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Child feeling uncomfortable. On saccharomyces boulardii. Stool test found presence of e.coli. Worrisome

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General & Family Physician
Practicing since : 2001
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my baby is 112 days old. Her stool culture and sentitive report says she has e.coli which is highly sensitive to gentamician, amikacin, imipenam, azithromycin and resistant to ampicillin, ciproflaxin etc. she under drug (azithromycin) for last 4 days. Before stool culture report, doctor recomended saccharomyces boulardii. But, still, she is having dysentry 7 to 9 times a day. Stool culture changed from XXXXXXX to yellow. stool culture report also shows redusing substance as trace, 2 - 4 pus cells, 5-8 rbc's, nil crystals. baby is feeling uncomfortable (dysentery) for the past 10 days. also baby is not dehydrated and no blood in her stool.
Posted Wed, 27 Mar 2013 in Child Health
Answered by Dr. Michelle Gibson James 29 minutes later
Hi, thanks for using healthcare magic

E coli is a bacteria normally found in the intestines but some strains or types of the virus can cause diarrhoea. In most cases, maintain hydration, resting are the recommended treatments as the infective bacteria passes out.

The reason that antibiotics are not commonly used (though they may be used in rare cases if thought necessary), is that they damage the bacteria and can , in some persons, cause the bacteria to release a toxin. This toxin can then cause further problems such as an illness called called hemolytic uremic syndrome which is a problem with the kidneys that can occur with this type of bacteria. It is not common and your baby is not likely to get it. For this reason,however, it is normally advised, to rest and use enough fluids till the infection clears, with no antibiotics.

Azithromycin may or may not be contributing to her present problem because the most common side effects of this medication is diarrhoea and gastrointestinal upset.
You may want to discuss if there is any possibility of this with her doctor.If he or she does not believe that it is having any affect then you can consider completely the course.

Some studies have suggested that the saccharomyces boulardii is beneficial in children with diarrhoea,more studies are to be conducted.

The most important aspect of fluid management is preventing dehydration and you have stated that she is well hydrated. In most persons the organism ( some types) causing the diarrhoea passes itself out and the illness resolves.

I hope this helps, feel free to ask any other questions
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Follow-up: Child feeling uncomfortable. On saccharomyces boulardii. Stool test found presence of e.coli. Worrisome 17 minutes later
From baby born to till date, baby is under breast feeding only. previously said symptoms are present for the last 10 days. whenever breast fed, she passes poo, which is watery sometimes foamy with noise. Before doctor's prescription of Azithromycin, her stool was XXXXXXX color, now it is yellowish. Is it shows any improvement. If yes, how many days it will take to get cured fully or we want to stop breast feeding and to give lactose free formulas like, nusobee. (Nusobee is made by Wockhardt India and soy-based lactose free formula).
or baby want to undergo any diagnosis or again stool culture & sensitive test.
Answered by Dr. Michelle Gibson James 1 hour later
Breast milk is not a cause of diarrhoea. Babies who are breast fed commonly stool after each meal, it is not abnormal.It occurs because the milk agrees with their intestines and they can easily break it down.
It is associated with far less problems and alot more benefits than any formula.This is the reason breast fed babies do not have constipation, they can easily breakdown and use the milk.

If she is active as a baby her age would normally be, feeding well and well hydrated then she will be fine.
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Follow-up: Child feeling uncomfortable. On saccharomyces boulardii. Stool test found presence of e.coli. Worrisome 8 hours later
She is active. But, she is not gaining wait for the last 10 days, after this dysentery. Before that also baby usually poo 4 to 5 times. But after this dysentery, she is poo for 9 to 10 times a day.

Even usually taking breast milk, she is feeling uncomfortable. That's why i am asking again, is it normal or we need any other diagnosis.
Answered by Dr. Michelle Gibson James 9 hours later

The stool report indicated E coli which is normally found in the intestines but some types of it can cause diarrhoea. In most persons with this type of diarrhoea the treatment involves rest and using enough fluids to prevent dehydration. No medication is used. Some antibiotics including azithromycin can cause diarrhoea as a side effect and it may actually be contributing to her present stooling regimen/ making her stool more often.

In terms of the colour of the stool, babies may not have the normal colour expected of stool till they are older because they only use milk. In fact yellow is sometimes seen as the colour till they reach the age that they start to use food at 6 months.

In terms of how often she is passing stool, if she was passing stool 5 times previously and now it is 9 times ,it is an increase for her but I do not know if the medication or bacteria is playing a part in that.
I know that my children passed stool each and everytime I breast fed them which meant I changed them about 8 to 9 times a day with a stool diaper.

Breast milk would not be causing any infection or diarrhea, it cannot. One of the noted advantages of breast milk is that is less likely to cause diarrhea because there is no bottle or nipple or formula to introduce a way infection.
This particular bacteria is normally spread from a person's hands.

You may want to consider discussing the antibiotics with your doctor to find out about the possibility of it making the stooling worse.
She will regain the weight if she is feeding as normal or as she starts feeding again.

I can understand your concern,it is difficult when they are so small and natural to worry.

So the yellow stool is ok, ask about the antibiotics, monitor how often she stools, let her drink as much as she wants, avoid giving her water because it will not help with weight gain.
If she is felt unwell she would not be active, this is how we know if a child is good or not , they can't tell us, they show us by how active they are, so activity means that she feels ok.
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