In 1885, Theodor Escherich had isolated the bacteria Escherichia coli from fecal material in newborns. Although it was initially thought to be a commensal organism, fifty years later scientists noticed that E. coli was in fact the cause of diarrhea in infants.
E. coli is a gram-negative rod bacteria and a facultative anaerobe. This means that it can live with and without the presence of oxygen (1). Their preferred temperature in which they grow is 37 degrees. This is the equivalent to our body temperature, making our bodies very hospitable for E. coli growth (2). E. coli will not grow spores. (3) However, they do possess acidic polysaccharide capsules. (4) E. coli are motile organisms and they move by means of their flagella (1).
E. coli may cause one of three different infections: urinary tract infection, neonatal meningitis, and or intestinal diseases. However, it most commonly causes intestinal disease. There are five classes of the bacteria that will cause this: enterotoxigenic E. coli, enteroinvasive E. coli, enterohemorrhagic E. coli, enteropathogenic E. coli and enteroaggregative E. coli. All five of these strains cause diarrhea. For
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the sake of simplicity, this paper will only focus on enteropathogenic E. coli. Transmission of E.
coli is spread from animals to people through by consumption of contaminated food and liquid. Common foods and liquids that might cause E. coli outbreaks include undercooked or raw hamburgers, salami, spinach, lettuce, sprouted seeds, unpasteurized milk, apple juice, and well water or water that animals frequently use. Other high-risk actions include failure to wash hands after contact with animals, and swimming in water that has low levels of sewage contamination (5). Enteropathogenic E. coli is seen all over the world but is more prominent in developing countries because of the lack of sanitation practices. It also is more frequent in younger people including children and infants less than two years of age. Therefore most of the E. coli outbreaks occur either in daycare centers or in pediatric wards.
(11) Effector proteins are the main virulence factors of E. coli. Most of the effector proteins are encoded in the LEE (locus of enterocyte effacement) but some of them are non-LEE encoded effector proteins. Some LEE-encoded effector proteins include intimin, Esc and Sep proteins, Ces proteins, EspA, EspB, and EspD. NleA-H which are also called EspI and EspJ are also effector proteins that are not encoded by LEE. When E. coli infects the intestinal system, the bacteria make A/E (attaching and effacing) lesions. When the bacteria come in contact with an intestinal cell, the bacteria produce bundle-forming pilli (10). The bundle forming pilli attach onto the host cell’s microvilli. An adhesion called actin mediates host cell attachment. Esc and Sep proteins that make up T3SS machinery deliver effector proteins, including Ces protein, EspA, EspB, and EspD into the host cell. Once effector proteins are in the cell, EspB and EspD interact to form pores in the host membrane for EspA to form a needle-shaped structure projecting from the host cell membrane to bacterial. Inside Ces proteins act as chaperones to form polymers to force the bacteria to rise up on the surface of the host cell, making a platform for the bacteria. This decreases any trace of microvilli that once was and creates a disturbance on the host cells surface. The decrease of microvilli in the intestine will in turn decrease the intestines’ absorptive surface area, and this diminish the intestinal cell’s ability to secrete and absorb. This causes the host to exhibit the symptom of diarrhea (8) (10) Enteropathogenic E. coli is the most important cause of traveler’s diarrhea in Mexico and Northern Africa. It causes a watery, yet sometimes bloody diarrhea. (1) Other symptoms of enteropathogenic E. coli include vomiting and low grade-fever. Normally, diarrhea will last anywhere from a month to four months. If diarrhea persists for a long period of time, the diarrhea is severe, or the patient is improperly treated, other related complications such as dehydration and electrolyte imbalance will occur. If such complications are not properly treated, it can sometimes result it death. The reported mortality rate is 25-50%. However, third world countries have a bigger mortality rate due insufficient health care (11) Most times, E. coli that causes intestinal diseases should go away without specific treatment. The main treatment is to keep up your electrolyte levels and hydration. Even if the patient has been vomiting, it is still possible to administer liquid in small amounts. If the patient has pediatric gastroenteritis, antimotility agents should be prescribed. Normally antibiotics aren’t prescribed until culture results are available. If one administers antibiotics to toxin producing E. coli, it may increase the microorganism’s ability to produce Shiga toxins. Since enteropathogenic E. coli does not release any toxins, they can still be prescribed (9). Treatment of traveler’s diarrhea is rarely ever necessary; though if it is necessary, you should follow antibiotic drug protocol prescribing first line antibiotics including Sulfamethoxazole and Trimethoprim. If first line antibiotics don’t work, then treatments such as second line antibiotics should be used, then third line and so fourth until the infection is gone. Prophylaxis medications including bismuth subsalicylate, trimethoprim and sulfamethoxazole should not be prescribed to children because of the chance of salicylate accumulation or allergic reactions. (12) There is no vaccine for the E. coli virus yet. The difficulty of developing one lies in the variety of different E. coli bacteria and their corresponding virulence factors. However, Scientists have studied ways to map out virulence factors of E. coli (specifically ETEC). This will increase the chances of finding a vaccine for the bacteria (6).
