期刊论文详细信息
BMC Microbiology
Therapeutic concentrations of antibiotics inhibit Shiga toxin release from enterohemorrhagic E. coli O104:H4 from the 2011 German outbreak
Martin Krönke3  Olaf Utermöhlen1  Georg Plum2  Martina Wolke2  Ruben Willmes2  Diana Corogeanu2 
[1] Center for Molecular Medicine University of Cologne, Cologne, Germany;Institute for Medical Microbiology, Immunology and Hygiene, Medical Center, University of Cologne, Goldenfelsstrasse 19-21, Cologne, D-50935, Germany;German Center for Infection Research (DZIF), Cologne, Germany
关键词: Antibiotics;    Enterohemorrhagic E. coli (EHEC);    Shiga toxin producing E. coli (STEC);   
Others  :  1221804
DOI  :  10.1186/1471-2180-12-160
 received in 2012-03-28, accepted in 2012-07-02,  发布年份 2012
PDF
【 摘 要 】

Background

The shiga toxin-producing E. coli (STEC) O104:H4 caused a major outbreak in Germany in spring 2011. STEC are usually susceptible to common antibiotics. However, antibiotic treatment of STEC-infected patients is not recommended because STEC may enhance production and release of shiga toxins (STX) in response to antibiotics, which eventually enhances the frequency and severity of clinical symptoms, including haemolytic uraemic syndrome (HUS) and fatalities.

Results

We characterized the response to antibiotics of STEC O104:H4 isolates from two HUS patients during the German STEC outbreak in spring 2011 in comparison to the common STEC O157:H7. Liquid cultures of STEC O157:H7 and O104:H4 were incubated with graded dilutions of the antibiotics ciprofloxacin, meropenem, fosfomycin, gentamicin, rifampicin, and chloramphenicol. At defined times of antibiotic treatment, transcriptional activation of the STX2 gene, contents of STX and STX-activity in the culture supernatants were quantified. Unlike the common serotype O157:H7, STEC O104:H4 does not release STX in response to therapeutic concentrations of ciprofloxacin, meropenem, fosfomycin, and chloramphenicol.

Conclusions

In future outbreaks, the response of the respective epidemiologic STEC strain to antibiotics should be rapidly characterized in order to identify antibiotics that do not enhance the release of STX. This will eventually allow clinical studies tackling the question whether antibiotic treatment impacts on the eradication of STEC, clinical course of disease, and frequency of carriers.

