Patterns of loss of enterotoxigenicity by Escherichia coli isolated from adults with diarrhea: suggestive evidence for an interrelationship with serotype.

Enterotoxigenic Escherichia coli isolates obtained in Mexico from adult subjects with diarrhea and from healthy controls were examined for the production of heat-stable enterotoxin (ST) and heat-labile enterotoxin (LT) after serial passage in the laboratory. Isolates were found to be either stable for the production of ST and LT or unstable with respect to ST, LT, or both. Unilateral loss of either ST or LT production allowed classification of E. coli isolates into four groups according to stability/instability of enterotoxin production. Fewer serotypes, with more representative isolates, were in group I (stable) than in group IV (completely unstable). Isolates from Dacca, Bangladesh, could be similarly classified into stability groups. There is an apparent relationship between serotype, stability of enterotoxin production, particularly LT, and isolation from diarrhea cases as opposed to isolation from healthy controls.