Escherichia coli in the urine

, a GRAM negative bacterium normally present in the colon, is the main cause of urinary infections, sustaining up to 90% of cases in the absence of concomitant risk factors or complications. Furthermore, it is estimated that the percentage of relapses after healing from a first urinary infection sustained by Escherichia Coli is around 44% over the next 12 months.

conducted to investigate the origin of one or more symptoms attributable to a urinary tract infection: pain or burning during urination, frequent urge to urinate, cloudy urine with a pungent odor, pain in the lower abdomen or kidneys, chills, fever, sweat, and aches during sexual intercourse.

Urinary infections caused by Escherichia coli are more common in women, due to the previously mentioned unfavorable anatomical characteristics (shorter urethra, urinary meatus closer to the anal region) and the absence of bactericidal activity of prostatic secretions. The risk also increases during pregnancy and in the presence of diabetes.

Uropathogenic Escherichia coli

Not all strains of Escherichia coli are capable of causing urinary infections; microorganisms endowed with this ability are therefore defined as "uropathogenic". This characteristic is due to the presence of adhesion factors, which allow Escherichia coli to anchor itself to the membrane of the uroepithelial cells by means of protein structures called adhesins, located at the distal end of thin filaments (pilio fimbriae) that project from the wall of the bacterium. Among these, the P (mannose-resistant) fimbriae bind to a disaccharide of galactose present on the surface of uroepithelial cells, and to the P antigen of erythrocytes.

Consequently, patients who harbor uropathogenic strains in their intestines run a greater risk of developing urinary infections from Escherichia coli (to learn more: mannose and cystitis); these infections can involve the urethra (urethritis), the bladder (cystitis), the kidney (pyelonephritis) or the prostate (prostatitis).

with structural abnormalities of the urinary tract or obstructive problems, for example caused by an enlarged prostate or a tumor. In severe cases, faced with a compromised immune system and general physical weakness, Escherichia coli can enter the bloodstream, causing a systemic reaction to its antigens, which can lead to disseminated intravascular coagulation with a poor prognosis.

The presence of localized pain in the side or lower back, accompanied by high fever (> 39 ° C), chills, sweating, headache, nausea and high frequency and urgency in urination, should lead to suspect a "kidney infection (pyelonephritis) or a "complicated urinary infection.

, ciprofloxacin and nitrofurantoin; in most uncomplicated urinary infections, a single administration of one of these antibiotics is sufficient. The choice of the drug and the duration of treatment depend on the patient's clinical history and the results of urine tests; the antibiogram, for example, allows to test the susceptibility of the bacterium to various antibiotics, limiting the spread of resistance to these medications.

In cases of recurrent Escherichia coli cystitis, the condition can be treated with prolonged daily therapy (six months) or postcoital prophylaxis with antibiotics (trimethoprim / sulfamethoxazole, fluoroquinolone or nitrofurantoin).

, urinate when needed without retaining urine, prefer a shower to a bath in the tub, clean the genital area and urinate after sexual intercourse, and avoid the use of perfumed sprays and showers for feminine intimate hygiene, in how much they can irritate the urethra. Finally, in the washing and cleaning operations, it is advisable to start from the vulva and go down towards the anus, not vice versa; this is to prevent intestinal bacteria such as Escherichia coli from coming into contact with the vagina or urinary tract.

Among the natural remedies we remember the juice of the American cranberry, which inhibits the adhesion of the bacterium to the walls of the urinary tract, while a "direct antimicrobial activity against" Escherichia coli is often ascribed to the bearberry, despite its bactericidal effect. is still uncertain.