Gastroenterology Book

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Escherichia coliAka: E. coli, EHEC, E. coli 0157, Enterotoxigenic E. coli, ETEC, Enteroinvasive E. coli, EIEC, Enteroadherent E. coli, EAEC, Enterohemorrhagic E. coli

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

Enteroinvasive Escherichia coli (bacteria) (C0580795)

Definition (MSH)A pathotype (virotype) of E. coli capable of invading and multiplying in the intestinal epithelial cells of the distal large intestines in humans.
ConceptsBacterium (T007)
EnglishEIEC, Enteroinvasive E. coli, Enteroinvasive Escherichia coli, Escherichia coli enteroinvasive
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Enterotoxigenic Escherichia coli (C0580797)

Definition (MSH)Strains of ESCHERICHIA COLI that produce or contain at least one member of either heat-labile or heat-stable ENTEROTOXINS. The organisms colonize the mucosal surface of the small intestine and elaborate their enterotoxins causing DIARRHEA. They are mainly associated with tropical and developing countries and affect susceptible travelers to those places.
ConceptsBacterium (T007)
EnglishEnterotoxigenic E. coli, Enterotoxigenic Escherichia coli, Escherichia coli enterotoxigenic, ETEC
SpanishEscherichia coli enterotoxígena, Escherichia coli enterotoxigénica, Escherichia coli enterotoxigena, Escherichia coli enterotoxigenica
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Enterohemorrhagic Escherichia coli (C0600414)

Definition (MSH)Strains of ESCHERICHIA COLI that are a subgroup of SHIGA-TOXIGENIC ESCHERICHIA COLI. They cause non-bloody and bloody DIARRHEA; HEMOLYTIC UREMIC SYNDROME; and hemorrhagic COLITIS. An important member of this subgroup is ESCHERICHIA COLI O157-H7.
ConceptsBacterium (T007)
EnglishEHEC, Enterohaemorrhagic Escherichia coli, Enterohemorrhagic E coli, Enterohemorrhagic E. coli, Enterohemorrhagic Escherichia coli
SpanishEscherichia coli enterohemorrágica, Escherichia coli enterohemorragica
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Enteroaggregative Escherichia coli (C0872165)

Definition (MSH)A pathotype (virotype) of E. coli characterized by a distinct aggregative adherence pattern to HEp-2 cells.
ConceptsBacterium (T007)
EnglishEAEC, EAggEC, EggEC, Enteroaggregative E. coli, Enteroaggregative Escherichia coli
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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