Tenner SM, Yadven MW, Kimmel PL. Acute pyelonephritis. Preventing complications through prompt diagnosis and proper therapy. Postgrad Med. 1992 Feb 1. 91(2):261-8. [Medline]. . coli with certain E. coli virulence factors, such as the production of hemolysin, capsule polysaccharide, colicin V, aerobactin, type 1 fimbriae, P fimbriae, and even the presence of certain adhesion operons (pap, sfa, afa, hly). However, it is not possible as yet to relate any of these putative E. coli virulence determinants or even a group of determinants with indigenous E. coli extraintestinal disease.Johnson JR. Virulence factors in Escherichia coli urinary tract infection. Clin Microbiol Rev. 1991 Jan. 4(1):80-128. [Medline]. The clinical findings of E. coli pneumonia are nonspecific359 and are similar to those of bacterial pneumonia of any etiology in the respective age group. The diagnosis is usually based on recovery of the causative organism from the blood.
. Escherichia coli sternal osteomyelitis after open heart surgery. Heart Lung. 1995 Mar-Apr. 24(2):177-8. [Medline]. Empiric antimicrobial therapy must be comprehensive and cover all likely pathogens in the context of the clinical setting. However, given the broad use of antibiotics in hospitals, a study was performed to determine the relationship between hospital use of 16 classes of antibacterial agents and the incidence of quinolone-resistant E coli isolates. The results revealed that although the level of hospital use of quinolones influenced the incidence of quinolone resistance in E coli hospital isolates, the consumption of 2 other classes of antibiotics, cephalosporins and tetracyclines, is also associated with quinolone resistance.  Escherichia coli, commonly known as E. coli, is another pathogen potentially found in drinking water supplies. Escherichia coli are bacteria found in human or animal intestines. Toxic strains of E. coli can cause serious illness, which can result in severe diarrhea and even kidney damage in some cases.34 The bacteria can potentially be passed to humans through contaminated water supplies. If any E. coli is detected in UK drinking water supplies, an investigation will be undertaken to identify and eliminate the source. Escherichia coli in the UK is associated considerably more with contaminated food than with water supplies, but outbreaks have been detected in water, particularly from private supplies.28 The bacteria itself will usually be removed during chlorination and routine disinfection of water supplies, therefore this form of treatment is usually effective for removing E. coli in drinking water. Monitoring for coliforms and E. coli itself is routinely done in assessing water quality as they are a good indication on the presence of pathogens, and microbiology of, a given supply, and thus, in themselves, they are a good measure of overall water quality.35
Since the late 1990s, multidrug-resistant Enterobacteriaceae (mostly E coli) that produce extended-spectrum beta-lactamases (ESBLs), such as the CTX-M enzymes, have emerged within the community setting as an important cause of UTIs. These bacteria are resistant to the groups of antibiotics that are commonly used to treat these types of infections (penicillins, cephalosporins) and to antibiotics normally reserved for more severe infections (eg, fluoroquinolones, gentamicin).Escherichia coli is the most common cause of urogenital infection and is implicated in the genesis of male infertility (Pellati et al., 2008). Recently an in vitro study was conducted to assess effect of CHM formula Qinglishengjing pills (清淋生精片) on spermatozoa infected with E. coli (Yu et al., 2011). It was observed that E. coli infection caused significant detrimental changes in sperm motility parameters, phosphatidylserine externalization, and morphology of spermatozoa. Treatment of Qinglishengjing pills to infected cells almost normalized all changes caused by E. coli compared with control groups (Yu et al., 2011). This study supported the clinical effect of Qinglishengjing pills as an anti-E. coli agent.Nordmann P. Trends in beta-lactam resistance among Enterobacteriaceae. Clin Infect Dis. 1998 Aug. 27 Suppl 1:S100-6. [Medline]. E. coli is an important cause of neonatal pneumonia when the causative organism is acquired either shortly before or during delivery.354 The source of the organism is usually the maternal gastrointestinal tract or aspirated amniotic fluid. The incubation period is variable and ranges from birth to several weeks of age. A study of 34 infants with late neonatal pneumonia (onset of symptoms more than 48 hours after birth) suggested that E. coli was the probable etiology in 6%; coliforms accounted for 44% of the episodes.355 E. coli strains with K1 capsular polysaccharide antigen are the most common causes of neonatal E. coli meningitis and bacteremia and of the less frequent invasive infections that occur in infants. In children older than 2 years of age, the importance of K1 is diminished356 because invasive E. coli infections usually occur only in association with underlying disease.Copyright © 2020 Elsevier B.V. or its licensors or contributors. ScienceDirect ® is a registered trademark of Elsevier B.V.
Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical InvestigationDisclosure: Nothing to disclose.E.coli B is the clonal descendant of a Bacillus coli strain from the Istitut Pasteur in Paris used by d'Herelle in his early studies of bacteriophages .Daegelen  examined the literature to derive what is known about the geneology of E. coli B strains. Current E. coli B strains are derived from the E. coli used in the phage studies of the Luria, Delbruck, and Hershey groups associated with the Cold Spring Harbor Phage community. Strain E.coli B is the common host for phages T1-T7 which led to the widspread use of B along with E. coli K-12.
Patients with complex cases (eg, those with diabetes, >65 years, or recent history of UTI) are treated with a 7- to 14-day course of antibiotics (eg, levofloxacin, third-generation cephalosporins, or aztreonam). Virtsatieinfektiot. Käypä hoito. Suomalaisen Lääkäriseuran Duodecimin, Suomen Nefrologiyhdistys ry:n, Kliiniset Long-term Escherichia coli asymptomatic bacteriuria among women with diabetes mellitus The Disease: Hemorrhagic colitis is the name of the disease caused by E. coli O157:H7. The elderly and children are more susceptible to this disease. A possible complication is hemolytic uremic syndrome (HUS), a urinary tract infection that is a leading cause of acute kidney failure in children.
Escherichia coli are ubiquitous and almost always innocuous members of the colonic microbiota, and are a very diverse set of organisms. Some of the members of this species can cause diarrhea, in which case they become relevant to food safety. This chapter reviews major categories of E. coli that have reasonably strong associations with human disease: enterohemorrhagic, enterotoxigenic, enteropathogenic, enteroaggregative, enteroinvasive, and diffuse adhering E. coli, as well as the hybrid enterohemorrhagic/enteroaggregative E. coli O104:H4. In clinical reality, few of these agents can be identified using current technology, so outbreaks and sporadic infections are quite likely very much undetected.The spread of CTX-M–positive bacteria considerably changes how the treatment of community-acquired infections is approached and limits the oral antibiotics that may be administered. This finding has major implications for treating individuals who do not clinically respond to first-line antibiotics.  Note that correct usage is K-12, not K12. E. coli K-12 is not serotype K. Escherichia coli K-12 was isolated in the fall of 1922 from the stool sample of a diptheria patient in Palo Atlo, California. The use of E. coli K-12 as a model organism for research was by sheer luck as E.L. Tatum received a culture of K-12 along with other species of bacteria for his biochemical genetic research. E. coli K-12 is prototrophic, easy to cultivate and its short generation time makes it easy to study in large populations.
