SHIGA-LIKE TOXIN PRODUCING ESCHERICHIA COLI ASSOCIATED WITH ULCERATIVE COLITIS

Abstract

Ulcerative colitis (UC) resembles clinically and histologically the newly recognized hemorrhagic colitis which has been etiologically linked to colonic colonization with Shiga-like toxin (SLT) producing E.coli 0157:H7. This prompted us to investigate a possible common infectious origin. SLT-producing non-0157 E.coli were identified in the feces from 4 out of 10 patients aged 10 to 35 years with exacerbating UC but not in juvenile patients with active Crohn's disease (n=5) using colony blot hybridization tests with SLT-I and SLT-II gene specific oligo-DNA probes. Stool filtrates in 5 of 7 cases of UC were cytotoxic for Vero and HeLa cells (titers 1:20 to 1:512). Two patients were treated antibiotically, and clinical remission with concomittant elimination of SLT producing strains was observed. Our findings suggest that SLT producing bacteria may play a role in supporting or exacerbating UC and that antiinfectives may be of therapeutic value in some patients.