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註釋Why do bacteria cause disease in humans? Is disease adaptive for the pathogen or just a biological accident? And if disease is adaptive, how does it influence the long-term or short-term fitness for the pathogen and how is it sustained in nature? In this chapter we try to address these questions by dissecting the molecular mechanisms of both pathogenicity and evolution of Escherichia coli, one of the most notorious and versatile human pathogens, which is also one of the most common human commensal bacteria. We examine how and, more importantly, why horizontally transferred virulence factors and pathoadaptive mutations are acquired by and sustained by certain E. coli lineages. The evolution of pathogenicity is thus reviewed from the perspective of E. coli ecology, with the discussion of various models of virulence evolution in general and some of its paradoxes. We hope to shed light from the evolutionary perspective on how professional, accidental, or opportunistic pathogens might be defined.