Childs SJ. Current concepts in the treatment of urinary tract infections and prostatitis. Am J Med. 1991 Dec 30. 91(6A):120S-123S. [Medline]. Infections due to ESBL-producing E coli have largely been regarded as a healthcare-associated phenomenon. However, reports of community-associated infections caused by ESBL-producing E coli have begun to emerge and this occurrence of community-associated infections due to extended-spectrum β-lactamase (ESBL)–producing Escherichia coli has been recognized among patients without discernible healthcare-associated risk factors in the United States. Most (54.2%) ESBL-producing strains that cause community-associated episodes belonged to ST131 or its related sequence types. Among these strains, all except one produced CTX-M–type ESBL, in particular CTX-M-15.  Bohnen JM. Antibiotic therapy for abdominal infection. World J Surg. 1998 Feb. 22(2):152-7. [Medline]. Childhood E. coli pneumonia is usually treated with an aminoglycoside, an extended-spectrum cephalosporin, or the two in combination. Although combination therapy is preferred, few explicit data document its superiority. Ampicillin may be substituted for the cephalosporin when the isolate is susceptible. Amikacin may be substituted for gentamicin if the isolate is resistant. At the University of Chicago Hospitals in 1996, 98% and 99% of E. coli isolates were susceptible to gentamicin and extended-spectrum cephalosporins, respectively.Moon HW. Pathogenesis of enteric diseases caused by Escherichia coli. Adv Vet Sci Comp Med. 1974. 18(0):179-211. [Medline].
Melzer M, Petersen I. Mortality following bacteraemic infection caused by extended spectrum beta-lactamase (ESBL) producing E. coli compared to non-ESBL producing E. coli. J Infect. 2007 Sep. 55(3):254-9. [Medline]. Recent research has highlighted the increased tolerance of E. coli biofilms to administered antimicrobials (Leung et al., 2012). The exact mechanisms for such tolerance remain uncertain, but are undoubtedly multifactorial. Interestingly, the rapid acquisition of heritable variation in both antibiotic sensitivity and resistance has been reported in E. coli biofilms, which could be one contributory factor explaining increased resistance to antibiotics (Tyerman et al., 2013). However, importantly, a number of antibiofilm compounds have been reported for E. coli, including brominated furanones, ursolic acid, indole derivatives, and 5-fluorouracil.Lieb et al.  describe differences between E. coli C, B, and K-12 in their study of hybrids between different E. coli strains.
Neu HC. Infections due to gram-negative bacteria: an overview. Rev Infect Dis. 1985 Nov-Dec. 7 Suppl 4:S778-82. [Medline]. Frank C, Werber D, Cramer JP, Askar M, Faber M, an der Heiden M, et al. Epidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany. N Engl J Med. 2011 Nov 10. 365(19):1771-80. [Medline]. Jonas M, Cunha BA. Bacteremic Escherichia coli pneumonia. Arch Intern Med. 1982 Nov. 142(12):2157-9. [Medline]. E. coli strains fall into five major taxonomic lineages (A, B1, B2, D, and E; ) . In addition, species in the genus Shigella group within the E. coli groupings and different Shigella species have different E. coli groups as their closest relatives. E. coli K-12 strains are in subgroup A. Different methods for producing phylogenies provide different insights into the evolution of E. coli as a group.
Chi Hiong U Go, MD Assistant Professor, Department of Internal Medicine, Texas Tech University Health Science Center at Odessa Chi Hiong U Go, MD is a member of the following medical societies: American College of Physicians-American Society of Internal MedicineDisclosure: Nothing to disclose. Escherichia coli O157:H7 (E Coli). Compiled By: Julie A. Albrecht, Ph.D., Associate Professor. The Organism: The specific Escherichia coli serotype O157:H7 is an aerobic bacteria that produces a.. The inability to attribute specific episodes of enteric infection to specific E. coli also complicates attempts to determine burden of disease on populations. The attributable etiologic percentage is the first step in determining the short- and long-term burden of any pathogen that underlies a particular syndrome, but as noted above and throughout this chapter, most E. coli diarrheas elude diagnosis. Furthermore, there are definable burdens of illness as measured by diarrhea-related mortality [4,5], but the widespread use of oral rehydration and the increasing use of the rotavirus vaccine are diminishing diarrhea-related mortality. Diarrhea-related morbidity, beyond the cost to individuals and families of the acute episode, is much more difficult to ascertain , especially as outcomes (stunting, cognitive deficits) can take years to be apparent. The agents in this chapter rarely are lethal. Hence, the burden to society in terms of disability-adjusted life years lost because of infection by any or all diarrheagenic E. coli remains incalculable.
