1、大肠埃希菌
Escherichia coli is a gram-negative facultative anaerobe that can cause of urinary tract and vulvovaginal infections,such as aerobic vaginitis. E. coli is a common cause of infections in the digestive tract resulting in diarrhoea, and gallbladder and blood infections, as E. coli lives naturally in the digestive tract. E. coli is easily passed from the anus to the vagina and urinary tract, and may cause food poisoning.
E. coli is adapted to live in the urinary tract, where the force of urine makes it cling on harder to your cells. This means you can’t wash E. coli away by drinking a lot of water. E. coli can also swim. E. coli in the vagina is less common than in the urethra, but vaginal infections can also occur, contributing to vaginal odour, inflammation and discharge. Usually a test will reveal E. coli in the vagina or urinary tract.
E. coli creates biofilms, which is the sticky matrix that protects E. coli and friends, and blocks other, friendly microbes from colonising. This is particularly problematic in the urinary tract and vagina, where a seemingly successful treatment leaves you susceptible to infections in future.
People who ‘get UTIs’ really get them. You can get one or two, but typically you either do or you don’t, and this is largely down to whether unhealthy biofilms make it easy for you to develop a UTI again. No unhealthy biofilms means each new infection is truly new. Recurrent infections are just being recycled, and the bacteria never really go away.
While there are many ways to have symptomatic infections due to E. coli, particularly food poisoning, here we focus on urinary tract infections and vaginal infections.
Vaginal infections of E. coli
If you are diagnosed with an infection that includes E. coli, you have what’s known as aerobic vaginitis. This condition is caused by different types of bacteria compared with AV’s cousin, bacterial vaginosis. See the information page for aerobic vaginitis for details, however you can go through the Killing BV treatment protocol.
E. coli can be found residing in the vagina without causing infections, and a positive test without symptoms may not require any treatment. Testing may find that you have normal levels of lactobacilli, with other microbes also found.
Often the presence of E. coli in a vaginal culture is considered to be contamination of the sample, with bacteria from the anus caught on the swab. The frequency of this underlines the importance of getting clean swabs, especially if you are using an at-home test.
How your digestion can contribute to a UTI or aerobic vaginitis
The urinary tract has its own microbial ecosystem, which in women resembles vaginal flora. This means that a healthy vagina supports a healthy urinary tract. If you have digestive problems, the gut microbiome can become unhealthy, contributing to poor vaginal health due to proximity of the anus to the vagina.
Poor digestive health typically results in unbalanced gut flora, where pathogens are able to proliferate because of the absence or lack of healthy intestinal flora. E. coli naturally resides in the colon, and can overgrow, resulting in more frequent cross-contamination with the vagina and urinary tract. This highlights the importance of focusing on gut health when dealing with frequent vulvovaginal or urinary tract infections.
Constipation, for example, leaves stool in the colon for long periods of time, providing an ongoing food source for microbes. Having a healthy bowel movement every day at least once ensures that the microbial colonies in the digestive tract are kept in check, since the stool passing through acts like a broom. Fibre makes stools larger and firmer, creating a sort of boulder that moves through the intestines, picking up anything in its way and pushing it out.
Diarrhoea doesn’t have the same effect as constipation, but comes with its own issues – think of wet sand in a wet sock. Bits of faeces can remain on the intestine walls, being slow to move through. This too provides a lingering food source for microbes.
The causes of constipation and diarrhoea vary, so if you find yourself with irritable bowel-type symptoms frequently, see a healthcare practitioner to figure out what is causing your problems.
2、肠粪球菌
Enterococcus faecalis is a facultative (aerobic and anaerobic) bacteria normally found in the intestines, however it can be found in the mouth or vagina/urinary tract, being a cause of urinary tract infections and aerobic vaginitis (linked to bacterial vaginosis).E. faecalis, like lactobacilli, produce lactic acid and hydrogen peroxide.When found in healthy people, in normal amounts, E. faecalis is not believed to cause a problem, however in some circumstances, E. faecalis can pose at worst a life-threatening risk of infection, and at “best” uncomfortable vulvovaginal or urinary tract symptoms including odour and inflammation.
