Sporadic infection caused by enterohemorrhagic d Escherichia coli O157

In 1997 the Austrian Federal Ministry of Health established a reference laboratory for enterohaemorrhagic Escherichia coli at the federal public health laboratory in Innsbruck. The reference laboratory investigates sources of infection causing food poison     

Outbreaks caused by diarrheagenic Escherichia coli

Escherichia coli are ubiquitous bacteria from a wide variety of ecosystems including the gastrointestinal tract of humans and warm-blooded animals. E. coli can play a role as an opportunistic bacteria causing a variety of infectious diseases including, among many others, sepsis, urinary tract infections, meningitis, and wound infections. Moreover, these bacteria can also act as primary pathogens in the intestinal tract. There are several pathotypes of E. coli that cause enteritis, and both sporadic cases and outbreaks have been reported. In this article, we review the pathogenicity and epidemiology of enteritis caused by these E. coli pathotypes, and provide some examples of outbreaks described in the scientific literature and the measures required to prevent them.     

Infectious endocarditis caused by Escherichia coli

Although Escherichia coli is among the most common causes of Gram-negative bacteraemia, infectious endocarditis (IE) due to this pathogen is rare. A 67-y-old male without a previous medical history presented with a new mitral regurgitation murmur and persisting E. coli bacteraemia in spite of broad-spectrum intravenous antibiotics. Transthoracic and transoesophageal echocardiography revealed a severe mitral endocarditis. E. coli DNA was identified from the mitral valve and the vegetation, and no other pathogen was found. The case was further complicated by spondylodiscitis and bilateral endophthalmitis. Extra-intestinal pathogenic E. coli (ExPEC) are able to colonize tissue outside the gastrointestinal tract and contain a variety of virulence factors that may enable the pathogens to invade and induce infections in the cardiac endothelia. In these cases echocardiography as the imaging technology is of paramount importance for the correct diagnosis and treatment.     

Diarrhea caused by enterotoxigenic Escherichia coli infection of humans is inhibited by dietary calcium

BACKGROUND & AIMS: In several rat infection experiments, we have shown that dietary calcium inhibits intestinal colonization and translocation of invasive salmonella. The aim of the present study was to find out whether calcium is also protective against enterotoxigenic Escherichia coli (ETEC) infection. This was first tested in our rat model and subsequently verified in a human infection study. METHODS: Rats were fed a purified diet with either a low or a high amount of calcium phosphate and orally infected with ETEC. In addition, a parallel, double-blind, placebo-controlled intervention study of 3 weeks was performed with 32 healthy men. Subjects largely maintained their habitual diet and consumed either regular milk products (calcium supply, 1100 mg/day) or placebo milk products (calcium supply, 60 mg/day). On day 10, subjects ingested a live but attenuated ETEC strain (strain E1392/75-2A), able to induce mild although short-lived symptoms. Primary outcomes studied were infection-induced diarrhea (total fecal output and relative fecal dry weight) and fecal mucin excretion. RESULTS: In humans, ETEC induced diarrhea in both groups, in that total fecal output doubled and mean relative fecal dry weight dropped from 25% to 20%. Additionally, fecal mucin excretion was increased in both groups. All these fecal parameters were completely normalized in the calcium group on the second infection day, in contrast to the placebo group, which recovered on the third infection day. Likewise, supplemental calcium inhibited ETEC colonization and diarrhea in rats. CONCLUSIONS: Calcium in milk products improves human resistance to ETEC infection as it inhibits infectious diarrhea.     

新型肠出血性大肠杆菌感染防治

近日,新型肠出血性大肠杆菌感染疫情造成欧洲大量人群感染和40人死亡.本文就新型肠出血性大肠杆菌感染病原、病因、感染后临床特点及并发症的治疗进行重点介绍.     

An outbreak of food-borne enterotoxigenic Escherichia coli diarrhoea in England

An outbreak of diarrhoea with abdominal pain occurred among members of the staff of a school and their guests after a social function at which a cold buffet was served. Sixty people attended the function and 43 subsequently completed questionnaires. Of these, 27 had diarrhoea. The median incubation period was 36 h and the range 12-66 h. Food history analysis showed an association between diarrhoea and eating curried turkey mayonnaise. Stool specimens from 13 of those who developed diarrhoea were examined: Escherichia coli 06.H16 (producing heat-stable and heat-labile enterotoxins) was found in nine specimens and E. coli 027.H20 (producing heat-stable enterotoxin) in 11 specimens. Eight patients had both strains and only one was negative for enterotoxigenic E. coli. Food samples were not available for examination. Enterotoxigenic E. coli should be considered as a possible cause in well-defined outbreaks of food-borne diarrhoea with abdominal pain.     

Urinary Escherichia coli infection presenting with jaundice

A 53-year-old man with lupus erythematosus (LE) developed an acute hemolytic crisis. Alpha-hemolytic Escherichia coli were isolated from the patient's urine and feces, and high titer anti-alpha-hemolytic antibodies appeared in his serum. The hemolytic crisis could be controlled by specific antibiotic treatment of the urinary tract infection. It is assumed that the patient's basic disease -- and the steroid therapy applied -- facilitated the progression of the urinary tract infection, and before starting with adequate antibiotic treatment his erythrocytes must have been subjected to the effect of massive amounts of alpha-hemolysin. The idea that alpha-hemolysin might contribute to the development of severe hemolysis in man is discussed. It is also assumed that harbouring alpha-hemolytic E. coli in the gut may represent a special risk for the immunocompromised host.     

