Enterovirulent E. coli (EEC)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
- Enterovirulent E. coli (EEC) facts
- What are enterovirulent E. coli (EEC)?
- What are the symptoms caused by enterovirulent E. coli (EEC)?
- A new EEC group? (update on the E. coli 0104:H4 outbreak in Germany)
- How do enterovirulent E. coli groups cause disease?
- When should one seek medical care for enterovirulent E. coli infection?
- How are enterovirulent E. coli infections diagnosed?
- How are enterovirulent E. coli infections treated?
- How is self-care at home done for enterovirulent E. coli?
- What are the complications associated with enterovirulent E. coli (EEC)?
- How are enterovirulent E. coli (EEC) infections prevented?
- What are the prognoses (outcomes) of enterovirulent E. coli infections?
- Find a local Doctor in your town
Enterovirulent E. coli (EEC) facts
- Enterovirulent E. coli (EEC) are bacteria that comprise several groups of
E. coli serovars, all of which may cause diarrhea and other problems in the
- EEC bacteria can cause a wide range of symptoms ranging from mild to bloody
diarrhea, nausea, vomiting, stomach cramping and dehydration. Different groups
often produce less (EAEC group) or more intense symptoms (EHEC group) and
- Although investigators vary on the group structure and names, six groups
are currently presented in the medical literature, listed by their main symptoms
produced or other "unique" group feature:
- EHEC (enterohemorrhagic E. coli): Shiga toxins; bloody diarrhea, 10% with
- ETEC (enterotoxigenic E. coli): secretory toxins; watery diarrhea
- EPEC (enteropathogenic E. coli): toxin similar to Shigella toxin; watery or
- EIEC (enteroinvasive E. coli): invade epithelial cells; mucoid, bloody
diarrhea and fever
- EAEC (enteroadherent E. coli): adhere to intestinal cells; watery diarrhea
- EAggEC (enteroaggregative E. coli): clump intestinal cells; chronic mucoid watery diarrhea
- EHEC (enterohemorrhagic E. coli): Shiga toxins; bloody diarrhea, 10% with complications
- Dehydration may occur in any EEC group infection; if any signs of
dehydration occur, seek medical care. Also seek care if bloody diarrhea
- EEC infections are often presumptively diagnosed by association with a
food, fluid or person that has been definitively diagnosed or associated with
EEC contamination. Definitive diagnosis is made by isolating the EEC organism
from feces of the patient and identifying the EEC group member by its toxin
production, its unique group properties and its serotype.
- The majority of EEC group infections are self-limited; however, preventing
dehydration is the major treatment for all EEC groups.
- Self-care at home can be done unless signs of dehydration or bloody
- The main complication that leads to other serious problems or death is
dehydration. Serious complications are seen with EHEC group (mainly E. coli
0157:H7) occur more frequently than with the other groups; however, a high death
rate (some report 50%) may occur in third-world countries with ETEC group
- About 10% of EHEC infections (mainly E. coli 0157:H7) develop moderate to
severe complications of bloody diarrhea, hemorrhagic colitis, hemolytic-uremic
syndrome (HUS) and Thrombotic thrombocytopenic purpura (TTP).
- Prevention of EEC centers on avoiding foods, fluids and touching persons with EEC. Cooking meats (especially hamburger meat) and other foods above 160F help kill the organisms. Food handlers should always keep food preparation items clean and their hands washed.
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