NEW PERSPECTIVES ON THE ROLE OF ESCHERICHIA-COLI O157 H7 AND OTHER ENTEROHEMORRHAGIC ESCHERICHIA-COLI SEROTYPES IN HUMAN-DISEASE/

This review compares the rates of detection of non-O157:H7 enterohaemo rrhagic Escherichia coli (EHEC) with EHEC O157:H7 in outbreaks and spo radic cases of human disease by analysing Australian data and the worl d literature. Numerous outbreaks of disease have been attributed to EH EC O157:H7. In many studies, isolation rates of this organism have bee n low and attempts to seek other EHEC have not been made. Ease of isol ation and identification of the O157:H7 serotype may have given the im pression that this serotype was the sole organism responsible for the outbreaks. Careful review and analysis shows that serotypes other than O157:H7 also play an important role in human disease. Evidence is pre sented from several overseas outbreaks described in the literature, as well as from investigations of the Adelaide O111:H- outbreak, that su ggests an association between severity of disease and multiple infecti ng serotypes. While not diminishing the role of the O157:H7/H- clone, this review indicates that other serotypes can be responsible for outb reaks as well as cases of sporadic human disease. The current focus an O157:H7 has major implications in terms of diagnosis, the food indust ry and human health.