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Dear expert team,

I am 47 years old, CF, and contracted E. coli in the lungs. A first i.v. treatment approach with Cefotaxime reduced the germ count but that was it.

Now I am supposed to inhale Colistin, E. coli is sensitive.
I also take Amoxiclav against staphylococcus aureus that I have had for as long as I can remember and which only seldom causes problems.
Is it possible that E. coli disappears completely? My lung function is very well and currently I am not feeling sick. I do not know what happens in case of a flue like infection with this mixture of germs since I have not had this situation so far. Is it possible to say in a general way which damage is caused by E. coli in the lungs? (I am aware of the problems regarding resistence and transmission to other bacteria).
Is there a danger to transfer the germ to the partner by kissing (diabetes patient).

Many thanks and best regards,

Dear U.,

You have some questions about Escherichia coli (E. coli) since this germ was detected several times in your airways (most probably by a sputum test).
E. coli is a so called gram-negative germ like Pseudomonas aeruginosa (PA). In opposite to PA, the pathogenic importance of E. coli – if detected in the airways (sputum) - in CF is not clear. So far there is no explicit evidence that E. coli in the CF airways leads to an exacerbation in the course of the disease. E. coli is an intestinal bacterium and is found in the intestines of animals and humans. There are several strains of these bacteria. Usually, E. coli is not harmful for humans. However, certain strains of E. coli show pathogenicity both in the intestine and outside of it. This especially affects humans with diseases that are accompanied by an impaired immune defence.
E.coli is not seldom detected in the sputum of CF patients and usually it is not necessary to treat it. Even repeated proofs of E. coli in the sputum without other signs of acute infection do not imperatively lead to an antibiotic treatment. The germ can also disappear without treatment; however, it is also possible that it stays for a long time.

In case of an additional flu like infection, it should be treated at first symptomatically; if problems go on, the therapy should be extended to an antibiotic that is appropriate for the germs that were detected in the sputum.

Germs like Pseudomonas aeruginosa or E. coli that are detected in the sputum could theoretically be transmitted by the saliva (e.g. by kissing) to the partner. However, I do not know any studies about this transmission path. Healthy persons are usually pretty resistant by their natural defence and cleaning mechanisms. If you are not sure about this you should also talk to a physician you trust. In a conversation it is much easier to respond to your questions and concerns.

Best regards,
Dr. Christina Smaczny
Apart from the "flu-like" infections, caused by diverse viral and/or bacterial pathogens, the "real-flu" caused by the influenza virus can be avoided by doing the anual influenza vaccination, that is strongly recommended for CF-patients.
D. d'Alquen