Esherichia coli

1
Esherichia coli
Gram-negative rod
Facultative anaerobe
Named for Theodor Escherich
German physician (ca. 1885)

Normal flora of the mouth and

intestine
Protects the intestinal tract from
www3.niaid.nih.gov
bacterial infection
Assists in digestion
Produces small amounts of vitamins
B12 and K
Colonizes newborns GI tract within
hours after birth
There > 700 different serotypes
of E. coli
Distinguished by different surface 2
Escherichia
Bergeys Manual of Systematic Bacteriology

Escherichia coli
coli- large intestine, colon
Mammalian large intestine

Escherichia blattae
blattae. L. n. blatta cockroach
Hindgut of cockroach Blatta orientalis

3
Escherichia coli K-12 strain
The original E. coli strain K-12 was
obtained from a stool sample of a
diphtheria patient in Palo Alto, CA in 1922
Strain K-12 was used for biochemical and
genetic studies for many years
Metabolism
F+ plasmids
Bacteriophages
Operons
Genome sequencing

4
Many strains
O antigen Serotypes
Antibody antigen rxn
Somatic (on LPS)
171 antigens
H antigen
Flagella
56 antigens
K antigen
Capsule and or
fimbrial antigen
80 antigens O18ac:H7:K1

18th O antigen 1st K antigen

7th H antigen 5
EPEC EIEC
Enteropathogenic E. coli Enteroinvasive E. coli

ETEC
Enterotoxigenic E. coli

Bergeys Manual of Systematic Bacteriology 6

Summary of the virulence factors of pathogenic
strains of E. coli
Thermolabile toxin (LT)
Fimbriae (Pili)
Hemolysins Thermostable toxin (ST)
Siderophores
Flagella Found alone or together
Toxins
Endotoxin LPS Both are plasmid borne
Capsules
K antigens
LPS
Antigenic variation
Drug resistance plasmids
Toxin and other virulence plasmids

textbookofbacteriology.net 7
Pathogenic Agent
Urinary Tract Infections
Sepsis / neonatal meningitis
Enteric / diarrheal diseases

8
Uropathogenic E. coli UPEC
Most common form of extraintestinal
E. coli infection
Acute symptomatic UTI
12% of all men
10-20% of women
100,000 patients hospitalized for renal
infections

9
 Adherence
Urovirulence Factors Fimbriae

Hemolysis Capsule


K antigens
Resist phagocytosis
Resist complement proteins

Aerobactin
Siderophore Endotoxin

10
Neonatal Meningitis E. coli NMEC
Meningitis in an infection of the fluid and membranes
that cover the brain and spinal cord
Bacteria ,Viruses ,Fungi

E. coli incites between 1/4 and 1/3 of meningitis cases

in newborns
Less than 2% of cases of meningitis at all other
ages
Approximately 1 out of 5 newborns with E. coli
meningitis dies
Survivors frequently sustain permanent brain damage
The majority of cases occur in premature babies

11
Neonatal Meningitis E. coli NMEC

K-1
80% of NMEC E. coli strains produce
K-1 capsular antigens
K1 capsular polysaccharide
O18ac:H7:K1
Inhibits phagocytosis

Siderophore production
Sequesters Fe

Endotoxin
12
13
Enteric / diarrheal diseases

E. coli can adhere to the mucosa of the

large intestine

14
Combinations of the O & H antigens Clinical Microbiology
Reviews 1998 11:142-201

identify the serotype

ETEC
Enterotoxigenic E. coli

EPEC
Enteropathogenic E. coli
EHEC
Enterohemorrhagic E. coli
EAEC
Enteroaggregative E. coli

EIEC
Enteroinvasive E. coli
15
Enterotoxigenic E. coli ETEC
Adhere to intestinal mucosa by fimbriae
Produce enterotoxins
Plasmids contain genes for enterotoxins
Cause leakage of intestinal epithelial cells
Loss of electrolytes & water
Attach by fimbriae
Cause diarrhea in children & adults
Toxins increase intracellular levels of cAMP
Causes cell leakage
Travelers diarrhea
Weanling diarrhea

16
Enteropathogenic E. coli EPEC

Attaching & effacing

Effacement of
microvilli
Adherence between
bacterium and
epithelial cells
Unique histopathology
Locus of enterocyte
effacement
Clinical Microbiology Reviews 1998 11:142-201

