What are the most common bacteria associated with colitis?

From the Guidelines

The most common bacteria associated with colitis are Clostridioides difficile (C. difficile), Escherichia coli (E. coli), Campylobacter, Salmonella, and Shigella species. According to the most recent evidence from 1, C. difficile is particularly significant as it causes antibiotic-associated colitis, which typically develops after antibiotic use disrupts the normal gut microbiome. E. coli can cause several forms of colitis, including traveler's diarrhea and hemorrhagic colitis. Campylobacter jejuni is a leading cause of bacterial gastroenteritis worldwide, while Salmonella and Shigella species cause inflammatory diarrhea and colitis through invasion of the intestinal mucosa.

Some key points to consider:

• The pathogenesis of bacterial colitis involves either toxin production that damages the intestinal lining or direct invasion of the colonic mucosa, triggering inflammation and the characteristic symptoms of diarrhea, abdominal pain, and sometimes bloody stools.
• Treatment typically involves supportive care with hydration, and in some cases, targeted antibiotics.
• For C. difficile infections, oral vancomycin (125 mg four times daily for 10-14 days) or fidaxomicin (200 mg twice daily for 10 days) are first-line treatments, as recommended by 1.
• Other bacterial colitis may require specific antibiotics based on culture results and susceptibility testing.
• The choice of empiric antibiotic regimens in patients with intra-abdominal infections, including colitis, should be based on the clinical condition of the patients, the individual risk for infection by resistant pathogens, and the local resistance epidemiology, as suggested by 1.

It's essential to note that the management of colitis should prioritize the patient's quality of life, morbidity, and mortality, and treatment decisions should be made on a case-by-case basis, taking into account the latest evidence and guidelines.

From the Research

Most Common Bacteria Associated with Colitis

• The most common bacteria associated with colitis include:
  • Shigella 2, 3
  • Salmonella 2, 3
  • Campylobacter 2, 3
  • Shiga toxin-producing Escherichia coli (STEC) 2
  • Clostridium difficile 4, 5
• These bacteria can cause infectious colitis, which is characterized by diarrhea, fever, and abdominal pain 2, 3
• The diagnosis of infectious colitis is based on stool culture, endoscopy, and laboratory tests 2, 3, 6
• Treatment of infectious colitis depends on the causative bacteria and may include antimicrobial therapy 2, 3, 6, 5

Transmission and Risk Factors

• The primary source of transmission of these bacteria is fecal-oral spread and ingestion of contaminated food and water 3
• Risk factors for colitis include prior international travel, shellfish-associated diarrhea, living in parasite-endemic regions, and recent exposure to health care facilities or antibiotics 2, 5

Diagnosis and Treatment

• Diagnosis of colitis is based on clinical features, work-up, and treatment, and may include multiplex polymerase chain reaction (PCR) and guided culture on PCR-positive pathogens 6
• Treatment of colitis depends on the severity of the infection and may include oral vancomycin, oral fidaxomicin, or fecal microbiota transplantation 4, 5