MEDICAL LABORATORY TECHNOLOGY

CSI251 : MICROBIOLOGY III

ESCHERICHIA COLI
(E. COLI)

PREPARED BY: ZAKARIA ISMAIL

SESSION DISEMBER –MAC 2012/2013
 INTRODUCTION
☼ Discovered by Theodore von Escherich in 1885

☼ 2 microns in length and 1 micron in wide

☼ Rod shaped

☼ Covered with small pili

☼ Family : Enterobacteriaceae

☼ Genus : Escherichia

☼ Species : E. coli (main)

 PATHOGENICITY
☼ Urinary Tract Infection
 Patient with cystitis (bladder infection) and pyeloneophritis
(kidney infection)
 Common in women

☼ Infections are wounds, peritonitis, sepsis and endotoxin induced

shock.

☼ Meningitis and bacteremia in neonates (E. coli capsular type K1)

☼ Diarrhoeal disease
 Infantile gastroenteritis
 Travellers’ diarrhoea
 Dysentery
 Haemorrhagic diarrhoea which may progress to HUS
 HABITAT
☼ Gastrointestinal tract (GIT) of human

☼ Abundant in soil, water and vegetation

☼ Used as indicator of human health risk from harmful organism

present in water

☼ The median number of E. coli present in water samples should

< than 126/100 mL if it is to use for recreation
 INFECTIONS
☼ 4 major types of E. coli strains

 Enteropathogenic (EPEC)

 Enterotoxigenic (ETEC)

 Enteroinvasive (EIEC)

 Enterohemorrhagic (EHEC) / E. coli 0157

☼ Enteropathogenic (EPEC)

 Infantile diarrea
 Due to bacteria adhering to epithelial cell, multiply and
causing lesion
 Common in children, adults are rare
 Low-grade fever, malaise, vomiting and diarrhea
 Stool contains great amount of mucus, but blood is not usually
present
 Outbreaks in hospital nurseries
 Can be life threatening to babies
 Rehydration
☼ Enterotoxigenic (ETEC)

 Infants and adults in developing countries

 Travelers diarrhea (faecal-oral route)
• The organism are likely to be new in their immune systems
 Colonisation of SI causes release of
• Heat labile (LT)
• Heat stable toxin (ST)
 Acquired by ingesting contaminated food or water
 Poor sources of clean drinking water
 Poor hygiene
 Infections
• 1-5 days
• Non-bloody and watery diarrhea
• Nausea
• Abdominal cramps
• Low-grade fever
 Dehydration in infants and young children
 Low incidence in adults
 Breast fed infants suggest protective immunity
 ETEC virulence factor
• Able to secrete 2 types of exotoxins that can act enteric
tract
i. Heat labile (similar to cholera toxin)
ii. Heat stable
• Causes stomach upset resulting to large amount of fluid
secretion
☼ Enteroinvasive (EIEC)

 Non motile (resembling Shigella)

 Causes dysentery (resembling Shigella)
 Direct penetration, invasion and destruction of intestinal
mucosa
 Child and adult transmitted via fecal-oral route
 Fever, severe abdominal cramps, malaise, watery diarrhea,
toxemia accompanied by stools containing mucus, pus and
blood
☼ Enterohemorrhagic (EHEC)

 Widely known for its lethal capability, E. coli 0157:H7 is the

most common and dangerous strain of E. coli
 Found in faeces and meat
 When milk, water, and even the air come in contact with cow
feces they may become contaminated with E. coli
 Meat is the primary source of infection in humans especially
ground meat
 Low infective dose (10 organism)
 Contaminations is caused by direct exposure to fecal matter of
cattle
 To eradicate E. coli 0157:H7, the contaminate material must be
cooked at >160°F
 Associated with hemorrhagic diarrhea and HUS (Hemolytic
Uremic Syndrome)
 E. coli 0157 VF : Shiga like toxin,
2 cytotoxins,
verotoxins I and II
 Adherence and colonization
 Identified by stool culture on sorbitol MacConkey medium
(E. coli 0157 does not ferment sorbitol in 48 hours),
biochemical test and finding the erotoxin in stool filtrates
 The infection can be fatal especially in young and elderly
 Processed meat, undercooked hamburger, unpasteurized milk,
mayonnaise have been implicated in the spread of organism
☼ Enteroaggregative (EAEC)

 Causes chronic watery diarrhoea and vomitting, mainly

children
 Due to bacteria adhering to tissue cells often in stacks
(aggregates)
 EPIDEMIOLOGY
☼ Recognised in 1980

☼ Jan 93
 3 children died after eating undercooked hamburger at fastfood
restaurant in Washington

☼ In US, approximately 73000 people afflicted with E. coli

0157:H7 and 50-60 people die each year

☼ Jan 93-Sept 95
 63 reported outbreaks in 23 states

☼ In Japan
 School lunch outbreaks
 SIGN & SYMPTOMS
☼ Vomiting

☼ High fever

☼ Prolonged diarrhea (infants)

☼ Feces with blood, mucus and pus

☼ Severe stomach cramps and stomach tenderness

☼ Diarrhea

☼ Nausea
 LAB DIAGNOSIS
☼ Specimen
 Pus
 Urine
 Blood

☼ Microscopic morphology
 Gram negative bacilli
 Motile rod
☼ Cultural morphology on selective and differential media
 Blood : Mucoid
β-hemolytic colonies
 MacConkey : LF (Pink)
Some EPEC are NLF
(Colorless)
 EMB : Green sheen
 Sorbitol MacConkey : EHEC 0157:H7 (No color)
 Most strain do not grow on XLD, DCA, SS or other selective
media used to isolate Shigella/Salmonella
 BIOCHEMICAL TEST
Indole Positive
Methyl Red (MR) Positive
Voges-Proskauer (VP) Negative
Citrate Negative
Motility Positive (most strain)
Triple Sugar Iron (TSI) A/A, gas present, no H2S
Urease Negative
Phenylalanine Deaminase Negative
(PD)

☼ Some EIAC gives similar biochemical reaction as Shigella spp.

 AST
☼ Antimicrobials that are used against Gram negative organisms
 Sulphonamides
 Trimethophrim
 Cotrimoxazole
 Nalidixic acid
 Tetracycline
 Ampicilin
 Aminoglycosides

☼ Plasmid-mediated antibiotic resistance, however, is common

☼ In treatment of E. coli diarrhea, the use of antibiotics is in general

only for minor importance
THANK
YOU