Strain-Specific Differences in the Amount of Shiga Toxin Released from Enterohemorrhagic Escherichia coli O157 following Exposure to Subinhibitory Concentrations of Antimicrobial Agents

Grif, Katharina; Dierich, M P; Karch, Helge; Allerberger, Franz

doi:10.1007/s100960050181

Cited by 138 publications

(114 citation statements)

References 20 publications

Supporting

Mentioning

106

Contrasting

Order By: Relevance

“…In conclusion, ETEEC accumulate Stx 2e in the bacterial cells, and it is important to be careful of not only the antimicrobial susceptibility but also the function of antibiotics when choosing antibiotics to use for the treatment of piglets sick with ED. Furthermore, because the amount of Stx released from EHEC O157 following exposure to subinhibitory concentrations of antimicrobial agents was different among strains [4], we will investigate the effect of antimicrobial agents on more ETEEC isolates.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Antimicrobial Agents on the Production and Release of Shiga Toxin by Enterotoxaemic <i>Escherichia coli</i> Isolates from Pigs

Uemura

Sueyoshi

Taura

et al. 2004

The Journal of Veterinary Medical Science

View full text Add to dashboard Cite

ABSTRACT. Edema disease (ED) of pigs is an enterotoxaemic disease caused by enterotoxaemic Escherichia coli (ETEEC) infection. Antimicrobial therapy for pigs with ED is controversial because it may induce death of sickish piglets. In this study, we investigated the effects in vitro of 7 antimicrobial agents, ampicillin, gentamicin, colistin, bicozamycin, fosfomycin, sulfamethoxazole-trimethoprim and enrofloxacin, on the release and production of shiga toxin (Stx) 2e by ETEEC strains. We found that more Stx 2e accumulated in the bacterial cells than was released into supernatant. Associated with inhibition of cell wall synthesis, the exposure to ampicillin or fosfomycin increased the release of Stx 2e. The production levels of Stx 2e in all antimicrobial-treated cultures were equal to the level in the control or less than in the control. These results suggest that cell wall synthesis inhibitors, such as ampicillin and fosfomycin, may change for the worse in the signs in ETEEC infectious pigs. On the other hand, gentamicin, colistin, bicozamycin and enrofloxac in may be useful for the treatment of pigs with ED. KEY WORDS: antimicrobia, edema disease, enterotoxaemic Escherichia coli, shiga toxin 2e, swine.J. Vet. Med. Sci. 66(8): 899-903, 2004 Edema disease (ED) of the pig has been found throughout the world since ED was first reported in Ireland in 1938 [17]. ED has been a sporadically occurring disease found mainly in post-weaned piglets that causes systemic vascular damage as a result of intestinal infection with shiga toxinproducing Escherichia coli (STEC) [1,2,5]. The STEC is also called enterotoxaemic Escherichia coli (ETEEC) [14]. After ETEEC colonizes in the intestines, shiga toxin (Stx) 2e produced by the ETEEC is absorbed into the capillary vessels and then damages the endothelial cells [1,2,5]. The manifestations of ED include palpebral edema, neurological impairment, lateral recumbence and sudden death [1,2]. The speed of onset and severity of clinical signs and gross pathological lesions are related to the dose of the toxin. Intervals between injection and onset of the disease vary from 7 to 28 hr, the mean time to death being from 24 to 42 hr [2]. Classical ED has been seen to occur sporadically and subside spontaneously [1,2,8,11]. Recently, ED has tended to persist and spread, causing great economic damage to pig farmers [20,21,24].Antimicrobial administration has been used as one of the most common treatments for the eradication of STEC from the intestines of humans and animals [12,14,16,22]. Nevertheless, some antimicrobial agents have been reported to increase the release of Stxs from enterohemorrhagic Escherichia coli (EHEC) associated with enterohemorrhagic colitis and hemolytic uremic syndrome of humans in vitro [4,10,13,22,23]. In ED affected farms, deaths of piglets associated with antimicrobial treatment have increased in number [7,24]. Until now, however, there has been no investigation to determine the effect of antimicrobial agents on the production and release of Stx 2e by ETEEC.In ...

