Escherichia coli: What infections does it cause and how is it treated? (E. coli)

Escherichia coli, also called E. coli, is a rod-shaped flagellated bacterium of the genus Escherichia.

This bacterium and some of its strains are a common part of the intestinal flora of humans and animals.

In the gut, it is important for maintaining physiological processes and rarely causes disease.

It is involved in the breakdown of indigestible food debris. Its role is also to protect against the penetration of pathogens, as it produces substances toxic to other bacteria.

It is involved in the formation of some vitamins K, B and other vitamins.

E. coli is relatively resistant to temperature and external influences. The bacteria can survive in soil for up to several months. They can survive at 55 °C for up to 60 minutes and survive relatively well even at 3-7 °C and frozen.

Escherichia coli is a bacterium which, if pathogenic strains are present, can cause infection in humans in the form of diarrhoeal disease and bleeding intestinal inflammation.

Some strains of E. coli produce shiga toxin, which causes serious illness.

Even a very small infectious dose of a pathogenic strain of E. coli is enough to spread the disease.

Diseases are divided into extraintestinal and intestinal depending on where the E. coli bacteria caused the infection.

An intestinal infection takes place in the intestine and causes diarrhea with different courses.

If the bacteria gets outside the intestine into the body, it is an extraintestinal disease. This includes urinary tract disease, wound infections and suppuration, blood poisoning and others.

Urinary tract infection is referred to as uropathogenic E. coli (UPEC) and is one of the most common causes of urinary tract infection.

In some people, it causes no complications. In others, it can cause a life-threatening condition.

People are most at risk:

• immunocompromised
• pregnant women
• young children
• elderly people

For patients who are hospitalized in hospitals and have weakened immunity, E. coli infection can cause respiratory inflammation, wound infections in post-operative care and even blood poisoning - sepsis - if it enters the bloodstream.

Newborns with E. coli are potentially at risk for meningitis.

The incubation period from infection to first symptoms is 1-8 days, but most commonly 3-5 days.

Escherichia coli and its types causing intestinal disease

E. coli is commonly found in the intestine. However, if ingested, E. coli sometimes causes severe intestinal infection.

Escherichia coli has several subtypes, but 6 of them can cause serious intestinal disease.

The table below lists the types of E. coli that cause intestinal disease

E. coli produces shiga toxin, which belongs to the enterohemorrhagic type of E. coli. It causes moderate to severe intestinal disease with a risk of complications of kidney damage.

Humans can become infected from a sick individual, from animals such as sheep, goats, cattle.

It manifests itself with various symptoms ranging from mild to severe bloody stools.

Often occurs in summer time, as epidemics in schools, camps, hospitals.

Read also our article:

• Summer diarrhea.
• What are the causes of diarrhea and how to treat it?
• The most common inflammatory bowel diseases. Do we know their symptoms?

How can we get infected?

• By ingesting contaminated food that has been contaminated with E. coli
• Undercooked meat
• Contaminated soil and subsequent oral transmission
• Untreated water
• Unwashed fruit and vegetables
• Transmission is possible from animals to humans, but also from humans to humans

Preventive measures

• Maintain hygiene habits
• Avoidance of food contamination
• Thorough washing and cleaning of vegetables
• Avoiding undercooked meat products
• Avoiding water consumption in areas with poor hygiene

Escherichia coli in the human body

Escherichia coli can cause various diseases and complications depending on the colonization of the bacteria.

Complications caused by E. coli

• Urinary tract infections
• Inflammation in the digestive tract - gastroenteritis (inflammatory disease of the stomach and intestines)
• Infection of the prostate gland - prostatitis
• Infection of the peritoneum and pelvic region
• Wound infection in the post-operative period
• Inflammation of the lungs
• Bacteraemia when bacteria enter the bloodstream
• Meningitis - inflammation of themeninges
• Haemolytic uraemic syndrome caused by E. coli occurs in 5 to 10% of people. It develops into a condition that causes damage to red blood cells, which can lead to kidney failure. It is a life-threatening condition, especially when it affects children and the elderly.