Second, diarrheagenic E. coli are quite difficult to precisely define as enteric pathogens. The ability to cause disease among E. coli relates to the presence or absence of multiple genes, which act in concert to avoid host defenses, and to enable the organism to injure host organs via a variety of mechanisms. E. coli use adhesins, sugars (capsular polysaccharides and lipopolysaccharides), protein toxins, invasion-promoting proteins (invasins), and iron acquisition systems (siderophores) to survive in and injure their hosts. Loci encoding these molecules are rarely restricted to pathogens, and are often on mobile genetic elements. Moreover, presence or absence of any given locus is usually not enough to cause disease: there are additional attributes of bacterial gene expression levels and allelic variation that need to be considered.Cunha BA. Antibiotic concentration dependent susceptibility of urinary tract isolates. Antib Clinician. 1999. 3:57-8. Larry I Lutwick, MD, FACP Editor-in-Chief, ID Cases; Moderator, Program for Monitoring Emerging Diseases; Adjunct Professor of Medicine, State University of New York Downstate College of Medicine Larry I Lutwick, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American Association for the Study of Liver Diseases, American College of Physicians, American Federation for Clinical Research, American Society for Microbiology, Infectious Diseases Society of America, Infectious Diseases Society of New York, International Society for Infectious Diseases, New York Academy of Sciences, Veterans Affairs Society of Practitioners in Infectious DiseasesDisclosure: Nothing to disclose.E. coli pneumonia may be acquired via inhalation or may result from bacteremic seeding of the lung. The organism is not a usual constituent of normal pharyngeal flora but may be found in the pharynx of ill children or adults, particularly among hospitalized patients. Spread in the hospital is facilitated by hand-to-mouth contact, often with fecal contamination, and by fomites such as contaminated respiratory equipment.Roberts JA. Pyelonephritis, cortical abscess, and perinephric abscess. Urol Clin North Am. 1986 Nov. 13(4):637-45. [Medline].
Batard E, Ollivier F, Boutoille D, Hardouin JB, Montassier E, Caillon J, et al. Relationship between hospital antibiotic use and quinolone resistance in Escherichia coli. Int J Infect Dis. 2012 Nov 22. [Medline]. Weinberger M, Cytron S, Servadio C, et al. Prostatic abscess in the antibiotic era. Rev Infect Dis. 1988 Mar-Apr. 10(2):239-49. [Medline]. Recent data from the Canadian national surveillance study, CANWARD, revealed that 868 urine isolates of E coli collected from 2010-2013 were sensitive to fosfomycin using the Clinical and Laboratory Standards Institute (CLSI) agar dilution method, with minimum inhibitory concentrations (MICs) interpreted using CLSI M100-S23 (2013) criteria. The concentrations of fosfomycin inhibiting 50% (MIC 50 ) and 90% (MIC 90 ) of isolates were 1 or less and 4 μg/mL, respectivelyl; 99.4% of isolates were susceptible to fosfomycin. 
Nitrofurantoin is synthetic nitrofuran and interferes with bacterial carbohydrate metabolism by inhibiting acetylcoenzyme A. It is used to treat uncomplicated UTIs for 7 days or for 3 days after urine is sterile.Tice AD. Short-course therapy of acute cystitis: a brief review of therapeutic strategies. J Antimicrob Chemother. 1999 Mar. 43 Suppl A:85-93. [Medline].
