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Escherichia Coli Infections - An Overview

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Escherichia coli is a bacterium that is found in humans and animals. It can cause serious and life-threatening complications. Read on to learn more about it.

Medically reviewed by

Dr. Shubadeep Debabrata Sinha

Published At April 13, 2023
Reviewed AtJuly 6, 2023

Introduction:

Escherichia coli, also known as E. coli, is a common and diverse group of bacteria found in food, the environment, and the intestines of humans and certain warm-blooded animals. E. coli gets a bad reputation, but in fact, most strains of E. coli are harmless and some strains are essential to health, as stated by the Centers for Disease Control and Prevention (CDC). E. coli produces vitamin K and vitamin B12, keeping the gut a haven for other beneficial bacteria.

What Is Escherichia Coli Infection?

Escherichia coli infection occurs primarily through consuming contaminated foods such as raw or undercooked ground meat, raw milk, and contaminated raw vegetables and sprouts.

Infection with Escherichia coli bacteria can cause severe bloody diarrhea. It can also cause urinary tract infections, pneumonia (lung inflammation), meningitis (inflammation of the brain), bacteremia (blood infection with a bacterial origin), or sepsis (a dangerous systemic reaction to bacteremia). Some infections can cause severe health problems, especially in extremely young or very old people or those with weakened immune systems. Some versions of E. coli can make a person sick by producing a toxin called shiga, which damages the lining of the intestine. A strain of E. coli that produces the toxin is sometimes called STEC, which stands for shiga-toxin-producing E. coli bacteria. This bacteria is also a leading cause of urinary tract infections in women.

What Are the Causes of Escherichia Coli Infection?

Infection with Escherichia coli can occur due to any of the reasons listed below:

1. Ingestion of Bacteria - Even a small amount of E. coli can cause infection if swallowed. Some common ways of ingestion of the bacteria are listed below:

  • Eating uncooked meat.

  • Consuming untreated milk.

  • Eating vegetables and fruits washed with contaminated water.

  • Drinking contaminated water.

  • Not washing hands properly after cleaning the baby.

  • Not washing hands properly after petting animals.

2. Improper Personal Hygiene - Maximum number of urinary tract infections are caused by E. coli bacteria. Not maintaining proper personal hygiene may lead to fecal E. coli bacteria contaminating the urinary tract area of women.

What Are the Symptoms of Escherichia Coli Infection?

The symptoms of Escherichia coli infections are listed below:

  • Nausea.

  • Severe stomach cramps.

  • Diarrhea, can be severe and bloody.

  • Fatigue.

  • Vomiting.

  • Fatigue and irritability.

  • Pallor.

  • Small, unexplained bruising.

  • Confusion or seizures.

  • Increased blood pressure.

  • Swelling (face, hands, feet, body).

  • Low-grade fever.

  • Painful urination.

  • Frequent urination.

  • Blood in the urine (hematuria).

When to Get Help for Escherichia Coli Infection?

Seek immediate medical help in case of the following signs and symptoms:

  • Seizure.

  • Fainting.

  • High fever.

  • Excessive diarrhea.

  • Vomiting.

  • Inability to stand.

  • Difficulty breathing.

How Is Escherichia Coli Infection Diagnosed?

The diagnosis of illness caused by E. coli infection is done by doctors sending a stool, urine, or blood sample to a laboratory to check for the presence of E. coli. Bacteria can be cultured to confirm the diagnosis and identify certain toxins, such as those produced by E. coli.

What Are the Treatment Options for Escherichia Coli Infection?

Treatment of E. coli infections may be done by doctors in the ways listed below:

  • Rest - Getting proper rest.

  • Water - Increased intake of water to prevent dehydration and fatigue.

  • Medications - Avoid taking anti-diarrheal medicine as it slows the digestive system and prevents the body from getting rid of toxins.

  • Antibiotics - Antibiotics may be used to relieve symptoms or prevent complications in some cases of E. coli infections like urinary tract infections. Antibiotics can increase the risk of serious complications in case of infection of the gastrointestinal tract and are unlikely to help treat infections. Therefore, it is generally not recommended.

