REVIEW OF RELATED LITERATURE AND STUDIES

Cagayan de Oro City is subdivided into 80 barangays with Cagayan de Oro River as its

boundary. Living near the Cagayan de Oro River, some of these barangays may be prone to

Escherichia coli or E. coli infections which may be due to contaminated water or food.

Symptoms of this infection includes diarrhea, abdominal cramping, fever, fatigue, and loss of

appetite or nausea. A research was done on December 2010 by Dr. Lesley Lubos on the extent

of fecal contamination on nine river barangays near the Cagayan de Oro River. This research

will be a reassessment on those findings, whether there were any changes for this past nine

years.

Escherichia coli (or E. coli) is the most prevalent infecting organism in the family of

gram-negative bacteria known as enterobacteriaceae (Eisenstein et al., 2000) and is often

referred to as the best or most studied free-living organism (Eisenstein et al., 2000; Jay, 2000).

A great body of knowledge regarding its biochemistry and genetics is well-documented, and

is considered by many researchers as a laboratory pet in microbiological research (Tortora,

2010).

E. Coli is normally found in large numbers as a resident of the colon (Brown and Smith,

2014) and the gastrointestinal tracts of humans and animals (Allan and Lockyer, 2013), and is

considered an endogenous bacterium, meaning infections occur when E. Coli grows outside

its natural site (Brown and Smith, 2014). Most strains however, are harmless (Allan and

Lockyer, 2013), but some strains of E. coli can be a cause of gastrointestinal and urinary tract

infections (Tortora, 2010). There are four different subgroups of E. coli – all of which produce
major clinical relevance. This includes enterotoxigenic E. coli (ETEC), enterohemorrhagic E.

coli (EHEC), entero-invasive E. coli (EIEC) and enteroaggregative E. coli (EAEC) – all of

which produce a variety of diseases such as traveler’s diarrhoea [Kumar, Abbas et. Al, 2014],

haemolytic-uremic syndrome (Bhat et al, 2016), typhoid fever, bacillary dysentery and other

intestinal viral diseases (Brown and Smith, 2014). Such diseases are caused by contamination

of E. coli which can occur in meat during the animal slaughtering process (Allan and Lockyer,

2013), or fecal contamination of water which can be a medium for spread of disease (Brown

and Smith, 2014).

Indeed, its ability to cause a wide variety of diseases in a broad array of species have

resulted in E. coli being considered as the quintessential pluripotent pathogen (Donnenburg, E

coli 1st edition). The strain usually responsible for contamination of beverages are those that

produce the Shiga toxin – so called because the toxin is identical to that produced by Shigella

dysenteria type 1 (Griffin et al,. 1991), which mediates nonbloody diarrhoea, hemorrhagic

colitis and thrombotic purpura (Papadakis and McPhee, 2006). Among the most notorious of

these is E. coli O157:H7 (Eisenstein et al., 2000; Griffin et al,. 1991), classified under the

entero-hemorrhagic E. coli (EHEC) subgroup (Kumar et al, 2018), which is responsible for

most cases in the United States and most severely affects elderly individuals and young

children (Papadakis and McPhee, 2006).

As reported by the World Health Organization (WHO), 600 million people suffer

E.coli-related illnesses every year, and 32,000 cases of food and waterborne diseases in the

Philippines have been recorded by the Department of Health (DOH) in September 2017 (SGS

PH, 2017).

Detection of E. coli in Drinking Water

 The tests for water purity in use today are aimed at detecting indicator organisms in the

sample. Out of the several criteria that classifies an indicator organism, the most important

criterion is that the microbe be consistently present in human feces in substantial numbers so

that its detection is a good indication of human wastes entering the water. The indicator

organisms should also survive in the water long enough to be detected, and should be detectable

by simple tests carried out by people with little experience in microbiology (Tortora, 2010).

Among the many potential organisms that fit this criteria, the usual indicator organisms

in fresh water are the coliform bacteria – aerobic or facultatively anaerobic, gram-negative

bacteria that are non-endospore-forming and are rod shaped bacteria that ferment lactose to

form gas after being placed in lactose broth at 35 degrees Celsius for 48 hours (Tortora, 2010).

