Disease: E. Coli

What Is E. Coli?

Some strains of E. coli are essential to good health — but others can cause severe illness.

Escherichia coli, or E. coli, is a type of bacteria commonly found in the intestines of warm-blooded animals, including humans.

The vast majority of E. coli strains are harmless, or even beneficial — for instance, E. coli produces vitamins K and B6, and maintains a protective space in your gut for other beneficial bacteria.

However, some strains of E. coli can cause sickness and severe complications.

If the bacteria enter your urinary tract, they can cause a urinary tract infection (UTI) — in fact, E. coli is behind more than 85 percent of all UTIs, according to a 2012 report in the journal Emerging Infectious Diseases.

When E. coli finds its way into the lungs, it can cause respiratory illness and, in rare cases, pneumonia. According to the Meningitis Research Foundation, E. coli is the cause of about 20 percent of all cases of neonatal meningitis, a potentially deadly infection of the membranes lining an infant’s brain and spinal cord.

But E. coli is perhaps best known for its role in intestinal infections and outbreaks of food poisoning.

E. Coli Food Poisoning

In the United States, the most common and severe disease-causing E. coli strain is O157:H7 (or O157), according to the Centers for Disease Control and Prevention (CDC).

This foodborne strain is classified as a Shiga toxin-producing E. coli, or STEC, because it makes you sick by damaging the lining of your intestines and kidneys with a powerful poison called Shiga toxin.

The O157 strain is behind about 36 percent of the roughly 176,000 STEC infections that occur each year in the United States, according to a 2011 article in Emerging Infectious Diseases.

Other STEC strains can also cause outbreaks — for example, E. coli O104:H4 caused a large 2011 E. coli outbreak in Germany.

Cattle are the main source of O157 and other STEC, but the bacteria are also present in other ruminants (cud-eating mammals such as goats and sheep).

The bacteria can infect your system if you get animal or human feces in your mouth. This typically happens when you eat food that’s been contaminated with tiny (usually invisible) amounts of feces, such as:

  • Ground beef
  • Unpasteurized dairy and apple juice
  • Fresh produce, such as spinach, lettuce, and sprouted seeds
  • Well water or surface water contaminated by animals

You can also get STEC from other sick people if they don't wash their hands thoroughly before preparing your food, and from swimming in contaminated bodies of water, such as ponds, rivers, or lakes.

You’ll start to experience the effects of an E. coli intestinal infection 2 to 5 days after the bacteria get into your system. Symptoms of an E. coli infection include:

  • Diarrhea, which can be severe and bloody
  • Nausea
  • Severe stomach cramps
  • Fatigue

Less-common symptoms include vomiting and low-grade fever. Most healthy adults recover from an STEC infection completely after about a week without any medical attention.

But about 5 to 15 percent of STEC infections lead to a life-threatening form of kidney failure called hemolytic uremic syndrome (HUS), according to a 2012 report in the journal Toxins.

Young children, the elderly, and people with weakened immune systems are more likely to experience severe STEC symptoms or get HUS. People who take antibiotics to treat an E. coli infection are also at an increased risk for HUS, the report notes.

E. Coli Outbreaks

Outbreaks of foodborne E. coli infections are a major issue in the United States, according to the National Institute of Allergy and Infectious Diseases. Since 2010, there have been more than a dozen U.S. outbreaks of E. coli infections, according to the CDC.

The majority of these epidemics were due to O157, which contaminated various food products, including ground beef, ready-to-eat-salads, and bologna. E. coli O121, O26, and O145 have also caused recent outbreaks.

E. coli is also a problem elsewhere in the world. The aforementioned 2011 German outbreak of O104:H4 killed over 50 people, according to the European Food Safety Authority.

And in developing countries, another type of the bacteria called enteropathogenic E. coli is a leading cause of infantile diarrhea, while enterotoxigenic E. coli is a leading cause of so-called traveller's diarrhea, according to the CDC.

In recent years, urinary tract infections caused by E. coli have also become a public health concern, as antibiotic-resistant strains of the bacteria have spread.

These strains, called extended spectrum beta lactamase E. coli, appear to be causing more UTIs now than ever before, according to a 2012 article in the journal Antimicrobial Agents and Chemotherapy.

