Escherichia coli enteritis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Serge Korjian M.D., Yazan Daaboul, M.D.

Overview

E. coli enteritis may be classified according to the E. coli strain into Enterotoxigenic E. coli (ETEC), Enteropathogenic E. coli (EPEC), Enterohemorrhagic E. coli (EHEC), Enteroinvasive E. coli (EIEC), and Enteroaggressive E. coli (EAEC).

Classification

E. coli enteritis may be classified according to the involved E. coli strain into the following:

  • Enterotoxigenic E. coli - ETEC
  • Enteropathogenic E. coli - EPEC (including diffusely adherent E. coli (DAEC), a subtype of EPEC)
  • Enterohemorrhagic E. coli - EHEC
  • Enteroinvasive E. coli - EIEC
  • Enteroaggressive E. coli - EAEC

The following table demonstrates the distinguishing clinical features and pathophysiological mechanisms of various enteritis-causing E. coli strains:

Properties/Symptoms ETEC EPEC EHEC EIEC
Toxin LT/STa - Shiga or Vero toxin -
(Stx or VT)
Invasive - - - +
Intimin - + + -
Enterohemolysin - - + -
Stool Watery Watery, Bloody Watery, very bloody Mucoid, bloody
Fever Low + - +
Fecal leukocytes - - - +
Intestine involved Small Small Colon Colon, lower small
Serology Various O26, O111 & others O157:H7, O26, O111 & others Various
IDb High High Low High

a=LT, labile toxin; ST, stable toxin; b=ID, infective dose.
Adapted from Food and Drug Administration (FDA) - Bacteriological Analytical Manual Chapter 4A - Diarrheagenic Escherichia coli.[1]

References

  1. Feng, Peter; Weagant, Stephen D.; Jinneman, Karen (February 2011). "Bacteriological Analytical Manual Chapter 4A - Diarrheagenic Escherichia coli". www.fda.gov. Food and Drug Administration. Retrieved December 19 2015. Check date values in: |access-date= (help)