Methods available for the detection of Escherichia coli O157 in clinical, food and environmental samples

Because of the potential severity of infections caused by Escherichia coli O157 it is important that the most sensitive laboratory methods are used both for outbreak investigation and surveillance. Selective culture of E. coli O157 remains the detection method of choice, particularly in investigation of outbreaks where strains isolated from various sources may need to be compared by various typing methods. Strains of E. coli O157 do not normally ferment sorbitol, whereas many other serogroups of E. coli do, and sorbitol MacConkey agar, or modified forms of this medium, have become widely used for their isolation. Detection of small numbers of E. coli O157 may be facilitated by enrichment culture which may include a recovery period during which selective agents are not added to the medium. Immunomagnetic separation of E. coli O157 after enrichment culture enhances sensitivity still further and has the potential to be fully automated. Alternatives to culture include immunoassays and PCR, both of which are available as commercial detection kits. The last 15 years has seen many advances in detection of E. coli O157 and has been accompanied by a plethora of reports in the scientific literature. However, it is an area which is continually developing and we are still far away from a universally accepted method for this purpose.