Sources:

  • Escherichia coli (E. coli); CDC.
  • E. coli; National Institute of Allergy and Infectious Diseases .
  • E. coli: Good, Bad, and Deadly; American Academy of Microbiology.
  • Scallan et al. (2011); "Foodborne Illness Acquired in the United States—Major Pathogens." Emerging Infectious Diseases.
  • Bergeron et al. (2012). "Chicken as Reservoir for Extraintestinal Pathogenic Escherichia coli in Humans, Canada." Emerging Infectious Diseases.
  • Sanchez et al. (2012). "In Vitro Antimicrobial Resistance of Urinary Escherichia coli Isolates among U.S. Outpatients from 2000 to 2010." Antimicrobial Agents and Chemotherapy.
  • Mayer et al. (2012). "Shiga Toxins and the Pathophysiology of Hemolytic Uremic Syndrome in Humans and Animals." Toxins.

Symptoms of an E. Coli Infection

The symptoms of an E. coli infection may be different in children.

E. coli, short for Escherichia coli, is a group of bacteria found in the intestines of humans and other warm-blooded animals. Most strains of E. coli are harmless, but some are pathogenic (disease-causing) bacteria.

To the public, E. coli is best known as the microbe that can cause outbreaks of foodborne intestinal infections (i.e., food poisoning).

But pathogenic E. coli can also be the cause of a number of other illnesses. Naturally, the symptoms you may feel from E. coli depend on what kind of E. coli infection you have.

E. coli Infections Outside of the Intestines

Uropathogenic E. coli is behind more than 85 percent of all urinary tract infections (UTIs), a 2012 report in the journal Emerging Infectious Diseases notes.

The infection occurs when E. coli, which typically lives in the colon, enters the urinary system through the urethra.

Urinary tract infections don't always produce symptoms, but most people will get at least one symptom, including:

  • Burning feeling during urination
  • Intense urges to urinate
  • Passing frequent but small amounts of urine
  • Unusual-smelling, cloudy, or bloody urine
  • Fever or chills
  • Pain in the lower back, hips, or flanks
  • Pelvic pain in women, rectal pain in men

A strain of E. coli called K1 causes about 20 percent of all cases of neonatal meningitis, according the Meningitis Research Foundation. Newborns may become infected with E. coli K1 during birth, or from bacteria later acquired in the hospital or home.

If your baby has meningitis, it may have one or more of the following symptoms:

  • Irritability
  • Breathing trouble
  • Diarrhea
  • Unusually cold or warm skin
  • Fussy feeding
  • Lethargy or inactivity
  • Bulging soft spot at the top of the head (the fontanelle)

Streptococcus pneumoniae is the most common bacterial perpetrator of pneumonia, but E. coli can also sometimes cause the disease, according to the Centers for Disease Control and Prevention (CDC).

The most common symptoms of pneumonia include:

  • Fever
  • Shaking chills
  • Cough with phlegm
  • Shortness of breath
  • Chest pain from coughing or deep breathing

Intestinal E. Coli Infections

There are numerous types of E. coli that can cause food poisoning, according to the American Academy of Microbiology.

Enterotoxigenic E. coli attaches to the intestine using hair-like appendages and attacks the body with toxins, which results in feverless diarrhea — these bacteria are often the cause of traveller's diarrhea.

Enteroinvasive E. coli, on the other hand, invades the cells lining the colon, causing diarrhea and fever.

Enteropathogenic E. coli, a common cause of infantile diarrhea in developing countries, causes watery and sometimes bloody diarrhea after attaching to intestinal cells using a special protein.

And enteroaggregative E. coli clumps onto the cells lining the intestine, then uses a toxin to cause prolonged diarrhea, particularly in children.

Shiga toxin-producing E. coli (STEC) is the type most commonly heard about on the news because of the outbreaks it causes. An intestinal infection by STEC — which typically lives in cattle and migrates to humans after animal feces contaminate human food — results in:

  • Nausea
  • Severe stomach cramps
  • Diarrhea, which can be severe and bloody
  • Fatigue
  • Vomiting (rare)
  • Low-grade fever (rare)

People generally recover from STEC infections after about a week. But some individuals, particularly children, the elderly, and people with weakened immune systems, may develop complications such as hemolytic uremic syndrome (HUS), a life-threatening form of kidney failure. Early symptoms of HUS include:

  • Bloody stools (typically diarrhea)
  • Vomiting
  • General weakness and lethargy
  • Irritability
  • Fever

If the condition progresses, it can lead to:

  • Bruising and spots on the skin (petechia)
  • Decreased urination
  • Pale skin
  • Jaundice
  • Seizures (rare)

Sources:

  • E. coli; National Institute of Allergy and Infectious Diseases.
  • E. coli: Good, Bad, and Deadly; American Academy of Microbiology.
  • Urinary Tract Infections; National Kidney and Urologic Diseases Information Clearinghouse.
  • Bergeron et al. (2012). "Chicken as Reservoir for Extraintestinal Pathogenic Escherichia coli in Humans, Canada." Emerging Infectious Diseases.
  • Hemolytic-uremic syndrome; Medline (NIH).