  • Intravenous Fluids - This may be given to cure dehydration from vomiting and diarrhea.

  • Blood Transfusions - This may be given to cure blood infection and the buildup of toxins in the body.

  • Kidney Dialysis - This may be given in case of kidney damage and failure.

What Are the Complications of Escherichia Coli Infection?

Most cases of E. coli infection are mild and do not pose a serious health risk. The infections usually heal on their own if proper rest is taken along with plenty of fluids. Some strains can cause serious symptoms and life-threatening complications, such as hemolytic-uremic syndrome. It can cause kidney failure and death.

How to Prevent Escherichia Coli Infection?

The prevention of E. coli infections can be done by ways listed below:

1. Hand Washing - One of the main way to prevent E. coli infections is washing hands regularly, especially in the following situations:

  • Before preparing a meal

  • Before preparing baby bottles and food for infants

  • After using the toilet or changing diapers.

  • After interacting with animals and pets.

  • After handling raw meat.

2. Drink Clean Liquids - Drink plenty of clean fluids, such as water, soups, and juices. Avoid apple and pear juice, caffeine, and alcohol.

3. Avoid Certain Foods - Dairy products, fatty foods, high-fiber foods, and spicy foods can make symptoms worse.

4. Eat Food from Hygenic Places - Food should only be consumed from places that are trusted and hygienic. Intake of stale food should be avoided at all costs.

5. Maintain Proper Personal Hygiene - To prevent urinary tract infections with E. coli bacteria, the following points should be followed:

  • Keeping genitals clean and dry.

  • Urinate regularly.

  • Always empty bladder completely while urinating.

  • Urinate after sexual intercourse to wash bacterial contamination on the urethra.

Conclusion

Escherichia coli (E. coli) bacteria normally is found in the intestines of healthy humans and animals. Most strains of E. coli cause relatively short-lived diarrhea or are harmless. But some strains of this bacteria can cause severe stomach cramps, bloody diarrhea, and vomiting. E. coli can also infect the urinary tract of a person and can lead to severe urinary tract infections. In some cases, antibiotics may be given to cure this infection, but the gastrointestinal infection usually clears out on its own without any intervention. Intake of antidiarrheal medicine should be avoided. To prevent this infection, food hygiene should be maintained, and hands should be washed regularly when dealing with food. Maintaining personal hygiene prevents urinary tract infections caused by E. coli bacteria.

Frequently Asked Questions

1.

How Long Does It Take for E. Coli to Leave the Urinary Tract?

In many cases, uncomplicated UTIs caused by E. coli can be effectively treated with antibiotics. The infection itself may be cleared within a few days to a week of completing the antibiotic course. In cases where the infection is more severe or recurrent, it may take longer to clear the E. coli bacteria from the urinary tract.

2.

What Should Be Avoided in E. Coli Infection?

Avoid raw or undercooked meat, unpasteurized dairy products, and untreated water. Practice good food hygiene by thoroughly washing hands and kitchen utensils, and cook meat to a safe internal temperature. Avoid dehydration by drinking clear fluids like water, oral rehydration solutions, and clear broths. Avoid alcohol, caffeine, and sugary drinks, as they can worsen dehydration.

3.

How Is E. Coli Infection Contracted?

One of the most common sources of E. coli infection is consuming contaminated food, particularly undercooked ground beef, raw or undercooked poultry, unpasteurized dairy products, and raw vegetables and fruits in contact with contaminated water or surfaces. Drinking water that has been contaminated with E. coli bacteria is another common route of infection. This can occur in areas with inadequate water treatment and sanitation systems. Swimming in or consuming water from contaminated recreational sources can also lead to infection.

4.

How Is E. Coli Spread From Person to Person?

Close contact with an infected person with E. coli can lead to transmission, often within households or healthcare settings. Besides this, transmission can occur by touching an infected person's hands or surfaces contaminated with feces and not practicing proper hand hygiene before touching the mouth, nose, or eyes.

5.

What Are the Factors Affecting E. Coli Growth?

- Temperature: E. coli bacteria grow most rapidly within a specific temperature range known as the "danger zone," which is typically between 40°F (4°C) and 140°F (60°C).


