Serotypes of enterotoxigenic Escherichia coli in Thailand and the Philippines

The serotypes of 386 enterotoxigenic Escherichia coli (ETEC) isolated from 82 individuals with and without diarrhea in Thailand and the Philippines were determined. The 136 strains producing both heat-labile toxin (LT) and heat-stable toxin (ST) belonged to 12 different O serogroups; however, 83% (113/136) were of one of four serogroups (O6, O8, O25, and O78), and 76% of (104/136) belonged to one of seven O:K:H serotypes. Only 14% (28/196) of LT-only-producing ETEC belonged to serogroups most common among LT and ST strains, and these 196 strains belonged to 35 different O:K:H serotypes. Three O serogroups (O20, O27, and O78) accounted for 94% (52/54) of strains producing only ST. Although only 4% (2/54) of ST-only ETEC belonged to the seven serotypes most commonly found among strains which produced LT and ST, 85% of ETEC belonged to three other serotypes, O20:K?:H21, O27:K?:H7, and O78:H-. A total of 46% (37/80) of ETEC of serotypes O6:H16, O8:H9, O25:H42, and O78:H12 were resistant to two or more antibiotics in comparison to 68% (208/306) of ETEC of other serotypes (P less than 0.001). In Thailand and the Philippines, E. coli which produced LT and ST or ST alone, but not those which produced LT alone, were restricted in their O:K:H serotypes.