Can You Get Food Poisoning From E. Coli?

Dozens of different microbes can cause food poisoning.

Foodborne illness, also known as "food poisoning," is a type of sickness caused by ingesting food or drink that has been contaminated by pathogenic (disease-causing) microbes — bacteria, viruses, and parasites — or their toxins.

Food poisoning can also result from other kinds of toxins and chemicals, such as pesticides and poisonous mushrooms.

There are about 48 million cases of food poisoning in the United States each year, according to the Centers for Disease Control and Prevention (CDC).

This means, essentially, that 1 in 6 people get sick from food poisoning each year.

What's more, the CDC estimates that of those people affected by food poisoning, 128,000 are hospitalized and 3,000 die.

What Causes Food Poisoning?

The most common food poisoning pathogens in the United States are the norovirus, which causes about 5.5 million cases of food poisoning each year, followed by the bacteria Salmonella, Clostridium perfringens, Campylobacter, and Staphylococcus aureus.

But you can also get food poisoning from Escherichia coli, or E. coli.

A type of E. coli called Shiga toxin-producing E. coli, or STEC, causes about 176,000 cases of foodborne illnesses each year — approximately 36 percent of these cases are due to a specific strain called O157:H7 (or O157), according to a 2011 article in the CDC-published journal Emerging Infectious Diseases.

Additionally, O157 is responsible for about 4 percent of all food poisoning hospitalizations by pathogenic microorganisms, the study found.

Cattle are the most common reservoirs for E. coli, which can get into people when they eat food that’s contaminated with the animals' bacteria-carrying feces. Typical sources of contamination include:

  • Ground beef
  • Unpasteurized dairy products and juices, including apple juice
  • Produce exposed to water runoff from cattle farms
  • Open water (lakes, rivers) frequented by animals

People can also pass E. coli to you if they touch your food or you (and you don't wash your hands before eating). Additionally, you may get E. coli in your system if you ingest water while swimming in a contaminated lake, river, or swimming pool.

Symptoms of E. coli Food Poisoning

If you have some kind of food poisoning, you will likely experience one or more of the following symptoms:

  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Fever
  • Weakness

The specific symptoms you experience from food poisoning partly depend on what kind of microbe (and how much) has invaded your body — and some pathogens may cause rather unique symptoms.

For instance, food poisoning from Listeria monocytogenes can cause muscle aches, and pregnant women infected with the bacteria sometimes experience flu-like symptoms. Clostridium botulinum food poisoning, on the other hand, may cause blurred vision and muscle weakness.

Symptoms of E. coli food poisoning include:

  • Nausea
  • Severe stomach cramps
  • Diarrhea, which can be severe and bloody
  • Fatigue
  • Vomiting (rarely)
  • Low-grade fever (rarely)

E. coli infections can sometimes lead to hemolytic uremic syndrome, or HUS, a life-threatening form of kidney failure.

Initial symptoms of the illness are similar to E. coli food poisoning, but later stages of the syndrome result in other issues, including jaundice, decreased urination, and petechia (red, brown, or purple skin spots).

Preventing E. Coli Food Poisoning

To reduce the risk of food poisoning from E. coli and other pathogens, use the following precautions when preparing your meals (unfortunately, there isn't much you can do to prevent getting E. coli from a restaurant or other food vendor):

  • Wash your hands before you touch any of your food to prevent contaminating it with bacteria you may have on your hands.
  • Rinse fruits and vegetables until there is no visible dirt and grime on the produce.
  • Discard the outermost leaves of a head of lettuce or cabbage.
  • Avoid cross-contamination by washing your hands, utensils, serving platters and cutting boards after they've been in contact with raw meat or poultry.
  • Thoroughly cook any meat, poultry, and eggs before eating them, to kill any bacteria that may have contaminated your food.
  • If leftover food isn't going to be eaten within 4 hours, refrigerate it.
  • Don't drink unpasteurized milk, juice, or cider.

Sources:

  • Escherichia coli (E. coli); CDC.
  • Scallan et al. (2011); "Foodborne Illness Acquired in the United States—Major Pathogens." Emerging Infectious Diseases.
  • Foodborne Illness, Foodborne Disease, (sometimes called “Food Poisoning”); CDC.
  • Foodborne Illnesses: What You Need to Know; FDA.
  • Food poisoning; MedlinePlus.
  • Be Food Safe: Protect Yourself from Food Poisoning; CDC.