E coli enteric infections require fluid replacement with solutions containing appropriate electrolytes. Antimicrobials known to be useful in cases of traveler's diarrhea include doxycycline, trimethoprim/sulfamethoxazole (TMP/SMZ), fluoroquinolones, rifaximin, and rifamycin. They shorten the duration of diarrhea by 24-36 hours. Antibiotics are not useful in enterohemorrhagic E coli (EHEC) infection and may predispose to development of HUS. Antimotility agents are contraindicated in children and in persons with enteroinvasive E coli (EIEC) infection.Barnett BJ, Stephens DS. Urinary tract infection: an overview. Am J Med Sci. 1997 Oct. 314(4):245-9. [Medline]. Download as PDFSet alertAbout this pageEscherichia coliJan T. Poolman, in International Encyclopedia of Public Health (Second Edition), 2017
Camins BC, Marschall J, De Vader SR, Maker DE, Hoffman MW, Fraser VJ. The clinical impact of fluoroquinolone resistance in patients with E coli bacteremia. J Hosp Med. 2011 Jul. 6(6):344-9. [Medline]. [Full Text].Recurrent E coli cystitis (ie, >2 episodes/year) is treated with continuous or postcoital prophylaxis with a fluoroquinolone, TMP/SMZ, or nitrofurantoin.A pneumatocele has been reported in a neonate with E. coli pneumonia360; lung abscesses are rare. In general, if the correct diagnosis is made and appropriate treatment is instituted, recovery usually occurs.Amoxicillin interferes with the synthesis of cell wall mucopeptides during active multiplication, resulting in bactericidal activity against susceptible bacteria. It is used to treat uncomplicated UTI for 7 days and complicated UTI or pyelonephritis for 10-14 days.Glandt M, Adachi JA, Mathewson JJ, Jiang ZD, DiCesare D, Ashley D. Enteroaggregative Escherichia coli as a cause of traveler's diarrhea: clinical response to ciprofloxacin. Clin Infect Dis. 1999 Aug. 29(2):335-8. [Medline].
Kappeli U, Hachler H, Giezendanner N, Beutin L, Stephan R. Human Infections with Non-O157 Shiga Toxin-producing Escherichia coli, Switzerland, 2000-2009. Emerg Infect Dis. 2011 Feb. 17(2):180-5. [Medline]. Koutkia P, Mylonakis E, Flanigan T. Enterohemorrhagic Escherichia coli O157:H7--an emerging pathogen. Am Fam Physician. 1997 Sep 1. 56(3):853-6, 859-61. [Medline]. Email: firstname.lastname@example.orgUncomplicated E coli cystitis can be treated with a single dose of antibiotic or 3-day course of a fluoroquinolone, TMP/SMZ, or nitrofurantoin. E. coli (Escherichia coli). Related Pages. Learn about an outbreak linked to clover sprouts. Escherichia coli (abbreviated as E. coli) are bacteria found in the environment, foods, and intestines..
Escherichia coli are nearly ubiquitous in the human gastrointestinal tract, although they account for only a small proportion of the overall gut flora and most often exist in this setting without compromising host health. Yet, E. coli expressing virulence traits are capable of causing a variety of disease syndromes via multiple mechanisms and display vast genetic differences within and between pathotypes. Escherichia coli is a common cause of diarrheagenic illness globally, is the most common cause of uncomplicated and complicated urinary tract infections, and a leading cause of bacteremia and neonatal meningitis. Increasing antibiotic resistance among E. coli contributes to morbidity, mortality, and substantial health-care and societal costs associated with infection. Many E. coli vaccines are under development, and effective vaccines could significantly contribute to control of E. coli disease and antibiotic resistance worldwide.Savatta D, Cunha BA. Acute pyelonephritis and its mimics: Xanthogranulomaotus pyelonephritis and malacoplakia. Infect Dis Prac. 1996. 20:86-8. Aztreonam is a monobactam that inhibits cell wall synthesis during bacterial growth. It is active against aerobic gram-negative bacilli. It is used to treat complicated UTIs/pyelonephritis and bacteremia for 7-14 days, intra-abdominal infections for 14-21 days, and pneumonia for 14 days. Palmer DL. Microbiology of pneumonia in the patient at risk. Am J Med. 1984 May 15. 76(5A):53-60. [Medline].
