Human Diarrheal Infections: Diagnosis of Diarrheagenic Escherichia coli Pathotypes

Diarrheagenic E. coli as a pathotype deserves special attention since it is responsible for up to 30–40 % of acute diarrhea episodes in children in developing countries; these bacteria are being recognized as important pathogens even in the developed world. However, the importance of diarrheagenic E. coli is underestimated due to currently available diagnostic methods with limited applications in routine laboratories, especially in developing countries. Several approaches have been described and applied for the diagnosis of diarrheagenic E. coli strains. Thus, this chapter presents general concepts about E. coli diagnosis and recent advances in isolation, screening, and identification procedures, in which mass spectrometry and whole genome sequencing are also discussed. It is important to mention that the method of choice will depend on the facilities available in each laboratory, taking into account the sensitivity, specificity, reproducibility, reliability, cost, infrastructural resources, and technical skills required for each method. Apart from diagnostic methods, an overall picture of advances in the Americas in the diagnosis of pathogenic E. coli strains is also included, considering the differences between countries regarding the epidemiology of diarrhea caused by E. coli strains.