17
Clinical Microbiology Reviews 1998 11:142-201

18
Enteroaggregative E. coli EAEC
Adhere to HEp-2
cells
Human laryngeal
carcinoma cells
Bacterial cells
autoagglutinate
Stick to one
another
Do not secrete
enterotoxins
Clinical Microbiology Reviews 1998 11:142-201

19
Clinical Microbiology Reviews 1998 11:142-201

20
Enteroinvasive E. coli EIEC
Biochemically, genetically, and pathogenetically
closely related to Shigella spp.
Cause watery diarrhea
Not bloody
EIEC cells invade intestinal epithelial cells, lyse
the phagosomal vacuole, spread through the
cytoplasm and infect adjacent cell
Shigella does the same thing
Plasmid encoding a gene for a K surface antigen
Attach and invade mucosal cells

21
Clinical Microbiology Reviews 1998 11:142-201

22
Enterohemorrhagic E. coli EHEC
Severe gastrointestinal distress
Hemorrhagic colitis
Crampy abdominal pain
Watery diarrhea
Little or no fever
Bloody diarrhea
New serotype O157:H7
1983
Undercooked hamburgers

23
E. coli 015:H7 Distinguished by serology
Cannot be
distinguished from
all other strains of
E. coli using other
standard
microbiological
tests

24
E. coli 015:H7
157th somatic O antigen
7th flagellar H antigen
Hemorrhagic colitis
Abdominal cramps, blood stools, with
minor or no fever
Post diarrheal hemolytic ureamic
syndrome
Acute renal injury
Thrombocytopenia The Lancet 1998 352:1207-1212
An abnormal decrease in the number of
platelets in circulatory blood.
Microangiopathic hemolytic anemia
The fragmentation of red blood cells
because of narrowing or obstruction of
small blood vessels.
Enterohemorrhagic E. coli
EHEC
Among the most dangerous enteric
pathogens

25
26
Reservoir
Healthy cattle are the major reservoir for
human infection
Deer, sheep, goats, horses, dogs, birds and flies

Bacterial cells can survive in manure and water

troughs

Infection is more common during the summer

in both the northern and southern hemisphere

27
 Transmitted via food
Ground beef
Raw milk
Lamb meat
Venison jerky
Salami and other fermented dried meat products
Lettuce, spinach, alfalfa sprouts
Unpasteurized apple cider

Transmitted via water

Drinking and swimming in unchlorinated water

Direct person to person contact

Diaper changing
Improper sanitation
Day care & chronic adult care facilities

28
Clinical Features
Average interval
between exposure &
illness is 3 days
Most patients recover
with 7 days
70% of patients report
bloody stools
30-60% of patients The Lancet 1998 352:1207-1212
report vomiting Sequelae
Approx 5% of patients A condition following as a
develop HUS consequence of a disease.
Proteinuria
Excess protein in the urine.

29
Identification
MacConkey agar (SMAC)
Does not ferment sorbitol rapidly
Forms colorless colonies on sorbitol
containing MacConkey agar
Serology
Colorless colonies on SMAC are screened
for the 0157 antigen

30
Shiga Toxins
Exotoxin
Very similar to toxin produced by Shigella
dysenteriae
Inhibits protein synthesis in host cell
A subunit inactivates the 60S ribosomal subunit
Shiga toxin producing E. coli (STEC)
Verotoxins
Most OH157 strains produce Shiga toxin 2
25% produce Shiga toxin 1
Identical to Shigella toxin
A B exotoxin
A subunit exists on a temperate bacteriophage
31
 Cells leak Na+, Cl-, K+, HCO3- and water
Watery diarrhea
Cramps
Nausea
Vomiting
Bloody stool

32
Virulence Factors
Virulence plasmid (pO157)
Encodes a hemolysin
O157 strains can use iron from blood
released into the intestine
Locus of enterocyte effacement
Adhesion proteins

33
Non O157 Shiga Toxin Producing E. coli
Several other serotypes of E. coli produce
Shiga toxins
O111:nonmotile
O26:H11
O132:H2
Incite diarrhea, hemorrhagic colitis &
HUS
Labs generally not prepared to identify
these strains
Many times go undetected
34