Ehec: treatment options

[Emily]

Woman e. coli patient in Germany responds to antibiotics


No medical advice intended in post - just sharing information.

http://www.washingtonpost.com/world/survivor-of-e-coli-outbreak-tells-stories-of-pain-chaos-and-confusion/2011/06/05/AGJ9iEJH_story_1.html

[snip]

Friedrich Hagenmueller, the medical director of Asklepios Hospital, treated Pabst with antibiotics early on ?because what we had been doing so far in this outbreak hasn?t been very successful.?

?Her quick recovery has encouraged me to try out antibiotics on other incoming patients as well,? Hagenmueller told the AP.

Hans-Joerg Epple, a gastroenterologist and infectologist at Berlin?s Benjamin-Franklin-Hospital, said that while antibiotics were normally not given to E. coli patients, some experts were looking into treating the current E. coli strain with specific kinds of antibiotics.

?It is quite unusual and we don?t have a lot of data on this, but there are indications that some kinds of antibiotics may be helpful here,? Epple said....

The patient said that she ate the same vegetables as her family, but she was the only one to get sick. She also said that the hospital was so overwhelmed, that there weren't enough bathrooms for patients in the ER and she feared that germs were being spread because of that.

 

[tetano]

Re: Woman e. coli patient in Germany responds to antibiotics

Re: Woman e. coli patient in Germany responds to antibiotics

Summary

Treatment of the german EHEC strain with antibiotics is difficult due to resistance and side effects caused by increased release of shiga toxin. Plasmaphoresis and dialysis appear to be the most effective treatments. The monoclonal antibody eculizumab is being tested as a possible treatment to prevent severe side effects due to the hemolytic-uremic syndrome (HUS), but there is only anecdotal evidence that this treatment works.
Analysis

The german EHEC strain appears to contains genetic material of two different previously identified strains (it's a so called hybrid). It also carries antibiotic resistance to aminoglycoside (e.g. Streptomycin), macrolides (e.g. Azithromycin) and Beta-lactam (e.g. Penicillin) antibiotics according to sequence analysis carried out by a group of german and chinese scientists. The strain also carries genetic code that increases it's pathogenicity for hemorrhagic colitis and hemolytic-uremic syndrome (HUS). Shiga toxin has been indicated as the causative agent of HUS. HUS can involve inflammation of the kidneys, bowels, and central nervous system, which can result in permament damage to these organs.Treatment with antibiotics is difficult due to the resistance of the strain to several commonly used types. In addition antibiotic treatment can increase symptoms due to increased release of shiga toxin by bacteria. Plasmaphoresis and dialysis appear to be the most effective treatments to clear the shiga toxin from the blood of patients. In addition the monoclonal antibody eculizumab (Soliris by Alexion Pharmaceuticals) is being tested as a possible treatment to prevent severe side effects due to HUS but there is currently only anecdotal evidence that this treatment works.

http://www.glgroup.com/News/Eculizu...ic-uremic-syndrome-caused-by-EHEC--54247.html