• We studied 15 cases of severe protracted diarrhea due to a strain of Escherichia coli serotype 0111:K58:H2. The clinical features of these patients were compared with those of 18 patients infected with other enteropathogenic serotypes of E coli. More patients infected with 0111:K58:H2 strains had been treated with ampicillin (six of 15 v one of 18), and more were dehydrated (nine of 15 v two of 18) and in a toxic condition (nine of 15 v three of 18). The number of stools per day (14.1 v 6.8), the total duration of the diarrhea (24.7 v 7.0 days), and the frequency of relapses (six of 15 v none of 18) were also greater in these patients. A large number had a serum sodium level below 135 mEq/L (ten of 15 v none of 18) and a serum protein level below 11 mEq/L (six of 15 v none of 18). At least two infants Infected with E coli 0111:K58:H2 manifested a urinary tract infection. All 15 strains of E coli 0111:K58:H2 studied adhered to HeLa cell lines, whereas none of the strains Isolated from the second group were adherent. None of the 0111:K58:H2 strains produced enterotoxins, and they were negative in the Serény test. All adherent strains were resistant to many antibiotics.
Lacroix J, Delage G, Gosselin F, Chicoine L. Severe Protracted Diarrhea due to Multiresistant Adherent Escherichia coli. Am J Dis Child. 1984;138(7):693–696. doi:10.1001/archpedi.1984.02140450075023