Just two species out of 17 enterococci are found in humans: E. faecalis and E. faecium, with some species of E. faecalis considered probiotics, being used in research for various medical purposes.
Understanding when you have a probiotic bacteria, or a normal element of your flora, and when you have an infection can be difficult. It is likely to come down to what else is found in your vagina: if you have a lot of lactobacilli present, you may have the normal kind; if you have an aerobic vaginitis or bacterial vaginosis-type presentation (odour, discharge, irritation), with few or no lactobacilli, you may have the other kind.
Symptoms of genitourinary E. faecalis infection：
Pelvic infections (vaginal, urethral, etc.)
Urinary tract infections (UTIs)
Painful urination
Vaginal odour (may smell like faeces or off)
Inflammation signs – itching, burning, discharge
General body symptoms of E. faecalis infection (not present for vulvovaginal infections only)：
Fatigue
Stomach cramping
Vomiting
Abdominal infections
Mouth and gum infections, particularly after a root canal
Septicaemia – blood poisoning
Infections in wounds
Endocarditis – heart lining infection
Enterococcal meningitis – brain infection, uncommon
Presence of bacteria in the blood (via test)
Treatment of vulvovaginal E. faecalis and antibiotic resistance
E. faecalis has natural and acquired antibiotic resistance, and can tolerate a range of conditions including changes in temperature and pH. E. faecalis develops biofilms, and can survive for long periods without a food source. Penicillin-binding proteins (PBPs) mean E. faecalis is naturally resistant to penicillin, which when prescribed inhibits E. faecalis activity, but does not kill the bacteria.E. faecalis requires folic acid to grow, and does not absorb it from their environment so much produce their own. Any medications that interfere with the production of folic acid can kill these bacterial infections, but E. faecalis can absorb folic acid from the body, so this medication doesn’t really work.E. faecalis alters host response, which means the bacteria changes the way the cells it lives on behave, to facilitate its own survival. It suppresses the action of lymphocytes, your infection-fighting white blood cells. The bacteria produce enzymes that are toxic to cells. E. faecalis is thought to be responsible for 80 per cent of human infections, usually when the bacteria enters a wound, the bloodstream, or urine. Extra susceptible people include those with impaired immunity.
About E. faecalis
E. Faecalis is a gram-positive bacteria, considered a non-motile microbe – that is, it doesn’t spontaneously move around using energy to do so, but is transported. This bacterium ferments glucose without producing gas, and is considered a facultative bacteria – that means it is adaptive to its circumstances.
The harsh conditions in which E. faecalis can survive include extremely alkaline conditions (up to a pH of 9.6) and high salt concentrations. It is resistant to bile salts, detergents, heavy metals, ethanol and extreme dryness (desiccation). Temperature ranges include 10-45 °C, with temperatures of up to 60°C survivable for up to half an hour.
E. faecalis was known as Streptococcus faecalis until 1984.
E. faecalis is known to have antibiotic resistance to
Aminoglycosides
Aztreonam
Cephalosporins
Clindamycin
Penicillins (nafcillin, oxacillin, trimethoprim-sulfamethoxazole)
More commonly, vancomycin
Antibiotic treatment options for E. faecalis include:
Nitrofurantoin (for uncomplicated UTIs)
Linezolid
Daptomycin
Ampicillin if bacteria are susceptible
Quinupristin/dalfopristin for E. faecium, but not E. faecalis
NaOCI and chlorhexidine (CHX) in root canals, though this wasn’t very effective in recent studies
How do people catch E. faecalis?
