Enterovirulent E. coli (EEC)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What are the prognoses (outcomes) of enterovirulent E. coli infections?

Although individuals are frequently uncomfortable with EEC infections, most individuals that live in industrialized countries that get these infections have few if any serious complications. However, people that are immunocompromised and children in third world countries often have complications. Some countries report a death rate in children as high as 50%, with dehydration playing a central role in these deaths due to EEC bacteria. People infected with strains that are highly virulent like E. coli 0104:H4 are at risk for complications and a less favorable prognosis.

People with EHEC group infections (E. coli 0157:H7 is the major serotype) usually (about 90%) have a self-limited disease and the outcome is excellent. However, the prognosis declines, depending on the development of complication(s). Good hydration decreases the chances of complications and improves the outcome. Individuals who develop hemorrhagic diarrhea and are treated promptly have better outcomes with reduced hospitalization. Complications such as HUS and TTP have a wide range of prognosis from good to poor, depending on the overall health of the individual and how quickly the complications are diagnosed and treated. For example, some individuals can recover completely, but others may require IV fluids, plasma exchange, plasma infusion, or dialysis and may have end-organ failure (usually kidney failure) and neurologic problems. A few (about 10%) of TTP patients will die.

Although infrequent, even relatively healthy children and adults have died from EEC infections due to dehydration.

Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease

REFERENCES:

CDC.gov. CDC Health Advisory: Notice to Health Care Providers — Shiga Toxin-producing E. coli O104 (STEC O104:H4) Infections in U.S. Travelers Returning from Germany. June 3, 2011.

FDA.gov. BBB - Escherichia coli O157:H7 (EHEC).

Itskowitz , M., Bacterial Diarrhea, N. Engl. J. Med., 2010; 362:558-559, 2010

Sodha SV, Griffin PM, Hughes JM. Foodborne Disease. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone, Chapter 99, 2009

MedscapeReference.com. Bacterial Gastroenteritis.

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