SENSITIVITY PATTERN OF ESCHERICHIA COLI TO ANTIBIOTICS.

INTRODUCTION: Escherichia coli { commonly abbreviated as E.coli named after Theodor Escherich} is a Gram negative rod shaped bacteria that is commonly found in lower intestine e of warm blooded organism {endotherms} . Most E.coli strains are harmless but some such as serotype 0157;H7 can cause serious food poisoning in human and are occasionally responsible for product recalls. The harmless strains are part of the normal flora of the gut and can benefits their host by producing vitamin k2 and by preventing the establishment of pathogenic bacteria within the intestine. E.coli are not always confined to the intestine and their ability to survive for brief periods outside the body make them the ideal indicator organisms to test environmental samples for faecal contamination. The bacterial can also be grown easily and its genetics are comparatively simple nad easily manipulated or duplicated through a process of metagenics making it one of the best studied prokariotic model organism and an important species in biotechnology and microbiology. E.coli was discovered by German paediatrician and bacteriologist Theodor Escherich in 1885 and is classified as part of Enterobacteriaceea family of gamma proteobacteria. CHARACTERISTICS OF ESCHERICHIA COLI. E.coli is Gram negative, facultative anaerobic and non sporulating cells are typically rod shaped are 2micrometer long and 0.5 micrometre in diameter with a cell volume of 0.6 0.7 micrometre. It can live on a wide variety of substrate. E.coli uses mixed acid fermentation in anaerobic condition producing lactate succinate,ethanol, acetate and co2. Optimal growth of E.coli occurs at 37*C but some lab. Strains can multiply at temperature of up to 49*C. Growth can be driven by aerobic or anaerobic respiration using a large variety of redox pairs including oxidation of pyruvic acid, formic acid, Hydrogen and an amino acids and reduction of substrate such as O2, Nitrate, dimethylsulfide and trimethylamine N- oxide. Some strains posses petrichous flagella and can swim and motile. DIVERSITY; E.albertii, E. fergusonii, E.coli 0157;H7. E.coli normally colonized an infants GIT. Non pathogenic E.coli {mutaflor used as probiotic agent in medicine} mainly for the treatment of varios gastroenterological diseases including inflammatory bowel diseases. PATHOGENICITY . Virulent strains of E.coli can cause gastroenteritis, urinary tract infections and neonatal meningitis and in rare cases virulents strains are also responsible for haemolytic uraemic syndrome, peritonitis, mastitis, septicaemia and Gram negative pneumonia. VIRULENT PROPERTIES. Enterics E.coli are classified on the basis of serological characteristic and virulence properties. Virotype includes;

{1} ETEC {Enterotoxigenic Escherichia coli}: Causative agent of diarrhoaea without fever in humans. They are non invasive and they do not leave the intestinal lumen and leading bacteria cause of diarrhoaea in children in developing World as well as most common cause of traveller diarrhoaea. {2} EPEC {Enteropathogenic Escherichia coli} : Causative agents of diarrhoaea in humans, rabbits, dogs, cats and horses. They are moderately invasive {i.e they enter the host cells} and elicit an inflammatory response changes in intestinal cell, ultrastructure due to attachments and effacement is likely the prime cause of diarrhoea in those afflicted with EPEC. {3} EIEC {Enteroinvassive Escherichia coli} : Found only in humans. Cause a syndrome that is identical to shigellosis with profuse diarrhoea and high fever. {4} EHEC {Entero haemorrhagic Escherichia coli}: Found in human, cattle and goats. Strain 0157;H7 which causes bloody diarrhoea and no fever. EHEC can cause haemolytic uremic syndrome and sudden kidney failure. {5} EAEC {Entero aggregative Escherichia coli} : Found only in human binds to intestinal mucosa to cause watery diarrhoea without fever. They are non invasive. They produce haemolysin and an ST enterotoxin similar to that of ETEC. LABORATORY DIAGNOSIS. In stool samples microscopy will show Gram negative rods, with no particular cell arrangement . Then MacConkey agar, or EMB or both. On MacConkey agar deep red colonies are produced as the organism is lactose positive and fermentation of this sugar will cause the medium pH to drop leading to darkening of the medium. Growth on Levine EMB agar produces black colonies with greenish black metallic sheer. E.coli is indole positive {red ring}, methyl red positive {bright red}, but VP negative, citrate negative. Other tests for detection of E.coli in stool is ELISA test, colony immune blots, direct immunofluorescence microscopy of filters as well as immunocapture technique using magnetic beads for rapid test of 0157;H7 prior culturing of the stool samples. ANTIBIOTIC THERAPY AND RESISTANCE. Bacterial infections are usually treated with antibiotics. However, the antibiotic sensitivity of different strains of E.coli vary widely. As Gram negative organism E.coli are resistant to many antibiotics that are effective against Gram positive organisms. Antibiotics which may be used to treat E.coli infection includes Amoxicillin, as well as semi synthetic penicillins, many cephalosporin, carbapenems, aztreonam, trimethoprimsulfamethoxazole, Ciprofloxacin, nitrofuratoin and aminoglycosides and quinolone. Antibiotic resistance is a growing problem. Some of this is due to overuse or over abuse of antibiotics in human, but some of it is probably due to the use of antibiotics as growth, promoters in food of animals. A study published in August 2007 found that the rate of adaptative mutation of E.coli is on the order of 10`5 per genome per generation which is 1,000 times as high as previous estimates. A finding which may have significance for the study and management of bacterial antibiotic resistance. Antibiotic resistant E.coli may also pass on the gene responsible for antibiotic resistance to other species of bacteria, such as Staphlococcus aureus through a process called horizontal gene transfer. E.coli often carry multidrug resistant plasmid and under stress readily

transfer those plasmids to other species. Indeed, E,coli is a frequent member of biofilms where many species of bacteria exist in close proximity to each other. This mixing of species allows E.coli strains that are piliated to accept and transfer plasmids from and to other bacteria. Thus E.coli and the other enterobacteria are important reservoirs of transferable antiobiotics resistance.. BETA LACTAMASE STRAINS. Resistance to beta lactam antibiotics has become a particularly problem in recent decades as strains bacteria that produce extended spectrum beta lactamase have become more common. These beta lactamase enzymes makes many if not all of the penicillin cephalosporins ineffective as therapy. Extended spectrum beta lactamase producing E.coli are highly resistance to an array of antibiotics and infections by these strains are difficult to treat. In some instance only oral antibiotics and a very limited group of intravenous antibiotics are effectives. In 2009, a gene called New Delhi metallo beta lactamase{shortened NDM-1} that even give gives resistance to intravenous antibiotic carbepenam were discovered in India and Pakistan on bacteria E.coli. PHAGE THERAPY. Viruses specifically target pathogenic bacteria has been developed over the last 80yrs, primarily in the former Soviet Union where it has been used to prevent diarrhoea caused by E.coli. Presently phage therapy for humans is available in phage therapy center in the Republic of Georgia and Poland. VACCINATION. Researcher have actively been working to develop safe, effective vaccines to lower the Worldwide incidence of E.coli infections. In 2009 a Michigan State University researcher announced that he has developed a working vaccine for a strain of E.coli. Mahdi Saeed, professor of epidemiology and infectious diseases in MSU*s college of Vetenary Medicine and Human Medicine has applied for his patients and contacts Pharmaceutical company for commercial production of the vaccine.