E. faecalis can’t move around by itself, so it is transmitted ‘by hand’. That is, E. faecalis is found in faecal matter (bowel motions and the anal area), so if the anus isn’t cleaned properly or contact is had with animal or human faeces (like not washing hands properly after the toilet, messy sex, etc.) the bacteria can be transmitted from person to person.Doorknobs, telephones, towels and soap can contain E. faecalis, but just because you touch a bacteria does not mean you will get infected – this comes down directly to your own defences being strong.
Studies into vulvovaginal E. faecalis infections/presence
One study looked into the incidence of E. faecalis in vaginal secretions, and how that correlated with antibiotic use for previous vaginal and other infections, finding that there was a far greater chance of the presence of E. faecalis in women who had been recently treated with antibiotics. The study involved 300 fertile-aged women, 282 of them married. The women were put into four groups of 75 women in each group:
Women who had not been treated with antibiotics in the previous six months
Women who had been treated for genital tract infections with antibiotics in the past six months
Women who were treated for nonspecific vaginitis in the previous six months with antibiotics
Women who were treated with antibiotics in the previous six months for a non-vaginal infection
Results include:
E. faecalis was found in 112 of the 300 patients
13 patients in the first group of women who had not been treated with antibiotics in the previous six months (17 per cent)
26 patients in the second group, who had been treated with antibiotics for a vaginal infection in the previous six months (35 per cent)
39 patients in the third group, who had been treated with antibiotics for nonspecific vaginitis over the previous six months (52 per cent)
34 patients in the fourth group, who were treated with antibiotics for a non-pelvic infection (45 per cent)
Overall, E. faecalis was found in 17 per cent of patients who had not had antibiotics in the past six months, but in 44 per cent who had.
Another study looked at the pH variations when E. faecalis was present, and the incidence of bacterial vaginosis. The study looked at 90 women, with 24 per cent returning a positive test result for E. faecalis, however out of those with signs of bacterial vaginosis, it was found 53 per cent of the time.E. faecalis was most often associated with the presence of signs of bacterial vaginosis. When only two signs of bacterial vaginosis were present (pH of more than 4.0 and changed vaginal discharge colour), E. faecalis was present in 60 per cent of cases.The researchers concluded that pH change in the vagina was associated with E. faecalis in bacterial vaginosis, but was not a sure sign of the presence of E. faecalis.A further study looked into interactions between urinary tract infection pathogens (Escherichia coli and Enterococcus faecalis) and bacterial vaginosis pathogen, Gardnerella vaginalis, using biofilm models in vitro. Results showed that dual-species biofilms reached significantly higher bacterial concentrations than a single species biofilm.All the urogenital pathogens coexisted with G. vaginalis, with the conclusion being that uropathogens can incorporate into mature BV biofilms.
3、产气肠杆菌
Enterobacter aerogenes was renamed as Klebsiella aerogenes.
What are the symptoms of Klebsiella aerogenes vulvovaginal infections?
Burning when urinating (dysuria)
Frequent urination
Urinary
Urinary Tract Infection (UTI)
Yet to be determined
What causes Klebsiella aerogenes vulvovaginal infections?
No causes found for Klebsiella aerogenes vulvovaginal infections, yet.
What are the risk factors associated with Klebsiella aerogenes vulvovaginal infections?
No risk factors for Klebsiella aerogenes vulvovaginal infections, yet.
How do you diagnose Klebsiella aerogenes vulvovaginal infections?
No diagnoses found for Klebsiella aerogenes vulvovaginal infections, yet.
How do you treat Klebsiella aerogenes vulvovaginal infections?
Treatments for Klebsiella aerogenes vulvovaginal infections are only for practitioners and people who purchased the book Killing BV and Killing BV for men.
Which treatments are likely to be ineffective for Klebsiella aerogenes vulvovaginal infections?
Gentian violet
Multi-drug resistance (MDR)
What complications are associated with Klebsiella aerogenes vulvovaginal infections?
No complications found for Klebsiella aerogenes vulvovaginal infections, yet.
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（更新时间：2018年11月03日）