Escherichia coli
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Epidemiology
- 20% of healthy women delivering twins are colonized with ciprofloxacin resistant E coli
- antibiotic exposure not identified as risk factor for colonization[5]
- multistate outbreak of E coli April 2019.
- 72 people from 5 states infected E. coli O103[7]
- outbreaks 2018 & 2019 from E coli-contaminated romaine lettuce
Pathology
- endotoxin-mediated sepsis
- bacteremia originates from the bowel, biliary tree or urinary tract
- toxin-mediated enteritis
- urinary tract infection (UTI)
- cystitis
- pyelonephritis
- largely sexually active women
- most common etiologic agent of UTI
- abdominal abscesses
- neonatal meningitis associated with K1 capsular antigen
- rare disorders
- adult meningitis
- pneumonia
- endocarditis
Laboratory
- Escherichia coli identified in isolate
- Escherichia coli antigen
- Escherichia coli toxin
- Escherichia coli serology
- Escherichia coli serotype
- culture of organism from a site that is generally sterile
- Escherichia coli DNA
- Escherichia coli adherence pattern in isolate
- extended spectrum beta lactamase (ESBL)-producing E coli
- carbapenem-resistance (India, Pakistan) conferred by New Delhi metallo-beta-lactamase 1 (emergence in 2010)
Management
- uncomplicated cystitis in healthy non-pregnant women
- Bactrim DS, 2 tablets once
- more severe infection
- ampicillin 3 g IV every 4 hours plus gentamicin 1 mg/kg IV every 8 hours
- ciprofloxacin 500 mg PO every 12 hours
- ciprofloxacin resistance common[5] -fluoroquinolone resistance common[6]
- 2 weeks of therapy for abscesses
- gastroenteritis (E. coli O157:H7)
- avoid antimotility agents-> slows elimination of bacteria
- treatment with antibiotics increases risk of hemolytic-uremic syndrome
- carbapenem for extended spectrum beta lactamase (ESBL)-producing E coli
More general terms
More specific terms
Component of
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 226
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 498, 535
- ↑ Prescriber's Letter 7(8):45 2000
- ↑ Journal Watch 21(18):149, 2001 Mohle-Boetani JC et al, Escherichia coli O157 and Salmonella infections associated with sprouts in California, 1996-1998. Ann Intern Med 2001, 135:239 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11511138
- ↑ 5.0 5.1 5.2 Gurnee EA et al. Gut colonization of healthy children and their mothers with pathogenic ciprofloxacin-resistant Escherichia coli. J Infect Dis 2015 Dec 15; 212:1862 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25969564 <Internet> http://jid.oxfordjournals.org/content/212/12/1862
Spellberg B and Doi Y. The rise of fluoroquinolone-resistant Escherichia coli in the community: Scarier than we thought. J Infect Dis 2015 Dec 15; 212:1853 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25969562 <Internet> http://jid.oxfordjournals.org/content/212/12/1853 - ↑ 6.0 6.1 Medical Knowledge Self Assessment Program (MKSAP) 18. American College of Physicians, Philadelphia 2018
- ↑ 7.0 7.1 Centers for Disease Control & Prevention (CDC) Outbreak of E. coli Infections Investigation Notice. April 5, 2019 https://www.cdc.gov/ecoli/2019/o103-04-19/index.html
- ↑ National Institute of Allergy and Infectious Diseases (NIAID) E coli https://www.niaid.nih.gov/diseases-conditions/e-coli