The Journal of Medical Microbiology, Vol 47, Issue 12 1039-1045, Copyright © 1998 by Society for General Microbiology

JOURNAL ARTICLE

New perspectives on the role of Escherichia coli O157:H7 and other enterohaemorrhagic E. coli serotypes in human disease

P. N. Goldwater and K. A. Bettelheim
Microbiology and Infectious Diseases Department, Women's and Children's Hospital, North Adelaide, South Australia, Australia.

This review compares the rates of detection of non-0157:H7 enterohaemorrhagic Escherichia coli (EHEC) with EHEC 0157:H7 in outbreaks and sporadic cases of human disease by analysing Australian data and the world literature. Numerous outbreaks of disease have been attributed to EHEC 0157:H7. In many studies, isolation rates of this organism have been low and attempts to seek other EHEC have not been made. Ease of isolation and identification of the 0157:H7 serotype may have given the impression that this serotype was the sole organism responsible for the outbreaks. Careful review and analysis shows that serotypes other than 0157:H7 also play an important role in human disease. Evidence is presented from several overseas outbreaks described in the literature, as well as from investigations of the Adelaide O111:H- outbreak, that suggests an association between severity of disease and multiple infecting serotypes. While not diminishing the role of the 0157:H7/H- clone, this review indicates that other serotypes can be responsible for outbreaks as well as cases of sporadic human disease. The current focus on 0157:H7 has major implications in terms of diagnosis, the food industry and human health.

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