Pathogen Groups of E. coli

Enterotoxigenic E. coli

“ETEC”

Virulence Factors and Genes: Heat stable enterotoxin similar to cholera toxin

Signs/Symptoms: Relatively mild, watery diarrhea.

Treatment: Self-limiting, if needed fluoroquinolones, doxycycline, rifaximin, TMP/SMZ; antibiotic resistance is a problem.

• Most common

Enteroinvasive E. coli

“EIEC”

Virulence Factors and Genes: Inv (Invasive plasmid) genes

Signs/Symptoms: Relatively mild, watery diarrhea; dysentery or inflammatory colitis may occur

Treatment: Supportive therapy only; antibiotics not recommended.

Enteropathogenic E. coli

“EPEC”

Virulence Factors and Genes: Locus of enterocyte effacement (LEE) pathogenicity island.

Signs/Symptoms: Severe fever, vomiting, nonbloody diarrhea, dehydration; potentially fatal.

Treatment: Self-limiting; if needed, fluoroquinolones, doxycycline, rifaximin (TMP/SMZ); antibiotic resistance is a problem.

• Infantile diarrhea

Enterohemorrhagic E. coli

“EHEC”

Virulence Factor and Genes: Verotoxin (Shiga toxin)

Signs/Symptoms: May be mild or very severe; bloody diarrhea; may result in HUS.

Treatment: Antibiotics are not recommended due to risk of HUS.

HUS

Hemolytic uremic syndrome

• Affects blood and blood vessels leading to kidney damage and failure.