E. Coli 0157, written by Mary Heersink, is a nerve-racking, adrenaline-filled story of a mother's experience with a then unknown deadly bacteria. The book brings up many reactions in its readers, especially the questioning of the practice of doctors in hospitals. The reader's knowledge base of scientific procedures in emergency centers was widened as well as the knowledge of how to the human body reacts to different agents in its system.
Clostridium difficile, otherwise known as C. diff, is a species of spore-forming, anaerobic, gram-positive bacteria that is known to cause watery diarrhea. 1 The genus name, Clostridium refers to the spindle shape of the organism while Difficile means difficult in Latin due to the fact that this organism thrives in unfavorable conditions and is very difficult to isolate.4 The incidence of getting CDI has increased over the years due to new strains of increased toxin production of the bacteria and increased resistance to antibiotics.2 It is a gastrointestinal infection, and the most common cause of infectious diarrhea.1 C. difficile was first identified in the feces of healthy newborns back in the 1930’s and by 1935, it was considered normal flora. 2 During 1974, researchers conducted that about 21% of patients that were treated with an antibiotic called clindamyacin reported diarrhea and about 10% of them reported to have conducted pseudomembranous colitis as a side effect of this treatment. 2 It was in 1978 where C. diff had been known to cause anti-biotic associated diarrhea and pseudomembranous colitis. 2 It is known to form spores that resist many disinfectants; it also survives for several months on different surfaces.1 It is a common form of a nosocomial infection and the prevalence of becoming infected with C. diff is about 0-15% in a health care setting. 3 The spores survive well in environments such as soil, water and animals and is distributed worldwide. 4 CDI produces two toxins (Toxin A and B), which are cytotoxic and cause tissue necrosis.4
ABSTRACT: Water samples from local ponds and lakes and snow runoff were collected and tested for coliform as well as Escherichia coli. Humans as well as animals come into contact with these areas, some are used for recreational activities such as swimming and some are a source of drinking water for both animals and humans The main goal of this experiment was to see which lakes, snow run off and ponds tested positive for coliform or Escherichia coli and to come up with some reasoning as to why. It was found that the more remote pond with less contact contained the most Escherichia coli. However, another lake that many swim in and use as their drinking water indeed tested positive for a small amount of Escherichia coli. The two samples from the snow showed negative results for both coliform and Escherichia coli and the two more public ponds that aren’t as commonly used as a source of human drinking water but animal drinking water tested in the higher range for coliforms but in the little to no Escherichia coli range. It was concluded that the remote pond should be avoided as it’s not a safe source of drinking water for humans or animals. Other than that, the the other ponds are likely to be safe from Escherichia coli, but coliforms are a risk factor.
The SMART goal for the patient’s diagnosis of diarrhea is that the patient will defecate formed, soft stool every 1 to 3 days and will express relief of cramping with little or no diarrhea. The intervention to meet this smart goal is the administration of fidaxomicin, a narrow spectrum antibiotic, to treat the infection of Clostridium difficile (Sears, 2013). Another nursing intervention for the treatment of diarrhea is assessing the patient for sodium and potassium loss, as well as explaining the prevention methods to avoid the spread of excessive diarrhea (Mitchell, 2014). The nurse must also provide proper skin integrity care to the peritoneal are and make the environment safe and easy for access to the bathroom. The SMART goal for the patient’s diagnosis of acute pain is that the patient will state relief of pain in abdominal area after treatment with opioids in a 24hr period. The nursing intervention for acute pain is the administration of opioids as well as positioning to keep patient in as much comfort as possible and take pressure off of the abdominal area. The nurse must also assess the patient’s vital signs and pain level
During the event of a communicable disease outbreak, as a human services administrator, I would take all of the necessary steps to communicate to youths, parents and medical staff in a timely and efficient manner. My priority would be to isolate the disease as much as possible and to assist those that have been infected with getting the treatment that they need (Graham-Clay, 2005). In the event that there is an outbreak of a disease such as E-coli within a local high school, I would begin by notifying the medical staff immediately. Considering the fact that Ecoli is a food borne illness, it is considered to be a public health crisis and should be handled as such. There are three recognized phases of a crisis: prevention, preparedness, and recovery. Each of these phases requires planned communication strategies. An outbreak often creates a high-emotion, low-trust situation (Heymann, 2004).
E. Coli and other foodborne illnesses are something that should be of major concern to everybody, becasue nobody is safe from it. It is not something that can be prevented or
Linton, Alan. 1982. Microbes, Man and Animals: The Natural History of Microbial Interactions. John Wiley & Sons. 342pp
E. coli are bacteria that can cause an infection in various parts of your body, including your intestines. E. coli bacteria normally live in the intestines of people and animals. Most types of E. coli do not cause infections, but some produce a poison (toxin) that can cause diarrhea. Depending on the toxin, this can cause mild or severe diarrhea.
