Gnotobiotic Piglet Infection Model for Evaluating the Safe Use of Antibiotics againstEscherichia coliO157:H7 Infection
Open Access
- 15 February 2009
- journal article
- Published by Oxford University Press (OUP) in The Journal of Infectious Diseases
- Vol. 199 (4), 486-493
- https://doi.org/10.1086/596509
Abstract
Background. Shiga toxin (Stx)-producing Escherichia coli (STEC), especially O157:H7, cause bloody diarrhea, and in 3%–15% of individuals the infection leads to hemolytic uremic syndrome (HUS) or other complications. Use of antibiotics to treat STEC infections is controversial. Here, we describe the use of piglets to evaluate the efficacy and mechanism of action of antibiotics in these infections. Methods. The effects of 2 antibiotics on STEC toxin production and their mechanisms of action were first determined by enzyme-linked immunosorbent assay and subsequently evaluated clinically in the gnotobiotic piglet infection model. Result. In vitro treatment of clinical and isogenic strains with ciprofloxacin increased the production of Stx2 via phage induction but not the production of Stx1. Azithromycin caused no significant increase in toxin production. After treatment with ciprofloxacin, infected piglets had diarrhea and the severe fatal neurological symptoms associated with Stx2 intoxication. Characteristic petechial hemorrhages in the cerebellum were more severe in ciprofloxacin-treated animals than in control animals. In contrast, azithromycin-treated piglets survived the infection and had little or no brain hemorrhaging. Conclusion. The increased in vitro toxin production caused by ciprofloxacin was strongly correlated with death and an increased rate of cerebellar hemorrhage, in contrast to the effect of azithromycin. The piglet is a suitable model for determining the effectiveness and safety of antibiotics available to treat patients.Keywords
This publication has 34 references indexed in Scilit:
- Management of diarrhea-associated hemolytic uremic syndrome in childrenClinical and Experimental Nephrology, 2008
- Pathogenesis and treatment of Shiga toxin-producing Escherichia coli infectionsCurrent Opinion in Gastroenterology, 2008
- Risk factors for sporadic Shiga toxin-producing Escherichia coli O157 infections in FoodNet sites, 1999–2000Epidemiology and Infection, 2006
- Toxin Gene Expression by Shiga Toxin-Producing Escherichia coli: the Role of Antibiotics and the Bacterial SOS ResponseEmerging Infectious Diseases, 2000
- Escherichia coli0157:H7 Strains That Express Shiga Toxin (Stx) 2 Alone Are More Neurotropic for Gnotobiotic Piglets Than Are Isotypes Producing Only Stx1 or Both Stx1 and Stx2The Journal of Infectious Diseases, 2000
- Randomized, controlled trial of antibiotic therapy for Escherichia coli O157:H7 enteritisThe Journal of Pediatrics, 1992
- Hemolytic-uremic syndrome during an outbreak of Escherichia coli O157:H7 infections in institutions for mentally retarded persons: Clinical and epidemiologic observationsThe Journal of Pediatrics, 1990
- Enzyme-Linked Immunosorbent Assay for Shiga Toxin and Shiga-like Toxin II Using P1 Glycoprotein from Hydatid CystsThe Journal of Infectious Diseases, 1990
- Toxin Genotypes and Plasmid Profiles as Determinants of Systemic Sequelae in Escherichia coli O157:H7 InfectionsThe Journal of Infectious Diseases, 1989
- Hemolytic uremic syndrome and diarrhea associated with Escherichia coli 0157:H7 in a day care centerThe Journal of Pediatrics, 1986