Indeed, E. coli is the most common coliform bacteria among the intestinal flora of warm-

blooded animals, and its presence is related to fecal contamination (Rompré et al. 2002). As a

result of its ubiquity, the presence of E. coli is used as an indicator to estimate fecal

contamination levels of water and can be easily enumerated by existing methods (U.S. EPA,

Water: Monitoring and Assessment, 2012).

In fact, microbial contamination is often caused by E. coli. A study focusing on bacteria

and water quality in the Philippines and other tropical climates from 1991 found that diarrheal

diseases could still be predicted by E. coli, no matter the type of water source (Moe et al.,

1991). In 2000, Edberg, Rice, Karlin and Allen published the paper “Escherichia coli: the 9

Best Biological Drinking Water Indicator for Public Health Protection,” where the advantages

of using E. Coli for determining water quality was aptly observed. This is also confirmed by

Luby et al. (2014) where the clear relationship between E. coli and childhood diarrhoea was
also observed, and found that the risk of diarrhoea increased, even with mild increases in E.

coli levels.

According to Wilson et al. (2014), detecting the presence of E. coli in water will most

likely indicate that other fecal pathogens such as giardia, cryptosporidium and vibrio – all

responsible for the outbreak of deadly diseases such as cholera and giardiasis, which is one of

the reasons why promulgating clean water and sanitation is a global goal for future sustainable

development (United Nations, Sustainable Development Goals, 2015).

Accepted Water Quality Assessment Techniques.

The methods for determining the presence of coliform in water are based mainly on the

lactose-fermenting ability of coliform bacteria (Tortora, 2010). The multiple tube method can

be used to estimate coliform numbers by the most probable number (MPN) method, whilst the

membrane filtration method is a more direct method of determining the presence of numbers

of coliforms. The latter is the most widely used in North America and Europe, and it utilizes a

filtration apparatus that acts to collect bacteria on the surface of a removable membrane filter,

placed on a medium and then incubated. The resulting coliform colonies have a distinct

appearance and are counted. This method is suitable for low-turbidity waters that do not clog

the filter, and have relatively few non-coliform bacteria that would mask the results (Tortora,

2010).

A more convenient method of detecting coliforms makes use of a media containing two

substrates: o-nitrophenyl-B-D-galactopyranoside (ONPG) and 4-methylumbelliferyl-B-D-

glucoronide (MUG). Coliforms produce B-galactosidase which acts on ONPG and forms a

yellow colour, indicating their presence in the sample. Note that E. coli is unique among

coliforms as it almost always produces the enzyme B-glucoronidase, which acts on MUG to
form a fluorescent compound that glows blue when illuminated by UV light. These tests can

detect the presence or absence of coliforms such as E coli and can be combined with the

multiple-tube method to enumerate them. It can also be applied to solid media such as that of

the membrane filtration method, and the colonies would fluoresce under UV light (Tortora,

2010).

On The Effective of Coliforms; Their Advantages and Limitations.

Coliforms have so far, been useful as indicator organisms in water sanitation but they

have limitations. One problem is the growth of coliform bacteria embedded in biofilms on the

inner surfaces of water pipes. These coliforms do not represent external fecal contamination of

water, and so they are not considered a threat to public health. Standards governing the

presence of coliforms in drinking water require that any positive water sample is reported and

occasionally these indigenous coliforms have been detected. This has led to unnecessary

community orders.

A more serious problem however, is that some pathogens – especially viruses and

protozoan cysts and oocysts – are more resistant than coliforms to chemical disinfection, and

via the use of methods in detecting viruses, it has been found that chemically disinfected water

samples free from coliforms are often still contaminated with enteric viruses. The cysts of

Giardia lamblia and occysts of Cryptosporidium are so resistant to chlorination that completely

eliminating them by this method is probably impractical. Mechanical methods such as filtration

is also necessary. And so the rule for chlorination is that viruses are more resistant to treatment

than E. coli and that the cysts of Cryptosporifdium and Giardia are a hundred times more

resistant than viruses.