The role of Shiga-toxin-producing Escherichia coli in hemorrhagic colitis and hemolytic uremic syndrome.

The Shiga-toxin-producing E. coli represent a major class of pathogens that have been defined over the last twenty years. They cause distinctive clinical manifestations such as afebrile bloody diarrhea with severe abdominal pain (hemorrhagic colitis) and microangiopathic hemolytic anemia with renal failure (hemolytic uremic syndrome). The most common Shiga-toxin-producing E. coli is serotype O157:H7, although at least one hundred different serotypes share the virulence traits and clinical manifestations with this organism. Understanding the pathophysicology, improving diagnostic tools, and developing a treatment strategy are important areas of ongoing investigations.