Escherichia coli bacterial diarrhea

Diarrhea—Bacteria, viruses, or parasites can cause diarrhea, which depletes the body of nutrients and fluids. Loose watery stools are accompanied by nausea, abdominal cramps, and vomiting. Oral rehydration treatment acts to replenish fluid loss and rectify electrolyte imbalances. Different types of diarrhea include travelers diarrhea, normally caused by Escherichia coli bacterial dysentery (shigellosis), an acute bacterial infection of the large intestine amoebic dysentery, where cysts of infecting organisms are transmitted through food and water and giardiasis, caused by parasites that infect the small intestine. 

Bacteria are likely precipitants in many other cases including Escherichia coli, Salmonella species, Shigella species, Vibrio cholerae, and Clostridium difficile. The term dysentery has often been used to describe some of these bacterial infections when associated with serious occurrences of bloody diarrhea. Additionally, acute diarrheal conditions can be prompted by parasites-protozoa such as Entamoeba histolytica, Microsporidium, Giardia lamblia, and Cryptosporidium parvum. Most of these infectious agents can be causes of traveler s diarrhea, a common malady alflicting travelers worldwide. It usually occurs during or just after travel subsequent to the ingestion of fecally-contaminated food or water. It has an abrupt onset but usually subsides within 2 to 3 days. 

After the submission of this paper several publications have appeared in the literature that reinforce the role of rifaximin in the treatment of infectious diarrhea [1]. An entire issue of the Journal of Travel Medicine devoted to the use of this antibiotic in the treatment of traveler s diarrhea (TD) has been published [2-5], In addition, a recent paper from our laboratory [6] confirmed the rifaximin efficacy also in enteroaggregative Escherichia coli-mediated TD. Furthermore, in a randomized, double-blind, placebo-con-trolled study [7] even once daily administration of the antibiotic proved to be capable of preventing TD. Finally, Lawler and Wallace [8] recently reviewed the treatment options for bacterial diarrhea and considered rifaximin a useful addition to our therapeutic armamentarium. 

There is some evidence that bismuth subsalicylate can be effective in travelers diarrhea due to Escherichia coli and for nonspecific diarrhea by such mechanisms as binding bacterial toxins, bactericidal action and local anti-inflammatory effects. 

The bacteria colonizing the small bowel (such as Escherichia coli and Bacteroides species) deconjugate and dehydroxylate bde salts, leading to conjugated bde salt deficiency, which causes fat malabsorption. Bacterial metabolism of vitamin B12 may also occur, leading to vitamin B,2 deficiency. The clinical symptoms of bacterial overgrowth are abdominal pain, diarrhea, and steatorrhea. ... 

Viral and bacterial organisms account for most episodes of infectious diarrhea. Common causative bacterial organisms include Shigella, Salmonella, Campylobacter, Staphylococcus, and Escherichia coli. Food-borne bacterial infection is amajor concern, as several major food poisoning episodes have occurred that were traced to poor sanitary conditions in meat-processing plants. Acute viral infections are attributed mostly to the Norwalk and rotavirus groups. 

Rifaximin is an antiinfective agent that inhibits bacterial RNA synthesis. It is indicated in the treatment of traveler s diarrhea by noninvasive strains of Escherichia coli. 

Enterotoxins. Toxic proteins formed by bacteria with molecular masses in the range from 27000 to 30000 which are usually excreted into the medium ( exotoxins). E. can be taken up with contaminated food or be formed by the bacteria colonizing the intestinal walls. Finally, the bacteria can penetrate the intestinal walls and then start to excrete the E. Some E. are thermally very stable and survive when food is boiled. E. from Salmonella and Staphylococcus species are the most frequent causes of food poisoning. Shortly after uptake, the symptoms of nausea, vomiting, diarrhea, and circulatory complaints occur. Deaths are rare and occur only when the subject is already in a weakened state. The sites of attack by E. vary, e.g., at intestinal epithelial cells or in the vegetative nervous system. For the production of antitoxins, E. are obtained by lysis of bacterial cells or from cell-free culture filtrates. E. have been detected, e. g., in the following bacterial species Bacillus cereus, Clostridium perfringens, Escherichia coli. Vibrio cholerae. Staphylococcus aureus, and Streptococcus faecalis. 

Berberine is currently being used to treat gastrointestinal-related medical disorders due to infections including bacterial diarrhea caused by Vibrio cholerae and Escherichia coli and intestinal parasites. The mechanism of the antidiarrheal activity of berberine has not been described yet. According to the study performed by Baker et al., berberine significantly inhibits myoelectric activity and transit of the small intestine that appears to be partially mediated by opioid and a-adrenergic receptors, concluding that the antidiarrheal properties of berberine may be mediated, at least in part, by its ability to delay small intestinal transit [67]. 

---