Escherichia coli urinary tract infection

A 49-year-old woman is treated for an Escherichia coli urinary tract infection (UTI). During treatment, the woman experiences hemolysis. 

Miedouge M, Hacini J, Grimont F, Watine J. Shiga toxin-producing Escherichia coli urinary tract infection associated with hemolytic-uremic syndrome in an adult and possible adverse effect of ofloxacin therapy. Qin Infect Dis 2000 30(2) 395-6. 

Escherichia coli ++ Urinary tract infections, meningitis, peritonitis, mastitis, septicemia, gastrointestinal toxicity and Gramnegative pneumonia. 

Polymyxin B may be indicated (when less toxic drugs are ineffective or contraindicated) in serious infections caused by susceptible strains of the following organisms Haemophilus influenzae (meningeal infections) Escherichia coli (urinary tract infections) Enterobacter aero-genes (bacteremia) Klebsiella pneumoniae (bacteremia). In meningeal infections, polymyxin B sulfate must be administered only intrathecally. 

Johnson JR. Virulence factors in Escherichia coli urinary tract infection. Clin Microbiol Rev 1991 4 80-128. 

The sulfonamides are often used to control urinary tract infections caused by certain bacteria such as Escherichia coli, Staphylococcus aureus, and Klebsiella-Enterobacter. Mafenide (Sulfamylon) and silver sulfadiazine (Silvadene) are topical sulfonamides used in the treatment of second- and third-degree bums. Additional uses of the sulfonamides are given in the Summary Drug Table The Sulfonamides. 

Perfetto EM, Gondek EK. Escherichia coli resistance in uncomplicated urinary tract infection a model for determining when to change first-line empirical antibiotic choice. Manag Care Interface 2002 6 35M2. 

Hagberg, L., Engberg, 1., Freter, R., Lam, J., Oiling, S., and Svanborg Eden, C. (1983). Ascending, unobstructed urinary tract infection in mice caused by pyelonephritogenic Escherichia coli of human origin. Infect. Immun. 40, 273-283. 

Thankavel, K., Madison, B., Ikeda, T., Malaviya, R., Shah, A. H., Arumugen, P. M., and Abraham, S. N. (1997). Localization of a domain in the FimH adhesin of Escherichia coli type 1 fimbriae capable of receptor recognition and use of a domain-specific antibody to confer protection against experimental urinary tract infection. /. Clin. Invest. 100, 1123-1126. 

Ulett, G. C., Valle, J., Beloin, C., Sherlock, O., Ghigo, J.-M., and Schembri, M. A. (2007b). Functional analysis of Antigen 43 in uropathogenic Escherichia coli reveals a role in longterm persistence in the urinary tract. Infect. Immun. 75, 3233-3244. 

Urinary tract infections are very commonly caused by Gram-negative bacteria such as Escherichia coli, the Proteus species and Pseudomonas species. 

Mild to moderate uncomplicated or complicated urinary tract infections, including pyelonephritis, caused by Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis.- 0.5 to 1 g IV/IM q 12 h 7 to 10... 

Urinary tract infections Urinary tract infections (complicated and uncomplicated), including pyelonephritis and cystitis (initial and recurrent) caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella oxytoca, Citrobacter sp., and Serratia marcescens. 

Urinary tract infections Nalidixic acid is indicated for the treatment of urinary tract infections (UTIs) caused by susceptible gram-negative microorganisms, including the majority of Escherichia coli, Enterobacter species, Klebsiella species, and Proteus species. Perform disc susceptibility testing with the 30 meg disc prior to administration of the drug and during treatment if clinical response warrants. 

Urinary tract infections (UTIs) For the treatment of UTIs when caused by susceptible strains of Escherichia coli, enterococci, Staphylococcus aureus, and certain susceptible strains of Klebsiella and Enterobacter species. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

For infections frequently encountered outside hospitals, e.g. uncomplicated urinary tract infection in young women, surveillance of resistance data of the most likely pathogens Escherichia coli) allows physicians to prescribe empiric therapy without performing cultures in the individual patient. However, in severely ill hospitalised patients, it is necessary to take samples for culture before starting empiric therapy. Microscopy of the Gram stained smear can help fine-tune empiric therapy at an early stage. Whether the infection is community-acquired or hospital-acquired, and whether the patient has been exposed to previous antimicrobial therapy should also be taken into account when choosing empiric therapy. 

Carbenicillin indanyl sodium is an antipseudomonal penicillin formulated for oral administration. The drug achieves negligible carbenicillin concentrations in the urine of patients with renal failure. Consequently, carbenicillin is not appropriate for patients with renal failure. In patients with normal renal function, however, carbenicillin indanyl sodium is used to treat urinary tract infections caused by P. aeruginosa, Proteus spp., and Escherichia coli. 

