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Foodborne E coli infection

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  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 22 Nov 2025
最后更新： 08 Feb 2024

小结

定义

病史和体格检查

关键诊断因素

  • diarrhea
  • history of travel, contact with contaminated food, or contact with infected person
完整详情

其他诊断因素

  • abdominal pain or discomfort
  • volume depletion
  • fever
  • nausea/vomiting
  • anorexia
  • lethargy
完整详情

危险因素

  • ingestion of contaminated food products or water
  • travel
  • poor hygiene practices
  • infantile or advanced age (<5 years and >60 years)
  • contact history
  • immunocompromised state
  • contact with infected animals
完整详情

诊断性检查

首要检查

  • stool cultures
  • CBC
  • renal function and electrolytes
完整详情

需考虑的检查

  • identification of Shiga toxin-producing E coli infection
  • blood cultures
  • inflammatory markers (CRP and/or erythrocyte sedimentation rate)
  • abdominal x-ray
  • endoscopy
  • abdominal CT scan
完整详情

治疗流程

初步治疗

all patients

急症处理

confirmed enterotoxigenic positive

confirmed enterohemorrhagic positive

other Escherichia coli serotypes

撰稿人

作者

Eli D. Ehrenpreis, MD, FACG, AGAF

Associate Director for Research

Internal Medicine Residency

Advocate Lutheran General Hospital

Park Ridge

IL

利益声明

EDE is a CEO for E2Bio Life Sciences LLC and G.I. Pharmaceuticals Inc. E2Bio Life Sciences LLC has developed Bocaliner, an FDA-registered class 1 medical device designed to enhance the efficacy of topical medications applied to the oral cavity. G.I. Pharmaceuticals Inc. has medical treatments for oral leukoplakia designed to prevent oral cancer, and a new medication for anal pruritis.

鸣谢

Dr Eli D. Ehrenpreis would like to gratefully acknowledge the assistance of Dr Thomas Adam Wichelmann, who contributed to this update. Dr Ehrenpreis would also like to acknowledge Dr Alexandra Kent and Professor Satis Keshav, the previous contributors to this topic.

利益声明

TAW, AK, and SK declare that they have no competing interests.

同行评议者

Andrew Poullis, BSc, MBBS, MD, FRCP

Consultant Gastroenterologist

St George’s Hospital

London

UK

利益声明

AP declares that he has no competing interests.

Fiona Cooke, MA, PhD, MSc, FRCPath, MRCP, DTM&H

Research Fellow and Medical Microbiologist

Wellcome Trust Sanger Institute

Department of Microbiology

Addenbrooke's Hospital

Cambridge

UK

利益声明

FC declares that she has no competing interests.

Houssam E. Mardini, MD, MPH, FACP

Voluntary Assistant Professor of Medicine

Digestive Health & Nutrition Center of Ashland

Ashland

KY

利益声明

HEM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Nataro JP, Kaper JB. Diarrheagenic Escherichia coli. Clin Microbiol Rev. 1998 Jan;11(1):142-201.全文  摘要

Kaper JB, Nataro JP, Mobley HL. Pathogenic Escherichia coli. Nat Rev Microbiol. 2004 Feb;2(2):123-40.全文  摘要

American Medical Association; American Nurses Association-American Nurses Foundation; Centers for Disease Control and Prevention; Center for Food Safety and Applied Nutrition, Food and Drug Administration; Food Safety and Inspection Service, US Department of Agriculture. Diagnosis and management of foodborne illnesses: a primer for physicians and other health care professionals. MMWR Recomm Rep. 2004 Apr 16;53(RR-4):1-33.全文  摘要

Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-80.全文  摘要

Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 2: preparing international travelers - travelers' diarrhea. May 2023 [internet publication].全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • 鉴别诊断

    • Viral gastroenteritis
    • Alternative foodborne bacterial gastroenteritis/traveler's diarrhea
    • Amebiasis
    更多 鉴别诊断

  • 指南

    • Infectious diarrhea - guideline for investigation
    • E. coli (Escherichia coli) infection
    更多 指南

  • 患者教育信息

    Diarrhea in adults

    Diarrhea in children

    更多 患者教育信息
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