Read also:

• Urinary tract inflammation in summer: more common in women. How to treat inflammation with medication?
• It comes on quickly, but lasts a short time
• What can cause inflammation of the uterus? How does it manifest itself?
• How does pneumonia manifest itself and what treatment is most effective?
• What is blood poisoning (sepsis), what are its symptoms and how does it occur?

Diarrhoeal disease caused by Escherichia coli

It affects both adults and children.

It presents with nausea, abdominal pain and cramps, watery diarrhea, mild fever, bloody diarrhea and vomiting.

Enterohaemorrhagic strains of E. coli can cause intestinal bleeding and other infections.

After the first symptoms appear, the illness may last 1 to 10 days. Most often, it takes 5 to 7 days for symptoms to disappear.

Mild to moderate symptoms

Their duration can be a few days, but also more than a week

• Abdominal cramps
• Stomach pain
• Sudden, severe watery diarrhoea
• Bloody diarrhea that appears after watery diarrhea
• Bloating
• Unappetite
• Nausea, in some cases vomiting
• Fatigue
• Fever, but not in all

Severe, severe symptoms

• Bloody urine
• Decreased urine production
• Pallor of the skin
• Bruising
• Dehydration

Read also our article: Why is dehydration dangerous in children? What are the symptoms?

What are the symptoms of dehydration?

Enteritis is an inflammatory disease or swelling of the small intestine. It is often caused by the bacterium E. coli.

It is manifested by diarrhea, abdominal cramps, bloating and nausea.

Symptoms usually appear 24 to 72 hours after infection.

The main symptom is persistent severe diarrhoea, which may be bloody.

Other symptoms:

• Fever
• Sweating
• Flatulence
• Severe abdominal cramps
• Nausea
• Vomiting
• Fatigue
• Lethargy

Pyelonephritis - inflammation of the kidneys caused by E. coli

Is a sudden severe kidney infection causing swelling of the kidneys and persistent inflammation leading to permanent kidney damage.

Repeated or persistent inflammation can develop into chronic inflammation.

Symptoms appear within two days after infection

• Fever above 38.9 °C
• Pain in the back, abdomen, flank or groin
• Pain and burning during urination
• Urine is cloudy
• Blood or pus in the urine
• Urgent and frequent urination
• Shivering, chills, nausea
• Vomiting
• General weakness, feeling like vomiting
• Fatigue
• Moist skin

Cause of inflammation

Bacteria pass through the urethra into the bladder, where they multiply and enter the kidneys through the ureter.

E. coli is a common cause of kidney inflammation.

Women are at risk more often than men because their urethra is shorter than men's.

Transmission of E. coli into the urethra can occur via the faecal route. The stool enters the urethra and begins to multiply there.

Read also.

Hemolytic uremic syndrome

Haemolytic uraemic syndrome is a condition causing the breakdown of red blood cells, a reduction in the number of platelets and subsequent acute kidney failure.

It is caused by E. coli or shigella bacteria and is often accompanied by bloody diarrhoea.

Acute renal failure develops in 55-70% of people and restoration of kidney function is often impossible.

Symptoms:

• Fever
• diarrhoea with rapid deterioration accompanied by pallor
• diarrhoea may be bloody
• dark-coloured urine
• vomiting
• reduced urine production, even complete cessation of urine production by the kidneys
• abdominal pain
• fatigue
• bruising
• increased heart rate
• dizziness, vertigo
• drowsiness

It is most common in children under 5, but also occurs in older children and adults.

When antibiotic treatment is given early, the success rate tends to be good and recovery without kidney damage.

