PEDIATRICS Vol. 71 No. 4 April 1983, pp. 626-630
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Necrotizing Enterocolitis with Escherichia coli Heat-Labile Enterotoxin

Alice H. Cushing MD1

1 From the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque

Twenty-one babies occupied a newborn intensive care unit during two separate clusters of necrotizing enterocolitis (NEC). Seven babies had suspected NEC, seven had proved NEC, two had diarrhea only, and five were unaffected. Of affected babies, 15 had toxigenic Escherichia coli or heat-labile E coli toxin in feces detected by enzyme-linked immunosorbent assay. One of five unaffected babies had fecal toxin (P = .01). Four of 12 affected babies had a fourfold immunoglobulin M (Igm) antitoxin titer rise within 3 weeks of the fecal studies. None of five unaffected infants had a serologic immune response. The clinical disease seen in the babies was not characteristic of previously described E coli heatlabile toxin-associated diarrhea.

Key Words: diarrhea • necrotizing enterocolitis • Escherichia coli toxin

Submitted on May 5, 1980
Accepted on July 20, 1982