Is Escherichia coli (E. coli) a gram-positive coccus?

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E. coli Classification

No, Escherichia coli (E. coli) is a gram-negative bacillus, not a gram-positive coccus. 1, 2

Microbiological Characteristics

E. coli is definitively classified as:

  • Gram-negative rod-shaped bacterium in the family Enterobacteriaceae 1, 2
  • Bacillus morphology (rod-shaped), not coccus (spherical) 1, 2
  • Facultative anaerobic organism that commonly inhabits the lower intestinal tract of warm-blooded animals 2

Clinical Context

Understanding E. coli's gram-negative classification is critical for antibiotic selection:

  • Gram-negative coverage is essential when treating E. coli infections, as it is the most common gram-negative facultative organism causing intra-abdominal infections 3
  • Antibiotics must be active against enteric gram-negative aerobic and facultative bacilli for community-acquired infections involving E. coli 3
  • In biliary infections, E. coli is among the most frequently encountered gram-negative bacteria requiring coverage 3

Common Pitfall

Do not confuse E. coli with gram-positive organisms like Enterococci or Staphylococci, which are gram-positive cocci and require different antimicrobial coverage 3. While both may coexist in polymicrobial infections (particularly intra-abdominal or biliary infections), their gram stain characteristics and antibiotic susceptibilities differ fundamentally 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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