Escherichia coli: symptoms, diagnosis and treatment

By Cristiano Antonino On Apr 28, 2023

The name Escherichia coli indicates a group of Gram-negative bacteria normally present in the intestines of healthy people

However, some strains are harmful and, if they take over, can trigger all sorts of problems, such as severe stomach cramps, bloody diarrhea and vomiting.

These strains can mostly come from contaminated water or food, especially raw vegetables and undercooked ground beef.

Healthy adults usually recover from infection with this bacteria within a short time.

Young children and the elderly, on the other hand, have a higher risk of developing more dangerous forms.

Escherichia coli

Escherichia coli or E. coli is a bacterial species, certainly the best known of the genus Escherichia.

It belongs to the group of Gram-negative bacteria, which are part of the normal intestinal bacterial flora and which under normal conditions live in the intestine without causing problems, indeed helping to keep the digestive tract healthy.

In fact, they participate in the correct digestion of food, inhibit the growth of harmful bacterial species and are used to synthesize a certain amount of vitamins.

Most strains of E. coli are harmless and cause no problems other than fairly brief diarrhea.

However, some strains, such as Escherichia coli O:157 and EPEC, if they arrive in the intestine and take over, can be harmful to health.

Some strains of E. coli are also the cause of various extra-intestinal diseases, such as urinary tract infections, meningitis, peritonitis, septicemia and pneumonia. In particular, diseases due to the presence of E. coli in the urine are common.

A particular strain of Escherichia coli also causes the so-called “traveller’s diarrhea”, which is typically contracted by traveling in poor countries with poor hygienic conditions.

It manifests itself essentially with abdominal cramps and watery diarrhea, sometimes nausea and vomiting.

How do you get Escherichia coli

Essentially, the harmful strains of Escherichia coli come from contaminated food or water: the person gets sick from consuming these products.

The foods most at risk are fruit and vegetables (which are often eaten raw) contaminated by the feces of infected animals, especially cattle, unpasteurized milk and derived cheeses, uncooked or undercooked meat.

Transmission can also occur from person to person, especially if infected individuals do not wash their hands properly.

You can then become infected by drinking water in swimming pools or aquatic structures that is not adequately disinfected with chlorine, contaminated by feces of infected individuals, and by touching animals carrying the bacteria in their digestive tract.

Unlike many other harmful bacteria, E. coli can cause an infection even if only small amounts are ingested.

Risk factors

E. coli infection can affect anyone who is exposed to these bacteria.

However, some people are more likely to develop problems than others.

Risk factors include:

age: young children and the elderly have a higher risk of developing serious complications if they come into contact with the “bad” strains;
weakened immune system: people who have low defenses – for example due to AIDS, cancer treatments or therapies based on immunosuppressive drugs – are more likely to get sick;
consumption of certain foods, such as undercooked hamburgers and unpasteurized milk;
exposure to the bacterium in the summer: although it is not clear why, most E. coli infections occur from June to September;

Decreased levels of stomach acid: The acid in the stomach offers some protection against E. coli. If you take medications to reduce stomach acid, you may be at more risk.

Escherichia coli symptoms

Signs and symptoms of E. coli infection typically begin three to four days after exposure to the bacteria.

However, the timing varies: in some cases, they could appear just a day after exposure and in others even a week later.

Signs and symptoms include:

diarrhea, which can range from mild and watery to severe and bloody
stomach cramps,
abdominal pain,
nausea and vomit.

There are some strains that produce a powerful toxin that damages the lining of the small intestine.

This can cause bloody diarrhea.

Diagnosis

In the presence of one or more symptoms that make you suspect the presence of an E. Coli infection, it is important to contact your doctor, who will first evaluate the situation.

To diagnose the disease, it may also require stool tests and a coproculture, a useful test to test for the presence of the bacterium.

Escherichia coli cure

There is no specific treatment for Escherichia Coli infection.

In most cases, those affected are advised to rest and drink fluids to help prevent dehydration and fatigue from diarrhea and vomiting.

Avoiding certain foods, such as dairy products, fatty foods, high-fiber products, and highly seasoned foods, may also help, because they may make symptoms worse.

Unless otherwise directed by your doctor, it is best to avoid taking antidiarrheal drugs, because they slow down the activity of the gastrointestinal system, preventing the body from getting rid of toxins.

Antibiotics are generally not recommended because they do not appear to help this infection and may increase the risk of serious complications.

If the infection is severe and complications have occurred, such as haemolytic uremic syndrome (a disease characterized by severe kidney failure, low platelets, and severe anemia), hospitalization is required.

Treatment may include intravenous fluid administration, blood transfusions, and kidney dialysis.

At the moment, there are no vaccines or drugs that can protect against the infection triggered by Escherichia coli

To reduce the risks, it is important to observe the normal rules of hygiene and common sense such as:

wash your hands often,
do not handle food with dirty hands,
avoid swallowing water from lakes or swimming pools,
avoid consuming “risky” foods, such as undercooked hamburgers, unpasteurized milk, fruits, vegetables grown on land fertilized with manure from infected cattle farms;
before buying food, especially meat and vegetables, it is good to check their origin;
pay attention to cross-contamination (the contact between cooked and raw foods or materials such as cutting boards and knives used in the kitchen);
wash raw foods thoroughly;
adequately clean kitchen utensils and tools with hot water and soap, especially after contact with raw foods;
store cooked and raw foods in different containers or in any case separately.

Enterobacteria are thermo-sensitive and are destroyed by temperatures above 70 degrees.

This is why good cooking helps prevent enterobacterial infections.

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