Nitrofurantoin is bacteriostatic and bactericidal for many gram-positive and gram-negative bacteria but P aeruginosa and many strains of proteus are resistant. There is no cross-resistance between nitrofurantoin and other antimicrobial agents and resistance emerges slowly. As Escherichia coli resistant to trimethoprim-sulfamethoxazole and fluoroquinolones has become more common, nitrofurantoin has become an important alternative oral agent for treatment of uncomplicated urinary tract infection. 

Vann, W.F., Schmidt, M.A., Jann, B. and Jann, K. (1981) The structure of the capsular polysaccharide (K5 antigen) of urinary tract infective Escherichia coli O10 K5 H9. A polymer similar to desulfo heparin. Eur. J. Biochem. 116 359-369... 

Escherichia coli Bacteremia urinary tract infections other systemic infections 3rd-generation cephalosporin, ampicillin, amoxicillin/clavu-lanate, trimethoprim/sul-famethoxazole, or cephalexin An aminoglycoside ampi-cillin/sulbactam imipenem meropenem a fluoroquinolone 1st- or 2nd-generation cephalosporin... 

Cranberry enhances the excretion of hippuric acid, a bacteria-fighting chemical. Recent studies support the speculation that eating cranberries or drinking their juice can prevent or fight urinary tract infections. Hippuric acid prevents Escherichia coli (E. coli) from adhering to the urinary tract. Cranberries also contain arbutin, which fights yeast infections. The berries are also used as a urinary deodorant. ... 

Escherichia coli Is the most common cause of urinary tract infections. 

Urinary tract infections are usually caused by bacteria from the gastrointestinal tract Escherichia coli accounts for about 90% of UTIs acquired in the community. 

Cranberries have been used traditionally for the treatment and prevention of urinary tract infections. Their effectiveness was demonstrated by a randomized, double-blind placebo-controlled trial (Avom et ah, 1994). Escherichia coli are the principal bacterial species responsible for urinary tract infection. The consumption of cranberry juice reduced the adherence of E. coli to the uroepithelial bladder cells in healthy human volunteers (Di Martino et ah, 2006). A-type procyanidin dimers and trimers that were isolated from cranberries were found to inhibit the adherence of uropathogenic E. Coli, whereas (—)-epicatechin and a B-type dimer were not effective (Foo et ah, 2000). 

Two types of gram-negative rods cause eye infections. Haemophilus influenzae causes infections in early childhood, with otitis media and conjimctivitis often seen concurrently. The enteric gram-negative rods include Escherichia coli, Serratia marcescens, Proteus, and Pseudomonas aeruginosa. These bacteria are typically found in the intestinal tract and commonly cause urinary tract infections. In the eye they can cause corneal ulcers. 

Septicaemia related to urinary tract infection usually involves Escherichia coli (or other Gramnegative bacteria), enterococci gentamicin plus benzylpenicillin or cefotaxime alone (ciprofloxacin plus vancomycin). 

G. Kallenius, S.B. Svenson, H. Hultberg, R. Mollby, I. Helin, B. Ceder-gren, J. Winberg, Occurrence of P-fimbriated Escherichia coli in urinary tract infections. Lancet. 2, 1369-1372 (1981)... 

Goettsch W, van Pelt W, Nagelkerke N, Hendrix MG, Buiting AG, Petit PL, Sabbe LJ, van Griethuysen AJ, de Neehng AJ. Increasing resistance to fluoroquinolones in Escherichia coli from urinary tract infections in the nether-lands. J Antimicrob Chemother 2000 46(2) 223-8. 

Eighty-five percent of uncomplicated urinary tract infections are caused by Escherichia coli, and the remainder are caused primarily by Staphylococcus saprophyticus, Proteus spp., and Klebsiella spp. Complicated infections are more frequently associated with gram-negative organisms and Enterococcus faecalis. 

Penicillins Ampicillin Amoxicillin-clavulanic acid Carbenicillin indanyl Ampicillin is the standard penicillin that has broad-spectrum activity. Increasing Escherichia coli resistance has limited amoxicillin use in acute cystitis. Drug of choice for enterococci sensitive to penicillin. Amoxicillin-clavulanate is preferred for resistance problems. Carbenicillin indanyl is only indicated for the treatment of urinary tract infections. 

Gupta K, Stapleton AE, Hooton TM, et al. Inverse association of H202-producing lactobacilli and vaginal Escherichia coli colonization in women with recurrent urinary tract infections. J Infect Dis 1998 178 446-450. 

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