An outbreak of diarrhea of the newborn in a premature nursery has been described. The results of bacteriologic, epidemiologic, and therapeutic studies identified the etiologic agent as a specific type of coliform organism, Escherichia coli O-111, B4.This organism was isolated in virtually pure culture from the stools of 24 premature infants who developed diarrhea. It was not found in premature infants who were effectively isolated and who remained clinically well. E. coli O-111, B4 was not present in the stools of patients before their illness started but was isolated, again in practically pure culture, almost simultaneously with the onset of symptoms.Neomycin proved to be an effective chemotherapeutic agent, both in eliminating the organism from the stools and causing the cessation of symptoms within a short time of each other.Three patients died. Their case histories and post-mortem findings with relation to the pathogenesis of the disease are discussed.
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