Abstract | PURPOSE OF REVIEW: RECENT FINDINGS:
Shiga toxin-producing E. coli continue to be prevalent in the industrialized world because of dissemination in food products contaminated by ruminant feces. Declines in ground beef-related outbreaks have been matched by increased cases related to green vegetables. Fifteen percent of patients infected with E. coli O157:H7 progress to hemolytic uremic syndrome, but this figure may reach 50% if antibiotics are used. Mechanisms for bacteriophage induction causing Shiga toxin production, and for Shiga toxin dissemination to endothelium in gut, kidney and brain, may explain the negative effects of antibiotics and lead to rational therapies. Shiga toxin binders were not effective in clinical trials, but more avid binding agents may be. Current treatment recommendations are to maintain hydration to prevent thrombotic complications. Human vaccines are unlikely to be utilized. Cattle vaccines may prove the most significant approach to this disease. SUMMARY: Improved understanding of Shiga toxin-producing Escherichia coli pathophysiology and progression to hemolytic uremic syndrome provides the basis for prevention, prophylactic and treatment strategies.
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Authors | Antonio Serna 4th, Edgar C Boedeker |
Journal | Current opinion in gastroenterology
(Curr Opin Gastroenterol)
Vol. 24
Issue 1
Pg. 38-47
(Jan 2008)
ISSN: 1531-7056 [Electronic] United States |
PMID | 18043231
(Publication Type: Journal Article, Review)
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Chemical References |
- Anti-Bacterial Agents
- Bacterial Vaccines
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Topics |
- Animals
- Anti-Bacterial Agents
(therapeutic use)
- Bacterial Vaccines
- Cattle
- Cattle Diseases
(microbiology)
- Colitis
(drug therapy, microbiology, physiopathology, prevention & control)
- Disease Reservoirs
- Escherichia coli Infections
(microbiology, physiopathology, prevention & control, veterinary)
- Hemolytic-Uremic Syndrome
(microbiology, physiopathology, prevention & control)
- Host-Pathogen Interactions
- Humans
- Shiga-Toxigenic Escherichia coli
(pathogenicity)
- Virulence
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