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What antibiotic treats ecoli. Effective Antibiotics for E. coli Treatment: A Comprehensive Guide

by alexxlab

Which antibiotics are most effective against E. coli infections. How do different classes of antibiotics impact E. coli treatment outcomes. What are the latest guidelines for managing E. coli-related diseases. When should clinicians consider alternative treatment approaches for antibiotic-resistant E. coli strains.

Understanding E. coli and Its Impact on Human Health

Escherichia coli, commonly known as E. coli, is a bacterium that plays a significant role in various infections affecting humans. While some strains are harmless and even beneficial to our digestive system, others can cause severe illnesses. Understanding the nature of E. coli infections is crucial for effective treatment.

E. coli can cause a range of infections, including:

  • Urinary tract infections (UTIs)
  • Gastroenteritis
  • Meningitis
  • Sepsis
  • Pneumonia

The severity of E. coli infections can vary greatly, from mild discomfort to life-threatening conditions. This variability underscores the importance of proper diagnosis and targeted antibiotic treatment.

Antibiotic Classes Effective Against E. coli

Several classes of antibiotics have shown efficacy in treating E. coli infections. The choice of antibiotic often depends on the specific strain, infection site, and potential antibiotic resistance. Here are the main antibiotic classes used to combat E. coli:

Cephalosporins

Cephalosporins, particularly third-generation variants, are widely used for E. coli infections. These antibiotics interfere with cell wall synthesis, effectively killing the bacteria.

Penicillins

Both amino penicillins and extended-spectrum penicillins can be effective against E. coli. They work similarly to cephalosporins by disrupting bacterial cell wall formation.

Fluoroquinolones

Fluoroquinolones are broad-spectrum antibiotics that inhibit DNA replication in bacteria. They are often used for complicated urinary tract infections caused by E. coli.

Tetracyclines

Tetracyclines inhibit protein synthesis in bacteria and can be effective against certain E. coli strains. However, their use has become limited due to increasing resistance.

Sulfonamides

Sulfonamides work by interfering with folic acid synthesis in bacteria. They are sometimes used in combination with other antibiotics to treat E. coli infections.

Monobactams

Monobactams, such as aztreonam, are effective against gram-negative bacteria like E. coli. They are particularly useful for patients with penicillin allergies.

Carbapenems

Carbapenems are often reserved for more severe infections or cases involving antibiotic-resistant strains of E. coli. They have a broad spectrum of activity and are considered a last-line defense against resistant bacteria.

Antibiotic Selection and Treatment Strategies

Choosing the right antibiotic for E. coli infections requires careful consideration of several factors. These include:

  1. The specific site of infection
  2. The severity of the infection
  3. Local antibiotic resistance patterns
  4. Patient-specific factors (e.g., allergies, comorbidities)
  5. Potential side effects of the antibiotics

Healthcare providers often start with empiric therapy based on the most likely causative organisms and local resistance patterns. Once culture results are available, treatment can be tailored to the specific E. coli strain identified.

Are there guidelines for managing E. coli infections? Yes, several professional organizations have published guidelines for treating E. coli-related diseases. For instance, the Infectious Diseases Society of America (IDSA) provides guidelines for managing urinary tract infections and intra-abdominal infections, which often involve E. coli.

The Challenge of Antibiotic Resistance in E. coli

Antibiotic resistance is a growing concern in the treatment of E. coli infections. Extended-spectrum beta-lactamase (ESBL) producing E. coli strains have become increasingly prevalent, limiting treatment options.

Studies have shown that infections caused by ESBL-producing E. coli are associated with higher mortality rates compared to non-ESBL producing strains. This highlights the need for judicious use of antibiotics and the development of new treatment strategies.

How can clinicians address antibiotic resistance in E. coli? Some approaches include:

  • Implementing antibiotic stewardship programs
  • Using combination therapy in severe cases
  • Considering alternative treatments like fosfomycin for urinary tract infections
  • Exploring novel antibiotics and treatment modalities

Specific Treatment Considerations for E. coli Infections

Different E. coli infections may require specific treatment approaches. Here are some considerations for common E. coli-related diseases:

Urinary Tract Infections (UTIs)

UTIs are among the most common E. coli infections. Treatment typically involves oral antibiotics such as trimethoprim-sulfamethoxazole, nitrofurantoin, or fluoroquinolones. For complicated UTIs or pyelonephritis, intravenous antibiotics may be necessary.

