9 newborns were infected with Escherichia coli and 3 died. Is this bacteria scary?

The outbreak of Escherichia coli infection in the neonatal department of the Dongsheng branch of Ordos Central Hospital has attracted attention. What is Escherichia coli? What symptoms can it cause? How can it be prevented?

Written by reporter Song Meng Edited by Liu Zhao

Interview experts:

Zhu Baoli (Researcher at the Institute of Microbiology, Chinese Academy of Sciences, Professor at the School of Medicine, University of Chinese Academy of Sciences)

Fan Ping (Professor of Anorectal Surgery, The First Affiliated Hospital of University of Science and Technology of China)

Since the outbreak of the COVID-19 pandemic, people's lives and economic activities around the world have almost come to a standstill, with losses amounting to trillions of dollars. As long as the general public talks about infectious diseases, they are highly nervous. Recently, a piece of news has aroused people's nervousness again. In this incident, a collective infection occurred in the neonatal department of the hospital, resulting in the death of many newborns. However, the cause has been found out, that is, an infection caused by enteroadhesive diarrhea-causing Escherichia coli.

(Picture from China Newsweek Weibo screenshot)

So, what exactly is Escherichia coli? What are the symptoms if you are infected? What are the daily preventive measures?

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What is the identity of Escherichia coli in our daily lives?

In fact, Escherichia coli also has a common name, namely Escherichia coli. They are divided into two categories, one is the symbiotic bacteria without pathogenicity; the other is Escherichia coli carrying pathogenic genes, generally called "Escherichia coli". Escherichia coli is a pathogenic bacterium that causes diarrhea when Escherichia discovered it in 1885 when he was trying to find the cause of cholera, so it was named "Escherichia coli". Zhu Baoli, a researcher at the Institute of Microbiology, Chinese Academy of Sciences and a professor at the School of Medicine, University of Chinese Academy of Sciences, said this in an interview with our reporter.

In general, E. coli is a bacterium that normally lives in the intestines of humans and animals. In most cases, it can coexist peacefully with the human body and produce some beneficial effects. However, there are also some E. coli that are pathogenic to humans and can cause infectious diarrhea. These bacteria are called diarrheagenic E. coli.

Zhu Baoli also pointed out that in the laboratory, a large number of E. coli with a mixed smell of rotten eggs and toilets can be grown in a short period of time using a special culture medium, but they are generally not pathogenic. Pathogenic E. coli are mainly diarrhea-causing E. coli, and they can be divided into five types according to the pathogenic genes they carry and their different pathogenic mechanisms: enteropathogenic, enterotoxigenic, enteroinvasive, enterohemorrhagic, and enteroaggregative.

▲White Escherichia coli in the culture medium (picture from the Internet)

Among E. coli, the most pathogenic one is enterohemorrhagic E. coli O157:H7. This type of E. coli is also transmitted through the most common food-borne routes, such as eating uncooked meat and other items contaminated by feces. Moreover, this type of bacteria is acid-resistant and low-temperature-resistant, and can survive in the refrigerator for a long time. In an acidic solution with a pH value of 2, it can survive for dozens of days. However, it is sensitive to heat and can die in 1 minute in 75°C water.

However, in general, E. coli can survive for weeks to months or even longer in natural water and feces at relatively low temperatures. Moreover, it is more resistant to heat than other enterobacteriaceae, and some of it can still survive at 55℃ for 60 minutes or 60℃ for 15 minutes.

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Besides causing diarrhea, are there any other reactions?

Certain strains of Escherichia coli are also associated with persistent diarrhea in infants and young children. This is because in the first few years of life, the microbial community in the intestines of infants and young children is dynamic and constantly developing and changing. During this period, if the intestinal microbiome develops poorly, it will increase the risk of multiple diseases later.

Professor Fan Ping of the Department of Anorectal Surgery at the First Affiliated Hospital of the University of Science and Technology of China said in an interview with reporters: May and June are the peak months for infection with this bacterium. Infants or children with mild symptoms may not have a fever, but may have yellow egg-drop-like stools 3 to 10 times a day. If the condition is more serious, there may be symptoms such as fever, vomiting, abdominal pain, and bloating. If vomiting and diarrhea are severe, there may be symptoms of dehydration and acidosis.

▲Escherichia coli shaped like a "caterpillar" (Photo from Huashan Infection WeChat account)

For adults, after being infected, the disease often develops acutely, with symptoms such as abdominal pain and dysentery-like stools. Even a large number of fat particles can be found in fecal microscopy.

In fact, in the first half of last year, there was an incident where students were collectively infected and suffered from diarrhea, fever and other reactions. At that time, the domestic epidemic situation eased, and many places had not seen new local cases for a long time. However, the sudden appearance of 209 people with fever, abdominal pain, and diarrhea made everyone's slightly relieved breath suddenly rise to their throats. Fortunately, after investigation and analysis, it was found that the symptoms of the students were suspected to be acute gastroenteritis (Escherichia coli) caused by water problems.

Fan Ping also added: However, in general, most patients can recover within 10 days after the onset of the disease. But there are a few people with serious conditions who may develop hemolytic uremic syndrome and even endanger their lives. Therefore, in daily life, we need to take some measures to reduce or avoid being infected by such bacteria.

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How can we avoid it?

Since Escherichia coli is a part of the intestinal flora of humans and animals, it can be excreted into the natural world with feces. Therefore, livestock, poultry, patients and asymptomatic infected persons may all become sources of infection. In addition, drinking water, meat, milk, vegetables, fruits and other foods are also easily contaminated. It is worth mentioning beef products, because in 1982, the culprit of the food poisoning outbreak in the United States was hamburger beef contaminated by Escherichia coli.

Therefore, in our daily lives, we can also take some measures to prevent Escherichia coli from taking advantage of people's dangers.

(Pictures from the Internet)

In fact, we can minimize the risk of being affected by E. coli by doing some small things. For example, wash your hands carefully before and after meals; ensure that drinking water is clean and hygienic; thoroughly heat meat, milk and other animal foods; eat less raw and cold foods; separate raw and cooked knives and cutting boards in the kitchen, etc.

In addition, when buying food, try to buy it from reliable places; perishable food should be sealed and stored in the freezer. The freezer should also be cleaned regularly to prevent bacteria from sleeping there.

References:

1.Caprioli AS, Brugere H, Oswald E. Enterohaemorrhagic Escherichia coli: Emerging issues onvirulence and modes of transmission[J]. Vet. Res, 2005, 36(3): 289 – 311.

2. Shen Dingshu. Research progress on enterohemorrhagic Escherichia coli O157:H7 and its plasmid O157[J]. Chinese Journal of Health Laboratory Technology, 2011, 021(006):1589-1592.

3.Martin R, Makino H, Yavuz AC, Ben-Amor K, Roelofs M, Ishikawa E, et al. Early-Life events, including mode of delivery and type of feeding, siblings and gender, shape the developing gut microbiota. PLoS One 2016.

4. Xiong Yan, Zhu Chunhui, Zhao Li, et al. Research progress on Escherichia coli and pediatric infectious diseases[J]. Chinese Journal of Practical Pediatrics, 2020, 35(06):478-480.

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