Clinical and Laboratory Assessment of the Pathogenicity of Serotyped Enteropathogenic Escherichia coli

Enteropathogenic Escherichia coli Serotypes and Endemic Diarrhea in Infants

“…Furthermore, these bacteria are the most frequent agents of diarrhea in children under 6 months of age. Recent data showing the association of EP E. coli and endemic infantile diarrhea have also been reported from Canada (10,11), India (13), Chile (9), and several other countries (15,33). In the studies carried out in Canada, EP E. coli strains were fully identified, and in addition to demonstrating numerical association of some serotypes with diarrhea (10), the authors showed that these bacteria would produce an illness more severe than that associated with nonbacterial gastroenteritis (11).…”

“…Although EP E. coli are considered important agents of epidemic and endemic infantile diarrhea in developing countries, investigators in developed countries have expressed controversial points of view on endemic EP E. coli disease. Some of these investigators hold that EP E. coli should not be searched for during the examination of sporadic cases of diarrhea (19,20), others state that the role of EP E. coli in sporadic diarrhea remains to be proven (27), a third group expresses some reservation and stresses the need for special reports when EP E. coli is isolated from children with diarrhea (6), and finally there are those that accept and present convincing data on the association of EP E. coli and endemic infantile diarrhea (10,11).…”

Enterotoxigenicity of Enteropathogenic Serotypes of Escherichia coli Isolated from Infants with Epidemic Diarrhea

“…The enterotoxigenicity of these strains is evaluated under usual circumstances by in vitro tissue culture systems such as the Y1-adrenal cell and Chinese hamster ovary assays for LT and the suckling mouse assay for ST (34). The application of these tests to strains of enteropathogenic sero-types isolated from infants in nursery epidemics (20,45) or from sporadic cases collected over a period oftime (10,17,18,22) or to those obtained during surveys of dianrrheal subjects among specific groups (5,43,47) has shown that these strains only rarely elaborate enterotoxins. Conversely, many strains not included among the enteropathogenic serotypes which have been isolated from persons with acute diarrhea have been shown to be toxigenic by these assay techniques (44).…”

Comparative study of the nature and biological activities of bacterial enterotoxins

“…In contrast, other E. coli strains that are serologically related to the shigellae (Formal et al, 1978) are able to penetrate and multiply within colonic epithelial cells (Dupont et al, 1971). Strains of a third group recognised by serotype as enteropathogenic E. coli (EPEC), have been incriminated as agents of epidemic and endemic diarrhoea1 disease in infants (table VIII) but they are not enteroinvasive nor do they produce LT or ST (Gurwith, Wiseman and Chow, 1977). Many EPEC and some other E. coli intestinal isolates that produce the classic enterotoxins also make a cell-associated cytotoxin that can be neutralised by antitoxin prepared against the purified toxin of Sh.…”