Piperacillin and tazobactam is an antipseudomonal penicillin plus beta-lactamase inhibitor. It inhibits biosynthesis of cell wall mucopeptide and is effective during the stage of active multiplication. It is used to treat intra-abdominal infections for 14-21 days. Escherichia coli is an extremely rare cause of childhood pneumonia except in neonates or in those with an underlying disease. E. coli, the “colon bacillus,” was first isolated in 1885 by T. Escherich from the feces of breastfed infants.352 It is a gram-negative, nonencapsulated bacillus that may be either motile or nonmotile. Typing of strains is based on the following antigens: flagellar (H), somatic (O), and capsular (K or B). The ability of E. coli to bind to host tissue via specific fimbriae is an important first step in infection. Hemolysin is another virulence-associated characteristic of severe E. coli infections in children.353Three major challenges are encountered when trying to detect diarrheagenic E. coli. First, diagnosis at presentation is rarely possible in anything approaching a CLIA-certified diagnostic environment, because, except for O157:H7 and non-O157:H7 Shiga toxin (Stx)-producing (STEC) E. coli, E. coli that cause diarrhea have no readily detectable phenotypes that set them apart from other E. coli in stool. Instead, the detection of diarrheagenic E. coli largely relies on cumbersome phenotypic determinations (cell invasion, patterns of adherence to cells, and toxicity assays) and/or DNA hybridization assays (colony hybridizations or the polymerase chain reaction (PCR)), which are not widely used. Identifying the O (somatic) antigen only partly suggests that diarrheagenic E. coli might be present. Also, most illnesses caused by diarrheagenic E. coli resolve spontaneously and without major injury to the host (except for STEC), so clinicians cannot make a compelling case for finding these agents in patients with diarrhea. These challenges have stalled attempts to study the extent of disease caused by these organisms. Moreover, without rapidly identifying such patients, and conducting treatment trials, it is impossible to know if antibiotics change the clinical course of such illnesses.See Category:Strain:E. coli and Category:Strains Major E. coli lab strains used for basic research are mostly derived from E. coli K-12 and E. coli B. A study of autopsy findings in neonates with E. coli pneumonia identified diffuse inflammation as the most common pathologic finding.359 In contrast, diffuse bilateral lower lobe bronchopneumonia was found with occasional abscess formation in adults at autopsy. The alveoli were typically filled with fluid in the presence of mononuclear cells. The alveolar cells exhibited cuboidal metaplastic changes with thickened, edematous septa.
K-12 is phenotypically rough Note that K-12 does NOT refer to an antigenic type, and should be hyphenated Complementation using WG1 shows that the parent of laboratory K-12 strains was of type O16 PMID:7512872 Whipp SC, Rasmussen MA, Cray WC Jr. Animals as a source of Escherichia coli pathogenic for human beings. J Am Vet Med Assoc. 1994 Apr 15. 204(8):1168-75. [Medline].
Doxycycline inhibits protein synthesis and thus, bacterial growth, by binding to the 30S and possibly 50S ribosomal subunits of susceptible bacteria. It is used to treat traveler's diarrhea. Escherichia coli is one of the most frequent causes of many common bacterial infections, including cholecystitis, bacteremia, cholangitis, urinary tract infection (UTI), and traveler's diarrhea.. Westphal JF, Brogard JM. Biliary tract infections: a guide to drug treatment. Drugs. 1999 Jan. 57(1):81-91. [Medline]. Lepelletier D, Caroff N, Reynaud A, Richet H. Escherichia coli: epidemiology and analysis of risk factors for infections caused by resistant strains. Clin Infect Dis. 1999 Sep. 29(3):548-52. [Medline].
As of January 2010, the groupings in the NCBI taxonomy do not reflect the major groupings of E. coli and Shigella strains. Escherichia coli biofilms are extensively reported in clinical settings and also are associated with The persistence of E. coli in natural environments will undoubtedly be aided through its ability to grow.. McDonald MI. Pyogenic liver abscess: diagnosis, bacteriology and treatment. Eur J Clin Microbiol. 1984 Dec. 3(6):506-9. [Medline].