Gastroenteritis

E. coli-induced gastroenteritis often resolves without antibiotic treatment. However, in severe cases or for immunocompromised patients, antibiotics may be prescribed. It’s important to note that antibiotics can potentially increase the risk of hemolytic uremic syndrome in cases of Shiga toxin-producing E. coli (STEC) infections.

Meningitis

E. coli meningitis, particularly in neonates, requires prompt treatment with intravenous antibiotics. Third-generation cephalosporins are often the first-line treatment, with the addition of ampicillin to cover Listeria monocytogenes in some cases.

Sepsis

E. coli sepsis is a medical emergency requiring immediate broad-spectrum antibiotic therapy. The choice of antibiotics depends on the suspected source of infection and local resistance patterns. Carbapenems or combinations of beta-lactams with beta-lactamase inhibitors are often used.

Emerging Therapies and Future Directions

As antibiotic resistance continues to pose challenges in treating E. coli infections, researchers are exploring new therapeutic approaches. Some promising areas include:

  • Bacteriophage therapy
  • Immunomodulatory treatments
  • Novel antibiotic combinations
  • Targeted drug delivery systems

These emerging therapies may provide new options for managing resistant E. coli infections in the future.

The Role of Prevention in Combating E. coli Infections

While effective antibiotic treatment is crucial, preventing E. coli infections is equally important. Prevention strategies include:

  • Proper hand hygiene
  • Safe food handling practices
  • Adequate water sanitation
  • Appropriate use of antibiotics to prevent resistance

Public health initiatives focusing on these preventive measures can significantly reduce the burden of E. coli infections in communities.

Conclusion: A Multifaceted Approach to E. coli Treatment

Effectively treating E. coli infections requires a comprehensive approach that considers the specific infection type, antibiotic resistance patterns, and individual patient factors. While various antibiotic classes have shown efficacy against E. coli, the challenge of antibiotic resistance necessitates ongoing research and the development of new treatment strategies.

Healthcare providers must stay informed about the latest guidelines and emerging therapies to provide optimal care for patients with E. coli infections. By combining targeted antibiotic treatment with preventive measures and exploring innovative therapies, we can improve outcomes and reduce the impact of E. coli-related diseases on public health.

Antibiotics, Cephalosporins, 3rd Generation, Penicillins, Amino, Penicillins, Extended-Spectrum, Fluoroquinolones, Tetracyclines, Sulfonamides, Monobactams, Carbapenems

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Combinations of Up To 5 Antibiotics May Work Against Resistant E Coli

The conventional approach to fighting resistant E coli infections typically involves the use of no more than 2 antibiotics; however, combining as many as 5 may be the trick to fighting these infections.

Drug-resistant Escherichia coli (E coli) bacteria are a growing public health threat, but investigators at the University of California, Los Angeles, say that combinations of up to 4 or 5 antibiotics may be effective at killing these harmful pathogens.

While most E coli are safe and part of healthy intestinal microflora, pathogenic forms of the bacteria cause intestinal illness. Exposure from contaminated food or water can lead to symptoms such as abdominal cramping, diarrhea, and vomiting, which can lead to life-threatening complications.

A 2018 E coli outbreak in 36 states linked to contaminated romaine lettuce was the largest E coli outbreak since 2006, leading to 210 reported cases, 96 hospitalizations, and 5 deaths. While most intestinal E. coli infections pass within a week, cases of pneumonia, meningitis, or urinary tract infections from the pathogen are typically treated with an antibiotic such as a third-generation cephalosporin. Increasingly, however, E coli are becoming resistant to antibiotics by producing extended-spectrum beta-lactamase, an enzyme rendering certain antibiotics ineffective and leading to multi-drug resistance.

Antibiotic-resistant E coli is a growing global problem, and in the United States, public health officials worry that the emergence of the mcr-1 gene in a number of pathogenic bacteria could make more superbugs resistant to even last-resort drugs such as colistin. While scientists have, in the past, discouraged combining more than 2 antibiotics to fight a resistant pathogen, a new study by UCLA investigators suggests that using as many as 5 antibiotics in tandem may be an effective strategy against resistant infections.

In the study, published on September 3, 2018 in the journal npj Systems Biology and Applications, investigators used 8 antibiotic drugs to create a total of 18,278 combinations of 2 to 5 drugs and study their interactive effects on E coli. Testing how the combinations affected bacterial growth responses, the research team found that of the combinations of 4 drugs, 1,676 performed better than they expected. Of the 5-drug combinations, 6,443 were more effective than expected. Many combinations also performed below the team’s expectations, including 2,331 4-drug combinations and 5,199 5-drug combinations.