Can E. Coli Cause a Urinary Tract Infection?

Several different types of microbes can cause a UTI.

Your urinary tract is an organ system consisting of two kidneys, a bladder, two ureters (tubes that connect the bladder and kidneys), and a urethra.

The system's primary job is to remove waste, regulate your electrolytes, and maintain water balance in your body. This process begins with the kidneys filtering your blood, producing urine.

Urine travels through the ureters to reach your bladder, where it's then stored. When you urinate, the bladder is emptied and the urine travels out the body through the urethra.

As its name suggests, a urinary tract infection, or UTI, is an infection of the kidneys, bladder, ureters, or urethra. An infection typically occurs when bacteria that live inside the bowel find their way into the urinary tract through the urethra.

Though the urinary tract has several safeguards to protect against bacteria, infections still occasionally occur.

E. Coli and UTIs

Escherichia coli, or E. coli, is responsible for more than 85 percent of all UTIs, according to a 2012 report in the journal Emerging Infectious Diseases.

Several other common bacteria also cause UTIs, including Staphylococcus saprophyticus, Pseudomonas aeruginosa, and Klebsiella pneumonia.

Symptoms of UTIs include:

  • Urination that burns
  • Frequent, intense urges to urinate, even if there's hardly any urine to pass
  • Urine that's foul-smelling, cloudy, or bloody
  • Fever or chills
  • Pelvic pain in women and rectal pain in men
  • Pain in the lower back, abdomen, hips, or flank

Urinary tract infections aren't usually serious, but they can be dangerous if the bacteria make their way into the kidneys.

Left untreated, a kidney infection (which is still considered a UTI) can cause permanent kidney damage and even deadly blood poisoning.

Prevalence and Risk Factors of UTIs

Each year, there are over 8 million cases of UTI in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

But the illness doesn't affect women and men equally: women get UTIs four times as often as men, and more than 50 percent of women will get a UTI at least once in their life.

This is partly because women have a shorter urethra, making it easier for E. coli and other bacteria to reach the bladder. Additionally, the opening of a woman’s urethra is near the anus, where bacteria live.

Men and women are more likely to get a UTI if they have:

  • Kidney stones or other conditions that block the urinary tract
  • A spinal cord injury or other nerve damage that prevents them from completely emptying their bladder, thereby allowing bacteria to multiply
  • A urinary catheter (tube used to drain the bladder)
  • A weakened immune system

Additionally, men with an enlarged prostate gland and women who use a diaphragm have an increased risk of UTIs because of the extra pressure put on the bladder, which prevents it from emptying properly.

Anatomical abnormalities of the urinary tract in men or women can also predispose people to UTIs. And sexually active women and those who use spermicidal condoms are also more likely to get UTIs.

UTIs from Antibiotic-Resistant E. Coli

Antibiotics are the standard treatment for UTIs, but some strains of E. coli, called extended-spectrum beta-lactamase (ESBL) E. coli, are resistant to most drugs.

In fact, ESBL E. coli appear to be causing more UTIs now than ever before, according to a 2012 article in the journal Antimicrobial Agents and Chemotherapy.

By tracking UTI cases from 2000 to 2010, the researchers found that UTI cases caused by E. coli resistant to the drug ciprofloxacin rose from 3 to 17.1 percent of all cases, while E. coli resistant to trimethoprim-sulfamethoxazole jumped from 17.9 to 24.2 percent.

Interestingly, scientists used to think that the E. coli that normally live harmoniously in our guts cause UTIs, but some recent research suggests that chickens may be the actual source of UTI bacteria.

For decades, farmers have been giving chicken and other livestock antibiotics, typically to help the animals put on weight quickly — but this procedure may be causing antibiotic-resistant E. coli to develop.

Some studies, including the Emerging Infectious Diseases report, have found a close genetic match between the drug-resistant E. coli in chicken and those in people with UTIs.

If people eat chicken with ESBL E. coli, the bacteria would wind up in their guts, and could eventually end up in the urinary tract and cause an infection, some researchers hypothesize.

But there's also the possibly that the hardy E. coli originate in humans, and then make their way to livestock through human sewage that spreads to the environment.