show abstract

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, some antimicrobial agents have been reported to increase the release of Stxs from enterohemorrhagic Escherichia coli (EHEC) associated with enterohemorrhagic colitis and hemolytic uremic syndrome of humans in vitro [4,10,13,22,23]. In ED affected farms, deaths of piglets associated with antimicrobial treatment have increased in number [7,24].…”

mentioning

confidence: 99%

Effect of Antimicrobial Agents on the Production and Release of Shiga Toxin by Enterotoxaemic <i>Escherichia coli</i> Isolates from Pigs

Uemura

Sueyoshi

Taura

et al. 2004

The Journal of Veterinary Medical Science

View full text Add to dashboard Cite

show abstract

“…HUS consists of nonimmune hemolytic anemia, thrombocytopenia, and renal insufficiency and is believed to be caused by circulating Shiga toxins [1]. An association between antibiotic administration and HUS is plausible: in vitro, a variety of antibiotics increase Shiga toxin production by E. coli [2,3].…”

mentioning

confidence: 99%

Shiga Toxin–ProducingEscherichia coliInfection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis

et al. 2016

View full text Add to dashboard Cite

Background. Antibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS).Methods. The analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS. Risk of bias was assessed; strength of evidence was adjudicated. HUS was the primary outcome. Secondary outcomes restricted the analysis to low-risk-of-bias studies employing commonly used HUS criteria. Pooled estimates of the odds ratio (OR) were obtained using random-effects models.Results. Seventeen reports and 1896 patients met eligibility; 8 (47%) studies were retrospective, 5 (29%) were prospective cohort, 3 (18%) were case-control, and 1 was a trial. The pooled OR, including all studies, associating antibiotic administration and development of HUS was 1.33 (95% confidence interval [CI], .89-1.99; I 2 = 42%). The repeat analysis including only studies with a low risk of bias and those employing an appropriate definition of HUS yielded an OR of 2.24 (95% CI, 1.45-3.46; I 2 = 0%).Conclusions. Overall, use of antibiotics was not associated with an increased risk of developing HUS; however, after excluding studies at high risk of bias and those that did not employ an acceptable definition of HUS, there was a significant association. Consequently, the use of antibiotics in individuals with STEC infections is not recommended.

show abstract

“…59 Antibiotics have not been shown to directly influence interaction between toxins and their Gb3 receptor, suggesting that the antibiotic influence on risk and outcome of HUS is mediated by modulation of toxin bioavailability. [60][61][62] Recently, further evidence for a possibly beneficial role of early use of antibiotics in patients with D+HUS was provided by the retrospective analysis of antibiotic use during the 2011 German mega-outbreak. 63 Nevertheless, based on best available evidence, the current recommendations are to avoid use of antibiotics in treatment of EHEC infections.…”

mentioning

confidence: 99%

Management of hemolytic-uremic syndrome in children

Grisaru¹

2014

IJNRD

View full text Add to dashboard Cite

Acute renal failure associated with a fulminant, life-threatening systemic disease is rare in previously healthy young children; however, when it occurs, the most common cause is hemolytic-uremic syndrome (HUS). In most cases (90%), this abrupt and devastating illness is a result of ingestion of food or drink contaminated with pathogens that produce very potent toxins. Currently, there are no proven treatment options that can directly inactivate the toxin or effectively interfere with the cascade of destructive events triggered by the toxin once it gains access to the bloodstream and binds its receptor. However, HUS is self-limited, and effective supportive management during the acute phase is proven to be a life saver for children affected by HUS. A minority of childhood HUS cases, approximately 5%, are caused by various genetic mutations causing uncontrolled activation of the complement system. These children, who used to have a poor prognosis leading to end-stage renal disease, now have access to exciting new treatment options that can preserve kidney function and avoid disease recurrences. This review provides a summary of the current knowledge on the epidemiology, pathophysiology, and clinical presentation of childhood HUS, focusing on a practical approach to best management measures.

show abstract

Strain-Specific Differences in the Amount of Shiga Toxin Released from Enterohemorrhagic Escherichia coli O157 following Exposure to Subinhibitory Concentrations of Antimicrobial Agents

Cited by 138 publications

References 20 publications

Effect of Antimicrobial Agents on the Production and Release of Shiga Toxin by Enterotoxaemic <i>Escherichia coli</i> Isolates from Pigs

Effect of Antimicrobial Agents on the Production and Release of Shiga Toxin by Enterotoxaemic <i>Escherichia coli</i> Isolates from Pigs

Shiga Toxin–ProducingEscherichia coliInfection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis

Management of hemolytic-uremic syndrome in children

Contact Info

Product

Resources

About