PROSPECTIVE-STUDY OF VEROCYTOTOXIN-PRODUCING, ENTEROAGGREGATIVE AND DIFFUSELY ADHERENT ESCHERICHIA-COLI IN DIFFERENT DIARRHEAL STATES

One hundred and eighty-one stool specimens from patients with various types of diarrhoea (135 patients) or from non-diarrhoeal controls (23 acute medical patients, 23 inflammatory bowel disease in remission) were investigated using a colony-blot DNA hybridization assay for the presence of Vero cyto toxin-producing (VTEC), enteroaggregative (EAggEC) and diffusely adherent (DAEC) Escherichia coli. Twelve patients had probe-positive EAggEC in the stool and 8 of these had diarrhoea, 6 following recent travel. Eight patients had DAEC, 7 of whom had travellers' diarrhoea. Six of 10 (60 %) travellers with gastroenteritis, but without a recognized enteric pathogen, were positive for EAggEC (4) or DBEC (2). Five of 10 (50 %) travellers with gastroenteritis related to a recognized enteric pathogen also had DAEC identified in their stool. Of the 23 acute medical control patients 11 had been abroad, 4 of these were immigrants and had EAggEC. VTEC were not found and, with one exception, immunoassays for antibodies to E. coli 0 157 and 0 2 lipopolysaccharides were negative.