Tag Archive | "e. coli"

IV Fluids Lowers Chances of Kidney Failure in Children

According to researchers at Washington University School of Medicine in St. Louis and other institutions, giving children intravenous fluids early in the course of an E. coli O157:H7 infection seems to lower the chances of developing severe kidney failure.  The results of this study were recently published in the Archives of Pediatric and Adolescent Medicine.

Children with E. coli O157:H7 have a high risk of hemolytic uremic syndrome (HUS), the most common cause of short-term, sudden-onset pediatric kidney failure.  Roughly 15 to 20 percent of children with this type of E. coli infection develop HUS.  Although most children recover and their kidneys heal, the syndrome can be fatal and might cause permanent kidney damage.

The first symptoms of E. coli O157:H7 are diarrhea and severe abdominal pain, and later symptoms include bloody diarrhea.  Kidney failure occurs because this strain of E. coli, called Shinga toxins, which hurt blood vessels. The kidneys are especially susceptible to the reduced blood flow that results from this injury. More than half of children with HUS develop kidney failure severe enough to require dialysis.

E. coli O157:H7 infection can come from eating undercooked hamburger, sprouts, unpasteurized fruit juices, dry-cured salami, lettuce, game meat and unpasteurized milk products, as well as exposure to contaminated water and contact with cattle. In the developed world, E. coli O157:H7 is the most common cause of acute kidney failure in otherwise healthy children.  The research team analyzed 50 children under 18 years old who were treated for diarrhea-associated HUS at 11 pediatric hospitals in the United States (St. Louis; Seattle; Sacramento, Calif.; Albuquerque, N.M.; Little Rock, Ark.; Milwaukee; Cincinnati and Columbus, Ohio; Indianapolis; and Memphis, Tenn.) and in Glasgow, Scotland.

Overall, 68 percent of the children stopped urinating. Of the 25 patients who had received no intravenous fluids in the first four days of illness, 84 percent stopped urinating. But in the other 25 patients who were given IV fluids to keep their kidneys working, only 52 percent stopped urinating.  Christina Ahn Hickey, MD, a third-year pediatrics resident at Washington University School of Medicine in St. Louis and St. Louis Children’s Hospital and the first author on the study, says that intravenous fluids are better for children than oral fluids because most of the children infected with E. coli O157:H7 are vomiting and having frequent bouts of diarrhea, so they cannot stay hydrated.

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Urinary Tract Infection Vaccine

Urinary Tract Infection (UTI) affects more than 8 million people each year.  The cost for treatment is estimated at $3.5 billion each year and it accounts for more than 3 million prescriptions.  If this is not enough to cause concern on UTI, a number of infections are resistant to common antibiotic treatments.

Roughly 80% of UTIs is caused by E. coli.  Studies from the University of Michigan showed that more than half of the E. coli samples they collected were resistant to an antibiotic commonly used to treat UTIs.  In some cases, E. Coli is resistant up to 15% to a class of antibiotics that includes Ciprofloxacin (“cipro”), a second line treatment for UTI.

Last year, the university published a study that showed a vaccine they had developed prevented UTI which are caused by E. coli bacteria and produced key types of immunity in mice. Though developing and testing this vaccine in humans will take several years, this study is a breakthrough in medicine. This will lead to developments that would save billions in health care costs and millions of doctors’ visits and hospitalizations from UTI each year.

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How to Avoid Cystitis

Have you ever suffered from cystitis?  If not, there is a significant chance you may at least once in your life.  Nearly 20% of women have had an attack at some point in their lives, and 20% of those will get more than one episode a year.

If you have suffered from cystitis before, then you know just how debilitating and miserable it can be.  The condition usually begins with a strong sensation of needing to urinate.  When you try to go, it either burns horribly, or nothing seems to come out.  You may have a full, uncomfortable sensation in the bladder, plus an aching back and stomach and a general feeling of being unwell.

Cystitis is an infection caused by bacteria.  And although both men and women can develop it, cystitis is much more common in women.  The reason is that the urinary tract of a woman is much shorter than in a man.  The culprit is the bacteria E. coli and is found in the rectum, which is closer to the urinary tract in women.  The E. coli that originates in the rectum can move to reside in the vagina.  From there, it has easy access to the urethra, which is the tube that transmits urine from the bladder to the outside of the body.

Several procedures exist to avoid contracting cystitis.  With internal tubing so close together in women, it is beneficial for them to wipe from front to back when they use the restroom to avoid spreading bacteria.  If you swipe the wrong way, you can move the E. coli from the rectum into the vagina and then into the urethra.

Another recommendation is to switch from nylon or synthetic underwear to the cooler cotton briefs which discourage the growth of bacteria.  In addition, thongs and G strings should be avoided by cystitis sufferers.  The string is an effective way for bacteria to move from the rectum to the bladder.

Yoghurt is often recommended for cystitis patients.  The probiotics naturally found in yoghurt help change the bacterial flora of the gastrointestinal tract.  If you follow this suggestion, remember to eat natural, low-to-no sugar yoghurt for a healthier snack.

