Escherichia coli is the numerically most common aerobic kommensalische residents of the colon. Certain strains cause diarrhea and all can cause infection when they enter sterile sites (eg. As the urinary tract). Diagnosis is by routine culture methods. Toxin assays can be helpful to determine the causes of diarrhea. The appropriate antibiotic therapy is selected from the results of susceptibility testing.
Escherichia coli is the numerically most common aerobic kommensalische residents of the colon. Certain strains cause diarrhea and all can cause infection when they enter sterile sites (eg. As the urinary tract). Diagnosis is by routine culture methods. Toxin assays can be helpful to determine the causes of diarrhea. The appropriate antibiotic therapy is selected from the results of susceptibility testing. Diseases caused by E. coli UTI (most common) intestinal infection (certain strains) Invasive infection (rare except in newborns) infection in other places most frequently causing E. coli urinary tract infections, which is ascending infection usually (ie from perineum through the urethra). E. coli can also cause inflammation of the prostate and pelvis (PID). E. coli normally inhabit the GI tract, but some strains have acquired genes, through which they can cause intestinal infections. When ingested, the following strains can cause diarrhea: Enterohämorrhagisch: These strains (including serotype O157: H7 and other) form various cytotoxins, neurotoxins and enterotoxins, including shiga toxin (Verotoxin), and cause bloody diarrhea; haemolytic uremic syndrome develops in 2-7% of cases. Such strains were mostly purchased from inadequately cooked ground beef, but can also be acquired from infected humans through the faecal-oral route, if the hygiene is inadequate. Enterotoxigen: These strains can cause watery diarrhea, especially in infants and travelers (traveler’s diarrhea). Enteroinvasiv: These strains can cause inflammatory diarrhea. Enteropathogen: These strains can cause watery diarrhea, especially in young children. Enteroaggregativ: Some strains are increasingly present as a potentially important causes of persistent diarrhea in AIDS patients and in children in tropical areas. Other strains can cause extra-intestinal infections when the normal intestinal anatomical barriers are disrupted (for. Example by ischemia, inflammatory bowel disease or trauma), in which case the exciter may extend into adjacent structures or penetrate into the bloodstream. Hepatobiliary, peritoneal, cutaneous and pulmonary infections also occur. It can -Bakteriämie come even without evidence of a portal of entry to an E. coli. In neonates, particularly premature infants who are E. coliBakteriämie meningitis and disseminated (caused by strains with the K1 capsule, a marker for neuroinvasiveness). Diagnosis culture are sent blood, stool and other clinical materials for an exciting culture. If you suspect a enterohemorrhagic strain, the laboratory must be informed, as special culture media are required. Therapy Various antibiotics depending on the site of infection and susceptibility testing, the treatment of E. coli infections has empirically based on the location and severity of infection (eg. As weak bladder, urosepsis) are started and then modified based on antibiotic susceptibility testing. Many strains are resistant to ampicillin and tetracycline, so that other substances must be used; these include ticarcillin, piperacillin, cephalosporins, aminoglycosides, trimethoprim-sulfamethoxazole (TMP / SMX) and fluoroquinolones. Surgical intervention may be required to control the source of infection (such. As pus drainage, debridement of necrotic lesions or removal of foreign bodies). Drug resistance Apart from that they are resistant to ampicillin and tetracycline, are E. coli become increasingly resistant to TMP / SMX and fluoroquinolones. In addition, multi-drug resistant strains of the extended-spectrum beta-lactamases-(ESBL) are producing, as emerged an important cause occurring in public urinary tract infections and sepsis. ESBL can hydrolyze most beta-lactam antibiotics, including penicillins and broad-spectrum cephalosporins and monobactams, but not carbapenems (imipenem, meropenem, doripenem, ertapenem); Carbapenems should be used for ESBL-producing E. coli.