“There is a tradition of using just 1 drug, maybe 2,” said one of the study’s senior authors Pamela Yeh, PhD, in a recent statement. The authors note that some combinations were effective because the medications target E coli in different ways, such as attacking cell walls or the bacteria’s DNA. “We’re offering an alternative that looks very promising. We shouldn’t limit ourselves to just single drugs or 2-drug combinations in our medical toolbox. We expect several of these combinations, or more will work much better than existing antibiotics.”

While the investigators say they’ve found antibiotic combinations that are effective in a laboratory setting, much more testing is required before these combinations can be considered ready for testing in humans. “With the specter of antibiotic resistance threatening to turn back health care to the pre-antibiotic era, the ability to more judiciously use combinations of existing antibiotics that singly are losing potency is welcome,” Michael Kurilla, MD, PhD, director of the Division of Clinical Innovation at the National Institutes of Health/National Center for Advancing Translational Sciences said. “This work will accelerate the testing in humans of promising antibiotic combinations for bacterial infections that we are ill-equipped to deal with today.”

Escherichia coli . ABC of antibiotic therapy. Vidal medicines guide

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The materials are intended exclusively for physicians and specialists with higher medical education. Articles are informational and educational in nature. Self-medication and self-diagnosis are extremely dangerous for health. The author of the articles does not give medical advice: a clinical pharmacologist is a doctor only and exclusively for doctors.

Author: Trubacheva E. S.,
doctor – clinical pharmacologist

With this article we begin our consideration of representatives of the microbiological world, with whom we most often meet in daily clinical practice, and the topic of today’s conversation will be Escherichia coli, it is also Escherichia coli li ).

The relevance of the discussion of this microorganism lies in the fact that E. coli is a champion in creating problems for both patients and medical staff in hospitals and outpatient services. Only Klebsiella is worse than her, but we’ll talk about it later. At the same time E. coli does not fly through the air and does not have legs for independent movement and infection with it is almost always a “dirty hand disease”. With the pathology caused by this pathogen, the patient can come to any doctor, and the medical staff can bring E. coli on their hands to any patient with only one difference – it will not be a wild and pretty animal killed by ordinary amoxicillin, but an individual armed to the teeth, able to kill herself very effectively. That is, this is one of those enemies that you definitely need to know in person.

Microbiological aspects

E. coli is a typical member of the family Enterobacteriacea e is a gram-negative bacterium, optional nym anaerobe as part of the normal human intestinal microflora. But it immediately becomes a pathogen, having got out of its normal habitat, although some strains are also pathogenic for the gastrointestinal tract. That is, E. coli refers to intestinal commensals, intestinal pathogens and extra-intestinal pathogens, each of which we will briefly analyze.

The more common strains E. coli are:

  1. Strain serotype O157:H7 (STEC O157 ) or the so-called enterohemorrhagic strain E.coli , which is the cause of 90% of cases of hemorrhagic colitis and 10% of cases of hemolytic uremic syndrome. It occurs quite often, and if you work in hospitals for planned care, then this is one of the mandatory analyzes for making a decision on hospitalization, so one way or another it is heard. The problem of infection with this pathogen is associated with the use of poorly thermally processed food and the transmission of the strain by contact from person to person, in other words, through the hands.
  2. The second extremely dangerous highly pathogenic strain of Escherichia coli – O104:h5, which caused an epidemic in Germany in 2011 with a high mortality rate among patients with food toxic infections due to the development of hemolytic uremic syndrome. If you remember, it was a very loud story with border closures for Spanish cucumbers, then in general for all fruit and vegetable products from Europe to Russia, while they were looking for at least a source, not to mention the culprit of those events. Lettuce leaves, which were irrigated with water with signs of fecal contamination, were finally blamed, and then it was about germinated seeds, which were also watered with fecal-infected water. So went out on a specific strain E. coli – O104:h5, which, after being sanitized with an antibiotic, splashes out endotoxin, which causes hemolysis and acute renal failure. As a result, mass mortality of patients treated with antibiotics.

The same strain was then found in an outbreak of PTI in Finland, but by that time, patients with diarrhea were no longer treated with bactericidal antibiotics until microbiological results were available and the situation was nipped in the bud.

And the third high-profile (for our country) case is a mass disease of St. Petersburg schoolchildren in Georgia, where this strain was also detected (the press release of Rospotrebnadzor on this case is here).

