RESUMEN
To evaluate the epidemiological significance of HEp-2 cell-adherent Escherichia coli isolates in diarrheal disease, we performed a study with 513 Venezuelan infants with diarrhea and 241 age-matched controls to determine the prevalence of enteropathogenic E. coli (enteroadherent E. coli, enterotoxigenic E. coli, enteroinvasive E. coli, and enterohemorrhagic E. coli) and their correlation with O:H serotypes. E. coli isolates exhibiting localized and aggregative adherence in the HEp-2 cell assay were significantly more frequently isolated from the patients (8.5 and 26.9%, respectively) than from the controls (1.7 and 15%, respectively). This difference was significant for the group 0 to 2 months of age but for older infants. Regardless of age, E. coli isolates with diffuse adherence were found at similar frequencies in both the patients and the controls. A striking correlation between classic O serogroups and localized adherence was also observed. These findings confirm the pathogenic role of E. coli with localized and aggregative adherence in diarrheal disease, as well as the epidemiological importance of O:H serotyping for characterizing localized-adhering E. coli.