Efficacy of Antibiotic therapy for infection with shiga-like toxin-producing Escherichia coli O157:H7 in mice with protein-calorie malnutrition

• Published in: European journal of clinical microbiology & infectious diseases Vol. 18; no. 8; pp. 561 - 571
• Main Authors: KURIOKA, T, YUNOU, Y, HARADA, H, KITA, E
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.08.1999; Springer Nature B.V
• Subjects: Ampicillin - administration & dosage; Animals; Anti-Bacterial Agents - administration & dosage; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial Toxins - analysis; Bacterial Toxins - biosynthesis; Biological and medical sciences; Blood; Brain Chemistry; Disease Models, Animal; Disease Progression; E coli; Escherichia coli; Escherichia coli Infections - blood; Escherichia coli Infections - complications; Escherichia coli Infections - drug therapy; Escherichia coli O157 - drug effects; Feces - chemistry; Fosfomycin - administration & dosage; Kanamycin - administration & dosage; Malnutrition; Medical sciences; Mice; Mice, Inbred C57BL; Norfloxacin - administration & dosage; Pathogens; Pharmacology. Drug treatments; Protein-Energy Malnutrition - complications; Reference Values; Sensitivity and Specificity; Shiga Toxins; Shiga-like toxin; Statistics, Nonparametric; Survival Rate; Toxins; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination - administration & dosage; Hemolytic uremic syndrome; Toxicity; Colibacillosis; Escherichia coli; Rodentia; Infection; Vertebrata; Antibiotic; Chemotherapy; Experimental disease; Mammalia; Treatment; Mouse; Animal; Encephalopathy; Risk factor; Bacteriosis; Bacteria; Complication; Antibacterial agent; Comparative study; Enterobacteriaceae
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s100960050348

Antibiotic therapy for infection with Shiga-toxin-producing Escherichia coli O157:H7 is controversial because of the possibility of its inducing hemolytic uremic syndrome and acute encephalopathy. In a previous study, mice with protein-calorie malnutrition were found to be highly susceptible to this pathogen. The efficacy of oral antibiotic therapy in malnourished mice infected 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 Shiga-toxin-producing strain of Escherichia coli O157:H7. Infected mice were orally given a therapeutic dose of an antibiotic, including norfloxacin, fosfomycin, kanamycin, ampicillin, clarithromycin or trimethoprim-sulfamethoxazole for 3 days: mice on protocol A received the antibiotic on days 1-3, starting on the day after infection, and mice on protocol B received the antibiotic on days 3-5. The duration of fecal pathogen excretion was shorter and the toxin level in the stool and blood lower in the mice that received protocol A than in untreated mice; all of the mice treated on protocol A survived the lethal infection. All antibiotics except trimethoprim-sulfamethoxazole, administered on protocol B, exhibited the same effect as that exhibited by the respective antibiotic administered on protocol A. Only the mice treated with protocol B of trimethoprim-sulfamethoxazole had a higher toxin level in the blood than untreated controls, resulting in 95% mortality. These results suggest that the antibiotics used in this study, except for trimethoprim-sulfamethoxazole, could reduce the risk of hemolytic uremic syndrome and acute encephalopathy following Escherichia coli O157:H7 infection in humans, and that fosfomycin, in particular, may be relevant for testing in humans.