Last updated: January 13, 2012

E coli in urine

E coli in urine: Introduction

E coli in urine

Image courtesy of: National Kidney & Urologic Diseases Information Clearinghouse (NKUDIC)

E coli in urine is a common finding in patients with urinary tract infection. sometimes, E coli in urine is incidentally discovered when routine urine tests are done. At other times, patients with symptoms of urinary tract infection get their diagnosis confirmed when the lab discovers the exact strain of E coli in urine. Among patients admitted to the hospital with other medical problems, a significant number usually have E coli in urine. The presence of E coli in urine in those patients sometimes complicate the treatment of the primary disease. I will describe some real patient cases who had E coli in urine. These are real patients I admitted to the hospital. You will learn how different patients with E coli in urine present and how they are treated.

E coli in urine: A 68 year old female admitted to the hospital with stroke

Mrs. G is a 68 year old female who was admitted to the hospital after she developed a weakness on the right side. She was diagnosed with ischemic stroke. She had some problems with speaking and swallowing. She was unable to get out of the bed by herself and was unable to control her urine. They inserted a catheter to help her drain the urine. Despite everything that was going on with her, Mrs G was relatively pleasant. He was still smiling even when her face was asymmetric and her voice as difficult to understand. She was working with her physical therapist and was moving as much as she could.

After two days in the hospital, Mrs. G had a low grade fever. She did not have complaints and she was able to speak in a better voice. We could understand most of what she was saying. We were worried that she might have developed on infection. But we did not know what kind of infection it was. We ordered a chest x-ray looking for possible pneumonia. We ordered a urine test looking for urine infection. Her chest x-ray came back normal but the urine had some white blood cells in it. E coli in urine takes a few days to show up. Until then you have to look for other things to decide if the urine is infected. Seeing more than 10 white blood cells in the urine is as good as seeing E coli in urine to diagnose urinary tract infection. But when you have not detected E coli in urine, the infection can be from any microorganisms. E coli is one of the most common bacteria that can cause urinary tract infection.

The full name of E coli is Escherichia Coli and it normally lives in the human colon. While most strains of E coli are harmless, some cause infection. When the harmful E coli finds a way to get out of the colon and climb up the urinary tract and cause kidney infection. The names of two other common bacteria that can cause urine infection are: Proteus mirabilis and Klebsiella pneumoniae. Overall, about 70% of patients with urinary tract infection have E coli in urine.

We started Mrs. G on an antibiotics that would kill E coli in urine and would also be effective against other common infections. She responded to the treatment. Her fevers went down and she was able to transfer to the bathroom to urinate on her own. We took the urine catheter out as that was probably what helped E coli to climb up into her urinary tract. Finally the urine culture came back and sure enough we found E coli in urine.

I hope the story of Mrs. G helped you understand more about E coli in urine and how it gets there in a patient admitted to the hospital with stroke. Please check back soon as I will be uploading more stories about different other types of scenarios and how you get E coli in urine in those cases.