- pH (Acidity): E. coli bacteria prefer a slightly acidic to neutral pH range of around 6.5 to 7.5 for optimal growth.


- Water Activity (Aw): Water activity refers to the amount of available water in a substance. E. coli bacteria require a relatively high water activity level to grow. Foods with low water activity, such as dried foods and some processed snacks, are less conducive to E. coli growth.


- Oxygen: E. coli is a facultative anaerobe, which can grow in the presence or absence of oxygen. It can switch between aerobic (with oxygen) and anaerobic (without oxygen) metabolism.

6.

What Is the Temperature That Kills E. Coli?

The temperature at which Escherichia coli (E. coli) bacteria are killed or inactivated depends on several factors, including the strain of E. coli, the duration of exposure to the heat, and the specific temperature reached. In general, E. coli bacteria can be effectively killed through cooking or heat treatment at temperatures above a certain threshold. Refrigeration (below 40°F or 4°C) and cooking (above 140°F or 60°C) are effective means of controlling E. coli growth.

7.

What Is the Prognosis of E. Coli Infection?

Many E. coli infections have a good prognosis, particularly those causing uncomplicated Urinary Tract Infections (UTIs) or gastroenteritis (food poisoning). Most people recover within a few days to a week with appropriate medical treatment, which often involves antibiotics for UTIs and supportive care (hydration and rest) for gastroenteritis.

8.

Is Escherichia Coli Infection Permanent?

No, Escherichia coli (E. coli) infections are not permanent. E. coli is a type of bacteria that can cause various infections in the human body, such as Urinary Tract Infections (UTIs), gastrointestinal infections, and more. These infections are typically acute, meaning they have a sudden onset and short duration.

9.

How Does E. Coli Get In Urine?

Escherichia coli (E. coli) can enter the urinary tract and cause a Urinary Tract Infection (UTI) when it is introduced into the urethra and travels upward into the bladder and the kidneys. UTIs are more common in women than in men, primarily because women have shorter urethras, which makes it easier for bacteria to travel from the external environment to the urinary tract.

10.

Which Antibiotics Treat E. Coli in Blood?

Third-generation Cephalosporins like Ceftriaxone and Cefotaxime are often used as initial empiric therapy for suspected E. coli bacteremia. They are effective against many E. coli strains. Ciprofloxacin and Levofloxacin are Fluoroquinolone antibiotics that can be effective against E. coli, but their use may be reserved for cases where other antibiotics are less appropriate due to resistance concerns or other factors. Gentamicin and Amikacin are aminoglycoside antibiotics that can be combined to treat severe E. coli infections.

11.

What Is the Normal Range for Escherichia Coli in Urine?

In a routine urine culture obtained from a healthy individual, Escherichia coli (E. coli) should not be present or in very low quantities (few to no colonies). The specific threshold for determining a UTI can vary slightly depending on the laboratory and clinical guidelines. Still, the presence of 100,000 colony-forming units (CFUs) of E. coli per milliliter (CFU/mL) or more in a urine culture indicates a UTI.

12.

What Kills E. Coli Effectively?

Heat is one of the most effective methods for killing E. coli and other bacteria. Cooking food, especially ground meat, poultry, and eggs, to the recommended safe temperatures (e.g., 160°F or 71°C for ground meat, 165°F or 74°C for poultry) will kill E. coli and make the food safe to eat. Boiling water at 212°F (100°C) for at least one minute also kills E. coli and other waterborne pathogens.

13.

Who Is Most at Risk for E. Coli Infection?

Infants and young children, especially those under 5, are at an increased risk of E. coli infections, including Shiga toxin-producing E. coli (STEC) infections. Older adults, particularly those over 65, may have weakened immune systems and underlying health conditions, making them more susceptible to severe E. coli infections and complications. Pregnant women are more susceptible to certain E. coli infections, such as those caused by E. coli O157:H7, which can lead to complications for both the mother and the fetus.

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Dr. Shubadeep Debabrata Sinha
Dr. Shubadeep Debabrata Sinha

Infectious Diseases

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