  1. In addition to the above, there are enterotoxic (cause “traveler’s diarrhea”), enteroinvasive (cause bloody diarrhea) and enteropathogenic (watery diarrhea in newborns) strains.

When is E. coli an extraintestinal pathogen ? Almost always when found outside of its normal habitat.

  1. Diseases of the urinary tract . Here E. coli is the absolute leader and plays a leading role in development:
  • Acute cystitis
  • Pyelonephritis
  • Renal abscesses and
  • Prostatitis

This fact is explained by the close anatomical location of the two systems and flaws in personal hygiene, which makes it possible to immediately prescribe drugs that are active against Escherichia coli at the stage of empirical therapy for the above diseases.

  1. Diseases of the gastrointestinal tract :
  • Traveler’s diarrhea
  • Intra-abdominal abscesses and peritonitis, most often of a secondary nature (perforation of the intestine as a result of a primary disease, or with defects in surgical intervention)
  1. Infections of the central nervous system in very debilitated patients, resulting in the development of meningitis. It occurs mainly in the elderly and newborns. In addition, in the case of nosocomial infection, meningitis can develop as a result of poor treatment of the hands of medical personnel before surgery or dressings.
  2. Bloodstream infections , namely sepsis, as a continuation of the development of diseases of the urinary tract, gastrointestinal tract and biliary tract due to metastasis of the focus of infection. It is extremely difficult to treat, especially if nosocomial strains are involved, the lethality is extremely high.
  3. Infections of the skin and soft tissues as a result of wound infections after interventions on the abdominal organs.
  4. Nosocomial pneumonia , caused by resistant strains of E. coli, is entirely associated with defects in patient care and the factor of cleanliness, or rather its absence, of the hands of medical personnel or caring relatives. The fact of nosocomial infection is proved elementarily, which will be clearly demonstrated in the next section.
  5. Postpartum (and not only) endometritis . We are forced to mention this pathology as well, since infection with Escherichia coli occurs more and more often, and there is no great alertness. As a result, it is possible to miss the antibiotic therapy very badly and, as a result, come to the extirpation of the organ due to the ineffectiveness of antibiotic therapy. A later than usual arrival and a more aggressive course than usual may suggest an idea. An additional examination of the prianal region can also lead to the likelihood of developing just such an infection.

(part two) Practical issues of diagnosis and treatment.

When can we suspect that we have a patient with an E. coli infection?

  • Patients with diarrhea who returned from vacation and were still able to attend (traveler’s diarrhea or enterotoxigenic E. coli strains).
  • Patients with all diseases of the urinary system, including pregnant women, but strictly symptomatic (no need to treat asymptomatic bacteriuria, otherwise you will grow resistant strains and create a problem for yourself, the woman, and the maternity hospital in the future).
  • In hospitals – nosocomial pneumonia, postoperative meningitis, peritonitis, sepsis, etc., which are secondary.

Only microbiological examination can confirm or completely exclude E. coli from pathogens. Of course, in modern conditions, microbiology is already becoming almost exclusive, but we came to learn, and we need to learn from the right examples, so a number of antibiograms performed by automated testing systems will be considered below. Suddenly you are lucky, and your medical institution already has everything or will soon, and you already know how to work with it all?

If you read this cycle in order, then in the basic section on microbiology, a series of antibiograms of a certain microorganism was laid out in the context of an increase in antibiotic resistance, and this was our today’s heroine – Escherichia coli.

  1. Let’s start with the wild and extremely cute strain E. coli , which lives in the intestines and provides vitamin K synthesis. antibiotics for about a year. And this is the sensitivity we have in mind when we prescribe empiric antibiotic therapy

How do we treat?

  • As you can see, the animal is sensitive to absolutely everything, and this is exactly the case when you can freely use the tabular materials of reference books or clinical recommendations, since the mechanisms of resistance are completely absent.
  1. If you have a patient who has been treated with penicillin antibiotics for the last six months, then the antibiogram may look like this.

If such E. coli turns out to be an extra-intestinal pathogen, and you have a pregnant woman and UTI (the most common case), then we need to overcome resistance to penicillins, that is, suppress the activity of penicillinases. Accordingly, drugs with beta-lactamase inhibitors, most often amoxicillin / clavulanate, will demonstrate high efficiency, as the safest and most effective. The only thing is that the patient must be warned that antibiotic-associated diarrhea may develop as a result of stimulation of intestinal receptors.

  1. Separately, I would like to draw attention to the following strain E. coli as a typical owner of extended spectrum beta-lactamase. And these ESBLs are most often produced as a result of the indefatigable use of third-generation cephalosporins and its very specific representative – ceftriaxone.