Risk factors

Some people are more at risk of infection. Risk factors include:

• Age - serious complications are more common in children and older people
• Weakened immune system - people with lower immunity are more at risk of E. coli infection
• Season - more common in the summer months, from June to September
• Low stomach acid levels - which can increase the risk of E. coli infection. People taking medication to reduce stomach acid are also at risk
• Foods such as unpasteurised milk or juices and undercooked meat increase the risk of infection

Escherichia coli in women and pregnancy

E. coli is part of the gut and vaginal microflora.

Some strains cause complications such as diarrhoea, but also other infections, vaginitis. In pregnant women, they can cause chorioamnionitis (infection of the membranes surrounding the fetus and amniotic fluid with bacteria).

If it does not cause trouble, its treatment is not necessary. It is considered harmless because it occurs in many women.

However, it can cause inflammation of the urinary tract.

If problems do occur, it can cause complications with fertility, problems in pregnancy and after childbirth if left untreated.

E. coli in pregnancy can cause diarrhoea. In this case, both mother and foetus are at risk of fluid loss, i.e. dehydration. In rare cases, vaginal bleeding also occurs.

Severe infections can lead to premature rupture of the amniotic sac, miscarriage, premature birth and in the worst cases stillbirth.

E. coli also eventually causes low fetal birth weight.

Urinary tract infections in pregnancy caused by E. coli are relatively common.

During pregnancy, women are more at risk for urinary tract infections from about 6 weeks of age.

In pregnancy, urine often stagnates and returns to the urinary tract because muscle tone is reduced due to pregnancy. Urine is also much more concentrated in pregnancy, along with higher levels of sugar and estrogen, which increase bacterial growth.

How is E. coli diagnosed?

Escherichia coli is relatively easy to diagnose by taking biological material for culture.

Collection:

• From a stool sample
• Sterile midstream urine
• Vaginal swab
• Throat and nasal swab
• Swab from a wound or sample from an infected site
• Blood collection for haemoculture (performed at high temperature)

What is the treatment for E. coli?

Treatment is mostly symptomatic (treating the symptoms).

Most people with mild to moderate symptoms can be treated at home.

Symptoms usually go away within a few days to a week.

When treating at home, it is important to:

• Taking medicines to suppress diarrhoea
• For travelers' diarrhea, it is recommended to take loperamide
• Drink plenty of fluids
• Rest
• Increase vitamin intake

If bloody diarrhea or fever appears, a visit to the doctor is necessary.

In most cases, after confirming E. coli with severe symptoms, the doctor will prescribe antibiotics based on the result from a culture where the bacteria's sensitivity to the type of antibiotic has been evaluated.

E. coli is unresponsive and resistant to many types of antibiotics.

For some conditions, such as severe diarrhea, bloody diarrhea, vomiting, when a person is unable to retain fluids, hospitalization is necessary to prevent dehydration.

Of the antibiotics to which E. coli is usually more sensitive, azithromycin, ciprofloxacin, rifaximin, aminoglycosides, chloramphenicol or macrolides are given.

In combination with antibiotic treatment, the use of probiotics is recommended to accelerate the return of the natural intestinal microflora.

Read also.

Vaginal creams with a moderate pH are recommended for vaginal colonization with E. coli, which inhibit the growth of microorganisms in the vagina. They are also suitable during pregnancy.

For E. coli colonisation in the urinary tract, it is also recommended to take dietary supplements that promote urinary tract cleansing, such as drinking urological tea to flush out the bacteria faster, cranberry supplements and an important increased drinking regime.

E. coli in the throat or nose?

E. coli bacteria found in the throat or nose may not cause complications at all. In some cases, scratching and a feeling of a stuffy throat or runny nose may occur, especially in children.

Treatment is symptomatic. Sea salt rinses are recommended.

If the infection does not cause further serious complications and a rise in temperature, antibiotic treatment is not necessary.

Natural treatments that can help and do no harm include:

• garlic, which is considered a natural antibiotic
• oregano oil in the form of tablets or drops