【 授权许可】

   
2012 Corogeanu et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150803205428577.pdf 497KB PDF download
Figure 3. 108KB Image download
Figure 2. 102KB Image download
Figure 1. 44KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]Robert Koch Institute: Report: Final presentation and evaluation of epidemiological findings in the EHEC O104:H4 outbreak, Germany 2011. , Berlin; 2011. www.rki.de
  • [2]Serna A, Boedeker EC: Pathogenesis and treatment of Shiga toxin-producing Escherichia coli infections. Curr Opin Gastroenterol 2008, 24(1):38-47.
  • [3]Grif K, Dierich MP, Karch H, Allerberger F: Strain-specific differences in the amount of Shiga toxin released from enterohemorrhagic Escherichia coli O157 following exposure to subinhibitory concentrations of antimicrobial agents. Eur J Clin Microbiol Infect Dis 1998, 17(11):761-766.
  • [4]Walterspiel JN, Ashkenazi S, Morrow AL, Cleary TG: Effect of subinhibitory concentrations of antibiotics on extracellular Shiga-like toxin I. Infection 1992, 20(1):25-29.
  • [5]MacConnachie AA, Todd WT: Potential therapeutic agents for the prevention and treatment of haemolytic uraemic syndrome in shiga toxin producing Escherichia coli infection. Curr Opin Infect Dis 2004, 17(5):479-482.
  • [6]Riley LW, Remis RS, Helgerson SD, McGee HB, Wells JG, Davis BR, Hebert RJ, Olcott ES, Johnson LM, Hargrett NT, et al.: Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med 1983, 308(12):681-685.
  • [7]Waldor MK, Friedman DI: Phage regulatory circuits and virulence gene expression. Curr Opin Microbiol 2005, 8(4):459-465.
  • [8]Dundas S, Todd WT, Stewart AI, Murdoch PS, Chaudhuri AK, Hutchinson SJ: The central Scotland Escherichia coli O157:H7 outbreak: risk factors for the hemolytic uremic syndrome and death among hospitalized patients. Clin Infect Dis 2001, 33(7):923-931.
  • [9]Yoh M, Honda T: The stimulating effect of fosfomycin, an antibiotic in common use in Japan, on the production/release of verotoxin-1 from enterohaemorrhagic Escherichia coli O157:H7 in vitro. Epidemiol Infect 1997, 119(1):101-103.
  • [10]Bielaszewska M, Mellmann A, Zhang W, Kock R, Fruth A, Bauwens A, Peters G, Karch H: Characterisation of the Escherichia coli strain associated with an outbreak of haemolytic uraemic syndrome in Germany: a microbiological study. Lancet Infect Dis 2011, 11(9):671-676.
  • [11]Strockbine NA, Marques LR, Newland JW, Smith HW, Holmes RK, O'Brien AD: Two toxin-converting phages from Escherichia coli O157:H7 strain 933 encode antigenically distinct toxins with similar biologic activities. Infect Immun 1986, 53(1):135-140.
  • [12]Brismar B, Edlund C, Malmborg AS, Nord CE: Ciprofloxacin concentrations and impact of the colon microflora in patients undergoing colorectal surgery. Antimicrob Agents Chemother 1990, 34(3):481-483.
  • [13]Condon RE, Walker AP, Hanna CB, Greenberg RN, Broom A, Pitkin D: Penetration of meropenem in plasma and abdominal tissues from patients undergoing intraabdominal surgery. Clin Infect Dis 1997, 24(Suppl 2):S181-S183.
  • [14]Wong CS, Jelacic S, Habeeb RL, Watkins SL, Tarr PI: The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. N Engl J Med 2000, 342(26):1930-1936.
  • [15]Safdar N, Said A, Gangnon RE, Maki DG: Risk of hemolytic uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 enteritis: a meta-analysis. Jama 2002, 288(8):996-1001.
  • [16]Martin DL, MacDonald KL, White KE, Soler JT, Osterholm MT: The epidemiology and clinical aspects of the hemolytic uremic syndrome in Minnesota. N Engl J Med 1990, 323(17):1161-1167.
  • [17]Bell BP, Griffin PM, Lozano P, Christie DL, Kobayashi JM, Tarr PI: Predictors of hemolytic uremic syndrome in children during a large outbreak of Escherichia coli O157:H7 infections. Pediatrics 1997, 100(1):E12.
  • [18]Ikeda K, Ida O, Kimoto K, Takatorige T, Nakanishi N, Tatara K: Effect of early fosfomycin treatment on prevention of hemolytic uremic syndrome accompanying Escherichia coli O157:H7 infection. Clin Nephrol 1999, 52(6):357-362.
  • [19]Kurioka T, Yunou Y, Harada H, Kita E: Efficacy of antibiotic therapy for infection with Shiga-like toxin-producing Escherichia coli O157:H7 in mice with protein-calorie malnutrition. Eur J Clin Microbiol Infect Dis 1999, 18(8):561-571.
  • [20]Rahal EA, Kazzi N, Kanbar A, Abdelnoor AM, Matar GM: Role of rifampicin in limiting Escherichia coli O157:H7 Shiga-like toxin expression and enhancement of survival of infected BALB/c mice. Int J Antimicrob Agents 2011, 37(2):135-139.
  • [21]Rahal EA, Kazzi N, Sabra A, Abdelnoor AM, Matar GM: Decrease in Shiga toxin expression using a minimal inhibitory concentration of rifampicin followed by bactericidal gentamicin treatment enhances survival of Escherichia coli O157:H7-infected BALB/c mice. Ann Clin Microbiol Antimicrob 2011, 10:34. BioMed Central Full Text
  • [22]Bielaszewska M, Idelevich EA, Zhang W, Bauwens A, Schaumburg F, Mellmann A, Peters G, Karch H: Epidemic Escherichia coli O104:H4: Effects of antibiotics on Shiga toxin 2 production and bacteriophage induction. Antimicrob Agents Chemother 2012, 56(6):3277-3282.
  • [23]Sharma VK, Dean-Nystrom EA, Casey TA: Semi-automated fluorogenic PCR assays (TaqMan) forrapid detection of Escherichia coli O157:H7 and other shiga toxigenic E. coli. Mol Cell Probes 1999, 13(4):291-302.
  • [24]Gentry MK, Dalrymple JM: Quantitative microtiter cytotoxicity assay for Shigella toxin. J Clin Microbiol 1980, 12(3):361-366.
  文献评价指标  
  下载次数:11次 浏览次数:1次