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Escherichia coli
Aka: Escherichia coli, E. coli, Enterotoxigenic E. coli, ETEC, Enteroinvasive E. coli, EIEC, Enteroadherent E. coli, EAEC, Enterohemorrhagic E. coli, EHEC, E. coli 0157
- See Also
- Diarrhea
- Infectious Diarrhea
- Types
- Enterotoxigenic E. coli (ETEC)
- Most common pathogen in Traveler's Diarrhea
- Enteroinvasive E. coli (EIEC)
- Causes acute dysentery-like Diarrhea
- Enteroadherent E. coli (EAEC)
- Causes Diarrhea in infants
- Enterohemorrhagic E. coli (EHEC)
- Bloody Diarrhea
- Includes serotype 0157:H7 (Shiga-toxin producer)
- Rapid onset in 12-72 hours
- Pathophysiology
- Some strains release Shiga-like toxin (e.g. 0157:H7)
- Certain E. coli strains have unique adherent ability
- E. coli 0157:H7
- E. coli various serotypes (over 200)
- Epidemiology
- Foodborne Illness (Shiga-toxin producing E. coli)
- Meat products
- Bovine (Most common)
- Undercooked hamburger (often commercial source)
- Pork
- Poultry
- Lamb
- Mayonnaise
- Sausage
- Salami
- Raw milk
- Alfalfa sprouts
- Unpasteurized apple cider and apple juice
- Waterborne Illness
- Outbreak at Rockford, IL lake swimming area (n=12)
- References
- MMWR (1996) 45:437-9
- Symptoms
- Enterohemorrhagic E. coli (EHEC)
- Acute hemorrhagic colitis
- Signs
- Enterohemorrhagic E. coli (EHEC)
- Bloody Diarrhea in 95%
- Complications
- Enterohemorrhagic E. coli (EHEC)
- Hemolytic Uremic Syndrome (HUS)
- Thrombotic Thrombocytopenic Purpura (TTP)
- Labs
- Specific E.Coli 0157:H7 Culture
- Management
- Supportive Care
- Oral Rehydration
- Avoid anti-motility (e.g. Imodium may worsen disease)
- Antibiotics
- Indications
- Severe cases
- Disadvantages of antibiotics
- Antibiotics do not alter disease course
- May increase Hemolytic Uremic Syndrome risk
- Course
- Enterotoxigenic E. coli: Treat for 3 days
- Enteroinvasive E. coli: Treat for 5 days
- Adults
- Trimethoprim-Sulfamethoxazole (Bactrim)
- Fluoroquinolone
- Children
- Trimethoprim-Sulfamethoxazole (Bactrim)
- Dose: 10 mg Trimethoprim/kg/day PO/IV divided bid
- Prevention
- Meat irradiation
- References
- Bower (1999) Pediatr Infect Dis J 18:909-10