In what situations can we see (or think about) such an animal:0059

  • The patient was transferred from another hospital (although the next picture can be found there)
  • The patient did not receive anything, and was not in the hospital at all, but the pathogen came from the hands of medical personnel, causing nosocomial infection
  • And the simplest case – the culture was taken at the time of ceftriaxone therapy

    • What to do?

    • Remember that the patient in front of you is a carrier of a pathogen that can be transferred and create a serious danger to the life of a weaker person. Therefore, both the staff and the patient himself must strictly observe sanitary rules to prevent transfer.
    • How to treat? Since not a single beta-lactamase inhibitor works here anymore, ESBL destroy them perfectly, the choice will be small, and it is better that this choice is made by a specially trained specialist – a clinical pharmacologist, since in this situation not only data on susceptibility and resistance, but also the MIC of the pathogen, for example. Not to mention the factor of pharmacodynamics and the focus of localization of infection.
    • If wedge. there is no pharma or he is not specially trained – then we treat in accordance with the clinical recommendations for the relevant nosology from the section “reserve drugs”. It would not be superfluous to discuss the situation with the bacteriologist of the clinical laboratory doing the crops for you.
    1. One of the worst choices you can see

    Such a patient will not come to you with his feet, he will not be seen by the outpatient service, these are absolutely inpatients, and if they are brought, then only from another medical institution. Most often, these are patients in intensive care or intensive care units, and such a pathogen is 100% nosocomial in nature.

    When can we detect it:

    • secondary peritonitis,
    • nosocomial pneumonia,
    • pyelonephritis,
    • postoperative meningitis,
    • sepsis, etc.

    And it will always be an iatrogenic lesion as a result of improper hand hygiene of personnel or handling of instruments. You can object “but what about severe peritonitis?”. I will answer that for severe peritonitis without care defects, the strain in the third figure is most characteristic, since in order to grow such a beast, severe peritonitis will not have enough health, it will have time to die from complications, and E. coli itself cannot walk with legs, we We only carry them with improperly washed pens, and it is elementary to prove this, since exactly the same strains will be sown during routine inspections of the epidemiological service.

    What to do?

    • For the eradication of such a pathogen, not only a separate trained specialist and a pharmacy with a full set of reserve drugs are needed, but also the hard work of the epidemiological service, since such a patient should be isolated in a separate ward, but rather an isolation room (do not think that it is nonsense – with proper organization, such things are quite real) with the implementation of quarantine measures, since the main problem of the appearance of this kind of pathogens is that they very quickly scatter throughout the building (or hospital, if the buildings are not isolated) and seed everyone and everything, harming others patients weakened by a serious illness and populating the intestines of all medical personnel.
    • And one more extremely vile property of such pathogens – they are able to carry out horizontal transfer of resistance mechanisms with other flora of the family Enterobacteriacea e , and even if you get rid of E. coli, her friend Klebsiella can become an unpleasant surprise, causing even more harm and essentially finishing off the patient. It is impossible to get rid of these pathogens completely, for this it is necessary to get rid of medical personnel as the main carriers, but it is possible to control – the measures are detailed in the current SanPiN 2.1.3.2630-10. So if such a pathogen is detected, we will talk not only about the treatment of the patient in whom it is found, but also about taking measures to prevent infection of all other patients (and this, I remind you, almost always ICU or ICU) who are nearby.
    1. In conclusion, it is necessary to mention the pan-resistant E. coli armed with a full range of resistance mechanisms. There will be total R in the antibiogram, and the MICs of pathogens will break through all possible ceilings. Fortunately for the author, she has not yet encountered such a beast, which is due to the presence of a working surveillance system, so there will be no picture, although it is easy to imagine. Such patients, if E. coli turns out to be a pathogen, and not a colonizer (you never know from whose hands, for example, fell into a wound), unfortunately, they almost do not survive, since they are initially extremely severe somatically, and E. coli usually draws a line to their existence on mortal earth.

    What to do?

    • Prevent the development of such, I’m not afraid of the word, beasts in your hospitals, and if it appears, drive the epidemiological service to save hands and surfaces from this kind of infection, which is possible only if there is a sufficient amount of consumables, gloves and disinfectants.

