A modern view of diarrheagenic <i>Escherichia coli</i> — a causative agent of acute intestinal infections

Acute intestinal infections caused by Escherichia coli affect the gastrointestinal tract, leading to development of diarrheal syndrome, intoxication, and, in some cases, generalization of the pathological process. Diarrheagenic E. coli (DEC) strains differ from non-pathogenic (commensal) strains by the presence of specific virulence genes, pathogenesis characteristics, clinical and epidemiological manifestations of the diseases they cause. Based on the virulence determinants, 6 pathogenic DEC groups are distinguished: enteropathogenic, enterotoxigenic, enteroinvasive, shiga toxin-producing, enteroaggregative, diffusely adherent E. coli strains. The strains of each pathogenic group have distinct pathogenic mechanisms responsible for inflammatory processes in different compartments of the human intestine, which are clinically manifested as diarrheal syndrome. This paper presents a review of current scientific publications on epidemiology, pathogenesis, genetic properties, and antigenic characteristics of pathogenic E. coli. Although DEC biological properties have been extensively studied, many aspects require deeper insights to develop effective laboratory-based diagnostic techniques, treatment methods, epidemic control measures, and prevention strategies against E. coli infections.