Escherichia coli (E. coli) in urinary tract infections

TL;DR

Escherichia coli (E. coli), a common bacterium in the digestive tract, is a leading cause of urinary tract infections (UTIs) and vaginal infections like aerobic vaginitis (AV). Its ability to form biofilms makes treatment challenging, leading to recurrent infections. Understanding the link between gut health and the prevalence of E. coli can provide insights into managing and preventing these infections effectively.

Escherichia coli is a gram-negative facultative anaerobe that can cause urinary tract and vulvovaginal infections, such as aerobic vaginitis (AV).

E. coli is a common cause of infections in the digestive tract resulting in diarrhoea, gallbladder, and blood infections, as this bacteria lives naturally in the digestive tract.

E. coli may be easily passed from the anus to the vagina and urinary tract. E. coli can live in the urinary tract, where the force of urine makes it cling on harder to your cells; sadly, you can’t wash E. coli away by drinking a lot of water.

E. coli can also move around a little more than some other bacteria. E. coli in the vagina is less common than in the urinary tract, but vaginal infections can also occur, contributing to vaginal odour, inflammation and discharge.

Getting tested

A comprehensive vaginal or urinary microbiome test will reveal E. coli in the vagina or urinary tract.

E. coli biofilms

E. coli creates biofilms, the sticky matrix that protects E. coli and friends, and works to block other protective microbes from re-colonising.

These biofilms are particularly problematic in the urinary tract and vagina, where a seemingly successful treatment leaves you susceptible to recurrences.

Chronic UTI

People who ‘get UTIs’ really get them, known as chronic UTI. You may get one or two UTIs, but typically you either do or you don’t have chronic UTIs.

The cause of chronic UTI can vary and may be related to a disrupted gut microbiome, genetic mutations, and metabolic pathway interruptions that result in excessive metabolites such as histamine, oxalates, hormones and wastes.

Having the help of a good practitioner can be the difference between the resolution of symptoms and chronic UTI being with you for a long time.

Recurrent infections are just being recycled, and the bacteria never really go away.

E. coli in urinary tract infections

Most urinary tract infections (80-90 per cent) are caused by E. coli, with high recurrence rates after the initial infection.

The other bacteria responsible for urinary tract infections include Enterococcus faecalis, a co-infector with E. coli. You’ll often see these two together – read more about the E. coli and E. faecalis codependency.

Symptoms of a urinary tract infection caused by E. coli

  • Urethritis (inflammation of the urethra)
  • Cystitis (inflammation of the bladder)
  • Burning while urinating
  • Bladder pressure
  • Tender bladder
  • Frequent urination
  • Urinary urgency
  • Low-grade fever
  • Cloudy urine (due to white blood cells)
  • Lower back pain
  • A positive test
  • Aerobic vaginitis (AV) or other vaginal microbiome disruptions

Diagnosis of E. coli UTI

A dipstick test is designed to establish if there is pus and/or bacteria in the urine, but dipstick tests are not always very reliable.

Cloudy urine can also indicate a urinary tract infection, which will be obvious both in the toilet and with a urine sample at the doctor’s office.

The cloudiness is caused by pus (white blood cells) in the urine. There are a few other causes of cloudy urine, so it doesn’t necessarily mean you have a UTI, but it can add to the diagnosis.

A scan may be scheduled if the kidneys are suspected of being involved.

Treating an uncomplicated UTI caused by E. coli

Treatment options vary widely for UTIs; however, the conventional medical treatment is antibiotics.

Antibiotic resistance is an emerging public health issue, with multi-drug resistant Enterobacteriaceae, mostly E. coli, hampering treatments.

Some E. coli strains are resistant to antibiotics such as penicillins, cephalosporins, fluoroquinolones and gentamicin.

Non-antibiotic treatments for E. coli UTI

Non-antibiotic treatments that can be applied at home include herbal medicines, reflexology, and others, but ongoing or severe infection, especially involving the kidneys, requires prompt medical attention.

Staying hydrated is very important, but plenty of fluids in your system can ease the pain of unfruitful urination and help keep the urinary tract clear as you do non-antibiotic treatments.

How to treat a UTI at home

Vaginal infections of E. coli

If you are diagnosed with a vaginal infection that includes E. coli, you have what’s known as aerobic vaginitis. Different types of bacteria cause AV compared to bacterial vaginosis.

E. coli can be found residing in the vagina without causing infections, and a positive test without symptoms may not require any treatment. Testing may find that you have normal levels of lactobacilli, with other microbes also found.

How your digestion can contribute to a UTI or aerobic vaginitis

The urinary tract has its own microbial ecosystem, which resembles vaginal flora. This means that a healthy vagina supports a healthy urinary tract and vice versa.

If you have digestive problems, the gut microbiome can become unhealthy, contributing to poor vaginal health due to proximity of the anus to the vagina.

Poor digestive health typically results in unbalanced gut flora, where pathogens are able to proliferate because of the absence or lack of healthy intestinal flora.

E. coli naturally resides in the colon and can overgrow, resulting in more frequent cross-contamination with the vagina and urinary tract. This highlights the importance of focusing on gut health when dealing with frequent vulvovaginal or urinary tract infections.

Constipation, diarrhoea and E. coli

Constipation, for example, leaves stool in the colon for long periods of time, providing an ongoing food source for microbes.

Having a healthy bowel movement every day at least once ensures that the microbial colonies in the digestive tract are kept in check, since the stool passing through acts like a broom.

Fibre makes stools larger and firmer, creating a sort of boulder that moves through the intestines, picking up anything in its way and pushing it out.

Diarrhoea doesn’t have the same effect as constipation, but comes with its own issues – think of wet sand in a wet sock. Bits of faeces can remain on the intestine walls, being slow to move through. This too provides a lingering food source for microbes.

The causes of constipation and diarrhoea vary, so if you find yourself with irritable bowel-type symptoms frequently, see a healthcare practitioner to figure out what is causing your problems.



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