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Clinical Microbiology Reviews, January 1998, p. 142-201, Vol. 11, No. 1
0893-8512/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Diarrheagenic Escherichia coli

James P. Nataro* and James B. Kaper

Center for Vaccine Development, Departments of Medicine, Pediatrics, and Microbiology & Immunology, University of Maryland School of Medicine, Baltimore, Maryland 21201

Escherichia coli is the predominant nonpathogenic facultative flora of the human intestine. Some E. coli strains, however, have developed the ability to cause disease of the gastrointestinal, urinary, or central nervous system in even the most robust human hosts. Diarrheagenic strains of E. coli can be divided into at least six different categories with corresponding distinct pathogenic schemes. Taken together, these organisms probably represent the most common cause of pediatric diarrhea worldwide. Several distinct clinical syndromes accompany infection with diarrheagenic E. coli categories, including traveler's diarrhea (enterotoxigenic E. coli), hemorrhagic colitis and hemolytic-uremic syndrome (enterohemorrhagic E. coli), persistent diarrhea (enteroaggregative E. coli), and watery diarrhea of infants (enteropathogenic E. coli). This review discusses the current level of understanding of the pathogenesis of the diarrheagenic E. coli strains and describes how their pathogenic schemes underlie the clinical manifestations, diagnostic approach, and epidemiologic investigation of these important pathogens.

* Corresponding author. Mailing address: Center for Vaccine Development, Departments of Medicine and Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201. Phone: (410) 706-8442. Fax: (410) 706-6205. E-mail: jnataro{at}umaryland.edu.

Clinical Microbiology Reviews, January 1998, p. 142-201, Vol. 11, No. 1
0893-8512/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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