“…Any pathogens present might also respond to other signals produced by the intestinal microbial flora, such as the LuxS-dependent AI-3, which also activates transcription of genes involved in attaching and effacing lesion formation (Sperandio et al, 2003;Kendall et al, 2007). The increasing numbers of pathogens, and possibly also endogenous gut bacteria (Lyte and Bailey, 1997;Bailey et al, 2006 and, could affect gut integrity leading to bacterial translocation (iii) either to the mesenteric lymphatic tissue or, in a worst-case scenario, directly into the systemic circulation, where even commensal bacteria could lead to sepsis and multiple organ failure. Previous exposure to NA might also cause increased expression of E. coli virulence genes, leading to increased attachment of the pathogen to the gut mucosa, either through non-intimate attachments (Chen et al, 2006) (iv) or through espA-or locus of enterocyte effacement (LEE)-dependent intimate attachment (Vlisidou et al, 2004;Kendall et al, 2007) (v and vi), causing the attaching and effacing lesions characteristic of enteropathogenic and enterohaemorrhagic E. coli (note that this figure was adapted with permission from Freestone et al 2008). bacteria to the intestinal mucosa.…”