Intestinal E. Coli Infections (2024)

Escherichia coli (E. coli) are bacteria that are all around you. You can find E. coli everywhere in your environment, including on your skin and in your intestines. Most strains of E. coli are harmless but some strains can make you very sick and can cause sepsis.

Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Suggested Citation:
Sepsis Alliance. Sepsis and Intestinal E. coli infections. 2024. https://www.sepsis.org/sepsisand/intestinal-e-coli-infections/

Updated January 19, 2024.

More About E. coli

Spread

An E. coli infection spreads from person to person and from animal to person. You can also contract the infection by touching a contaminated object or consuming contaminated food or drink.

The type of E. coli infection we may be most familiar with is often referred to as travelers’ diarrhea. This type of infection is caused by the enterotoxigenic E. coli (ETEC) bacteria. These bacteria produce substances that are toxic (poisonous) to intestinal cells. The toxins stimulate the intestinal wall lining, which then produces more fluid and this causes diarrhea.

Travelers may get the infection by drinking unclean water or eating food that hasn’t been properly prepared. Closer to home, there are often reports in the news of E. coli outbreaks or recalls for processed foods that may be contaminated with the bacteria.

Food and water:

  • Contaminated ground beef is one of the most common causes of E. coli infection. Thorough cooking will kill the bacteria.
  • E. coli bacteria found on a cow’s udder or milking equipment can get into raw milk. Pasteurizing the milk will kill the bacteria.
  • Fresh produce can be contaminated with E. coli as it comes in touch with the runoff from cattle farms. The bacteria can also transfer to fresh produce during harvesting and packing if the workers or the equipment carry the bacteria.
  • Human and animal feces may pollute ground and surface water.

Personal contact

  • People can spread E. coli bacteria. It can easily travel from person to person if someone has the bacteria on their hands, most often when infected adults and children don’t wash their hands properly. Children who visit petting zoos and animal barns can also contract the infection after touching the animals.

Symptoms

The symptoms of an E. coli infection can be much more serious among infants and seniors, as well as people who are already ill. It can take anywhere from one to seven days for the symptoms to appear after exposure to the bacteria. The most commonly known symptoms are severe abdominal cramping and watery or bloody diarrhea. Others include:

  • Nausea
  • Vomiting
  • Headache
  • Mild fever

Most healthy people recover from an E. coli infection in a week or so. However, young children and seniors, as well as anyone who is medically fragile can become very ill quite quickly. The diarrhea and vomiting can cause dehydration. If you are experiencing severe diarrhea and/or vomiting, consult with your doctor or nurse practitioner as soon as possible.

E. coli infection can also lead to a life-threatening complication of the kidneys called hemolytic uremic syndrome. If you experience any of these symptoms, see your doctor or go to an emergency department immediately:

  • Decreased urine output
  • Unexplained bruises
  • Unusual bleeding
  • Extreme fatigue

E. coli infection can lead to sepsis, so it is important to watch for the signs and symptoms of sepsis, particularly among seniors.

Treatment

There is no treatment for E. coli infection yet. Treatment focuses on staying hydrated and resting. If necessary, your doctor may recommend IV fluids for hydration. It may be tempting to take an anti-diarrhea medication, but if you have an infection, this could slow down your body’s efforts to naturally expel the toxin, so check with your doctor first. There are no antibiotics for most E. coli infections.

If you have contracted traveler’s diarrhea, your doctor may recommend that you do take anti-diarrhea medications for a short period or bismuth subsalicylate (Pepto-Bismol). In some instances, doctors treat the infection with antibiotics.

Prevention

We can’t prevent all infections, but the chances of developing an E. coli infection are lower if you follow these tips:

  • Cook all meat thoroughly, particularly ground beef or mechanically tenderized meat.
  • Don’t reuse cutting boards or utensils after using them for meat products unless they’ve been washed in hot, soapy water first.
  • Drink only pasteurized milk and eat pasteurized dairy products.
  • Wash all fruits and vegetables thoroughly.
  • Wash your hands thoroughly, especially after touching animals and before and after handling food.

To reduce the risk of contracting travelers’ diarrhea while in countries where the bacteria is more common:

  • Drink bottled water and use bottled water to brush your teeth
  • Do not eat undercooked foods.
  • Do not use ice cubes made with tap water
  • Eat fruits that you can peel yourself
  • Wash your hands frequently

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Intestinal E. Coli Infections (2024)

FAQs

Intestinal E. Coli Infections? ›

Escherichia coli (E. coli) bacteria normally live in the intestines of healthy people and animals. Most types of E. coli are harmless or cause relatively brief diarrhea. But a few strains, such as E. coli O157:H7, can cause severe stomach cramps, bloody diarrhea and vomiting.

