10.3205/ID000004
Knobloch, Johannes K.-M.
Johannes K.-M.
Knobloch
Hauswaldt, Susanne
Susanne
Hauswaldt
Solbach, Werner
Werner
Solbach
Nitschke, Martin
Martin
Nitschke
Sayk, Friedhelm
Friedhelm
Sayk
Antibiotic therapy in Shiga toxin producing Escherichia coli infection and colonization
German Medical Science GMS Publishing House
2013
JournalArticle
Shiga toxin producing E. coli
enterohemorrhagic E. coli
haemolytic uremic syndrome
O104:H4 outbreak
STEC decolonization
610 Medical sciences; Medicine
2013-07-08
2013
en
urn:nbn:de:0183-id0000043
id000004
text/html
GMS Infectious Diseases; 1:Doc04; ISSN 2195-8831
The post diarrheal hemolytic uremic syndrome (HUS) is a major complication of enteric infections with Shiga toxin producing E. coli (STEC). According to the present recommendations, antibiotic therapy of acute bloody diarrhea caused by STEC is generally discouraged. These recommendations are based on historically conflicting results describing the potential induction of HUS by antibiotic treatment during the early phase of infection with enterohemorrhagic E. coli O157 whereas no guidelines are available for the use of antibiotics in cases of already fully established HUS or in asymptomatic long term STEC carriers. In 2011, a large outbreak of hemorrhagic colitis complicated by HUS occurred in northern Germany caused by a STEC strain of serotype O104:H4 harbouring both a phage encoding Stx 2 as well as a plasmid mediated enteroaggregative phenotype. The majority of infections were observed in adults, complicated by the highest number of HUS cases ever encountered. Due to different newly introduced therapeutic strategies (e.g. complement blockade) antibiotic therapy was used in many patients once HUS was established. The outbreak therefore provided important new insights for the understanding of antibiotic therapy of STEC associated HUS in adults and for decolonization of long term STEC carriers. This review highlights new aspects concerning use of antibiotics in STEC infection and colonization.
GMS Infectious Diseases; 1:Doc04; ISSN 2195-8831