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GI Grand Rounds: A Brief Discussion of E coli 0157:H7
The document discusses a medical case involving a patient with severe colitis and diarrhea linked to various pathogenic strains of E. coli and other bacteria. It highlights the risks of hemolytic uremic syndrome (HUS), particularly in children, and reviews the efficacy of antibiotics in treating E. coli O157:H7 enteritis. The findings suggest that while antibiotics do not significantly affect symptom duration, they may contribute to complications like HUS.
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GI Grand Rounds: A Brief Discussion of E coli 0157:H7
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- 10. Severe colitis w/rectal sparing
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- 14. Salmonella 0.9% Shigella 0.6% Campylobacter 1.4% E. Coli O157 0.3% 1996: 233,212stools tested Overall 1.5%-2.9% Clin Infect Dis. (2001) 32 (3): 331-351
- 17. Diffusely Adhering (DAEC) Enteroaggregative (EAEC) Enteroinvasive (EIEC) PathogenicStrains of Ecoli Enterohemorrhagic (EHEC) Enteropathogenic (EPEC) Enterotoxigenic (ETEC)
- 18. Cows are anatural habitat a role for vaccination and probiotics
- 19. Hamburger meat isthe leading vehicle of infection
- 20. CDC: 2012 IncidenceRate per 100,000 people 16.4214.30 E. coli 1.12 Vibrio 0.41 SalmonellaCampylobacter
- 21. Isolation rate ofSTEC O157 by age United States 2009 (n=1,947) National Enteric Disease Surveillance: Shiga toxin- producing Escherichia coli (STEC) Annual Summary, 2009
- 22. result in colitisthat resembles ischemic colitis
- 23. Would you treatthis patient?
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- 25. 159 cases ofE. coli O157: H7 in children who attended a fair in Canada in 1999 BMC Public Health. 2013; 13: 799
- 26. Cipro- increases Shigaproduction in mice models Hemolytic Uremic Syndrome No effect on duration of symptoms Is concern about giving antibiotics legitimate? Proulx F, Turgeon JP, Delage G, et al: Randomized, controlled trial of antibiotic therapy for Escherichia coli O157:H7 enteritis.
- 27. Non-immune Hemolytic Anemia Thrombocytopenia Renal Impairment NHS-0583-3DC-3N HUS Hemolytic UremicSyndrome (HUS) *Most common cause of renal failure in children
- 28. Micrographs of Samplesfrom Patients with Hemolytic–Uremic Syndrome. Noris M, Remuzzi G. N Engl J Med 2009;361:1676-1687.
- 29. 1997 – 2009:981 Cases of HUS National Enteric Disease Surveillance: Shiga toxin- producing Escherichia coli (STEC) Annual Summar Median 4.5 yrs Deaths 52 (5%) Summer 569 (58%) E. Coli O157:H7 95%
- 30. Antibiotics and HUS SystemicReviews Safdar 2002 • 9 Studies • Neither protection nor increased risk • Pooled OR 1.15 (95% CI 0.79-1.68) Panos 2006 • 19 Studies • Inconclusive Safdar N. JAMA 2002; 288:996-1001
- 31. Other Treatment andHUS Synsorb • an agent that binds to ST to prevent its absorption from the gut. Antibodies • Monoclonal Ab against Shiga 1 and 2
- 32. •Antibiotics were stoppedby ID •Hgb 11.7 9.1 •Schistocytes on Smear •Normal Renal Function