title: Approaches to treatment of emerging Shiga toxin-producing Escherichia coli infections highlighting the O104:H4 serotype.
abstract: Shiga toxin-producing Escherichia coli (STEC) are a group of diarrheagenic bacteria associated with foodborne outbreaks. Infection with these agents may result in grave sequelae that include fatality. A large number of STEC serotypes has been identified to date. E. coli serotype O104:H4 is an emerging pathogen responsible for a 2011 outbreak in Europe that resulted in over 4000 infections and 50 deaths. STEC pathogenicity is highly reliant on the production of one or more Shiga toxins that can inhibit protein synthesis in host cells resulting in a cytotoxicity that may affect various organ systems. Antimicrobials are usually avoided in the treatment of STEC infections since they are believed to induce bacterial cell lysis and the release of stored toxins. Some antimicrobials have also been reported to enhance toxin synthesis and production from these organisms. Various groups have attempted alternative treatment approaches including the administration of toxin-directed antibodies, toxin-adsorbing polymers, probiotic agents and natural remedies. The utility of antibiotics in treating STEC infections has also been reconsidered in recent years with certain modalities showing promise.
authors: Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut Beirut, Lebanon.
authors: Elias A
authors: EA
authors: Rahal
authors: Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut Beirut, Lebanon.
authors: Sukayna M
authors: SM
authors: Fadlallah
authors: Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut Beirut, Lebanon.
authors: Farah J
authors: FJ
authors: Nassar
authors: Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut Beirut, Lebanon.
authors: Natalie
authors: N
authors: Kazzi
authors: Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut Beirut, Lebanon.
authors: Ghassan M
authors: GM
authors: Matar
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000906:Antibodies / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005060:Europe / Q000453:epidemiology; D006801:Humans; D019936:Probiotics / Q000627:therapeutic use; D054323:Shiga-Toxigenic Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D000906:Antibodies
keywords: Shiga toxin 1; Shiga toxin 2; Shiga toxin-producing Escherichia coli; antimicrobial agents; hemolytic uremic syndrome; hemorrhagic colitis