Yersiniosis: • Caused by Yersinia enterocolitica or Yersinia pseudotuberculosis bacteria. • Typically transmitted through contaminated food or water, or contact with infected animals. • Symptoms include abdominal pain (similar to appendicitis), diarrhea (sometimes bloody), fever, nausea, vomiting, and fatigue. • Treatment involves supportive care and, in severe cases, antibiotics. Escherichia coli (E. coli) infections: • Caused by certain strains of E. coli bacteria, often transmitted through contaminated food or water. • Symptoms include diarrhea (sometimes bloody), abdominal cramps, nausea, vomiting, fever, fatigue, and signs of dehydration. • In severe cases, especially when E. coli O157:H7 is involved, complications like hemolytic uremic syndrome (HUS) can occur. • Treatment involves supportive care for mild cases, such as rehydration, and antibiotics may be used in severe cases or when systemic infection is present.

1. ESCHERICHIA,
YERSINIOSIS IN
CHILDREN
Created by: Dr Ankur Verma

2. ESCHERICHIA COLI
It is a gram negative facultative
anaerobic Rod shift form bacterium
Normal animal and human colonic
floraFlora of variety of
environmental habitats, including
long-term care, facilities and
hospitals

3. MOST NOSOCOMIAL
INFECTION
-Commensal strains
-Extra-pathogenic strains
-Intestinal pathogenic strains

4. COMMENSAL STRAINS
In most humans, commensal strains of
E. coli constitute the bulk of the normal
facultative intestinal flora and confer
benefits to the host (e.g. resistance to
colonisation with pathogenic
organisms).
These strains do. not cause. disease
outside and within the
gastrointestinaltract.
Commensal strains generally lack the
specialized virulence traits.

5. EXTRAINTESTINALPATHOGENIC
(EXPEC)STRAINS
E.coli is the most common enteric gram-negative species to
,cause extra intestinal infection in ambulatory and hospital
settings.
"Peritoneum (spontaneous bacterial peritonitis).
The majority of ExPEC strains isolates from
symptomatic infections of the-
"Urinary tract,
"Bloodstream,
"Cerebrospinal fluid,
"Respiratory tract,

6. E. coli is the species in which resistance i s evolving
most rapidly.
Until recently, TMP-SMX was the drug of choice for
the treatment of uncomplicated cystitis in many
locales.
The prevalence of resistance t o cephalosporins I a
n d trimethoprim-sulfamethoxazole (TMP-SMX) is
increasing among community acquired strains. in
the United States
fosfomycin and nitrofurantoin appear to be viable
options for cystitis.
• Carbapenems(e.g.,imipenem)andamikacin
a r et h em o s tpredictablyactiveagentsoverall
TREATMENT

7. INTESTINAL PATHOGENIC STRAINS
IntestinalpathogenicstrainsofE.coliarer
arely encountered in the fecal flora of
healthy persons and instead appear t o
b e essentially obligate pathogens.
Cause enteritis,enterocolitis,andcolitis.
Transmission occurs predominantly via
contaminated food and water for
ETEC, STEC, EIEC, and probably EAEC
and by person-to person spread for
EPEC(andoccasionally STEC/EHEC).

8. INTESTINAL PATHOGENIC STRAINS
CertainstrainsofE.coliarecapableofcaus
ing diarrheal disease.
Entero hemorrhagic E.coli(ShigaToxin-
Producing) (STEC/EHEC)
Enterotoxigenic E. coli (ETEC)
Entero pathogenic E. coli (EPEC)
Entero invasive E. coli (EIEC)
Entero aggregative a n d Diffusely
Adherent E. coli (EAEC)

9. Incubation period is 3 or 4 days.
Colonic edema and an initial secretory
diarrhea may develop into the STEC/EHEC
hallmark syndrome of grossly bloody diarrhea
in>90% of cases
Significant abdominal pain and fecal
leukocytes in 70% of cases.
Fever is not common.
STEC/EHEC disease is usually self-limited,
lasting 5-10 days
CLINICAL MANIFESTATION

10. The mainstay of treatment for all diarrheal
syndromes is replacement of water and
electrolytes.
The use of prophylactic antibiotics to prevent
traveler's diarrhea generally should be
discouraged, especially in light of high rates of
antimicrobial resistance.
In selected patients (e.g., those who cannot
afford a brief illness or have an increased
susceptibility to infection), the use of rifaximin,
which is nonabsorbable and well tolerated, is
reasonable.
TREATMENT

11. When stools are free of mucus and blood, early
patient-initiated treatment of traveler's diarrhea
with a quinolone or azithromycin decreases the
duration of illness, and the use of loperamide
may halt symptoms within a few hours.
Although dysentery caused by EIEC is self-
limited, treatment hastens the resolution of
symptoms, particularly in severe cases.
Antimicrobial therapy for STEC/EHEC infection
(the presence of which is suggested by bloody
diarrhea without fever) should be avoided,
since antibiotics may increase the incidence of
TREATMENT