ArticleAntimicrobial agents and chemotherapy2012
Effects of antibiotics on Shiga toxin 2 production and bacteriophage induction by epidemic Escherichia coli O104:H4 strain.
Article in Antimicrobial agents and chemotherapy, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 1 of them a synthesis that pooled it.
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Who cites it
110 citing papers in PubMed, 1 synthesis or guideline pooled it, 196 citations in OpenAlex.
- Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Pooled it
- Ribosome-inactivating proteins in bacteria.Microbial genomics · 2026Review
- Article
- Shiga toxin-centered pathophysiology defines the therapeutic limits of enterohemorrhagic Escherichia coli infection.Archives of microbiology · 2026Review
- Inter-society consensus on the management of acute bloody diarrhea and shiga toxin-producing Escherichia coli infection in the molecular microbiology era.Italian journal of pediatrics · 2026Review
- Bloody diarrhea, STEC infection, and HUS in the molecular microbiology era.Pediatric nephrology (Berlin, Germany) · 2026Review
- Development of an impedimetric aptasensor for Shiga-like toxin 1 using a DNA aptamer and an interdigitated microelectrode.RSC advances · 2026Article
- Pathogenesis and therapeutic strategies in the interaction between gut microbiota and enterohemorrhagic Escherichia coli infection.FEMS microbiology reviews · 2026Review
- Diarrhea management: from pathophysiology to microbiota modulation.Therapeutic advances in gastroenterology · 2026Review
- Article
- Precise virulence inactivation using a CRISPR-associated transposase for combating Enterobacteriaceae gut pathogens.Nature biomedical engineering · 2025Article
- Curcumin Reverses Antibiotic Resistance and Downregulates Shiga Toxin Expression in EnterohemorrhagicDiseases (Basel, Switzerland) · 2025Article
- Evaluation of Single and Multi-Strain Probiotics with Gentamicin AgainstMicroorganisms · 2025Article
- Characterization of Broad Spectrum Bacteriophage vB ESM-pEJ01 and Its Antimicrobial Efficacy Against Shiga Toxin-ProducingMicroorganisms · 2025Article
- Article
- Sub-MIC Antibiotics Modulate Productions of Outer Membrane Vesicles in Tigecycline-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- A prophage encoded ribosomal RNA methyltransferase regulates the virulence of Shiga-toxin-producing Escherichia coli (STEC).Nucleic acids research · 2024Article
- Do asymptomatic STEC-long-term carriers need to be isolated or decolonized? New evidence from a community case study and concepts in favor of an individualized strategy.Frontiers in public health · 2024Article
- Prophages: an integral but understudied component of the human microbiome.Microbial genomics · 2024Article
- Pathogenomes and virulence profiles of representative big six non-O157 serogroup Shiga toxin-producingFrontiers in microbiology · 2024Article
50 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The role of antibiotics in treatment of enterohemorrhagic Escherichia coli (EHEC) infections is controversial because of concerns about triggering hemolytic-uremic syndrome (HUS) by increasing Shiga toxin (Stx) production. During the recent large EHEC O104:H4 outbreak, antibiotic therapy was indicated for some patients. We tested a diverse panel of antibiotics to which the outbreak strain is susceptible to interrogate the effects of subinhibitory antibiotic concentrations on induction of stx(2)-harboring bacteriophages, stx(2) transcription, and Stx2 production in this emerging pathogen. Ciprofloxacin significantly increased stx(2)-harboring phage induction and Stx2 production in outbreak isolates (P values of <0.001 to <0.05), while fosfomycin, gentamicin, and kanamycin insignificantly influenced them (P > 0.1) and chloramphenicol, meropenem, azithromycin, rifaximin, and tigecycline significantly decreased them (P ≤ 0.05). Ciprofloxacin and chloramphenicol significantly upregulated and downregulated stx(2) transcription, respectively (P < 0.01); the other antibiotics had insignificant effects (P > 0.1). Meropenem, azithromycin, and rifaximin, which were used for necessary therapeutic or prophylactic interventions during the EHEC O104:H4 outbreak, as well as tigecycline, neither induced stx(2)-harboring phages nor increased stx(2) transcription or Stx2 production in the outbreak strain. These antibiotics might represent therapeutic options for patients with EHEC O104:H4 infection if antibiotic treatment is inevitable. We await further analysis of the epidemic to determine if usage of these agents was associated with an altered risk of developing HUS.
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