Escherichia coli

AS AN UROPATHOGEN
Gram-negative, rod-shaped bacterium that is commonly found in
the lower intestine of warm-blooded organisms (endotherms).
E. coli and related bacteria constitute about 0.1% of gut
flora, and fecaloral transmission is the major route through which
pathogenic strains of the bacterium cause disease. Cells are able to
survive outside the body for a limited amount of time, which makes
them ideal indicator organisms to test environmental samples
for fecal contamination.
Urinary tract infection
UPEC (uropathogenic E. coli) is one of the main causes of urinary
tract infections. It is part of the normal flora in the gut and can be
introduced many ways. In particular for females, the direction of
wiping after defecation (wiping back to front) can lead to fecal
contamination of the urogenital orifices. Anal sex can also introduce
this bacteria into the male urethra, and in switching from anal to
vaginal intercourse the male can also introduce UPEC to the female
urogenital system.
Responsible for approximately 90% of urinary tract infections (UTI)
seen in individuals with ordinary anatomy. In ascending infections,
fecal bacteria colonize the urethra and spread up the urinary
tract to the bladder as well as to the kidneys ,or the prostate in
males.
Uropathogenic E. coli use P fimbriae (pyelonephritis-
associated pili) to bind urinary tract endothelial
cells and colonize the bladder.
Uropathogenic E. coli produce alpha- and beta-
hemolysins, which cause lysis of urinary tract cells.
UPEC can evade the body's innate immune
defences (e.g. the complement system) by
invading superficial umbrella cells to
form intracellular bacterial communities (IBCs).
Have the ability to form K antigen, capsular
polysaccharides that contribute
to biofilm formation. Biofilm-producing E. coli are
recalcitrant to immune factors and
antibiotic therapy, and are often responsible for
chronic urinary tract infections. K antigen-
producing E. coli infections are commonly found in
the upper urinary tract.

Laboratory diagnosis

On MacConkey agar, deep red colonies are produced, as the
organism is lactose-positive, and fermentation of this sugar will
cause the medium's pH to drop, leading to darkening of the
medium. Growth on EMB agar produces black colonies with a
greenish-black metallic sheen. This is diagnostic of E. coli. The
organism is also lysine positive, and grows on TSI slant with a
(A/A/g+/H
2
S-) profile. Also,IMViC is {+ + -} for E. coli; as it is indole-
positive (red ring) and methyl red-positive (bright red), but VP-
negative (no change-colourless) and citrate-negative (no change-
green colour). Tests for toxin production can use mammalian cells
in tissue culture, which are rapidly killed by shiga toxin. Although
sensitive and very specific, this method is slow and expensive.