ToxigenicEscherichia coli

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Abstract
Approximately 1000 children per year are admitted to Cook County Hospital with acute diarrhea. The etiologic agent cannot be found in the majority of cases. Six hundred strains of Escherichia coli were isolated from the stools of 29 children with diarrhea not yielding salmonella and shigella. Classic serotypes of enteropathogenic Esch. coli (EPEC) were found in nine of 29 cases. Esch. coli enterotoxin was assayed in an infant rabbit model; strains causing fluid accumulation and distention of the small bowel were found in 24 of 29 cases. This reaction could be induced by sterile filtrates as well as viable cultures. Two or three enterotoxin-positive strains were often present in the same stool specimen. Simple serotyping for EPEC identified pathogens in 31 per cent of cases of diarrhea whereas the animal model incriminated pathogenic strains in 83 per cent of cases.