Escherichia coli ( ehsherihioza ) - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Infectious Diseases

E. coli is a fairly common microorganisms causing numerous problems of the digestive tract, urinary and reproductive systems in humans, which has the ability to be present on the skin and mucous membranes of various body systems as a variant of the norm.

E. coli (Escherichia coli or E. coli) - Gram-negative bacterium (in smears stained by Gram, not colored), belonging to the family Enterobacteriaceae, which has the shape of sticks, are facultative anaerobes (ie mainly develops without the presence of oxygen, butunder certain conditions as admission of oxygen does not lose its viability).E. coli was opened in 1885 by the German bacteriologist Theodor Escherichia.The sticks have rounded ends, a size of 0.4 to 3 microns.Some strains have mobility due to the presence of flagella, others - still.

dimensional image of E. coli

optimum temperature for growth of E. coli - 37 °.E. coli is sufficiently stable in the environment, in such media as water, soil and feces remains viable for a long time.They hav

e the ability to multiply in foods (eg, milk).When boiling die almost immediately at a temperature of 60º for 15 minutes, disinfectants (chloramine solutions, formalin, etc.) detrimental effect on E. coli in a short time.

There are numerous strains (varieties) of E. coli, of which most representatives are harmless and normally located in the mucous membranes of the digestive tract, predominantly in the lower divisions.

E. coli normally

Under normal conditions, E. coli colonizes the human gut (secure its strains), the average number varies from 106 to 108 CFU / g of intestinal contents distal (CFU - colony forming units).E. coli content in the composition of the intestinal microflora other than 1%.Under ordinary conditions of E. coli are involved in the normal functioning of the intestines, it synthesizes vitamin K, B1, B2, B3, B5, B6, B9, B12.A very important feature - competitive interaction with conditionally pathogenic intestinal flora (breeding restrictions opportunistic pathogens).

nonpathogenic strain Nissle 1917 (Mutaflor) used for therapeutic purposes in children as a probiotic for intestinal dysbiosis.The intestines are more useful so-called laktozopozitivnye coliform bacteria, lactose-content should not exceed 105 cfu / g, and hemolytic E. coli and all must be absent.

Qualitative and quantitative composition of E. coli colon in healthy people of different ages, both children under one year, and over 60 years, has no differences.For E. coli is typically 107-108 CFU / g of feces, E. coli lactosonegative & lt; 105, hemolytic E. coli normally absent.The composition of the rest of the intestinal flora is different in age by other parameters.

Deviations in the content of non-pathogenic strains of E. coli in the intestine called dysbiosis and have several degrees.

Degrees microbiological disorders E. coli in intestinal dysbacteriosis

1st degree of microbiological disorders : typical Escherichia to 106-105 CFU / g, may increase the content of Escherichia typical 109- to 1010 CFU / g
2-I have a degree of microbiological disorders : elevated levels of hemolytic Escherichia to a concentration of 105-107 CFU / g
3rd degree of microbiological disorders : detection of E. coli in association with other uslovnopatogen-governmental organisms at a concentration of 106-107 CFU / g or higher

pathogenic E. coli

There are more than 100 strains of pathogenic E. coli, which are combined into 4 classes:
- enteropathogenic E. coli (ETEC);
- enterotoxigenic E. coli;
- enteroinvasive E. coli (EIEC);
- enterohaemorrhagic E. coli (EHEC).

morphologically they do not differ.A special feature is the ability of pathogenic strains in contact with the human body to produce enterotoxins (thermostable or resistant to high temperatures and heat-labile or bystrorazrushayuschiesya), due to which there is diarrhea.For example, E. coli O157: H7, which produce similar toxins.In addition to each group has its own features of the disease symptoms.

Defeat E. coli gastrointestinal

ehsherihioza - disorders resulting from ingestion of pathogenic strains of E. coli, characterized by intoxication and defeat mainly the gastrointestinal tract, but sometimes affecting the urinary system, bile duct and other bodies withthe possibility of some patients of sepsis.

alimentary infection mechanism, fecal-oral route.transfer factors are contaminated water and food.Most of the sick young children.

incubation period (from the time of infection to the appearance of the clinical picture) from 48 to 72 hours, most often (sometimes shortened to 1 day or extended to 10 days).

ehsherihioza caused by enterotoxigenic Escherichia coli : often affects infants and children first year of life.Is the cause of diarrhea in hospitals.In young patients vomiting or regurgitation, loose stools without pathological impurities (blood), severe pain in the abdomen, the child's anxiety, refusal to eat, disturbed sleep.

ehsherihioza caused by enterotoxigenic Escherichia coli : these strains have the ability to attach to cells of the intestinal epithelium, significantly impairing their function and causing severe watery diarrhea.Also often occur in children, adults and the so-called "traveler's diarrhea".Patients watery diarrhea without blood, retching, pain in the abdomen.

