Subtype-Specific Suppression of Shiga Toxin 2 Released from
            <i>Escherichia coli</i>
            upon Exposure to Protein Synthesis Inhibitors

Pedersen, Malene Gantzhorn; Hansen, C. F.; Riise, Erik; Persson, Søren; Olsen, Katharina E. P.

doi:10.1128/jcm.00871-08

Cited by 25 publications

(19 citation statements)

References 22 publications

(31 reference statements)

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“…4). These results support previous studies which demonstrated that antibiotics that inhibited protein synthesis decrease toxin production in vitro (25,38,39). Furthermore, two studies have shown that AZM affords protection from Stx-mediated disease in vivo.…”

Section: Discussionsupporting

confidence: 81%

“…Some studies report antibiotic treatment of patients with STEC infection to be beneficial and others do not (reviewed in reference 23). Similarly, studies examining the ability of antibiotics to promote Stx production in vitro have given mixed results (9,13,18,21,25,37). In several studies Stx expression was assessed by enzyme-linked immunosorbent assay (ELISA), Western blotting, or mRNA levels, and these indirect assays may not accurately reflect levels of biologically active Stx, since not all subunits may be part of assembled functional AB 5 complexes.…”

mentioning

confidence: 99%

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Different Classes of Antibiotics Differentially Influence Shiga Toxin Production

McGannon

Fuller

Weiss

2010

Antimicrob Agents Chemother

163

128

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Shiga toxin (Stx) in Escherichia coli O157:H7 is encoded as a late gene product by temperate bacteriophage integrated into the chromosome. Phage late genes, including stx, are silent in the lysogenic state. However, stress signals, including some induced by antibiotics, trigger the phage to enter the lytic cycle, and phage replication and Stx production occur concurrently. In addition to the Stx produced by O157:H7, phage produced by O157:H7 can infect harmless intestinal E. coli and recruit them to produce Shiga toxin. To understand how antibiotics influence Stx production, Stx lysogens were treated with different classes of antibiotics in the presence or absence of phage-sensitive E. coli, and Stx-mediated inhibition of protein synthesis was monitored using luciferase-expressing Vero cells. Growth-inhibitory levels of antibiotics suppressed Stx production. Subinhibitory levels of antibiotics that target DNA synthesis, including ciprofloxacin (CIP) and trimethoprim-sulfamethoxazole, increased Stx production, while antibiotics that target the cell wall, transcription, or translation did not. More Stx was produced when E. coli O157:H7 was incubated in the presence of phage-sensitive E. coli than when grown as a pure culture. Remarkably, very high levels of Stx were detected even when growth of O157:H7 was completely suppressed by CIP. In contrast, azithromycin significantly reduced Stx levels even when O157:H7 viability remained high.

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

Different Classes of Antibiotics Differentially Influence Shiga Toxin Production

McGannon

Fuller

Weiss

2010

Antimicrob Agents Chemother

163

128

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“…There are conflicting reports regarding its effect on release of both Stx1 and Stx2. One study reported its increasing effect on toxin release from STEC (Grif et al, 1998); however, the recent studies demonstrated suppression in toxin release from STEC carrying stx2 upon exposure to MIC or sub-MIC of gentamicin (Pedersen et al, 2008). We found a considerable decrease in Stx release at MIC and sub-MIC of gentamicin.…”

Section: Discussionmentioning

confidence: 75%

“…Although the exact mechanism of toxin suppression remains to be revealed, it has been proposed that the decrease in toxin amount could be due to inhibition of protein synthesis, as some antibiotic molecules attach to the membrane-bounded ribosome involved in protein synthesis (Shibl, 1984). The suppression of late gene promoter of stx gene in case of protein synthesis inhibitor (gentamicin) is also reported, promising use of these agents in STEC infections (Pedersen et al, 2008).…”

Section: Discussionmentioning

confidence: 98%

Effects of Ampicillin, Gentamicin, and Cefotaxime on the Release of Shiga Toxins from Shiga Toxin–ProducingEscherichia coliIsolated During a Diarrhea Episode in Faisalabad, Pakistan

