Updates on defining and detecting diarrheagenic Escherichia coli pathotypes

Curr Opin Infect Dis. 2020 Oct;33(5):372-380. doi: 10.1097/QCO.0000000000000665.


Purpose of review: Several types of Escherichia coli cause acute diarrhea in humans and are responsible for a large burden of disease globally. The purpose of this review is to summarize diarrheagenic Escherichia coli (DEC) pathotype definitions and discuss existing and emerging molecular, genomic, and gut microbiome methods to detect, define, and study DEC pathotypes.

Recent findings: DEC pathotypes are currently diagnosed by molecular detection of unique virulence genes. However, some pathotypes have defied coherent molecular definitions because of imperfect gene targets, and pathotype categories are complicated by hybrid strains and isolation of pathotypes from asymptomatic individuals. Recent progress toward more efficient, sensitive, and multiplex DEC pathotype detection has been made using emerging PCR-based technologies. Genomics and gut microbiome detection methods continue to advance rapidly and are contributing to a better understanding of DEC pathotype diversity and functional potential.

Summary: DEC pathotype categorizations and detection methods are useful but imperfect. The implementation of molecular and sequence-based methods and well designed epidemiological studies will continue to advance understanding of DEC pathotypes. Additional emphasis is needed on sequencing DEC genomes from regions of the world where they cause the most disease and from the pathotypes that cause the greatest burden of disease globally.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Diarrhea / microbiology*
  • Enteropathogenic Escherichia coli / genetics
  • Enteropathogenic Escherichia coli / isolation & purification
  • Enterotoxigenic Escherichia coli / genetics
  • Escherichia coli / classification
  • Escherichia coli / genetics*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / diagnosis*
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Gastrointestinal Microbiome / genetics
  • Genes, Bacterial
  • Genomics
  • Humans
  • Polymerase Chain Reaction
  • Virulence
  • Virulence Factors


  • Virulence Factors