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Infections caused by Shiga toxin–producing strains of Escherichia coli (STEC) are a major public health problem. In the U.S., O157:H7 is the most common STEC; worldwide, however, other STEC strains underlie a substantial proportion of such disease. Since 1992, clinical laboratories in Connecticut have been required to report all E. coli O157 infections to that state's Department of Health, and since 2000, they have also been required to submit Shiga toxin (ST)-positive broth cultures to the State Laboratory for confirmation and typing of the causative organism.
From 2000 through 2009, 663 STEC infections were reported. E. coli O157 was detected in 271 of these infections by culture, as well as in 163 of the 392 infections with ST-positive br…