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E Coli
E Coli
coli
INTRODUCTION
E. coli is usually considered to be an
opportunistic pathogen which constitutes a
large portion of the normal intestinal flora of
humans
This organism can, however, contaminate,
colonize, and subsequently cause infection of
extraintestinal sites and is a major cause of
septicemia, peritonitis, abscesses, meningitis,
and urinary tract infections in humans
Morphology
usually motile, produce peritrichous flagella
some produce polysaccharide capsules
grow well on non-selective media, forming
smooth, colourless colonies 2-3 mm in
diameter in 18h on nutrient agar
temperature (15-45)
Biochemical reaction
aerobic or anaerobic --can grow in the
presence or absence of O2.
typically oxidase-negative
most strains ferment lactose & glucose with
the production of acid and gas
IMViC reaction : + + - -
Many strains
Serotypes:
Antibody antigen rxn
O antigen
Somatic (on LPS)
171 antigens
H antigen
Flagella
56 antigens
K antigen
Capsule and or
fimbrial antigen
80 antigens
18th O antigen
O18ac:H7:K1
1st K antigen
7th H antigen
11
Urovirulence Factors
Adherence
Fimbriae
Capsule
Hemolysis
a
b
Aerobactin
Siderophore
K antigens
Resist phagocytosis
Resist complement proteins
Endotoxin
Diarrhegenic E. coli
The most highly conserved feature of diarrheagenic E. coli
strains is their ability to colonize the intestinal mucosal
surface despite peristalsis and competition for nutrients by
the indigenous flora of the gut (including other E. coli strains)
diarrheagenic E. coli strains possess specific fimbrial antigens
that enhance their intestinal colonizing ability and allow
adherence to the small bowel mucosa, a site that is not
normally colonized
Five classes (virotypes) of E. coli that cause diarrheal diseases
are now recognized: enterotoxigenic E. coli (ETEC),
enteroinvasive E. coli (EIEC), enterohemorrhagic E. coli
(EHEC), enteropathogenic E. coli (EPEC), enteroaggregative E.
coli (EAggEC).
pathogenesis of ETEC
involves two steps:
intestinal colonization,
fimbrial adhesins e.g. CFA I, CFAII, K88. K99
non invasive
diarrheagenic enterotoxin(s) -- LT and/or ST toxin
both traits are plasmid-encoded
Enterotoxins
LT
(heatlabile)
toxin
ST
(heatstable)
toxin
heat-stable toxin
ST enterotoxin causes an increase in cyclic GMP
in host cell cytoplasm.
Those termed STa stimulate intestinal guanylate
cyclase, the enzyme that converts guanosine 5'triphosphate (GTP) to cyclic guanosine 5'monophosphate (cGMP). Increased intracellular
cGMP inhibits intestinal fluid uptake.
Those termed STb do not seem to cause diarrhea
by the same mechanism.
HEAT-STABLE ENTEROTOXINS
HEAT-STABLE ENTEROTOXINS
STb is a heat-stable enterotoxin which does
not cause intestinal fluid secretion in the
suckling mouse as STa does, but does cause
intestinal fluid secretion in pig intestinal loop
assays.
It is insoluble in methanol, while STa is
methanol-soluble
Control
controlled by preventing transmission and
by stressing the importance of breastfeeding of infants
The best treatment is oral fluid and
electrolyte replacement (intravenous in
severe cases).
Antibiotics are not recommended ----antibiotic-resistant pathogenic E coli
EIEC cells invade intestinal epithelial cells, lyse the phagosomal vacuole, spread
through the cytoplasm and infect adjacent cell
E. coli 015:H7
157th somatic O antigen
7th flagellar H antigen
Hemorrhagic colitis
Abdominal cramps, blood stools, with minor or
no fever
Enterohemorrhagic E. coli
EHEC
Reservoir
Healthy cattle are the major reservoir for
human infection
Deer, sheep, goats, horses, dogs, birds and flies
37
Ground beef
Raw milk
Lamb meat
Venison jerky
Salami and other fermented dried meat products
Lettuce, spinach, alfalfa sprouts
Unpasteurized apple cider
38
Clinical Features
39
Identification
MacConkey agar (SMAC)
Does not ferment sorbitol rapidly
Forms colorless colonies on sorbitol containing
MacConkey agar
Serology
Colorless colonies on SMAC are screened for the
0157 antigen
40
Shiga Toxins
Exotoxin
Very similar to toxin produced by Shigella dysenteriae
Inhibits protein synthesis in host cell
A subunit inactivates the 60S ribosomal subunit
A B exotoxin
A subunit exists on a temperate bacteriophage
41
Virulence Factors
Virulence plasmid (pO157)
Encodes a hemolysin
O157 strains can use iron from blood released into
the intestine
42