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Escherichia coli

Escherichia coli is a facultative anaerobic, Gram-negative, acid-forming bacterium.

Escherichia coli bacteria are the most common pathogens of nosocomial infections. They can cause a variety of diseases, including:

  • Urinary tract infections

  • Intestinal infections

  • Prostatitis (inflammation of the prostate)

  • Cholecystitis (inflammation of the gall bladder)

  • Wound infections

  • Pneumonia

  • Meningitis in newborns

Escherichia coli is prevalent worldwide. Non-pathogenic Escherichia coli are commensals of the oral cavity and intestinal tract and skin.

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Very high

  • Pulmonology: High

  • Ear, nose, and throat: Not relevant

  • Urology: Very high

Relevance for endoscope surveillance

  • High concern organism

Transmission route

The pathogen is transmitted by the fecal–oral route via contaminated food or water. Contact infections via animals such as cattle, goats, sheep, and pigs can also occur.

Resistance to antibiotics

Escherichia coli shows high rates of decreased antimicrobial susceptibility, including to beta-lactams, carbapenems, aminoglycosides, and tetracyclines, through to panresistance.

Further readings

  1. Epstein L et al. New Delhi metallo-beta-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA 2014; 312: 1447–1455

  2. Escherichia coli, Centers for Disease Control and Prevention, https://www.cdc.gov/ecoli/general/index.html (accessed on 02.22.2021)

  3. Escherichia coli, Robert Koch-Institut, https://www.rki.de/DE/Content/Infekt/Antibiotikaresistenz/nosokomiale_Erreger/E_coli.html (accessed on 06.22.2021).

  4. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.

  5. Ross AS et al. A quarantine process for the resolution of duodenoscope-associated transmission of multidrug-resistant Escherichia coli. Gastrointest Endosc 2015; 82:477–83.