Seroepidemiologic Evaluation of Anti-Toxic and Anti-Colonization Factor Immunity against Infections by LT-Producing Escherichia coli in Rural Bangladesh

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Abstract
To evaluate serologic immunity against clinical infections by heat-labile enterotoxin-producing Escherichia coli (LT-ETEC) in rural Bangladesh, 124 children and adult women with LT-ETEC diarrhea (cases) were compared with 347 age-matched community controls. In paired acuteconvalescent sera from the cases, IgG anti-CFA I and anti-eFA II antibody titers increased eightto ninefold after infection by LT-ETEC with the homologous CFA, and 19O anti-LT antibody titers increased fourfold for all LT-ETEC infections. Anti-CFA and anti-LT titers peaked in controls aged 12-23 months, the age group with the highest incidence ofETEC infections. However, antibody titers were similar in acute sera from cases and in sera from controls. Although serum IgG anti-CFA and anti-LT antibodies rose in response to LT-ETEC infections and paralleled the age-specific incidence ofETEC in the community, these antibodies were not associated with a lower risk of LT-ETEC diarrhea.