Video:Escherichia coli O157:H7

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Escherichia coli O157:H7 is a serotype of the bacterial species Escherichia coli and is one of the Shiga-like toxin–producing types of E. coli. It is a cause of disease, typically foodborne illness, through consumption of contaminated and raw food, including raw milk and undercooked ground beef.[1][2] Infection with this type of pathogenic bacteria may lead to hemorrhagic diarrhea, and to kidney failure.[3]Fluid replacement and blood pressure support can prevent death from dehydration.[4]


E. coli O157:H7 infection often causes severe, acute hemorrhagic diarrhea (although nonhemorrhagic diarrhea is also possible) and abdominal cramps. Usually little or no fever is present, and the illness resolves in 5 to 10 days.[5] It can also sometimes be asymptomatic.[6]


Like other strains of the species, O157:H7 is gram-negative and oxidase-negative. Unlike many other strains, it does not ferment sorbitol, which provides a basis for clinical laboratory differentiation of the strain. Strains of E. coli that express Shiga and Shiga-like toxins gained that ability via infection with a prophage containing the structural gene coding for the toxin.[7][8]


Infection with E. coli O157:H7 can come from ingestion of contaminated food or water, or oral contact with contaminated surfaces. Examples of this can be undercooked ground beef but also leafy vegetables and raw milk.[9]


Some strains of E. coli, like O157:H7, can produce Shiga toxin . The Shiga toxin causes inflammatory responses in target cells of the gut, leaving behind lesions which result in the bloody diarrhea that is a symptom of a Shiga toxin-producing E. coli infection.[10][11]


A stool culture can detect the bacterium, although it is not a routine test and so must be specifically requested. The sample is cultured on sorbitol-MacConkey agar, or the variant cefixime potassium tellurite sorbitol-MacConkey agar.[3]


Proper hand washing after using the lavatory or changing a diaper, especially among children or those with diarrhea, reduces the risk of transmission. One should also cook meat thoroughly and avoid raw milk.[12]


While fluid replacement and blood pressure support may be necessary to prevent death from dehydration, most patients recover without treatment in 5–10 days. There is no evidence that antibiotics improve the course of disease, and treatment with antibiotics may precipitate hemolytic uremic syndrome.[13]


Estimates indicate that the pathogen results in more than two thousand hospitalizations annually in the United States; the illness is sometimes misdiagnosed.[14]


  1. Gally DL, Stevens MP (January 2017). "Microbe Profile: Escherichia coli O157:H7 - notorious relative of the microbiologist's workhorse" (PDF). Microbiology. 163 (1): 1–3. doi:10.1099/mic.0.000387. PMID 28218576. Archived (PDF) from the original on 2020-10-31. Retrieved 2022-10-10.
  2. Karch H, Tarr PI, Bielaszewska M (October 2005). "Enterohaemorrhagic Escherichia coli in human medicine". International Journal of Medical Microbiology. 295 (6–7): 405–18. doi:10.1016/j.ijmm.2005.06.009. PMID 16238016.
  3. 3.0 3.1 Ameer, M. A., Wasey, A., & Salen, P. (2023, August 8). Escherichia coli (e Coli 0157 H7). StatPearls - NCBI Bookshelf.
  4. Walterspiel JN, Ashkenazi S, Morrow AL, Cleary TG (1992). "Effect of subinhibitory concentrations of antibiotics on extracellular Shiga-like toxin I". Infection. 20 (1): 25–29. doi:10.1007/BF01704889. PMID 1563808. S2CID 39513818.
  5. Ciccarelli S, Stolfi I, Caramia G (October 2013). "Management strategies in the treatment of neonatal and pediatric gastroenteritis". Infection and Drug Resistance. 6: 133–61. doi:10.2147/IDR.S12718. PMC 3815002. PMID 24194646.
  6. Roos V, Ulett GC, Schembri MA, Klemm P (January 2006). "The asymptomatic bacteriuria Escherichia coli strain 83972 outcompetes uropathogenic E. coli strains in human urine". Infection and Immunity. 74 (1): 615–24. doi:10.1128/IAI.74.1.615-624.2006. PMC 1346649. PMID 16369018.
  7. O'Brien AD, Newland JW, Miller SF, Holmes RK, Smith HW, Formal SB (November 1984). "Shiga-like toxin-converting phages from Escherichia coli strains that cause hemorrhagic colitis or infantile diarrhea". Science. 226 (4675): 694–96. Bibcode:1984Sci...226..694O. doi:10.1126/science.6387911. PMID 6387911.
  8. Strockbine NA, Marques LR, Newland JW, Smith HW, Holmes RK, O'Brien AD (July 1986). "Two toxin-converting phages from Escherichia coli O157:H7 strain 933 encode antigenically distinct toxins with similar biologic activities". Infection and Immunity. 53 (1): 135–40. doi:10.1128/IAI.53.1.135-140.1986. PMC 260087. PMID 3522426.
  9. Lim, Ji Youn; Yoon, Jangwon; Hovde, Carolyn J. (January 2010). "A brief overview of Escherichia coli O157:H7 and its plasmid O157". Journal of Microbiology and Biotechnology. 20 (1): 5–14. ISSN 1017-7825.
  10. "Hemolytic uremic syndrome (HUS)". Mayo Clinic. Archived from the original on 2014-01-02. Retrieved 2022-10-26.
  11. "CDC Features - E. coli Infection and Food Safety". 1 February 2014. Archived from the original on 1 February 2014. Retrieved 26 October 2022.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  12. "E coli 0157:H7". USDA. Retrieved 12 June 2024.
  13. Walterspiel JN, Ashkenazi S, Morrow AL, Cleary TG (1992). "Effect of subinhibitory concentrations of antibiotics on extracellular Shiga-like toxin I". Infection. 20 (1): 25–29. doi:10.1007/BF01704889. PMID 1563808. S2CID 39513818.
  14. Berkenpas, E.; Millard, P.; Pereira da Cunha, M. (2005-12-13). "Detection of Escherichia coli O157:H7 with langasite pure shear horizontal surface acoustic wave sensors". Biosensors and Bioelectronics. 21 (12): 2255–2262. doi:10.1016/j.bios.2005.11.005. PMID 16356708.