Treatment Strategies for Infections With Shiga Toxin-Producing Escherichia coli.

Sabrina Mühlen,Petra Dersch

doi:10.3389/fcimb.2020.00169

Abstract

Infections with Shiga toxin-producing Escherichia coli (STEC) cause outbreaks of severe diarrheal disease in children and the elderly around the world. The severe complications associated with toxin production and release range from bloody diarrhea and hemorrhagic colitis to hemolytic-uremic syndrome, kidney failure, and neurological issues. As the use of antibiotics for treatment of the infection has long been controversial due to reports that antibiotics may increase the production of Shiga toxin, the recommended therapy today is mainly supportive. In recent years, a variety of alternative treatment approaches such as monoclonal antibodies or antisera directed against Shiga toxin, toxin receptor analogs, and several vaccination strategies have been developed and evaluated in vitro and in animal models. A few strategies have progressed to the clinical trial phase. Here, we review the current understanding of and the progress made in the development of treatment options against STEC infections and discuss their potential.

Highlights

Shiga-toxin producing Escherichia coli (STEC/EHEC) are a major cause of severe gastrointestinal disease in industrialized countries and a major public health problem with most frequent and severe infections linked to serotype O157:H7 (Kaper and O’Brien, 2014)
Almost four decades have passed since the first clinical human hemolytic uremic syndrome (HUS) case (Centers for Disease Control, 1982) and the incidence of HUS increases, a generally accepted and successful therapy for Shiga toxin-producing Escherichia coli (STEC)-induced HUS in patients is still missing
Further studies examining these issues and testing the efficacy of Stx-inhibiting agents according to gained knowledge from these experiments are required to select the most successful regimens that could be assessed in clinical trials

Summary

Introduction

Shiga-toxin producing (enterohemorrhagic) Escherichia coli (STEC/EHEC) are a major cause of severe gastrointestinal disease in industrialized countries and a major public health problem with most frequent and severe infections linked to serotype O157:H7 (Kaper and O’Brien, 2014). They absorb and neutralize Stx1, Stx2, Stx2c, and Stx2d in vitro and oral administration of Gb3 analog-expressing bacteria protected mice from fatal challenge with different highly virulent STEC strains.

Results

Conclusion