Escherichia coli serotyping and disease in man and animals

Serotyping of Escherichia coli is useful, but complex, with 173 O antigens, 80 K antigens, and 56 H antigens, which can all be subdivided into partial antigens. The O, K, and H antigens can be found in nature in many of the possible combinations. The final number of E. coli serotypes is very high, 50,000-100,000 or more. The number of frequent pathogenic serotypes is, however, limited. Two main groups of such frequent serotypes are (i) serotypes from diarrhoeal disease and (ii) serotypes from extraintestinal disease. Serotypes from diarrhoeal diseases are mostly species specific, and could at present be used as epidemiological markers for bacterial clones equipped with special virulence markers, such as toxins and adhesins. Their O-antigen lipopolysaccharides may be regarded as virulence factors. These strains are not inhabitants of the normal intestine. Serotypes from extraintestinal diseases constitute a different set of clones, which are good colonizers of the intestinal tract, that under certain conditions succeed in invading host tissues. They are characterized by virulence factors different from those found in strains from diarrhoeal disease. Thus, the two groups of pathogenic E. coli are both composed of a limited number of clones for which the O:K:H serotypes are excellent, although not faultless, markers.