medical staff attending their care. We present the first case, confirmed by plasmid and restriction analyses and outer membrane protein determination, of a neonate who acquired EPEC during delivery through ingestion of organisms residing in the maternal birth canal.