THE STIMULATING EFFECT OF FOSFOMYCIN, AN ANTIBIOTIC IN COMMON USE IN JAPAN, ON THE PRODUCTION RELEASE OF VEROTOXIN-1 FROM ENTEROHEMORRHAGICESCHERICHIA-COLI O157-H7 IN-VITRO/

In 1996 Japan had a big outbreak of enterohaemorrhagic Escherichia col i (EHEC) O157:H7, especially in Osaka prefecture where about 6000 pati ents (mainly schoolchildren) suffered from diarrhoea, haemorrhagic col itis and haemolytic uraemic syndrome (HUS) due to EHEC infection via s chool lunch. Our survey of doctors who took care of those patients sho wed that most patients had received antibiotics, especially fosfomycin which comprised 84% of the prescribed treatment. Since the administra tion of antibiotics for EHEC infection is under discussion, we analyse d the effect of fosfomycin on production/release of verotoxins (VTs). Addition of fosfomycin into EHEC culture in CAYE broth at 2 and 5 h af ter start of incubation caused marked increase of VT1 release. This ob servation warns of the possibility of fosfomycin treatment making the disease worse.