Sexual intercourse also promotes transportation of bacteria from the vagina into the urethra.  If the bacteria are allowed to remain in the urethra, the bacteria multiply in the bladder, creating symptoms of cystitis.  It is important for women who get cystitis after intercourse to urinate frequently after sexual intimacy.  This washes the bacteria out of the urethra so they do not create an infection.

Doctors have traditionally recommended cranberries as a way to reduce the attacks of recurrent cystitis.  Cranberries were originally believed to be a source of acid that prevented cystitis.  Recent research has revealed that cranberries actually contain chemicals that help stop the bacteria from sticking onto the bladder wall.  Due to the strong taste of pure cranberries, many cranberry juices are a mixture with very little actual cranberry content.  You should look for 100% cranberry juices and avoid those from concentrate.  Also, you might consider cranberry supplements instead.

If you are currently experiencing symptoms of cystitis attack, the first practical step is to consume two glasses of water every 20 minutes for the first three hours.  This will help flush your system out, removing the bacteria.  Sometimes this is enough to prevent further problems; however, if not, drink a few glasses of cranberry juice.  Sipping a glass of water with a teaspoon of bicarbonate or soda stirred into it may help the burning sensation when you urinate.

If you are still experiencing symptoms after a day or two, you may need to see your doctor for a short course of antibiotics.  Do not leave cystitis symptoms untreated.  Failure to treat the infection can result in a much more serious kidney infection.  If you have more than three to four infections in a 12 month period, seek the advice of your physician as a more serious problem may be causing the infections.

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Overly Prescribed Bladder Bug Antibiotics are Causing Resistance

When E. coli is mentioned, most people think of a diarrhea-causing intestinal bug that is transmitted through tainted hamburger or spinach.  But one of the most common strains of E. coli is actually found outside the intestine, infecting urinary tracts and bladders.

Between 6 million to 8 million people, mostly women, are treated for the painful, annoying bladder infections every year.  Now health officials are beginning to worry about an aggressive strain of multi-drug-resistant E. coli bacteria, called E. coli ST131, which is responsible for up to 1 million bladder infections and 3,000 deaths a year.  According to Dr. James R. Johnson, an infectious disease expert at the Veterans Affairs Medical Center in Minneapolis, these infections start out in the urinary tract and spread to the bladder with no known antibiotics proving efficacious.

“I think it’s high time to worry,” said Johnson, who adds that the new strain is one resistance gene away from being untreatable.  “Before, resistant strains were wimpy.  Now, we have a winner.”

Between 80 percent and 90 percent of urinary tract infections each year are caused by extra-intestinal E. coli.  Normally, most of these infections respond to drinking lots of water and quarts of cranberry juice.  But many people choose to take a quick trip to the doctor for antibiotics before trying natural remedies.  As a result of over-prescription and failure to continue the full course of the antibiotics, drug-resistant E. coli in the urinary tract and bladder have emerged.

In a recent national study, Johnson found that although the E. coli ST131 strain accounted for only about 17 percent of E. coli isolates overall, it accounted for more than 50 percent of bacteria resistant to more than one antibiotic, including the top two used to treat urinary tract infections.  Further, it was responsible for nearly 70 percent of resistance to the main drugs prescribed for UTI treatment:  fluoroquinolones and extended-spectrum cephalosporins.

Johnson’s study in 2007 showed that E. coli ST131 probably caused the most significant multi-drug resistant E. coli infections in the U.S., which constitutes a serious public health threat.

“What’s new about our research is we’re seeing there’s more resistance out there,” Johnson said.  “What we’ve found is an explanation for that rising resistance:  It’s this one strain.”

Just a few years ago, drug-resistant E. coli bugs were rare, says Dr. Thomas “Mac” Hooton, a professor of medicine and infectious disease expert at the University of Miami.  “Now, [they] are like a second-language.  I guarantee you that this will be something we’re seeing in five or 10 years and it will be all over the place.”

Doctors and scientists have worried about resistance in common infections such as UTIs and have watched it grow over the last two decades.  When trimethoprim-sulfamethoxazole, or TMP/SMX with brand names of Septra and Bactrim, fell to drug-resistant bacteria, fluoroquinolones such as Cipro and Floxin became the drug of choice to fight urinary tract and bladder infections.  But now even these top guns are showing resistance in at least 10 percent of cases in the United States.  Cipro was even known as “Vitamin C” because of its high rate of prescription to treat UTIs and bladder infections.

This fall, the Infectious Diseases Society of America is expected to step in with new UTI guidelines in order to address the over-usage of fluoroquinolones, explains Hooton.  “They’re going to say, ‘We’ve got a big problem with resistance, let’s reserve our fluoroquinolones for the big infections,’” he said.  “We’re advocating it be approached like a public health problem.”

The rising levels of resistance and new highly resistant bugs needs to be addressed.  Something needs to be done, and more attention and action needs to be taken.

“Part of the reason that now is the time to worry is that you need to worry in advance to do something about it,” explains Johnson, who has received grants and served as a consultant for several top drug companies.  “The lead time to coming up with any fixes is pretty long.”

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