Serotype diversity as a drawback in the surveillance of Shiga toxin-producing Escherichia coli infections in Brazil

Shiga toxin-producing Escherichia coli (STEC) strains have emerged worldwide as an important cause of gastrointestinal diseases and complications in humans (Nataro & Kaper, 1998). Diarrhoea and haemolytic uraemic syndrome (HUS) associated with STEC have also been reported in patients with acquired immunodeficiency syndrome (AIDS) (Garcia Lara et al., 2000; Suthienkul et al., 2001; Pouessel et al., 2004). Although O157: H7 is the prominent STEC serotype, in the last decade many non-0157 STEC strains were also reported in diarrhoea-associated illnesses and complications. Some outbreaks caused by non-O157 STEC strains have already been reported, although in many countries these organisms are more frequently associated with sporadic cases of diarrhoea, haemorrhagic colitis and HUS (Brooks et al., 2004; Pradel et al., 2000).