Prevalence of enterotoxigenic Bacteroides fragilis in adult patients with diarrhea and healthy controls.

Enterotoxigenic strains of Bacteroides fragilis (ETBF) have been associated with diarrheal diseases in animals and humans. The enterotoxin of ETBF induces fluid changes in ligated intestinal segments and a cytotoxic response in HT29/C1 cells. An assay based on immunomagnetic-beads separation in combination with PCR was used to detect ETBF in fecal samples from patients with diarrhea and healthy Swedish adults. A total of 922 fecal samples were analyzed in this study, including 728 samples from patients with diarrhea and 194 samples from controls. ETBF was detected in 195 of 728 patients (26.8%) and 24 of 194 healthy controls (12.4%). The difference between the two groups was statistically significant (P<.01). ETBF was the only potential diarrheal agent in 91 (12.5%) of 728 patients. All ETBF-positive samples from patients and controls were also positive in the HT29/C1 assay. The data show high carriage of ETBF in Swedish adults, which might be associated with diarrheal disease.