    And now let’s summarize our difficult conversation:

    • Escherichia coli is a very serious pathogen and should not be underestimated. Its types also need to be clearly oriented.
    • First of all, we think about it in the treatment of urinary tract infections, especially in pregnant women.
    • If we have a patient with signs of an intestinal infection, then the approach to antibiotic therapy should be purely individual, and if the condition allows, then before receiving microbiology – no antibiotics at all. If it does not allow, it should be bacteriostatics.
    • We never treat only the analysis, and even the microbiological conclusion, we always treat the patient with the whole complex of his symptoms and syndromes. But microbiology helps to solve both differential diagnostic problems, which makes it possible to separate an unconditional pathogen from a peacefully living commensal.
    • Microbiological diagnosis is key both to confirm the pathogen itself and to select the appropriate antibiotic
    • In case of detection of resistant and pan-resistant pathogens, in addition to treating the patient himself, the epidemiological service of the medical institution should be fully involved

    Summarizing the above, and no matter how insulting it may sound, but almost always infections caused by E. coli are “diseases of dirty hands” and an indicator of microbiological trouble. And one of the serious problems of medical and preventive services, since, with all their desire, they will not be able to completely remove the source of infection, since it is literally in all of us, and only compliance with sanitary rules and sanitary education. work can significantly contribute to curbing the development of the above diseases.

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    Escherichia coli and cystitis

    Escherichia coli and cystitis

    coli Escherichia coli was isolated in 1885 by the German scientist Theodor Escherich, after whom the genus of bacteria was named.

    Escherichia live in the intestines of humans, animals, birds, reptiles, and fish.

    RESISTANCE (RESISTANCE) E.Coli

    For Escherichia coli , the optimum growth temperature is 35-37°C. These microorganisms are able to form colonies, including those protected by the so-called “biofilms”.

    In the environment E.Coli are relatively stable. At a temperature of 60°C, they die within 15 minutes, at 100°C – instantly. In soil and water, they are able to remain viable for months. They “survive” in milk for more than 30 days, in infant formula for more than 3 months, on objects and toys for up to 3-5 months. Direct sunlight causes bacteria to die after a few minutes.

    E.Coli are sensitive to most disinfectants (chlorine preparations, formaldehyde, sodium hydroxide, etc.) and antibiotics (aminoglycosides, tetracyclines, rifampicin, etc.). However, the bacterium is able to rapidly acquire resistance to antimicrobial agents.

    Escherichia coli SPECIES

    – Non-pathogenic

    Most strains of E. coli are harmless and are part of the normal intestinal flora of humans and animals. Moreover, E. coli benefits the body, for example, preventing the development of pathogenic microorganisms in the intestines.

    – Diarrheal

    According to WHO, the first place among diarrheal diseases in newborns and young children is occupied by escherichiosis.

    Allocate the so-called traveler’s diarrhea. This disease, caused by Escherichia, is most often found in tourists in countries with a hot climate. The spread of infection is facilitated by pollution with sewage, violation of sanitary and hygienic conditions, infection of food products (dairy, meat and vegetables) with Escherichia.

    – Pathogenic

    Can cause extraintestinal disease. In some cases, Escherichia coli invades other organs. For example, in the genitourinary system, respiratory organs, in the biliary tract. Such bacteria can cause inflammatory processes, especially against the background of immunodeficiency.

    An example of a pathogenic species is uropathogenic Escherichia coli.

    Infection with the uropathogenic bacterium Escherichia coli occurs more often in women. This is facilitated by the peculiarity of the urinary system. Bacteria enter the bladder from the urethra, multiply in the urine, and cause inflammation (cystitis) .

    Possible mechanism of infection with uropathogenic Escherichia coli:

    Bacteria E.Coli are motile due to flagella and have pili (fimbria) with which they attach to the walls of internal organs.

    Approximately 150 million people are affected annually by urinary tract infections caused by uropathogenic Escherichia coli. Despite antibiotic therapy, 30–50% of patients relapse. This is due to the increase in the prevalence of E.Coli resistant to the latest generation of antibiotics. Antibiotic resistance calls for new approaches to the treatment and prevention of bacterial infections.

    One such approach is the use of natural substances D-mannose and cranberry proanthocyanadins. According to studies, D-mannose binds the fimbria of bacteria and prevents it from attaching to the wall of organs: the intestines, the bladder … The “bound” bacteria are washed out of the body without causing harm. This reduces the colonization of pathogenic Escherichia coli ., and the frequency of exacerbations of cystitis decreases. Cranberry proanthocyanidins have a similar effect.

    It is useful to take lactobacilli, especially the stamp Lactobacillus casei et rhamnosus, which is an antagonist of E.