E coli indigenous to the gastrointestinal tract

E. coli is a member of the indigenous (i.e. normal) microflora (400-500 species) present in the gastrointestinal tract of humans and animals. Indigenous E. coli differ from the pathogenic ETEC, EPEC, EHEC, EIEC and EAEC virotypes discussed above. The indigenous E. coli are not usually responsible for intestinal infection or diarrhea, but may translocate across the intestinal barrier to cause extraintestinal infections in other tissues and even bacteremia/-septicemia. Consequently, indigenous E. coli are 'opportunistic' pathogens and can cause disease depending upon increased populations of E. coli in the intestines ('intestinal overgrowth') and predisposing host factors, such as compromised immune defenses and increased intestinal permeability. Thus, E. coli septicemia in debilitated patients probably originates from the patient's own gastrointestinal tract rather than from E. coli contamination from the environment, even if entering via wound sires.

Attempts have been made to associate extraintestinal disease caused by indigenous E. coli with certain E. coli virulence factors, such as the production of hemolysin, capsule polysaccharide, colicin V, aero-bactin, type 1 fimbriae, P fimbriae, and even the presence of certain adhesion operons (pap, sfa, afa, hly). However, it is not possible as yet to relate any of these putative E. coli virulence determinants or even a group of determinants with indigenous F. coli extraintestinal disease.

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