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Abstract
This chapter discusses two new enteric pathotypes—namely, enteroaggregative E.coli (EAEC) and diffusely adherent E.coli (DAEC). These pathotypes exhibit distinctive clinical, epidemiologic, and pathogenetic features. EAEC are currently defined as E.coli that does not secrete the enterotoxigenic E.coli (ETEC) heat-labile or heat-stable enterotoxins, and which adheres to HEp-2 cells in an aggregative (AA) pattern. The AA pattern is recognized by the distinctive stacked brick autoagglutination of the bacteria either on the surface of the HEp-2 cells or on the glass substratum. This definition essentially encompasses both pathogenic and nonpathogenic bacteria. DAEC is defined by its ability to adhere to HEp-2 cells in a diffuse pattern, with little adherence to the substratum. No DAEC outbreak has yet been documented, and volunteer studies using two different DAEC strains also does not result in diarrhea. Thus resulting in little knowledge regarding the pathogenetic and clinical characteristics of DAEC. Presence of the DA pattern in the HEp-2 assay defines DAEC. Studies suggest that DAEC is linked to diarrhea only outside infancy.
Published Version
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