Epidemiology and Public Health of Escherichia coli Infections-An Updated Review
Abstract
Background: Escherichia coli is a gram-negative bacterium that constitutes part of the normal human intestinal microbiota but is also one of the most important causes of intestinal and extraintestinal infections worldwide. Pathogenic strains are responsible for a wide clinical spectrum ranging from self-limiting diarrhea to life-threatening conditions such as sepsis and hemolytic uremic syndrome, representing a significant public health concern.
Aim: This review aimed to provide an updated overview of the epidemiology, pathogenic mechanisms, clinical features, diagnostic approaches, and management strategies related to E. coli infections, with emphasis on implications for public health and healthcare systems.
Methods: A narrative review approach was applied, integrating current evidence on E. coli pathotypes, modes of transmission, disease burden, diagnostic modalities, treatment options, and prevention strategies, including infection control and antimicrobial stewardship.
Results: Intestinal E. coli infections are categorized into major pathotypes—ETEC, EPEC, EAEC, EHEC/STEC, and EIEC—each characterized by distinct virulence factors and epidemiological patterns. Extraintestinal infections, particularly urinary tract infections and bacteremia, account for a substantial burden in healthcare settings. Advances in molecular diagnostics have improved pathogen identification, while rising antimicrobial resistance, including ESBL- and carbapenemase-producing strains, has complicated treatment decisions.
Conclusion: E. coli infections remain a major cause of morbidity worldwide. Early recognition, accurate diagnosis, rational antimicrobial use, and strong preventive strategies are essential to reduce disease burden and limit the spread of resistant strains.
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