Escherichia Coli

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Contents 1 More Specific Terms 2 Pathology 3 Laboratory 4 Management 5 More General Terms 6 References

More Specific Terms

• Escherichia coli O157:H7

Pathology

• endotoxin-mediated sepsis

• bacteremia originates from the bowel, biliary tree or urinary tract

• toxin-mediated enteritis

• traveler's diarrhea
• infantile diarrhea
• dysentery
• E. coli O157:H7 ( hemolytic uremic syndrome)

• urinary tract infection ( UTI)

• cystitis
• pyelonephritis
• largely sexually active women
• most common etiologic agent of UTI

• abdominal abscesses
• neonatal meningitis associated with K1 capsular antigen
• rare disorders

• adult meningitis
• pneumonia
• endocarditis

Laboratory

• gram staining is non-specific
• culture of organism from a site that is generally sterile
• E coli O157:H7 is cultured on sorbitol agar
• carbepenem-resistance (India, Pakistan) conferred by New Delhi metallo-beta-lactamase 1 (emergence in 2010)

Management

• uncomplicated cystitis in healthy non- pregnant women

• Bactrim DS, 2 tablets once

• more severe infection

• ampicillin 3 g IV every 4 hours plus gentamicin 1 mg/kg IV every 8 hours
• ciprofloxacin 500 mg PO every 12 hours

• 2 weeks of therapy for abscesses
• gastroenteritis ( E. coli O157:H7)

• avoid antimotility agents-> slows elimination of bacteria
• treatment with antibiotics increases risk of hemolytic-uremic syndrome

More General Terms

• Escherichia

References

1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 226
2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 498, 535
3. Prescriber's Letter 7(8):45 2000
4. Journal Watch 21(18):149, 2001 Mohle-Boetani JC et al, Escherichia coli O157 and Salmonella infections associated with sprouts in California, 1996-1998. Ann Intern Med 2001, 135:239 PMID: [1]
5. E. Coli Infections: NIH Institute and Center Resources [2]

Escherichia coli