Enterotoxic Escherichia coli infection

　　The main source of enterotoxigenic Escherichia coli infection is the patient and asymptomatic carriers. The main route of transmission is through the digestive tract, mainly through contaminated water, food, milk, beverages, etc., which can spread sporadically or in outbreaks, manifesting as 'traveler's diarrhea' or food poisoning. According to volunteer studies, the amount of pathogenic bacteria is 10^8 to 10^9, higher than that of dysentery, typhoid fever, and cholera, so the direct transmission between people is not frequent. The population is generally susceptible to ETEC, and both adults and children can be affected. Therefore, after understanding the etiology, we should keep away from the above sources of infection to avoid being infected. Of course, after contacting things that may contain virus sources, it is necessary to wash hands immediately and maintain personal hygiene. In fact, under proper attention, enterotoxigenic Escherichia coli infection is not easy to spread, as its source of infection can be avoided by contact.

　　Common complications of pathogenic Escherichia coli infection in the intestines include severe dehydration and metabolic acidosis, which can seriously damage the human body and even lead to life-threatening conditions in severe cases. At the same time, due to the increased acidity and severe dehydration, complications such as hypokalemia and hypocalcemia may occur, leading to respiratory failure, heart, liver, and kidney dysfunction, and in more severe cases, sepsis. Although these internal complications of the human body are not easy to be noticed, they are still very worthy of attention, as slight changes can threaten life. These complications also serve as a warning that attention should be paid to strengthen precautions. Since pathogenic Escherichia coli infection in the intestines is inherently dangerous, it is necessary to be extremely cautious in dealing with different complications, and to seek medical attention in a timely manner when necessary to ensure one's health.

　　The onset of pathogenic Escherichia coli infection in the intestines is generally slow, with an average incubation period of 0.5 to 7 days. Of course, it can also be acute. It is manifested as secretory diarrhea, with watery stools. Accompanied by abdominal cramps, nausea, vomiting, chills, headache, myalgia, rarely fever, with a course of 4 to 7 days. The severity of the disease varies, ranging from mild diarrhea to severe cholera-like symptoms, severe dehydration, acidosis, and even death. At this time, it is necessary to pay close attention, as further deterioration can harm the body, and in severe cases, it can be life-threatening. Adults are often infected with strains that produce ST and LT, while children are more commonly infected with strains that produce only ST, so adult diarrhea is more severe and lasts longer. The 302 Hospital admitted a case of adult ETEC enteritis patient, with up to 9000 ml of watery stools per day, and the course of the disease lasted for 38 days. These cases need to be analyzed on a case-by-case basis. Of course, in any case, after these symptoms appear, immediate medical attention should be sought and cannot be neglected to prevent the worsening of the condition.

　　As an infectious disease, the most important preventive measure for enterotoxic Escherichia coli infection is naturally to prevent hospital-acquired cross-infection. Of course, we should also start from our daily lives:

　　Firstly, it is necessary to carry out the 'three management and one elimination' activities, wash vegetables and fruits, do not drink raw water, cook meat thoroughly, heat leftovers thoroughly, and have fly prevention equipment in the kitchen during the summer.

　　The second point is to strictly prohibit the mixing of humans and animals. Livestock and poultry in the epidemic area must be kept in pens, and the pens should be disinfected and fly control measures should be taken regularly. The manure of livestock and poultry should be treated as harmless before fertilization.

　　The third point is to disinfect the dining utensils of the patients, and the toilets and compost in the epidemic area should be disinfected.

　　The fourth point is to treat the contaminated domestic water supply system. Take disinfection measures. Strictly follow the disinfection procedures, investigate the causes of contamination, and make timely corrections. Conduct pathogen tests on stool specimens of relevant personnel. The last point is to handle contaminated commercially sold meat and meat processing and sales sites. Immediately stop sales and seal the unsold products, investigate wholesale and sales records. Strictly implement disinfection and hygiene regulations in the meat processing and sales process, and disinfect the meat processing sites and animal feces and waste. For personnel in close contact, in addition to conducting stool pathogen tests when leaving their positions, early preventive medication should also be taken... At the same time, patients should use doxycycline for treatment, which can shorten the time of excretion of bacteria. To prevent aggravation and recurrence.

