E. coli in the Era of Antimicrobial Resistance: A multidisciplinary approach to understanding and mitigating its impact in Healthcare and Community setups

Escherichia coli (E. coli) is a versatile gram-negative, rod-shaped bacterium that plays a dual role as both a harmless inhabitant of the gastrointestinal tract and a significant pathogen responsible for various infections. This review provides a comprehensive overview of E. coli, focusing on its characteristics, pathogenic strains, clinical relevance, and antibiotic resistance patterns. Pathogenic strains — including enterohemorrhagic and Uropathogenic E. coli — are major causes of morbidity worldwide. The clinical impact of E. coli is relevant to the hospital, outpatient clinic, and community settings, particularly as an increasing burden of antibiotic-resistant strains continues to challenge healthcare systems. Patterns of resistance, especially of those in the hospital and community-acquired infections are discussed as well as the mechanisms behind this resistance. This review discusses the evidence-based management of E. coli infections with attention to both antibiotic therapy and incorporation of novel alternatives to combat resistance. Emphasis is placed on preventive actions, such as hygiene and vaccination, to control E. coli epidemics. This approach will contribute to the impact of E. coli on disease and the design of research projects/care directed at reducing the impact E. coli has clinically and as such direct future studies to eliminate this threat.