<unk>  <unk>  or<unk>  are a pathotype of<unk> <unk>  which cause acute and chronic diarrhea in both the developed and developing world. They may also cause urinary tract infections.<unk>  are defined by their "stacked-brick" pattern of adhesion to the human laryngeal epithelial cell line HEp-2. The pathogenesis of<unk>  involves the aggregation of and adherence of the bacteria to the intestinal mucosa, where they elaborate enterotoxins and cytotoxins that damage host cells and induce inflammation that results in diarrhea.<unk>  is now recognized as an emerging enteric pathogen. In particular,<unk>  are reported as the second most common cause of traveler's diarrhea, second only to Enterotoxigenic E.<unk> , and a common cause of diarrhea amongst pediatric populations. It has also been associated with chronic infections in the latter, as well as in immunocompromised hosts, such as HIV-infected individuals. Awareness of<unk>  was increased by a serious outbreak in Germany during 2011, causing over 5000 cases and at least 50 fatalities. The pathogen responsible was found to be an<unk>  O104:H4 strain which was lysogenized by a Shiga toxin encoding phage (typically associated with Shiga toxin-producing<unk> <unk> , which often encode the adhesin intimin). The putative cause of the outbreak were sprouted fenugreek seeds. Strains of<unk>  are highly genetically heterogeneous, and the identification of virulence factors important for pathogenesis has proven difficult. Many<unk>  encode a transcriptional factor named aggR (aggregative regulator), part of the AraC family of transcription activators. AggR regulates many plasmid, as well chromosomally encoded, virulence factors, that include genes implicated in aggregative adherence fimbriae biogenesis and toxin production. Several toxins have been linked to<unk>  virulence, including ShET1 (Shigella enterotoxin 1), Pet (plasmid‐encoded toxin), and EAST-1. However, further studies of these factors have failed to elucidate their role in pathogenesis.
Enteroaggregative Escherichia coli
Enterotoxigenic Escherichia coli
Enteroinvasive Escherichia coli
Salmonella
Escherichia coli O157:H7
Clostridioides difficile 
Campylobacter upsaliensis
Yersinia enterocolitica