Sources:

  • What I need to know about Urinary Tract Infections; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
  • Urinary Tract Infections in Adults; NIDDK.
  • Urinary tract infections in adults; NHS.
  • Sanchez et al. (2012). "In Vitro Antimicrobial Resistance of Urinary Escherichia coli Isolates among U.S. Outpatients from 2000 to 2010." Antimicrobial Agents and Chemotherapy.
  • Bergeron et al. (2012). "Chicken as Reservoir for Extraintestinal Pathogenic Escherichia coli in Humans, Canada." Emerging Infectious Diseases.
  • Manges & Johnson (2012). "Food-Borne Origins of Escherichia coli Causing Extraintestinal Infections." Clinical Infectious Diseases.

E. Coli Infections in Children

Are kids more susceptible to E. coli infections?

Escherichia coli, or E. coli, is a type of bacteria that lives in the intestines of warm-blooded animals.

In humans, E. coli bacteria are a normal part of the microbial community in the gut, and some strains are even beneficial to us.

However, if pathogenic (disease-causing) E. coli makes its way into our bodies, it can cause illness. As is the case with adults, pathogenic E. coli in children most commonly causes food poisoning and urinary tract infections (UTIs).

In the United States, Shiga toxin-producing E. coli, or STEC, causes approximately 176,000 cases of intestinal infections each year, according to a 2011 article in the journal Emerging Infectious Diseases.

UTIs, on the other hand, affect about 3 percent of all children in the United States and result in more than 1 million pediatrician visits each year, according to National Institutes of Health (NIH).

A 2012 report in Emerging Infectious Diseases states E. coli is behind more than 85 percent of all UTIs in adults and children.

Escherichia coli is also responsible for about 20 percent of neonatal meningitis (an infection of the membranes surrounding an infant’s brain and spinal cord), according to the Meningitis Research Foundation.

E. Coli Intestinal Infections in Children

The E. coli that causes intestinal infections mostly live in the guts of cattle, and can get into humans when animal feces contaminate human food, such as ground beef, fresh produce, or unpasteurized milk or juice.

Swimming in a contaminated lake or pool can also allow the bacteria to get into your body if you ingest the water.

Toddlers can pass the bacteria to their playmates (especially if they're not potty trained), and adults can pass it to other children if they don’t wash their hands after changing a child's diapers, according to the Centers for Disease Control and Prevention (CDC).

What's more, children can still spread E. coli to other people for 2 weeks after they've gotten over their sickness, the CDC reports.

Food poisoning from STEC most frequently causes:

  • Diarrhea, which can be severe and bloody
  • Nausea
  • Severe stomach cramps
  • Fatigue

Other types of pathogenic E. coli also cause illness — typically diarrhea — in children. For example, enteropathogenic E. coli is a leading cause of infantile diarrhea in developing countries.

And enteroaggregative E. coli often results in persistent diarrhea in children that lasts at least 14 days.

Most healthy individuals recover from E. coli intestinal infections with little more than bed rest and lots of fluids (antibiotics aren't recommended).

However, some people develop a life-threatening condition called hemolytic uremic syndrome, or HUS, which destroys red blood cells and platelets (which allow blood to clot) and can lead to kidney failure — children under 5 years old are most susceptible to the condition, as are the elderly and immune deficient.

Other E. Coli Infections in Children

Urinary tract infections develop when E. coli and other bowel bacteria enter the urethra and spread to other urinary organs, particularly the bladder.

Because of their anatomy, girls are four times more likely to get a UTI than boys.

Uncircumcised boys younger than 6 months old are also more likely to get a UTI than circumcised boys of the same age, according to the NIH.

Urinary tract infections can cause a number of symptoms, including urination that burns, foul-smelling urine, severe abdominal pain, and fever. For children too young to express how they feel, signs of a UTI include high fever, irritability, and lack of appetite.

Older children with UTIs may cry or complain that it hurts to urinate, and may leak urine into clothing and bed sheets. They may also have cloudy or bloody urine, and experience belly pain.

Newborns typically contract E. coli meningitis during birth, or from caregivers in the hospital or home. Symptoms include:

  • Irritability
  • Breathing trouble
  • Diarrhea
  • Cold or warm skin
  • Fussy feeding
  • Bulging soft spot at the top of the head (the fontanelle)

Unlike intestinal E. coli infections, UTIs and bacterial meningitis require antibiotic treatments.

Sources:

  • Questions & Answers: Sickness caused by E. coli; CDC.
  • Urinary Tract Infections in Children; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
  • Bergeron et al. (2012). "Chicken as Reservoir for Extraintestinal Pathogenic Escherichia coli in Humans, Canada." Emerging Infectious Diseases.
  • E. coli; National Institute of Allergy and Infectious Diseases.
  • Scallan et al. (2011); "Foodborne Illness Acquired in the United States—Major Pathogens." Emerging Infectious Diseases.

