The species Escherichia coli is serologically divided in serogroups and serotypes on the basis of its antigenic composition (somatic or O antigens for serogroups and flagelar or H antigens for serotypes). Many strains express a third class of antigens (capsular or K antigens) that although important in pathogenesis only occasionally are used in serotyping.The species comprise intestinal and extraintestinal pathogens. The intestinal pathogens are also known as diarrheagenic E. coli (DEC) of which six categories have been characterized: enteropathogenic E. coli (EPEC), enterohaemorrhagic E. coli (EHEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAEC), and diffusely adhering E. coli (DAEC) (Nataro & Kaper 1998). Recently EPEC has been divided in typical EPEC (t-EPEC) and atypical EPEC (a-EPEC) . There are many differences between these categories but in routine they are defined by a few virulence markers (Table I). The extraintestinal pathogens (EXPEC) more frequent includes the strains associated with urinary tract infections (UPEC), neonatal meningitis (MAEC), and bacteremia. For an excellent review on DEC see Nataro and Kaper (1998) and on E. coli in general Gyles (1994). E. coli is also a very important veterinary pathogen (Gyles 1994 (WHO 1987). At this time already there were studies showing that at least some of these serogroups contained different diarrheagenic serotypes but their pathogenic diversity only latter became really clear (Nataro & Kaper 1998).During the last 10 years we have studied most of the EPEC O serogroups in regard to DEC categories, serotypes, clones, and genetic relationships. The purpose of this article is to review these characteristics. It is based on the study of 805 strains of serogroups O26, O55, O86, O111, O114, O119, O125, O126, O127, O128, and O142 most of which were isolated in São Paulo from children with diarrhea between 1970 and 1990. All strains were studied in regard to adhesion patterns, virulence genes implicated in the definition of the DEC category, and serotypes. The strains of serogropus O55, O111, and O119 were also studied by MLEE and a representative number of strains of serogroups O86, O127, O128, and O142 were studied by ribotyping. Serogroup O26 was studied by RAPD. Potential virulence factors were studied in a representative number of strains of the DEC categories detected (Campos et al. 1994, Valle et al. 1997, Gonçalves et al. 1997, Monteiro-Neto et al. 1997, Dias 1998, Valle 1998, Ghilardi et al. 2003. Other studies performed will be mentioned during the review.
DEC CATEGORIES IN THE EPEC O SEROGROUPSThe DEC categories and the number of strains of each category as well the number of avirulent strains are shown in Table II. Typical EPEC was the most frequent category followed by EAEC, atypical EPEC, ETEC, and EHEC. EIEC and DAEC were not found among the strains tested. A number of strains showed the diffuse adherence (DA) pattern but they proved to belong to the ETEC, EAEC, and atypical EPEC categories. The n...