Direct plating of faecal specimens on blood agar was compared with the use of enrichment culture for isolation of spp. from faeces during a large epidemiological study. Of enterotoxigenic strains isolated by direct plating, 89% were associated with acute diarrhoea and 7% with an episode of diarrhoea during the month before collection, but 79% of enterotoxigenic strains isolated only after enrichment were not associated with acute diarrhoea. With spp., as with intestinal pathogens, it appears that enrichment allows isolation of the bacteria when in low faecal concentrations likely to be found in convalescent patients, carriers and those with subclinical infection. The routine use of enrichment for isolation of faecal aeromonads, by detecting spp. in low numbers in patients without diarrhoea, is likely to confuse interpretation of epidemiological studies seeking to clarify the relationship between spp. and acute diarrhoea.


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