Question

E .coli include recent outbreaks

who it affected ,what caused it, pathophysiology  and pediatric treatment and nursing intervention

Answer 1

Escherichia coli (E. coli) bacteria normally live in the intestines of healthy people and animals. Most varieties of E. coli are harmless or cause relatively brief diarrhea. But a few particularly nasty strains, such as E. coli O157:H7, can cause severe abdominal cramps, bloody diarrhea and vomiting.

Escherichia coli (E. coli) bacteria normally live in the intestines of healthy people and animals. Most varieties of E. coli are harmless or cause relatively brief diarrhea. But a few particularly nasty strains, such as E. coli O157:H7, can cause severe abdominal cramps, bloody diarrhea and vomiting.

Contaminated food

The most common way to acquire an E. coli infection is by eating contaminated food, such as:

• Ground beef. When cattle are slaughtered and processed, E. coli bacteria in their intestines can get on the meat. Ground beef combines meat from many different cattle, increasing the risk of contamination.
• Unpasteurized milk. E. coli bacteria on a cow's udder or on milking equipment can get into raw milk.
• Fresh produce. Runoff from cattle farms can contaminate fields where fresh produce is grown. Certain vegetables, such as spinach and lettuce, are particularly vulnerable to this type of contamination.

Contaminated water

Human and animal feces may pollute ground and surface water, including streams, rivers, lakes and water used to irrigate crops. Although public water systems use chlorine, ultraviolet light or ozone to kill E. coli, some outbreaks have been linked to contaminated municipal water supplies.

Private wells are a greater cause for concern because they don't often have any disinfecting system. Rural water supplies are the most likely to be contaminated. Some people also have been infected after swimming in pools or lakes contaminated with feces.

Treatment for pediatric group

Treatment of bacterial gastroenteritis is primarily supportive and directed toward maintaining hydration and electrolyte balance. Antibiotic therapy is rarely indicated and should be deferred until culture results are available.

Oral rehydration therapy (ORT) is the preferred treatment for fluid and electrolyte losses caused by diarrhea in children with mild-to-moderate dehydration. Intravenous hydration is often administered for severe dehydration or when vomiting prevents ORT. In most cases, even children who are vomiting can tolerate oral fluids if administered frequently in small amounts.

Do not use antimotility agents to treat acute diarrhea in pediatric patients.

Antibiotic treatment of E coli 0157:H7 colitis is controversial. Early data indicated antimicrobials offer no substantial benefit and may increase the risk of developing HUS. ^[In vitro studies have shown subinhibitory antibiotic concentrations can increase toxin production.However, a subsequent meta-analysis reported no association between the use of antimicrobials and higher risk of HUS.In the absence of conclusive evidence, empiric antibiotics should not be administered due to the potential risk of HUS.

Administer intravenous antibiotics to children who have evidence of systemic infection (eg, bacteremia, sepsis). Include a combination of ampicillin and an aminoglycoside in the initial empiric treatment of a neonate with suspected sepsis. Alternative regimens of ampicillin and a cephalosporin, such as cefotaxime, are also acceptable. Coverage may be narrowed when the etiologic agent and its antimicrobial susceptibilities have been determined. Base therapy duration on the patient's response and established treatment guidelines (usually 10-14 d for uncomplicated sepsis, >21 d for meningitis).

Nursing Interventions: Escherichia Coli

1. Replace fluids and electrolytes as needed.
2. Use proper hand-washing technique.
3. Clean the perianal area and lubricate after each episode of diarrhea.
4. give nothing by mouth, administer antibiotics as ordered, and maintain body warmth.
5. Keep accurate intake and output records.
6. Measure stool volume and note the presence of blood and pus.
7. Monitor for decreases serum sodium and chloride levels and signs of gram-negative septic shock.
8. Watch for signs of dehydration.
9. Monitor vital signs to detect early indications of circulatory prolapse.
10. Explain proper hand-washing technique to patient and family.