Neonatal meningitis caused by Escherichia coli in The Netherlands

Bacteriological and clinical data on 132 children with neonatal meningitis caused by Escherichia coli were analyzed as a part of a larger study of bacterial meningitis undertaken between 1976 and 1982 in The Netherlands. Eighty-eight percent of the E. coli strains that were isolated carried the K1 capsular antigen. Most (80%) of these E. coli K1 strains were serotyped as O7, O18, O83, or were autoagglutinable. The male/female ratio of the infants was 1.64. In the majority of cases the onset of meningitis was at the end of the first week of life. The birth weight of 42% of the infants was less than or equal to 2,500 g, and congenital defects were present in 11% of the infants. Thirty-seven percent of the neonates had no recognized risk factors. The case fatality rate was 26%. Meningitis recurred in 8% of the survivors.     

Primary chest wall abscess caused by Escherichia coli costochondritis

Chest wall abscess may occur as primary infection or secondary to open trauma or thoracic wall surgery. The authors describe an unusual case of Escherichia coli costochondritis occurring 2 months after a blunt chest wall trauma. Primary chest wall abscess due to E coli costochondritis has been previously reported only twice occurring after urinary tract infection. All other very few reports of E coli costochondritis have been reported only after thoracic surgical procedures. An English literature review of primary chest wall abscess showed that 4 pathogens are responsible for the majority of cases: Actinomyces, Staphylococcus aureus, Candida albicans and Salmonella. C albicans costochondritis was most commonly reported among heroin addicts. The appearance of a growing chest wall mass should always prompt a search for an infectious cause, even with little or no systemic signs and symptoms.     

Outbreak caused by Escherichia coli in Chalco,Mexico

OBJECTIVE: To identify the etiologic agent responsible for a disease outbreak following an overflow of sewage water in Valle de Chalco, Mexico. MATERIAL AND METHODS: A retrospective cross-sectional study was carried out. Rectal samples were collected from the population of Chalco valley, who suffered from diarrhea and vomiting during a natural disaster that took place on May 31, 2000. The Instituto de Diagnóstico y Referencia Epidemiológicos (Epidemic Reference and Diagnosis Institute, InDRE, Ministry of Health), received 1521 rectal swab samples from diarrhea cases, to test for E. coli strains. Statistical analysis was performed to find a difference of proportions between cases and non-cases (chi-squared test). ETEC, EIEC, EPEC and EHEC pathogenic E. coli groups were hybridized by colony blot. RESULTS: Strains isolated were ETEC (62.2%), EIEC (0.84%), EPEC (0.84%), and EHEC non-O157:H7 (0.08%); there was no hybridization in 36.02% of E. coli strains. Other isolated microorganisms were Salmonella spp (0.45%) and Shigella spp (0.06%). CONCLUSIONS: Enterotoxigenic E. coli was the most likely etiologic agent. Sanitary control strategies should be targeted to preventing outbreaks caused by this pathogenic agent. The English version of this paper is available at: http://www.insp.mx/salud/index.html.     

一起由产毒性大肠埃希菌引起的腹泻暴发疫情

本文对一起以腹泻为主要症状的暴发疫情进行了现场流行病学调查和实验室病原学检查,结合临床症状判断是由产毒性大肠埃希菌污染生活用井水引起的.     

Two cases of human urinary tract infection complicated by hemolytic uremic syndrome caused by verotoxin-producing Escherichia coli.

In 1993, 2 cases of urinary tract infection (UTI) caused by verotoxin-producing Escherichia coli were diagnosed at Rigshospitalet in Copenhagen, Denmark. Neither of the patients had any previous history of diarrhea. We suggest that E. coli strains isolated from UTI be examined for the production of verotoxin when hemolytic uremic syndrome is clinically suspected.     

Necrotizing lung infection caused by the protozoan Balantidium coli

Balantidium coli, a ciliated protozoan, is well known to cause intestinal infection in humans. Extraintestinal spread to the peritoneal cavity and genitourinary tract has rarely been reported. There have also been a few cases of lung involvement from this parasite. A case of B coli causing a thick-walled right upper lobe cavity in an organic farmer who had contact with aerosolized pig manure is reported. Bronchoalveolar lavage fluid examined for ova and parasite revealed trophozoites of B coli in large numbers. Treatment with doxycycline hyclate led to marked improvement. Necrotizing lung infection caused by the protozoan B coli should be considered in individuals who report contact with pigs.Key Words: Balantidium coli, Necrotizing lung infection     

Recurrent reactive arthritis associated with urinary tract infection by Escherichia coli.

We describe a patient with recurrent Escherichia coli urinary tract infection followed by recurrent reactive arthritis. During a 9 year period the patient developed 4 episodes of arthritis. During each attack, triggering infections were thoroughly investigated but no other causative infection was found. Although the urinary tract is not routinely targeted for triggering infections for reactive arthritis, we suggest that urinary tract infections should be included in the diagnostic investigations of patients with acute arthritis.