Treatment for an E. Coli Infection

Are antibiotics safe for treating an E. coli infection?

The bacteria Escherichia coli (E. coli) can cause a number of different illnesses, depending on where the infection occurs.

E. coli may be best known for causing food poisoning, or intestinal infections that occur after you ingest food or drink that’s been contaminated with a pathogenic (disease-causing) strain of E. coli.

The E. coli that causes intestinal infections falls into several different broad categories.

In the United States, Shiga toxin-producing E. coli, or STEC, causes the most illnesses, and one STEC strain known as O157 is responsible for over one-third of those cases.

Treating an Intestinal E. Coli Infection

Treatment for your E. coli intestinal infection involves resting and drinking a lot of water to replenish fluids lost from diarrhea and vomiting.

Antibiotics aren't recommended because they can triple your risk of developing hemolytic uremic syndrome (HUS), a disease in which Shiga toxin destroys red blood cells and platelets (which assist in blood clotting), eventually causing kidney failure, according to a 2012 article in the journal Toxins.

Antimotility (antidiarrheal) medications may also increase your risk of developing HUS, according to a 2011 article in the journal Clinical Infectious Diseases.

However, antibiotics and antimotility agents may be useful for other types of E. coli, such as enterotoxigenic E. coli, which causes traveler's diarrhea.

In the absence of severe symptoms, such as bloody diarrhea or intense abdominal pain, some doctors believe it’s acceptable to use antimotility medication.

Treating Hemolytic Uremic Syndrome (HUS)

About 5 to 15 percent of STEC infections lead to the life-threatening syndrome HUS, which is more common among young children, the elderly, and people with weakened immune systems, the Toxins article notes.

If you have HUS, you will initially experience symptoms similar to your E. coli intestinal infection, including vomiting, fatigue, and bloody diarrhea.

Left untreated, HUS can cause numerous skin symptoms, such as bruising, petechia (red or purple spots on the skin), pale skin, and jaundice. Other signs of HUS include decreased urination and, sometimes, seizures.

HUS requires prompt medical treatment. This may include:

  • IV fluid and electrolyte replacement
  • Red blood cell transfusion
  • Platelet transfusion (to help the blood clot normally)
  • Kidney dialysis to temporarily take over your kidney's job of filtering waste and extra fluid from the body

If your kidneys become permanently damaged, you may need to switch to a low-protein diet and take medications such as angiotensin-converting enzyme (ACE) inhibitors, which lower your blood pressure to help prevent further kidney damage.

You may also need long-term dialysis or a kidney transplant.

Treating Urinary Tract Infections

Infection with E. coli doesn't just cause foodborne illnesses. Some strains of the bacteria are a normal part of microbial communities in your gut, but can cause a urinary tract infection (UTI) if they make their way into your urinary system.

Doctors typically treat UTIs with a wide range of different antibiotics, such as ciprofloxacin (Cipro) and trimethoprim-sulfamethoxazole (Bactrim).

However, some strains of E. coli, called extended-spectrum beta-lactamase (ESBL) E. coli, are resistant to most antibiotic treatments.

There are now only a few classes of oral antibiotics that remain effective at treating UTIs from ESBL E. coli, such as fosfomycin (Monural) and nitrofurantoin (Macrobid).

Sources:

  • Nelson et al. (2011). "Antimicrobial and Antimotility Agent Use in Persons with Shiga Toxin–Producing Escherichia coli O157 Infection in FoodNet Sites." Clinical Infectious Diseases.
  • Travelers' Diarrhea; CDC.
  • Hemolytic uremic syndrome (HUS); Mayo Clinic.
  • Auer et al. (2010). "Oral Treatment Options for Ambulatory Patients with Urinary Tract Infections Caused by Extended-Spectrum-?-Lactamase-Producing Escherichia coli." Antimicrobial Agents and Chemotherapy.
  • E. coli; National Institute of Allergy and Infectious Diseases.
  • Mayer et al. (2012). "Shiga Toxins and the Pathophysiology of Hemolytic Uremic Syndrome in Humans and Animals." Toxins.

Risk Factors for E. Coli Infections

Which foods are most likely to cause an E. coli infection?

Escherichia coli, or E. coli, can cause an intestinal infection if you ingest food or drink contaminated with the bacteria.

Our guts normally contain harmless types of E. coli, which differ from the pathogenic, or disease-causing strains, such as Shiga toxin-producing E. coli (STEC).

