Escherichia coli infection, a negative prognostic factor on the evolution of patients with surgical diseases

Abstract

The bacterium Escherichia coli, one of the most studied bacteria in the world, with the greatest epidemiological impact, includes both commensal and pathogenic strains, with a genome that can be extremely varied both in size and genetic content, and it also can produce numerous diseases with specific symptoms. The vast majority of these strains can cause severe gastrointestinal diseases, hemolytic uremic syndrome, hemorrhagic colitis, renal failure and even death. Hemolytic uremic syndrome can be a consequence of the presence of Escherichia coli infection in gastrointestinal diseases. In this study, uremia in patients with and without the declared renal comorbidity, was negatively correlated with the response to antibiotic treatment. The increase of uremia above 92 mg/dl increases the risk of death. The highest risk categories include people with kidney disease like comorbidities starting with admission in surgical and intensive care wards in IRGH Cluj-Napoca, having as main diagnosis of hospitalization surgical digestive diseases. The occurrence of Coli pathogen infection was associated with increased morbidity and mortality rates in patients included in the study. In these patients, it was noticed the need to introduce therapy with increasingly complex antibiotic formulas, which lead to an increase in the duration and cost of hospitalization. In the studied group, due to E coli infection at admission, uremia had an average value of 23.99mg/dl +/-8.987(SD) in the case of patients without kidney disease, the number of patients with normal uremia values ​​was lower than that of those with increased values ​​of uremia. In the case of patients with confirmed kidney disease, uremia had mean values ​​of 65.76 mg/dl +/-52.41(SD). At discharge, both in the case of patients with renal disease and in the case of those without confirmed renal disease, the number of patients with normal values ​​of uremia was higher than those with pathological values, this proportion being reversed in the case of deceased patients where the number of patients with values pathological urea levels were significantly higher than those with normal values, proving kidney damage.

Keywords

• bacterial infections
• Escherichia coli
• hemolytic uremic syndrome
• multiresistant bacteria resistant to antibiotic therapy