Immunofluorescent demonstration of enteropathogenic Escherichia coli in tissues of infants dying with enteritis

Intestinal sections from twenty-eight autopsies of infants with diarrhea were examined by immunofluorescent (IF) staining for the presence of enteropathogenic E. coli (EEC). EEC were identified in seventeen (61%) of these infants, and in more than 80% of them the serotype was 0111:B4. In only six of the sixteen cases identified by the retrospective staining had the causative organism been cultured during life or at autopsy. All seventeen infants showed inflammatory changes in the intestine, and in nine infants the changes were found to be severe. Escherichia coli were identified in the lungs in seven infants. It is suggested that IF staining for EEC is a useful method for arriving at a specific etiological diagnosis, when bacteriological findings during life were negative. In view of the evidence of spread of the bacteria beyond the intestinal mucosa, it is suggested that systemic treatment with antibiotics may be indicated in certain cases of gastroenteritis.