E. coli: A Persistent Threat to Public Health

Escherichia coli: Epidemiology, Impact, Antimicrobial Resistance and Prevention

Public health aims to protect and improve community health by preventing and controlling infectious diseases. This includes surveillance, policy development, health education, immunization, research, and collaboration. Escherichia coli (E. coli) is a bacterium found in the intestines of humans and animals, with harmless and pathogenic strains causing serious illnesses. Pathogenic E. coli, like Shiga toxin-producing E. coli (STEC), can lead to severe food poisoning and outbreaks, making it a major public health concern. E. coli is transmitted through contaminated food, water, and direct contact with infected animals or individuals. It can survive in various environments and acquire antibiotic resistance. Vulnerable populations, such as children, elderly, and immunocompromised individuals, are at higher risk of severe infections. Studies in Egypt show high resistance rates to commonly used antibiotics in both clinical and food samples.E. coli isolates from various sources in Egypt and Tunisia demonstrated high resistance to commonly used antibiotics, limiting treatment options and posing a public health risk. E. coli isolates from patient urine in Nigeria showed high resistance to most antibiotics tested except newer drugs, indicating misuse of antibiotics in healthcare. The typical symptoms of infection include diarrhea, abdominal pain, symptoms of urinary tract infection and fever. The most serious complication is hemolytic uremic syndrome (HUS), which can cause acute kidney failure and be life-threatening, especially in young children and elders. Long-term consequences of infection and HUS can include chronic kidney disease and neurological impairment. The present review article summarizes the current knowledge, highlights the challenges and gaps and provides recommendations and solutions.