You are reading this probably because E.coli has become your enemy by invading parts of your body where it is not welcome. It's worth getting to know your enemy, so that it can be defeated. This article should help. E.coli, the cause of over ninety percent of bladder infections, is a well studied acid-tolerant bacterium* that is always present in the human intestine, even in newborn babies. (It is of course also present in other animals) E.coli as Pathogens.
E.coli can survive in acidic environments [evidence] that are lethal to other pathogens, such as in fermented foods like sausage and apple cider. It also survives and even thrives in acidic urine conditions with a PH as low as 2. Drinking cranberry juice (which acidifies the urine) when you have an E.coli bladder infection or UTI is therefore pointless and will probably do more harm than good.
But E.coli is not all bad. Non-pathogenic E.coli are one of our most prolific intestinal flora, and it plays an essential part in the processing of food and waste materials. E.coli is therefore useful to us, and we have also made use of it medically. For example, it is used for genetic engineering, since cultures of E.coli can be made to produce unlimited quantities of the product of an introduced gene.
Unfortunately, E.coli is also one of the most dangerous bugs we could have chosen to have a symbiotic relationship with. It is a fast mutator, since it multiplies at an enormous rate given the right conditions, (doubling the colony size approximately every 20 minutes) and it is 'opportunist', being non-fussy about where it lives and breeds. It will happily live and breed on medical equipment, on your hands, in your mouth, up your nose, on any mucous membrane, in your hair, in your bladder, on your towel, on door handles, toilet seats, and in your water filter...
It is also an unusually hardy bug. In an study by Abigail F. Weliver, Heat as a Microbial Agent, she said that:
"E.coli can grow both aerobically and anaerobically. It can synthesize all its own amino acids, purines and pyrimidines using the nitrogen donor molecule glutamine (Berks, 2002). E. coli is a mesophile, which lives in the temperature range near that of humans, with a growth optimum between 25°C and 40°C (Madigan, 2002)...."
She goes on to show that the bug can occasionally withstand extended boiling...
"The one week old E. coli was tested at 100° C. We predicted that absolutely no E. coli would be able to survive a 100° C environment, however, there were two positive tests - the first being the 10 mL sample at t = 0, and the second being the 0.1 mL sample at 60 minutes."
So it can thrive with or without oxygen, in almost any conditions, and other studies show that E.coli can hibernate in freezing temperatures almost indefinitely. The E.coli bug is therefore both creiophilic (can survive freezing, so watch those ice cubes when you are on holiday abroad) and thermophilic (can survive boiling, so that towel may not be as clean as you think...)
And you won't kill it by washing something in warm soapy water. In fact, it thrives in those conditions. It even lives on soap. You can, however, flush it away, and more on that later...
E.coli has an amazing affinity with the bodies of warm blooded animals like us. The entire bug (the variety that can stick to the bladder) is covered with molecular hairs (fimbria or pili with lectins - the special molecules that attach to mannose) that stick like velcro to the cell walls of body tissue and anything else with the correctly oriented mannose molecules (like Waterfall D-Mannose® ). There is a natural antibiotic we produce called human beta-defensin-1 that helps to break the fimbria/pili that E.coli use to attach.
The bug expresses these fimbria quickly in demanding conditons. It's like a human realising they were in the water, and growing fins and gills, or like a human slipping down the face of a cliff, and growing hooks and climbing tackle right out of our skin.
So it is uniquely adapted to survive in the human body, and can quickly mutate to resist antibiotics. It can travel upwards and attack the kidneys, and it can progress to cause serious kidney problems. The trick is to stop the E.coli in its tracks before it gets to the kidneys.
Using antibiotics against bladder and urinary tract infections just leads to more resistant bacteria, the proliferation of thrush, and long term antibiotic-related complications
"The problem is that bacteria are immensely adaptable critters. Expose them to antibiotics long enough, and they'll evolve ways to survive the drugs." Abigail A. Salyers - University of Illinois.
It used to be thought that small amounts of D-Mannose could be found in cranberry (we've since realised that is mostly untrue - because most cranberry contains absolutely no mannose. But worse than that is the fact that cranberry just makes the infections worse
Now comes the interesting bit. E.coli like most of all to attach to a sugar-type substance called D-Mannose, which our body produces naturally as part of the walls of cells, particularly abundantly in the bladder and urinary tract, providing the ideal docking ports for the E.coli. We don't have perfect bodies, and nature has really messed things up here, because if it weren't for the D-Mannose in the cell walls, any E.coli that managed to get up the urethra would be flushed away in normal urination. But they are not. They get up there, and they find a docking port, and they start to multiply. And that's when the trouble begins. They burrow their way into the walls of the bladder, which somehow doesn't recognise them as enemies, but embraces them as if they were fond friends. It is one of the bacterial survival mechanisms. It is their job to perpetuate their genes. Burying themselves in the bladder wall helps them to create repeat attacks of cystitis, multiplying their numbers in exponential profusion.

The cell walls of the E.coli bacterium are covered with minute fimbria (hairs) with lectins (molecular projections) that hook like velcro to the mannose in the walls of the bladder and urinary tract.

In this photo the E.coli are the 'docked' white egg-shaped cells. The E.coli love the D-Mannose in the cell walls. The mannose receptors love to have lectins attached. Waterfall D-Mannose occupies the E.coli lectins, preventing attachment.
The unique adaptability of most uropathogens - a result of natural selection for the challenging environment they live in - makes them difficult to get rid of, once they 'get a grip'. Unfortunately, not even D-Mannose can immediately rid the bladder of embedded bio-film-protected bacteria. But an extended course of high quality bio-active D-Mannose treatment over perhaps three months can reduce these colonies to the point where they can no longer cause problems. In most cases antibiotics will not achieve this effect, leaving no allopathic answer to the problem, apart from burning off the lining of the bladder with chemicals or laser treatment.
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