Chapter 64 - Diarrhoeagenic Escherichia coli

Abstract

First identified in 1885 from the faeces of healthy individuals, Escherichia coli is a predominant facultative anaerobe of the human colonic flora. Although most E. coli isolates are harmless intestinal commensals, several highly adapted clones have the ability to cause a spectrum of human diseases, including (i) intestinal disease (gastroenteritis), (ii) urinary tract infection (UTI, which may sometimes evolve to haemolytic-uremic syndrome or HUS), and (iii) neonatal meningitis. E. coli strains responsible for enteric disease are further separated into enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enterohaemorrhagic E. coli (EHEC), enteroaggregative E. coli (EAEC), Shiga-toxin-producing enteroaggregative E. coli (STEAEC), enteroinvasive E. coli (EIEC), diffusely adhering E. coli (DAEC), and adherent invasive E. coli (AIEC), of which ETEC, EPEC, EHEC, EAEC, STEAEC, EIEC and DAEC are collectively known as diarrhoeagenic E. coli. This chapter focuses on diarrhoeagenic E. coli in relation to their clinical manifestation, pathogenesis, epidemiology and detection.