Should all poop samples be tested for dangerous E. coli?

There was this one time, Chapman came to Manhattan (Kansas) and lasted one quarter of a Kansas State football game before rushing home with explosive diarrhea.

My whiny kid didn’t help either.

He spent the rest of the visit holed up downstairs, sucking back Gatorade and sitting on the toilet.

When he got back to North Carolina he had the wherewithal to donate a stool sample, and eventually found out he was part of a state-wide antibiotic-resistant campylobacter outbreak.

In light of the German-based E. coli O104 outbreak in raw sprouts last year, researchers in Germany and Sweden are now calling for all stool samples from patients with diarrhea to be tested for enteropathic E. coli.

Writing in Eurosurveillance, the authors state:

Following an outbreak of enterohaemorrhagic Escherichia coli (EHEC) in Germany 2011, we observed increases in EHEC and non-EHEC E. coli cases in Bavaria. We compared the demographic, clinical and laboratory features of the cases reported during the outbreak period, but not related to the outbreak, to the cases reported before and after. The number of EHEC and non-EHEC E. coli cases notified per week during the outbreak was fivefold and twofold higher respectively, compared to previous years. EHEC cases notified during the outbreak were more often reported with bloody diarrhoea, and less often with unspecified diarrhoea, compared to the other periods. They were more often hospitalised during the outbreak and the following period compared to the period before. Their median age (26.5 years, range: 0–90) was higher compared to before (14.5 years, range: 0–94) and after (5 years, range: 0–81). The median age of non-EHEC E. coli cases notified during the outbreak period (18 years, range 0–88) was also higher than before and after (2 years, p<0.001). The surveillance system likely underestimates the incidence of both EHEC and non-EHEC E. coli cases, especially among adults, and overestimates the proportion of severe EHEC cases. Testing all stool samples from patients with diarrhoea for enteropathic E. coli should be considered.