E. coli Serotype D433: Occurrence in Intestinal and Respiratory Tracts, Cultural Characteristics, Pathogenicity, Sensitivity to Antibiotics.

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Abstract
Escherichia coli serotype D433, was recovered from 5 sporadic cases of infantile diarrhea; it was present in the feces of all, in the nasopharynx of 2 and in the throat of 1 of these patients. The presence of this micro-organism in the upper respiratory tract renders air-borne transmission particularly in nurseries, a distinct possibility. E. coli D433 was not found in 33 additional patients suffering from diarrheal disease, or in 23 premature normal infants harboring E. coli during the 1st wk. of life, or in 28 patients suffering from various E. coli in-fections of organs other than the intestinal tract. Ingestion of serotype D433 of E. coli resulted in diarrhea and wt. loss in a 2-mos.-old infant, whereas a similar exposure to the patient''s own strain of E. coli failed to do so. Terramycin therapy was followed by clinical improvement and the disappearance of E. coli serotype D433. 4 strains received from England and 5 isolated at Buffalo were completely or considerably inhibited on SS agar and desoxycholate citrate agar but grew well on Endo agar. These selective culture media should not be used exclusively in examinations for the presence of this organism. The above-mentioned 9 strains were found to be highly susceptible to aureomycin, chloromycetin, terramycin, and polymyxin B (10 [mu]g./ml.), but less so to streptomycin. None of the strains was susceptible to bacitracin (100 U./ml.) and penicillin (500 U./ml.). Treatment with aureomycin of 4 patients resulted in prompt disappearance of serotype D433 and clinical improvement; the 5th patient was treated with sulfadiazine and penicillin and continued to excrete this micro-organism in the feces.

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