E.Coli and Urinary Tract Infections: All that You Want to Know

The urinary tract of the human body plays a vital role in filtering blood, eliminating harmful wastes, and regulating arterial blood pressure. Consequently, Urinary tract infections impact the kidneys, ureters, urinary bladder, and prostate (in males) that comprise the urinary tract of the individual. Usually, the lower the urinary tract is impacted in the initial conditions. When left untreated, these problems can spread into the upper tract. This can lead to bladder outlet obstruction, hydronephrosis, and intrauterine renal damage. The problem can equally impact children and adults. At the same time, females are more prone to UTIs because of the shorter urethra and its proximity to the anus.

Overview: Bacteria & Fungi

Bacteria and fungi are some of the most common pathogens that enter the tract through ascending routes (gastrointestinal tract) and hematogenous routes (originating or carried in the blood or through lymphatic pathways in the system. E.Coli is one such bacteria that lives in the intestines of healthy individuals and is regarded as one of the most common causes of UTI in humans and animals.

What is E.Coli

E.Coli or Escherichia Coli is a gram-negative, anaerobic bacteria of the Escherichia species commonly found in the lower intestines of warm-blooded organisms. A lot of strains of E.coli are harmless, and some are even beneficial for digestion and protection against invasive pathogens in the gut. The problem lies with some strains like the Shiga toxin-producing E Coli transmitted through contaminated foods and water. Infection by these strains can lead to food poisoning with urinary tract infections.

The connection between E.coli and Urinary Infections

It is essential to evaluate the pathogenesis of urinary infections to understand E.Coli invasion better. Urine is a liquid or semi-solid solution of water, urea, and other metabolic wastes usually eliminated from the urinary system without contamination. Normal urine is free of bacteria and of a sterile nature. in the process of collection from the system, it gets contaminated to a variable extent through the skin bacteria of the individual. According to the study, up to 10,000 colonies/ml are deemed normal, while greater than 100,000 colonies/ml is a sign of urinary tract infection.

How UTIs Happens

Most UTIs live harmlessly in the gut. When shed in the feces, the bacteria spread to the opening of the urinary tract and bladder, infecting them before moving higher up. Frequent UTIs occur when the gut is continuously re-seeded with toxic e.coli strains that are not appropriately treated or are resistant to treatment methods.

Improper wiping techniques, hormone changes during pregnancy, and use of spermicides can facilitate E.Coli invasion by killing the protective pathogens shielding you from E.coli or facilitating their movement into your urinary system. Sometimes improper functioning of the vesicoureteral valve that prevents the urine from flowing backward to the ureters or kidneys can facilitate symptoms of E. coli-induced UTI infections.

Before invasion by E. coli other species of harmful bacteria, the human defense mechanism tries its level best to fend off or control the infection to a considerable extent. But a weak or compromised defense system due to previous viral infections, smoking or alcohol intake, or poor nutrition conditions can reduce the pH of the urine and make it difficult to flush them out from the system.

Researchers have hypothesized that the increased adherence capacity of the bacterial cell structure to vaginal and uroepithelial cells, advanced genome sequence, and genetic disposition to virulence with resistance to medications/serum-killing activity help them multiply and invade in an intense manner.

Symptoms of UTIs Caused by E. Coli

Clinically UTIs are classified into uncomplicated or complicated, based on which physicians are provided an idea of the severity of the infection. Uncomplicated UTIs impact otherwise healthy individuals without any structural or neurological tract abnormalities and can occur due to genetic susceptibility, systemic conditions like diabetes, or vaginal infection with/without sexual activity. Complicated UTIs result from systemic or physiological conditions impacting the urinary tract, like urinary obstruction, compromised host defense, pregnancy, or through foreign bodies like catheters or drainage devices inserted within persons.

Studies have shown the symptoms caused by UTIs to be a combination of the above-mentioned reasons, out of which catheter-induced UTIs and those resulting from pregnancy are the most common. Uncomplicated E.Coli induced UTI present in the form of pain during urination or dysuria, urgent need to urinate, frequent urination, and hesitancy to start urinating. Fever, chills, nausea, vomiting, and back pain are among the secondary infections that develop on spreading of the infection to the kidneys or upper urinary tract.

Several E.Coli bacteria-induced UTI symptoms overlap with the symptoms of other infections. In such conditions, a urine culture can identify the E.coli strain and make it easy for physicians to diagnose and advise treatment/ preventative options.

Treatment Options

In cases of mild infection, E.Coli infections can self-resolve, especially by increasing fluid intake to flush out the toxins. But when the infection is symptomatic, antibiotics are considered the first line of treatment. Ciprofloxacin, Ampicillin, and Nitrofurantoin are some of the most common FDA-approved antibiotics used for E.Coli induced UTI infections. Phenazopyridine or Pyridium is an important adjuvant medication used to deal with symptoms like discomfort and pain caused by the infection. In cases of recurrent E.Coli UTIs, low-dose antibiotics can be advised from 6 months-2 years and combined with other medications like Vitamin C supplements.


E.Coli is fast emerging as a common cause of UTI infections and accounts for 90% of the infections. Medications can provide symptomatic relief, but the individual may develop resistance to them when used on a prolonged basis. Preventive measures in the form of sufficient hydration and practicing hygiene, like proper wiping methods with avoidance of feminine products that can exacerbate the infection, can work as prophylactic measures for dealing with the problem.

Updated on: 24-Jan-2023


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