[Diagnosis of entero-invasive Escherichia coli associated with diarrhea]

Sixteen Escherichia coli strains isolated from diarrhea patients, characterized as enteroinvasive (EIEC) by the keratoconjunctivitis test (Sereny test), and 15 non-EIEC strains, were studied. The aim of this study was to establish a possible correlation between the Sereny test and several other tests as enzyme-linked immunosorbent assay (ELISA) and biochemical markers, which are more easily accessible to general practice laboratories. Strains were assayed for the virulence marker antigen (the outer membrane proteins) by direct ELISA, biochemical tests, antimicrobial susceptibility profile and serotyping. Mean optical density (OD) values in the ELISA were 2.018 +/- 0.336 for EIEC strains, and 0.569 +/- 0.283 for non-EIEC strains. Difference between the OD values of the two groups was found to be significant at p < 0.01 by the one-tailed Student's test. One (6.2%) of the 16 Sereny test-positive strains was negative by ELISA. Considered as a group, the EIEC strains are rather heterogeneous in their biochemical characteristics. Lysine decarboxylase test appeared as the most relevant assay, since all EIEC strains were negative for this enzyme, whereas 66.7% of non-EIEC strains were positive. Other helpful tests performed for strain characterization were: gas production from glucose and from glycerol, sucrose and salicin fermentation, and esculin hydrolysis (p < 0.01). However, strains behaviour was variable with these tests. Differences between both groups of strains with regard to mucate utilization and dulcitol fermentation was significative only to a 5% level. Antibiotic sensitivity patterns showed differences between EIEC and non-EIEC strains: 37.5% of the former vs 80% of the latter, were resistant to at least four of the antibiotics tested.(ABSTRACT TRUNCATED AT 250 WORDS)