No Evidence for a Role of Enteroadherent Escherichia coli in Diarrhea in Human Immunodeficiency Virus- Infected Patients

To the Editor-Diarrhea is an important problem in human im-munodeficiency virus (HIV)-infected patients. Although enteric pathogens are implicated in the majority of cases, the diarrhea remains unexplained in about one-third of patients [1]. Recently, Kotler et al. [2] described chronic bacterial enteropathy in AIDS patients that was possibly due to the presence of enteroadherent Escherichia coli. In addition, Mathewson et al. [3] detected such E. coli strains more often in HIV-infected patients with diarrhea than in HIV-negative patients with diarrhea. Enteroadherent E. coli have also been implicated as possible diarrheal pathogens in immunocompetent persons [4]. The bacterial adherence pattern to HEp-2 or HeLa cells discriminates diffuse adherent E. coli (DAEC), which display a pattern of well-separated, distinct bacte-ria with complete cell surface coverage; aggregative adherent E. coli (AAEC), which appear in clumps with a characteristi