Mohsin

Haque²,

Ali³

et al. 2010

Foodborne Pathogens and Disease

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The Shiga toxin-producing Escherichia coli (STEC) is an emerging foodborne pathogen. The proportion of cases attributed to STEC in an episode of diarrhea in the Faisalabad region of Pakistan was investigated. In addition, as increase in Shiga toxin (Stx) release after exposure to various antimicrobial agents is widely reported, we also elucidated the in vitro effects of three commonly used antibiotics (ampicillin, gentamicin, and cefotaxime) on Stx release. Isolation and detection of STEC was done using enzyme-linked immunosorbent assay and polymerase chain reaction, followed by phenotypic characterization. In vitro Stx release from isolated STEC was determined using enzyme-linked immunosorbent assay, and Stx-induced verocytotoxicity was quantified using cytotoxicity detection assay. STEC was detected in 5 (21.7%) of 23 patients. Exposure to minimum inhibitory concentration (MIC) of ampicillin, gentamicin, and cefotaxime resulted in a considerable decrease in toxin release and level of cytotoxicity in most of the STEC isolates when compared with control (without antibiotic exposure). Exposure to sub-MIC of ampicillin resulted in a relative increase in Stx release and cytotoxicity (p

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“…However, the effects of different antibiotic classes on Stx production in vitro differ and are also dependent on the antibiotic concentration and the nature of the EHEC strain (e.g., O group or Stx type) (16,22,24,28,29,39). In studies performed with EHEC O157:H7, fluoroquinolones, trimethoprim-sulfamethoxazole, and ampicillin significantly increased Stx2 production (16,20,22,23,24,29,39,40), whereas macrolides (24,29,39), carbapenems (22,23), aminoglycosides (22,24), rifampin (31), rifaximin (28), and fosfomycin (22,24,40) either had no effect on Stx2 production or suppressed it. These in vitro data are in accordance with experiments with animal models (31,39,40).…”

mentioning

confidence: 99%

Effects of Antibiotics on Shiga Toxin 2 Production and Bacteriophage Induction by Epidemic Escherichia coli O104:H4 Strain

Bielaszewska

Idelevich

Zhang

et al. 2012

Antimicrob Agents Chemother

169

144

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ABSTRACTThe role of antibiotics in treatment of enterohemorrhagicEscherichia coli(EHEC) infections is controversial because of concerns about triggering hemolytic-uremic syndrome (HUS) by increasing Shiga toxin (Stx) production. During the recent large EHEC O104:H4 outbreak, antibiotic therapy was indicated for some patients. We tested a diverse panel of antibiotics to which the outbreak strain is susceptible to interrogate the effects of subinhibitory antibiotic concentrations on induction ofstx2-harboring bacteriophages,stx2transcription, and Stx2 production in this emerging pathogen. Ciprofloxacin significantly increasedstx2-harboring phage induction and Stx2 production in outbreak isolates (Pvalues of <0.001 to <0.05), while fosfomycin, gentamicin, and kanamycin insignificantly influenced them (P> 0.1) and chloramphenicol, meropenem, azithromycin, rifaximin, and tigecycline significantly decreased them (P≤ 0.05). Ciprofloxacin and chloramphenicol significantly upregulated and downregulatedstx2transcription, respectively (P< 0.01); the other antibiotics had insignificant effects (P> 0.1). Meropenem, azithromycin, and rifaximin, which were used for necessary therapeutic or prophylactic interventions during the EHEC O104:H4 outbreak, as well as tigecycline, neither inducedstx2-harboring phages nor increasedstx2transcription or Stx2 production in the outbreak strain. These antibiotics might represent therapeutic options for patients with EHEC O104:H4 infection if antibiotic treatment is inevitable. We await further analysis of the epidemic to determine if usage of these agents was associated with an altered risk of developing HUS.

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Subtype-Specific Suppression of Shiga Toxin 2 Released from Escherichia coli upon Exposure to Protein Synthesis Inhibitors

Cited by 25 publications

References 22 publications

Different Classes of Antibiotics Differentially Influence Shiga Toxin Production

Different Classes of Antibiotics Differentially Influence Shiga Toxin Production

Effects of Ampicillin, Gentamicin, and Cefotaxime on the Release of Shiga Toxins from Shiga Toxin–ProducingEscherichia coliIsolated During a Diarrhea Episode in Faisalabad, Pakistan

Effects of Antibiotics on Shiga Toxin 2 Production and Bacteriophage Induction by Epidemic Escherichia coli O104:H4 Strain

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