Pathogenicity of Escherichia coli recovered from food.

In Western nations, pathogenic biotypes are sporadically encountered in foodborne gastroentetis. Cholera, dysentery, and chronic ulcerative colitis syndromes are recognized. E. coli has been associated on the average with 2% of annual food outbreaks and 5% of total cases. In developing nations, the incidence may be greater. In contrast with Salmonella and Shigella, significance can be assessed only by fulfillment of Koch's postulates. Preliminary studies using vascular permeability reaction for the detection of heart-labile toxin and the Sereny keratoconjunctivities test for demonstration of invasiveness indicate limited incidence of these pathogenicity markers in cultures from foods. Two per cent of isolates from cheeses involved in recent outbreaks were toxigenic; 14% were invasive. Corresponding values for food isolates not associated with illness were 10 and 0, respectively. To facilitate examination of multiple isolates, 10 may be pooled for the detection of heat-labile toxin, and 5 for invasiveness. Present model pathogenicity systems require standardization, estimation of specificity and sensitivity limits, examination by collaborative study, and ascertainment of human equivalence. Supplemental tests include capacity for colonization of intestinal epithelium and intracellular growth. Stereotypes based upon serology, host range, and recognized toxic factors may require modification.