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Escherichia coli (E. coli)


Image: Dr M.S. Mitchell/CDC

Most strains of Escherichia coli form part of the normal intestinal microflora in humans and warm-blooded animals. However, some strains have the ability to cause disease in humans through the presence of specific virulence factors.

These diseases include food poisoning, eg E. coli O157, or infections outside the intestinal tract such as urinary tract infections (UTIs), and bacteraemia. E. coli are also becoming an important reservoir of extended-spectrum beta-lactamases (ESBLs).

Escherichia coli (commonly referred to as E. coli) is a species of bacteria commonly found in the intestines of humans and animals. There are many different types of E. coli, and while some live in the intestine quite harmlessly, others may cause a variety of diseases. The bacterium is found in faeces and can survive in the environment.

The commonest infection caused by E. coli is infection of the urinary tract, the organism normally spreading from the gut to the urinary tract.

E. coli is also the commonest cause of cystitis (infection of the bladder), and in a minority of patients the infection may spread up the urinary tract to the kidneys, causing pyelonephritis. Otherwise healthy patients in the community may develop cystitis, and patients in hospital who have catheters, or tubes, placed in the urethra and bladder are also at risk.

E. coli is also present in the bacteria that cause intra-abdominal infections following leakage from the gut into the abdomen, as for example with a ruptured appendix or following traumatic injury to the abdomen.

E. coli bacteria may also cause infections in the intestine. Diarrhoeal infections (intestinal) are caused by a group of E. coli known as 'enterovirulent' (harmful to the intestines).

Overspill from the primary infection sites to the bloodstream may cause blood poisoning (E. coli bacteraemia). In rare instances, E. coli may cause meningitis in very young children.

Most people normally carry harmless strains of E. coli in their intestine. Both the harmless strains and the strains that cause diarrhoea are acquired primarily through ingestion of contaminated food or water. Person-to-person transmission is through the oral-faecal route.

To avoid getting strains capable of causing intestinal disease people should avoid eating undercooked meat, in particular inadequately cooked minced beef, and avoid drinking unpasteurised milk. Individuals working with uncooked meats or on farms should pay close attention to good hygiene practices, as should visitors to farms.

It is important to always wash your hands with soap or disinfectant after going to the toilet, and before and after handling food. Handwashing in young children should be supervised, especially after handling animals or their surroundings, for instance on a visit to a farm.

The risk of getting traveller's diarrhoea can be lowered by drinking only safe water (treated, boiled or sealed bottle), or by consuming ice known to be made from treated water. Food should be eaten freshly cooked and piping hot, salads should be avoided and fruit eaten only if it can be peeled.

The symptoms of E. coli infections vary according to the site of infection. For intestinal infections the symptoms may be diarrhoea, which can range from mild to profuse watery or bloody, cramps, nausea or vomiting.


Image: Dr M.S. Mitchell/CDC

Most strains of Escherichia coli form part of the normal intestinal microflora in humans and warm-blooded animals. However, some strains have the ability to cause disease in humans through the presence of specific virulence factors.

These diseases include food poisoning, eg E. coli O157, or infections outside the intestinal tract such as urinary tract infections (UTIs), and bacteraemia. E. coli are also becoming an important reservoir of extended-spectrum beta-lactamases (ESBLs).

Escherichia coli (commonly referred to as E. coli) is a species of bacteria commonly found in the intestines of humans and animals. There are many different types of E. coli, and while some live in the intestine quite harmlessly, others may cause a variety of diseases. The bacterium is found in faeces and can survive in the environment.

The commonest infection caused by E. coli is infection of the urinary tract, the organism normally spreading from the gut to the urinary tract.

E. coli is also the commonest cause of cystitis (infection of the bladder), and in a minority of patients the infection may spread up the urinary tract to the kidneys, causing pyelonephritis. Otherwise healthy patients in the community may develop cystitis, and patients in hospital who have catheters, or tubes, placed in the urethra and bladder are also at risk.

E. coli is also present in the bacteria that cause intra-abdominal infections following leakage from the gut into the abdomen, as for example with a ruptured appendix or following traumatic injury to the abdomen.

E. coli bacteria may also cause infections in the intestine. Diarrhoeal infections (intestinal) are caused by a group of E. coli known as 'enterovirulent' (harmful to the intestines).

Overspill from the primary infection sites to the bloodstream may cause blood poisoning (E. coli bacteraemia). In rare instances, E. coli may cause meningitis in very young children.

Most people normally carry harmless strains of E. coli in their intestine. Both the harmless strains and the strains that cause diarrhoea are acquired primarily through ingestion of contaminated food or water. Person-to-person transmission is through the oral-faecal route.

To avoid getting strains capable of causing intestinal disease people should avoid eating undercooked meat, in particular inadequately cooked minced beef, and avoid drinking unpasteurised milk. Individuals working with uncooked meats or on farms should pay close attention to good hygiene practices, as should visitors to farms.

It is important to always wash your hands with soap or disinfectant after going to the toilet, and before and after handling food. Handwashing in young children should be supervised, especially after handling animals or their surroundings, for instance on a visit to a farm.

The risk of getting traveller's diarrhoea can be lowered by drinking only safe water (treated, boiled or sealed bottle), or by consuming ice known to be made from treated water. Food should be eaten freshly cooked and piping hot, salads should be avoided and fruit eaten only if it can be peeled.

The symptoms of E. coli infections vary according to the site of infection. For intestinal infections the symptoms may be diarrhoea, which can range from mild to profuse watery or bloody, cramps, nausea or vomiting.

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