Escherichia coli is probably the best-known bacterial species and one of the most frequently isolated organisms from clinical specimens. Despite this, underappreciation and misunderstandings exist among medical professionals and the lay public alike regarding E. coli as an extraintestinal pathogen. Underappreciated features include (i) the wide variety of extraintestinal infections E. coli can cause, (ii) the high incidence and associated morbidity, mortality, and costs of these diverse clinical syndromes, (iii) the pathogenic potential of different groups of E. coli strains for causing intestinal versus extraintestinal disease, and (iv) increasing antimicrobial resistance. In this era in which health news often sensationalizes uncommon infection syndromes or pathogens, the strains of E. coli that cause extraintestinal infection are an increasingly important endemic problem and underappreciated "killers". Billions of health care dollars, millions of work days, and hundreds of thousands of lives are lost each year to extraintestinal infections due to E. coli. New treatments and prevention measures will be needed for improved outcomes and a diminished disease burden.
Bibliographical noteFunding Information:
Financial Support: VA Merit Review (T.A. Russo and J.R. Johnson), NIH AI 42059, HL 69763 (T.A. Russo) and DK 47504 (J.R. Johnson), National Research Initiative Competitive Grants Program/US Department of Agriculture grant 00-35212-9408 (J.R. Johnson) and The John R. Oishei Foundation (T.A. Russo).
- Antibiotic resistance
- Extraintestinal Escherichia coli infections
- Incidence of infection
- Urinary tract infection