T. Kurioka et al., Efficacy of antibiotic therapy for infection with Shiga-like toxin-producing Escherichia coli O157 : H7 in mice with protein-calorie malnutrition, EUR J CL M, 18(8), 1999, pp. 561-571
Citations number
31
Categorie Soggetti
Microbiology
Journal title
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
Antibiotic therapy for infection with Shiga-toxin-producing Escherichia col
i O157.H7 is controversial because of the possibility of its inducing hemol
ytic uremic syndrome and acute encephalopathy. In a previous study, mice wi
th protein-calorie malnutrition were found to be highly susceptible to this
pathogen. The efficacy of oral antibiotic therapy in malnourished mice inf
ected with O157 organisms was assessed. Mice fed a low-protein calorie diet
were infected intragastrically with 2 x 10(6) colony-forming units of a Sh
iga-toxin-producing strain of Escherichia coli O157:H7. Infected mice were
orally given a therapeutic dose of an antibiotic, including norfloxacin, fo
sfomycin, kanamycin, ampicillin, clarithromycin or trimethoprim-sulfamethox
azole for 3 days: mice on protocol A received the antibiotic on days 1-3, s
tarting on the day after infection, and mice on protocol B received the ant
ibiotic on days 3-5. The duration of fecal pathogen excretion was shorter a
nd the toxin level in the stool and blood lower in the mice that received p
rotocol A than in untreated mice; all of the mice treated on protocol A sur
vived the lethal infection. All antibiotics except trimethoprim-sulfamethox
azole, administered on protocol B, exhibited the same effect as that exhibi
ted by the respective antibiotic administered on protocol A. Only the mice
treated with protocol B of trimethoprim-sulfamethoxatole had a higher toxin
level in the blood than untreated controls, resulting in 95% mortality. Th
ese results suggest that the antibiotics used in this study, except for tri
methoprim-sulfamethoxazole, could reduce the risk of hemolytic uremic syndr
ome and acute encephalopathy following Escherichia coli O157:H7 infection i
n humans, and that fosfomycin, in particular, may be relevant for testing i
n humans.