Bacterial cells, like plant cells, are surrounded by a cell wall. However, bacterial cell walls are made up of polysaccharide chains linked to amino acids, while plant cell walls are made up of cellulose, which contains no amino acids. Many bacteria secrete a slimy capsule around the outside of the cell wall. The capsule provides additional protection for the cell. Many of the bacteria that cause diseases in animals are surrounded by a capsule. The capsule prevents the white blood cells and antibodies from destroying the invading bacterium. Inside the capsule and the cell wall is the cell membrane. In aerobic bacteria, the reactions of cellular respiration take place on fingerlike infoldings of the cell membrane. Ribosomes are scattered throughout the cytoplasm, and the DNA is generally found in the center of the cell. Many bacilli and spirilla have flagella, which are used for locomotion in water. A few types of bacteria that lack flagella move by gliding on a surface. However, the mechanism of this gliding motion is unknown. Most bacteria are aerobic, they require free oxygen to carry on cellular respiration. Some bacteria, called facultatibe anaerobes can live in either the presence or absence of free oxygen. They obtain energy either by aerobic respiration when oxygen is present or by fermentation when oxygen is absent. Still other bacteria cannot live in the presence of oxygen. These are called obligate anaerobes. Such bacteria obtain energy only fermentation. Through fermentation, different groups of bacteria produce a wide variety of organic compounds. Besides ethyl alcohol and lactic acid, bacterial fermentation can produce acetic acid, acetone, butyl alcohol, glycol, butyric acid, propionic acid, and methane, the main component of natural gas. Most bacteria are heterotrophic bacteria are either saprophytes or parasites. Saprophytes feed on the remains of dead plants and animals, and ordinarily do not cause disease. They release digestive enzymes onto the organic matter. The enzymes breakdown the large food molecules into smaller molecules, which are absorbed by the bacterial cells. Parasites live on or in living organisms, and may cause disease. A few types of bacteria are Autotrophic, they can synthesize the organic nutrients they require from inorganic substances. Autotrophic bacteria are either photosynthetic or Chemosynthetic. The photosynthetic bacteria contain chlorophyll that are different from the plant chlorophyll. In bacterial photosynthesis, hydrogen is obtained by the splitting of compounds other than water.
One major outbreak was on March and April 1998. The major outbreak was Salmonella Enteritidis associated with the contamination of cheese in a commercial product. This happened in Newfoundland. Nearly 700 cases were reported, most of which were children that got the illness. It was found that the source of the outbreak of Salmonella Enteritidis was the cheese in a prepackaged processed lunch packs. The cheese was contaminated when it was being packaged into the lunch packs. It was never found how the cheese got contaminated, but they discover that the cheese was contaminated before it arrived to the place where the products were processed and packaged. They suspect that something must have happen in Parmalat¡¦s plant, the company that provides the cheeses for the lunch pack, because it was only the cheese that got contaminated. However, they will not release any information, so the real explanation of how the cheese got contaminated will never be known.
Food-borne transmission refers to any illness that results due to the consumption of contaminated food, pathogenic bacteria, viruses, or parasites that contaminate food, as well as chemical or natural toxins such as poisonous mushrooms (cdc.gov). Bacteria is the most often the pathogen that causes food-borne illness. This is usually due to improper handling of foods, improper preparation of food and improper food storage. According to the CDC, the top 5 contributing pathogens to food-borne illness are Norovirus, non-typhoidal Salmonella, Clostridium perfringens, Campylobacter spp. and Staphylococcus aureus.
Salmonella is also a bacterium that is widespread in the intestines of birds, reptiles, and mammals. It can spread to the human species a variety of different ways; through foods or animal origins. Some examples of food involved in outbreaks are eggs, poultry and other meats, raw milk and chocolate. The illnesses it causes are typically fever, diarrhea, and abdominal cramps. In people with poor underlying health or weakened immune...
It was believed that cholera was caused by an exorbitant production of bile by the patient before the study of bacteria gained importance and before microorganisms were linked to infectious diseases. In the 1800s this explanation was no longer adequate,and scientists started to look for new answers. In the 19th century, around the time a cholera pandemic was devastating Asia, the disease arrived in Italy. Pacini started performing autopsies on the bodies of victims intransigent...
A meta-analysis of some controlled trails has proved that probiotics are effective in preventing antibiotic associated diarrhea [23], including the yeast Saccharomyces boulardii and bacterium lactobacillus acidophilus in combination with L. bulgaricus. A variety of probiotics like lactobacillus species, enterococcus species , etc are effective in the treatment of diarrhea in both adults and children by reducing the mean duration of the diseases by more than 30 hr [24].
A common source of food poisoning is cross contamination. This occurs when raw food mixes with cooked food (Hollingsworth). It can happen when the same utensil or surface is used in food preparation. Fecal Materials can also contaminate food before it reaches the one who prepares it (“E. Coli Now”).