What are three symptoms of E. coli intestinal infection? ›

Symptoms include diarrhoea, stomach cramps and occasionally fever. About half of people with the infection will have bloody diarrhoea.

What causes E. coli in intestines? ›

How do you get E. coli? Most diarrheagenic E. coli strains spread through fecal-oral transmission. This happens when bacteria from poop that's too small to see make their way into your mouth and digestive tract. Some forms, like STEC, can also transmit through undercooked meat and unpasteurized beverages.

How do you treat an E. coli bowel infection? ›

Rifaximin, azithromycin, and ciprofloxacin are currently recommended by the Infectious Diseases Society of America (IDSA) and the International Society of Travel Medicine (ISTM) to treat E. coli diarrheal illness.

What are 3 infections caused by E. coli? ›

Common infections with E coli as a pathogen include cholecystitis, bacteremia, cholangitis, urinary tract infection (UTI), traveler's diarrhea, pneumonia, and neonatal meningitis.

How do I know if I have E. coli in my gut? ›

To diagnose illness caused by E. coli infection, your doctor sends a sample of your stool to a laboratory to test for the presence of E. coli bacteria. The bacteria may be cultured to confirm the diagnosis and identify specific toxins, such as those produced by E.

How long does E. coli last in intestines? ›

How long does it last? Symptoms usually last 5 to 10 days. People with mild symptoms usually recover on their own without treatment. Antibiotics are not helpful for treating E.

How contagious is E. coli? ›

It's mostly harmless, but some strains of this bacteria can cause infection and illness. E. coli is typically spread through contaminated food, but it can also pass from person to person.

Does E. coli make you gassy? ›

coli, which is a facultative anaerobic (can grow both aerobically and anaerobically), gram-negative, rod-shaped bacterium that ferments sugar, which results in gas production. The gas is released from the body as flatulence. E. coli is one of several bacteria normally found in the intestines of humans and animals.

What probiotic kills E. coli? ›

rhamnosus GR-1 can kill E. coli and can disrupt biofilms produced by these microbes (McMillan et al., 2011). Moreover, this strain can modulate aspects of host immunity, including NF-κB and mitogen-activated protein kinases (Kim et al., 2006; Karlsson et al., 2012).

Can E. coli cause sepsis? ›

Most strains of E. coli are harmless but some strains can make you very sick and can cause sepsis. Sepsis, which was often called blood poisoning, is the body's life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

What antibiotic kills E. coli? ›

For E coli intra-abdominal abscess, antibiotics must include anaerobic coverage (eg, ampicillin/sulbactam or metronidazole). In severe infection, piperacillin/tazobactam, ertapenem, or meropenem may be used.

What is the deadliest form of E. coli? ›

Shiga toxin-producing E.

coli (EHEC). STEC strains can cause serious illness in humans by producing toxins that can severely damage the lining of your intestines and kidneys. Infection with STEC strains can lead to serious complications like hemolytic uremic syndrome (HUS), which sometimes is fatal.

What are the symptoms of a gut infection? ›

Bacterial gastroenteritis is a digestive problem caused by bacteria. Symptoms include nausea, vomiting, fever, diarrhea, abdominal cramping, and pain. In severe cases, you may become dehydrated and have an electrolyte imbalance. Bacterial gastroenteritis is sometimes treated with antibiotics.

What are the worst symptoms of E. coli? ›

Symptoms of E. coli O157 infection include severe diarrhea (often bloody) and abdominal cramps. Most people infected with E. coli O157 do not have a fever or vomiting.

What does E. coli diarrhea look like? ›

coli (Escherichia coli) bacteria can cause severe, bloody diarrhea. Sometimes they also cause urinary tract infections, pneumonia, meningitis, bacteremia (a bacterial infection in the blood), or sepsis (a dangerous full-body response to bacteremia).

How to tell the difference between E. coli and a stomach virus? ›

Norovirus makes you vomit, violently

Norovirus is commonly known as stomach flu or winter vomiting disease. Both infections cause abdominal cramps and diarrhea, and often fever. E. coli infections can cause bloody diarrhea and sometimes but not always vomiting; norovirus is more likely to cause watery diarrhea.

What are 3 symptoms that you can have if you have E. coli or salmonella? ›

Symptoms include diarrhea, fever, stomach cramps and vomiting. Salmonella poisoning symptoms are not as critical as those of E. Coli poisoning. They are usually mild and will resolve on their own.

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