Epidemiologic Assessment of the Relevance of the So-Called Enteropathogenic Serogroups of Escherichia coli in Diarrhea

Since the early 1950's the concept has evolved that certain serogroups of Escherichia coli, commonly designated enteropathogenic, are like shigellae and salmonellae, inherent enteric pathogens. This view is so widely held that many clinicians regard diarrhea associated with these serogroups as a distinct clinical entity, and many large hospitals include, as diagnostic laboratory routine, a search for these serogroups in stools from patients, particularly infants, with diarrhea. In the light of knowledge obtained in the last 10 years about virulence plasmids and about mechanisms by which Esch. coli causes diarrhea, we attempt to evaluate this concept through a historical.