Cattle are the main reservoirs of STEC, but other mammals, including goats, sheep, and deer, also carry the bacteria in their guts.

If the animals' feces — even tiny, invisible amounts — contaminate food, E. coli bacteria can make their way into your body to cause illness.

You're at risk of an E. coli infection if you consume food or drink that's commonly contaminated with the bacteria, including:

  • Ground beef
  • Unpasteurized (raw) milk and any cheeses made from raw milk
  • Unpasteurized ciders and juices
  • Fresh produce, especially spinach, lettuce, and sprouted seeds, that are subject to water runoff from cattle fields
  • Well water or surface water that may be contaminated by animals

You can also get an E. coli infection from swimming in a contaminated lake, swimming pool, or other body of water.

Additionally, you can contract E. coli after handling feces from infected animals or people (e.g., changing diapers), if you don't thoroughly wash your hands afterward and touch your mouth or food.

Preventing Food Poisoning From E. coli

If you're at a restaurant, there isn't much you can do to prevent food poisoning from E. coli, aside from sending back any meat that looks like it wasn't cooked completely, such as pink hamburger meat.

But there are a number of steps you can take at home to reduce your risk of getting an E. coli intestinal infection.

First off, make sure to thoroughly cook any meat, poultry, or eggs before eating them. This is especially true for ground beef — the surface of all kinds of beef can become contaminated with E. coli, but the grinding process to make ground beef mixes the bacteria throughout the meat.

Ground beef should be cooked until even the thickest parts are 160 degrees F (71 degrees C), according to the Centers for Disease Control and Prevention (CDC).

Fruits and vegetables, on the other hand, should be rinsed until no visible grime or dirt is left on the produce. They should also be kept separate from raw meats.

You can avoid cross-contaminating your food by making sure you wash your hands, utensils, counters, serving trays and cutting boards after they've been in contact with raw meat and poultry.

And don’t put cooked meat back on the same plate it was on before it was cooked.

Finally, leftover food shouldn't stay unrefrigerated for more than four hours.

Other Tips to Reduce E. Coli Infection Risks

Practicing proper hygiene outside of the kitchen can also help reduce your risk of an E. coli infection, and prevent you from spreading the bacteria to other people.

Specifically, you should always wash your hands with soap and water:

  • After using the bathroom
  • After changing diapers
  • Before touching a infant's mouth or any objects that go into an infant's mouth, such as pacifiers, feeding bottles, and toys
  • Before preparing or eating food
  • After coming into contact with animals or their environments, including petting zoos and fairs

Additionally, avoid swallowing water while swimming and playing in lakes, ponds, streams, water parks, and backyard pools.

Sources:

  • E. coli Infection and Food Safety; CDC.
  • Escherichia coli (E. coli); CDC.
  • E. coli; National Institute of Allergy and Infectious Diseases.
  • Mayer et al. (2012). "Shiga Toxins and the Pathophysiology of Hemolytic Uremic Syndrome in Humans and Animals." Toxins.

Is E. Coli Contagious?

Discover how to prevent an E. coli infection.

Escherichia coli (E. coli) is a type of bacteria that's a normal part of the microbial community in our guts.

However, pathogenic (disease-causing) strains of the bacteria are found in the guts of cattle and other mammals, including goats, deer, and sheep.

Pathogenic E. coli can cause foodborne illnesses when the feces of animals — even tiny, invisible amounts — contaminate our food. Food poisoning results when food or drinks allows the E. coli to get into our intestines and cause illness.

Typical sources of contamination include:

  • Ground beef
  • Produce, particularly leafy greens, that has been subjected to water runoff from animal farms
  • Well or surface water frequently visited by ruminants
  • Unpasteurized (raw) dairy products, juices, and cider

Though E. coli outbreaks are usually the result of widespread food contamination, the bacteria is contagious and can sometimes spread directly between people.

How E. Coli Gets Passed Between People

E. coli doesn't typically spread between people through coughing, kissing, or other normal, everyday interactions between friends and family.

However, you can pass the bacteria to another person if you fail to take proper hygiene measures.

As with cattle, E. coli in humans spreads due to fecal contamination. For example, you can give E. coli to another person if you don't wash your hands after using the bathroom, and then you prepare someone's food.

You can also contaminate a baby's bottle nipple, pacifier, or teething toy through a similar process. Additionally, direct hand-to-mouth contact allows E. coli to spread between people.

You can pass E. coli to other people even if you aren't infected. Changing a baby's diaper without washing your hands afterward could allow bacteria from the infant's feces to spread.

Similarly, you can get E. coli on your hands and spread it if you touch animals or their environments.

