Studies on the Epidemiology of Escherichia coli Infections. IV. Evidence for a Nosocomial Flora*

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Abstract
The E. coli serogroups that are most often responsible for extraintestinal infections, 04, 06, 075 are concentrated within the hospital and constitute a nosocomial flora. The remaining serologic groups are distributed at random throughout the hospital and in the community. Group 01 is an exception in that it appears to be predominantly a community strain. Groups 04, 06 and 075 caused urinary tract infection with greater frequency than strains of other serologic groups. These organisms also resemble Pseudomonas Klebsiella-aerobacter, Proteus, Citrobacter in their association with the hospital and in their propensity to cause urinary tract infections. They tend to persist within the gastrointestinal tract and may account, in part, for increased hospital prevalence. E. coli urinary tract infections are usually associated with colonization in the stool by the same organism. Urinary tract infections caused by other gram-negative organisms are usually acquired from external sources.