726 - Investigation of Epidemiological Characteristics and Outcomes in Enteropathogenic Escherichia coli positive patients

Background: New generation multiplex polymerase chain reaction (PCR) panels have led to the ability of rapid detection of Enteropathogenic Escherichia coli (EPEC).  Although many studies have looked at the pathogenesis of this organism in the pediatric populations, fewer studies include adults. We aimed to determine if EPEC is pathogenic on its own, or has a predilection for certain populations based upon risk factors. This was achieved by comparing risk factors in patients positive for EPEC on the BioFire Gastrointestinal (GI) Pathogen Panel versus patients negative for all targets on the panel.

Methods: This is a single center case control study that was performed using a retrospective chart review from January 1, 2016 thru August 31, 2019. All patients were symptomatic with diarrheal illness and had a GI pathogen panel performed. The study group were patients that were EPEC positive. The control group were patients with a negative PCR panel that were matched three to one based upon age and gender. Chi-squared statistical analysis was used.

Results: 792 patients were evaluated. In the adult group the EPEC positive actual length of stay (LOS) was 13.5 rather than 9.3 in the control. Although this was not statically significant this trended towards a longer LOS as seen in Table 1. In the pediatric population, both expected and actual LOS were statically longer viewed in Table 2. This may be due to these patients being more chronically ill at baseline, with a greater number of pediatric coronary artery disease and ulcerative colitis in the control. Males were more likely to test positive for EPEC at 69.86% in the pediatric population than in the adult population with statistical significance at p=0.0035. The pediatric population had more co-infections with EPEC at 57.53% with p< 0.0001. This can be further seen in Table 3. Table 1
Table 2
Table 3


Conclusion: In the adult EPEC positive patients there was no statistically significant difference in length of stay in comparison to negative control. This raises the question to if this is truly a pathogen in adults. In the pediatric population, our control group was likely more ill, which made it difficult interpret the significance of differences in LOS.