Finally, you may inadvertently contaminate lakes, swimming pools, ponds, and rivers if you swim in them while you have an E. coli infection.

Preventing the Spread of E. Coli

The best way to prevent spreading E. coli to other people is to maintain proper hygiene. Always wash your hands carefully with soap and water after you:

  • Use the bathroom
  • Change a diaper
  • Come into direct contact with an animal or its environment, such as the enclosure of a petting zoo or a stable

You should also wash your hands before touching someone's mouth or any object that will go into someone's mouth, including food and a pacifier, and avoid swimming if you are sick. Use similar precautions to avoid catching an E. coli infection from other people.

To tell if you or someone else has the condition, watch out for symptoms of an E. coli infection, which include:

  • Severe or bloody diarrhea
  • Nausea, with or without vomiting
  • Severe stomach cramps
  • Fatigue
  • Low-grade fever (a rare symptom)

However, keep in mind that you may still have pathogenic E. coli in your system even if you do not experience any symptoms.

In fact, some people continue to "shed" the bacteria for several months after getting over their illness, according to the Centers for Disease Control and Prevention. Because of this, it's important to practice proper hygiene at all times.

Sources:

  • E. coli Infection and Food Safety; CDC.
  • Escherichia coli (E. coli); CDC.
  • E. coli; National Institute of Allergy and Infectious Diseases.

Complications of an E. Coli Infection

Some E. coli infections can spread within the body, causing serious health problems.

Many types of Escherichia coli (E. coli) bacteria are harmless and make up a normal part of the microbes in our guts, but some strains of E. coli can cause serious illness.

Intestinal infections and urinary tract infections (UTIs) are two of the most common conditions caused by E. coli.

Shiga toxin-producing E. coli, or STEC, normally lives in cattle and other animals, and usually gets into our system when the animals' feces contaminate our food, including ground beef, leafy greens, and unpasteurized juice or milk.

Urinary tract infections (UTIs) usually occur when bacteria from the colon enter the urethra and colonize the urinary system.

Though many different bacteria can cause the infection, E. coli is behind more than 85 percent of all UTIs, according to a 2012 report in the journal Emerging Infectious Diseases.

Complications from E. Coli Intestinal Infections

With rest and lots of water, most healthy adults recover from an E. coli infection within a week. But if you don't replenish the fluid you lose from diarrhea and vomiting, you could become dehydrated.

Initially, dehydration only causes mild symptoms, such as headaches, fatigue, and muscle aches.

However, severe dehydration can result in more serious health issues, including dizziness, delirium, rapid heartbeat, and cardiac and kidney problems. It can potentially cause seizures, permanent brain damage, and death.

A common complication of an STEC intestinal infection is hemolytic uremic syndrome (HUS), a disease in which the bacteria's toxins destroy red blood cells.

About 5 to 15 percent of STEC infections result in HUS, and the condition is most infection is common in children, the elderly, and people with weakened immune systems, according to a 2012 article in the journal Toxins.

Initial symptoms of HUS are mostly similar to a normal E. coli intestinal infection, but the later stages of the syndrome can cause pale skin, jaundice, and skin bruising.

Left untreated, HUS can cause permanent kidney damage and kidney failure.

Without working kidneys to filter the body of waste and modulate fluid volume, conditions that affect the heart, blood, bones, nerves, and skin can develop — these include anemia, itchy skin, and cardiovascular issues, among other things.

Complications from UTIs

Doctors treat UTIs with antibiotics. However, complications can arise if the infection isn't detected early, or if the antibiotics don't work (some types of E. coli are resistant to most currently available antibiotics).

If the bacteria spread throughout the urinary system, they can cause kidney infections. These infections can result in permanent kidney damage, which often lead to kidney scars, decreased kidney function, and high blood pressure.

A kidney infection, if severe enough, could also cause kidney failure.

In the most severe cases, UTIs can lead to a blood infection called sepsis, or septicemia, which can cause the blood pressure to drop.

With poor blood flow, major organs and body systems will stop working properly — and without treatment, the disease can ultimately cause death.

Sources:

  • Dehydration; MedlinePlus (NIH).
  • Hemolytic-uremic syndrome; MedlinePlus (NIH).
  • Kidney Failure: What to Expect; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
  • Scallan et al. (2011); "Foodborne Illness Acquired in the United States—Major Pathogens." Emerging Infectious Diseases.
  • Urinary Tract Infections in Adults; NIDDK
  • Sepsis; MedlinePlus (NIH)

Source: http://www.everydayhealth.com

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