ehsherihioza caused by enterohaemorrhagic Escherichia coli : causes hemorrhagic colitis, in severe cases of hemolytic uremic syndrome (HUS).When hemorrhagic colitis patients to high fever 39-39,5º, intoxication symptoms, cramping (or spastic), abdominal pain, as well as the appearance of watery stools mixed with blood.Complications may develop hemolytic anemia nature, acute renal failure and hemorrhagic syndrome.
Hemolytic uremic syndrome (HUS) - specific syndrome, which is characterized by a triad of symptoms - hemolytic anemia, acute renal failure and critical reduction in platelet count.There is often in the pediatric age group of 6 months to 4 years, as well as in elderly patients.In 90% of cases occurs in intestinal infections (E. coli, verotoxin producing, Shigellae, etc.).The reason - the defeat of the vascular endothelial cells.There is on average one week after infection.Clinically may appear lemon yellow jaundice, abnormal flow of urine, edema, hemorrhages in the skin and other serious symptoms.However, with the appearance of this symptom can speak about the developed clinical picture of HUS.Early signs are also his laboratory: the appearance of protein in the urine - proteinuria, the appearance of red blood cells in urine - red blood cell, increase in serum creatinine, as well as reduction of red blood cells and hemoglobin in the blood.

ehsherihioza caused by Escherichia coli Enteroinvasive : biochemical properties of E. coli enteroinvasive similar to Shigella - dysentery pathogens, in particular, have the ability to penetrate into cells specific intestine epithelium (colon) and multiply there.This explains the appearance of certain symptoms in such ehsherihioza: pain in the left iliac region (lower left abdomen), copious watery stools mixed with blood.Unlike dysentery, often it is still watery stools, and not skimpy with mucus and blood (as in shigellosis).
In summary, it is clear that there is no single specific pattern ehsherihioza, patient complaints may be different: fever, vomiting, watery stools without impurities and with blood, abdominal pain, aching nature of different localization.

defeat urinary tract E. coli infection mechanism

often associated with immediate inflow of intestinal colon bacillus for non-compliance or lack of personal hygiene, as well as by using non-traditional methods of sexual contact (with anal sex).Prior

80-85% of urinary tract infections associated with E. coli.More than 60% of acute inflammatory processes in the prostate is associated with this pathogen.The vast majority of chronic prostatitis is associated with E. coli.

Clinical forms of urinary tract lesions are different.It may be urethritis, cystitis, pyelonephritis, prostatitis.

Defeat E. coli

reproductive system Most of the inflammatory processes in the epididymis (epididymitis), inflammation of the testicles (orchitis), and their combined lesion, inflammation of the ovaries (adnexitis) is associated with E. coli.

diagnosis of infections caused by E. coli

1) bacteriological method - planting biological materials on special culture media.The materials are used for intestinal infections - excrement and vomit, with infections of the urinary system - urine in infections of the reproductive system - swabs and scrapings from the mucous membranes of the genitals.After identification of the pathogen carrying antibiogram (susceptibility to antibiotics).
In the event the content of E. coli in the feces pose a certain degree of microbiological disorders (dysbiosis) or detect pathogenic strains of E. coli.The presence of E. coli in the urine called bacteriuria.In the absence of symptoms exhibited when a diagnosis of microorganisms in an amount above 105 cfu / ml of urine.If their number is less, then it is considered a sign of contamination (contamination of urine at a fence).If the symptoms of the disease is clearly expressed, it is sufficient 102-104KOE / ml urine.

E. coli in a nutrient medium

2) General clinical research methods (coprogram, urinalysis, blood, biochemical blood analysis, etc.) are optional.
3) instrumental methods of investigation (sigmoidoscopy, urography, ultrasound, etc.).

General principles of treatment of infections caused by E. coli

1. Organizational-regime activities (hospitalization for clinical indications), dietny mode according to defeat certain body systems (table number 4 in the intestinal lesion, the table number 7 in the defeat of the urogenital system).

2. Drug therapy includes causal treatment (antibiotics, bacteriophages), pathogenetic therapy (usually infusion), posindromalnuyu therapy.

Antibiotic therapy should take into account antibiotikogrammy isolated E. coli.Most revealed the sensitivity of E. coli to fluoroquinolone drugs group (ciprofloxacin, levofloxacin), amoxicillin, nitrofuranam, and others.And the drug itself, and the dose and duration of treatment is appointed only by a physician.Self-medication in order to prevent the development of stability of Escherichia coli to antibiotics is unacceptable!

also against E. coli bacteriophages are effective (used in intestinal disease) - if liquid is bakeriofag, intestibakteriofag, koliproteyny bacteriophage piobakteriofag combined liquid, piobakteriofag multivalent combined liquid and others.

Specially produced strains of E. coli are part of some drugs that are used at dysbacteriosis with the lack of E. coli in the intestine (helak fort bifikol, kolibakterin).Also at dysbacteriosis with overgrowth of E. coli appointed probiotics (linneks, Atsipol, atsilakt, laktobakterin, bifiform, Bifistim and others).

Pathogenetic therapy is to carry out infusion therapy - the introduction into the bloodstream of different solutions of a certain volume and concentration for the purpose of detoxification and replenish the fluid loss in lesions of the gastrointestinal tract and detoxify the body when kidney damage.

Posindromalnaya therapy is prescribed by the doctor individually, depending on the host of the disease syndrome.

Features of the treatment of children and pregnant women: in these groups of patients starting treatment regimen using biakteriofagov and probiotics and only the ineffectiveness of these drugs are prescribed antibiotics for age, the degree of destruction.

prevention of infections caused by E. coli

In the first place the prevention is personal hygiene and rules of cooking and storing food, washing fruits and vegetables, as well as avoiding the use of water in food from unknown sources.

infectious disease doctor Bykov NI