Escherichia Coli Strains as Etiological Agents of Diarrheal Disease

AGKEAT DEAL of evidence has been com¬ piled during the past 15 years indicating that certain strains of Escherichia coli are in¬ timately associated with diarrhea of the new¬ born.These E. coli strains are associated not only with cases of diarrhea occurring in hospi¬ tal nurseries in the newborn but with sporadic cases occurring outside the hospital.In spite of the evidence, there is considerable doubt in the minds of many highly competent individuals that this association is one of cause and effect.This paper reviews the currently available evidence concerning these organisms in an at¬ tempt to shed further light on this rather complex situation.The idea that at least some strains of E. coli might be a causative agent of epidemic diar¬ rhea of the newborn is not a new one.Adam described a biochemical type of E. coli which he felt was responsible for such an outbreak in Germany in the 1920's (1).He labeled his strain "dyspepsi-coli."However, biochemical variations do not permit a satisfactory clas¬ sification of the genus Escherichia, and the work was not followed up.Bray (#), working in Great Britain in the early forties, noted that the seminal odor which characterized the stools of infants with summer diarrhea originated from the E. coli found in them.Serologic studies showed the coli from Dr.