E. coli Diagnosis and Treatment

E. coli Diagnosis and Treatment


DIAGNOSIS:
  • Organisms grow rapidly on most culture media(MacConkey Agar plate)
  • EMB agar—Selective AND Differential
  • E. coli forms blue-black colonies with a green metalic sheen. (due to lactose fermentation)

UTI Diagnosis

  • Bacteriuria>105/ml asymptomatic
  • Bacteriuria of > l04/ml in symptomatic
  • Bacteriuria of >102/ml in catheterized sample
  • Bacteriuria of any degree in suprapubic aspirate
  • Presumptive diagnosis of bacteriuria ie made by: –
  • Griess nitrite test
  • Catalasenitrite teest
  • Triphenyl tetrazolium chloride test
  • Methods for detection of ETEC enterotoxins 

Assay

LT

ST

In vivo tests

±

+

+

?

Ligated rabbit deal loop

Read at 6 hours

Read at 18 hours

Infant rabbit bowel

+

+

Infant mouse intragastric (4 hours)

+

Adult rabbit skin (vascular permeability)

+

?

In vitro tests

 

 

Tissue culture tests

 

 

Rounding of Y1 mouse adrenal cells

Elongation of chinese hamster ovary (CHO) cells

+

 ?

Serological tests

 

 

ELISA

+

(ST-ELISA with

monocolonial antibody)

Passive agglutination tests, passive immune hemolysis, precipitin (Eiken’s) test

+

Genetic tests

 

 

DNA probes

+

 +

TREATMENT, PREVENTION & CONTROL:
  • Antibiotic therapy is guided by in vitro susceptibility tests
  • UTI
  • DOC: Fluotoquinolone
  • Diarrhea
  • Fluid and electrolyte correction
  • Drug resistance is plasmin mediated
  • Lactoferrin 
  • Binds to iron and makes it unavailable for E.coli 
  • Acts a defence mechanism against infections
  • Appropriate infection-control practices are used to reduce the risk of nosocomial infections 
  • Restricting use of antibiotics
  • Avoiding unnecessary use of urinary tract catheters
  • Maintenance of high hygienic standards to reduce the risk of exposure to gastroenteritis strains
  • Proper cooking of beef products to reduce risk of EHEC infections

Vaccines 

  • Against Adhesins 
  • colonization factor antigen
  • Dr adhesins
  • K-88 antigen 
  •  K-99 antigen can prevent attachment of diarrhoeagenic E.coli to the specific receptors in the gastro-intestinal tract.
Exam Question
 
DIAGNOSIS:
  • EMB agar—Selective AND Differential
  • E. coli forms blue-black colonies with a green metalic sheen. (due to lactose fermentation)

Methods for detection of ETEC enterotoxins

Assay

LT

ST

In vivo tests

±

+

+

?

Ligated rabbit deal loop

Read at 6 hours

Read at 18 hours

Infant rabbit bowel

+

+

Infant mouse intragastric (4 hours)

+

Adult rabbit skin (vascular permeability)

+

?

In vitro tests

 

 

Tissue culture tests

 

 

Rounding of Y1 mouse adrenal cells

Elongation of chinese hamster ovary (CHO) cells

+

 ?

Serological tests

 

 

ELISA

+

(ST-ELISA with

monocolonial antibody)

Passive agglutination tests, passive immune hemolysis, precipitin (Eiken’s) test

+

Genetic tests

 

 

DNA probes

+

 +

 Lactoferrin 
  • Binds to iron and makes it unavailable for E.coli 
  • Acts a defence mechanism against infections
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