E Coli in Urine

Escherichia coli, often called E.coli is a bacterium that is responsible for the development of urinary tract infections. A urinary tract infection (UTI) refers to an infection of the bladder or the kidney, and is characterised by burning micturition with increased frequency of urination.

In this article, we shall take a closer look at E.Coli and how it can be treated.


E.coli is a gram negative anaerobic bacterium that is a normal resident of the lower intestine in humans. While being mostly harmless, it can in fact cause serious infections on occasion, affecting the bowel and urinary tract. It is believed to be responsible for up to 85% of all UTIs.

Studies have suggested that E.coli urine infections are more common in women.

Causes of E.coli UTI

There are a number of causes that lead to E.coli entering the urinary tract and causing infection –

1. Urinary catheterisation – This refers to insertion of a catheter into the urinary tract for a medical or surgical reason. The bacteria are carried into the tract through this catheter, or even form a portal of entry for E.coli to enter the urinary tract.

2. Sexual intercourse – This is a common cause of UTIs in women.

3. Previous E.coli infection – E.coli can remain persistent despite treatment, making patients who had developed infection in the past more prone to developing them again.

4. Other risk factors – E.coli infections are common in patients with diabetes. Elderly patients are more prone to developing recurrent E.coli urine infections. An enlarged prostate has been associated with E.coli infections as well.

Symptoms of E.coli UTI

The common symptoms include increased frequency of urination and stinging pain when passing urine. Patients may have a fever as well and may develop rigors. In severe cases, patients may pass cloudy urine containing a high number of pus cells.


Diagnosis is best made from a urine test and culture. E.coli in high quantities in the urine with the presence of many pus cells is indicative of an E.coli urine infection. Urine dipstick test will reveal high level of nitrites and white blood cells as well.


E.coli infections respond well to antibiotic treatment. Commonly used antibiotics include Nitrofurantoin and Trimethoprim.

If E.coli affects the kidney and causes pyelonephritis, intravenous antibiotics may be needed along with admission to hospital.

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