A number of distinct serologic types of Escherichia coli have been shown to be responsible for institutional outbreaks as well as sporadic cases of diarrhea in newborn and young infants. In this laboratory an extensive nursery outbreak of diarrhea was studied in 1953 and was shown to be caused by E. coli O111:B4.1 The etiologic role of this organism was evident by its regular presence in virtually pure culture in the stools during the acute stage of the disease and by the simultaneous disappearance of both symptoms and organisms under effective antibiotic therapy. It was observed in the majority of cases that, after therapy was discontinued, the organisms recurred in large numbers in the stools in the absence of renewed diarrheal symptoms, a finding briefly mentioned by others.* Thus, the presence of asymptomatic carriers indicated the pattern of spread of the infection and, as noted also by several
STULBERG CS, ZUELZER WW, NOLKE AC, THOMPSON AL. Escherichia Coli O127:B8, a Pathogenic Strain Causing Infantile Diarrhea: I. Epidemiology and Bacteriology of a Prolonged Outbreak in a Premature Nursery. AMA Am J Dis Child. 1955;90(2):125–134. doi:https://doi.org/10.1001/archpedi.1955.04030010127001
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