Infection By Escherichia Coli O157: H7 And Other Enterohemorrhagic E. Coli (Ehec)

E. coli O157: H7 and other enterohemorrhagic E. coli (EHEC) cause characteristically acute, bloody diarrhea that can lead to a hemolytic uremic syndrome. The symptoms consist of abdominal cramps and diarrhea, which can also have massive blood in. It is not too distinctive fever. The diagnosis is made by stool cultures and toxin assays. The therapy is more supportive, the use of antibiotics is not recommended.

E. coli O157: H7 and other enterohemorrhagic E. coli (EHEC) cause characteristically acute, bloody diarrhea that can lead to a hemolytic uremic syndrome. The symptoms consist of abdominal cramps and diarrhea, which can also have massive blood in. It is not too distinctive fever. The diagnosis is made by stool cultures and toxin assays. The therapy is more supportive, the use of antibiotics is not recommended. Epidemiology The EHEC include> 100 serotypes Shiga and Shiga-like toxins produce (Shiga toxin-producing E. coli [STEC]; also known as verotoxin-producing E. coli [VTEC]). E. coli O157: H7 is the most common STEC strain in North America. Non-O157 STEC-serotypes (especially O26, O45, O91, O103, O111, O113, O121, O128 and O145) can also cause enterohaemorrhagic disease, especially outside the United States. In 2011, the serotype O104 caused: H4 considerable multinational outbreak in Europe. In some parts of the US and Canada, E. coli O157 can: H7 are a frequent cause of bloody diarrhea than shigellosis or salmonellosis. E. coli O157: H7 infection can occur in people of all ages, but severe infections occur among children and the elderly most often. E. coli O157: H7 and other STEC have a bovine reservoir. Infections can be transmitted through food or water contaminated with cow manure as the outbreaks and sporadic cases usually after ingestion of undercooked meat is not completely (especially ground beef) or unpasteurized milk occur. In the European O104: H4 outbreak of 2011, the infection was transmitted by contaminated raw bean sprouts. The organism can also be transmitted by the fecal-oral route, especially in infants in diapers (eg., Via inadequately chlorinated children’s wading pool). Pathophysiology After ingestion form E. coli O157: H7 STEC serotypes and the like in the colon large quantities of various toxins; these toxins are closely related to the potent cytotoxins that dysenteriae Shigella type 1 are formed. The toxins appear to damage mucosal cells and vascular endothelial cells in the intestinal wall directly. After absorption, it is also toxic effects on other vascular endothelium (z. B. renal). Something 5% of cases (mostly children <5 years and adults> 60 years) are associated with the complication of hemolytic -urämischen syndrome, which characteristically develops in the second week of illness. It can, especially in the elderly, come to deaths that can occur with or without this complication. Symptoms and signs An infection with EHEC begins acutely with severe abdominal cramps and aqueous diarrhea that can be bloody macroscopically within 24 hours. Some patients describe the diarrhea as “pure blood without chair”, which led to the concept of hemorrhagic colitis. Fever is usually absent or mild and occasionally reaches 39 ° C. In uncomplicated infections, the diarrhea can last for 1-8 days. Diagnostic stool cultures Rasche stool tests for Shiga toxin An E. coli O157: H7 infection and other STEC infections should be distinguished by pathogens isolation from stool cultures of other infectious diarrheal diseases. The identification of the specific serotype helps to determine the origin of the outbreak. Often, the clinician should instruct the laboratory using a specific testing for these pathogens. be considered even in cases of suspected ischemic colitis, intussusception and inflammatory bowel disease H7: Because bloody diarrhea and severe abdominal pain may indicate various non-infectious causes without fever, infection with E. coli O157 should. Characteristically, no inflammatory cells are found in the stool liquid. A rapid stool assay for Shiga toxin or, if available, a test for the gene that encodes the toxin, can help. In patients at risk for a non-infectious diarrhea sigmoidoscopy may be required. This is performed, the sigmoidoscopy can give a erythema and edema; a barium enema shows edema with the appearance of thumbprints. Therapy Supportive treatment The primary treatment is mainly supportive. Although E. coli is sensitive to most common antibiotics, the use of antibiotics proved to be unsuitable for relief of symptoms, reduction of pathogen-carrier status or for the prevention of hemolytic-uremic syndrome. Fluoroquinolones are suspected to increase the secretion of enterotoxins. In the following weeks infection (children z. B. <5 years, the elderly) should in patients who are at increased risk for the development of haemolytic uraemic syndrome, for early signs such. Proteinuria, hematuria, red blood cell casts and increase in serum creatinine are respected. Later, edema and hypertension develop. Patients who develop complications often require intensive care in a hospital of maximum care, including dialysis and other specific therapies. Prevention Improved meat processing procedure in the US have helped to reduce the rate of meat contamination. A spread of infection can through proper disposal of the stool of infected people, adequate hygiene measures and hygienic hand disinfection are limited. Preventive measures such. As in a day care center before the visit will be allowed again include cohorting of known infected with STEC children or the requirement for two negative stool cultures. Transmission through food is prevented by pasteurization of milk and complete thorough cooking of beef. The message bloody diarrhea to the health department is important because additional infections can be prevented by an intervention. Important points enterohaemorrhagic E. coli (EHEC) produce Shiga toxin, the heavy, bloody diarrhea and sometimes hemolytic uremic syndrome caused. There are> 100 serotypes of EHEC; O157: H7 is the most famous, but many others cause similar diseases. The reservoir of EHEC are cattle, which is why outbreaks often result from the ingestion of insufficiently cooked beef, but many other foods (eg. As fresh produce, raw milk) and origins (eg. As direct contact with animals) may be involved. Stool tests are used to identify Shiga toxin and cultures for the identification of EHEC. Grooming is supportive; Antibiotics are not helpful. Observe risk patients (eg. As children <5 years, seniors) for signs of hemolytic uremic syndrome for 1 or 2 weeks after disease onset.

Health Life Media Team

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