　　The diagnosis of enterotoxic Escherichia coli infection must be confirmed by cultivating Escherichia coli from the stool and detecting ST, LT positivity. Therefore, one can also judge whether a hospital has relevant authority in this disease based on the examination items. Although a tentative diagnosis can be proposed based on clinical and epidemiological characteristics, we still encourage doing a stool test personally to ensure the accuracy of the results, as reliability is the most important point in medicine. Enterotoxic Escherichia coli infection should mainly be differentiated from cholera, followed by viral enteritis, Salmonella enteritis, and other diseases. These diseases are easy to confuse with this disease, although the symptoms are somewhat similar, there are actually many differences. If the treatment method is incorrect, it may delay treatment or even worsen the condition. Therefore, it is necessary to clarify and distinguish them.

　　The diet of patients with enterotoxic Escherichia coli infection should pay attention to:

　　1. Patients should rest in bed and pay attention to keeping warm.

　　2. Patients in the acute stage often have symptoms such as vomiting and diarrhea, and lose a lot of water, so they need to replenish fluids, and can provide fresh fruit juice, lotus root starch, rice porridge, and egg soup as fluid foods, and drink plenty of water and light salt water as appropriate.

　　3. To avoid gastrointestinal fermentation and flatulence, it is advisable to avoid eating beef and other gas-producing foods during the acute stage, and to reduce the intake of sucrose as much as possible. Attention should be paid to food hygiene. It is forbidden to eat high-fat fried, grilled, and smoked fish, vegetables and fruits with high fiber content,刺激性饮料、食物和调味品, etc.

　　During the early stage of gastroenteritis: it is the severe stage of acute congestion, edema, inflammation, and exudation of the intestines. At this time, intestinal peristalsis is active or in a spastic state, and its digestive and absorptive functions are relatively weak. Therefore, within 8 to 12 hours after onset, patients can eat liquid foods such as rice porridge, egg noodle paste, and thin noodles. If diarrhea is severe or sweating is significant, patients should also be given more soup and water to supplement the body's water, vitamins, and electrolytes.

　　During the improvement period of gastroenteritis: patients can be given easily digestible and nutrient-rich liquid or semi-liquid foods, such as thin wonton wrappers, steamed egg custard, etc. It is recommended to use the method of eating small meals frequently, with 4 to 5 meals per day. It should be noted that milk and a large amount of sucrose should not be consumed at this time.

　　During the recovery period of gastroenteritis: it is especially important to regulate diet, and it is advisable to eat light, soft, and warm foods, avoiding eating fatty meats, fried foods, cold and hard foods, and high-fiber foods such as celery, soybean sprouts, chives, garlic sprouts, etc. After 2 to 3 days, one can return to normal meals.

　　In the treatment of enterotoxic Escherichia coli infection, different medications should be taken strictly according to the severity of the illness. Enterotoxic Escherichia coli infection has a self-limiting tendency, and antibiotics may not be necessary for mild cases. In severe cases, after antibacterial treatment, the excretion time can be shortened, and rifaximin (sparfloxacin) or norfloxacin in combination with attapulgite or berberine can be used. The dosage is the same as that for EPEC treatment. The focus of this disease treatment is to correct dehydration, acidosis, and hypokalemia. Mild cases can use ORS solution, while severe cases may require intravenous fluid replacement, with the preferred '5:4:1' solution, which is 5g of sodium chloride, 4g of sodium bicarbonate, and 1g of potassium chloride per 1000ml of fluid. The following list includes commonly available treatment medications that can be purchased at pharmacies for reference: adenine, rifaximin, norfloxacin, attapulgite, berberine, sodium chloride, sodium bicarbonate, potassium chloride, and doxycycline. In summary, enterotoxic Escherichia coli infection is prone to worsen, so it is encouraged to seek medical attention promptly and receive treatment as soon as possible to avoid deterioration of the condition or delays.