Escherichia coli: Difference between revisions
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*Rapid assay for Shiga toxin | *Rapid assay for Shiga toxin | ||
==Management== | ==Management<ref>Bush LM and Perez MT. | ||
Infection by Escherichia coli O157:H7 and Other Enterohemorrhagic E. coli (EHEC). Merck Manual. http://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/infection-by-escherichia-coli-o157,-c-,h7-and-other-enterohemorrhagic-e,-d-,-coli-(ehec)</ref>== | |||
*'''Supportive only''' | |||
*Do not treat with antibiotics | |||
**Abx do not alleviate sxs, reduce carrier risk of organism, or reduce HUS risk | |||
**Ciprofloxacin may increase enterotoxin release | |||
*7-14 days after infection, highest risk for HUS, which may need f/u and monitoring of: | |||
**Proteinuria | |||
**Hematuria | |||
**Red cell casts | |||
**Cr elevation | |||
===[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>=== | ===[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>=== | ||
{| class="wikitable" | {| class="wikitable" | ||
Revision as of 23:27, 20 February 2016
Background
Clinical Features
Differential Diagnosis
Acute diarrhea
Infectious
- Viral (e.g. rotavirus)
- Bacterial
- Campylobacter
- Shigella
- Salmonella (non-typhi)
- Escherichia coli
- E. coli 0157:H7
- Yersinia enterocolitica
- Vibrio cholerae
- Clostridium difficile
- Parasitic
- Toxin
Noninfectious
- GI Bleed
- Appendicitis
- Mesenteric Ischemia
- Diverticulitis
- Adrenal Crisis
- Thyroid Storm
- Toxicologic exposures
- Antibiotic or drug-associated
- Inflammatory bowel disease
Watery Diarrhea
- Enterotoxigenic E. coli (most common cause of watery diarrhea)[1]
- Norovirus (often has prominent vomiting)
- Campylobacter
- Non-typhoidal Salmonella
- Enteroaggregative E. coli (EAEC)
- Enterotoxigenic Bacteroides fragilis
Traveler's Diarrhea
- Giardia lamblia
- Cryptosporidiosis
- Entamoeba histolytica
- Cyclospora
- Clostridium perfringens
- Listeriosis
- Helminth infections
- Marine toxins
- Ciguatera
- Scombroid poisoning
- Paralytic shellfish poisoning
- Neurotoxic shellfish poisoning
- Diarrheal shellfish poisoning
Diagnosis
- Stool culture
- Rapid assay for Shiga toxin
Management[2]
- Supportive only
- Do not treat with antibiotics
- Abx do not alleviate sxs, reduce carrier risk of organism, or reduce HUS risk
- Ciprofloxacin may increase enterotoxin release
- 7-14 days after infection, highest risk for HUS, which may need f/u and monitoring of:
- Proteinuria
- Hematuria
- Red cell casts
- Cr elevation
Antibiotic Sensitivities[3]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
Table Overview
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See Also
References
- ↑ Marx et al. “Cholera and Gastroenteritis caused by Noncholera Vibrio Species”. Rosen’s Emergency Medicine 8th edition vol 1 pg 1245-1246.
- ↑ Bush LM and Perez MT. Infection by Escherichia coli O157:H7 and Other Enterohemorrhagic E. coli (EHEC). Merck Manual. http://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/infection-by-escherichia-coli-o157,-c-,h7-and-other-enterohemorrhagic-e,-d-,-coli-(ehec)
- ↑ Sanford Guide to Antimicrobial Therapy 2014