This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ochoa, T. J.
Right arrow Articles by Cleary, T. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ochoa, T. J.
Right arrow Articles by Cleary, T. G.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, August 2007, p. 2837-2841, Vol. 51, No. 8
0066-4804/07/$08.00+0     doi:10.1128/AAC.01397-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Rifaximin Does Not Induce Toxin Production or Phage-Mediated Lysis of Shiga Toxin-Producing Escherichia coli{triangledown}

Theresa J. Ochoa,1,2 Jane Chen,1 Christopher M. Walker,1 Elsa Gonzales,2 and Thomas G. Cleary1*

Center for Infectious Diseases, University of Texas Health Science Center, Houston, Texas,1 Universidad Peruana Cayetano Heredia, Lima, Perú2

Received 8 November 2006/ Returned for modification 23 January 2007/ Accepted 14 May 2007

Diarrhea in children is often caused by enteropathogen infections that might benefit from early empirical antibiotic therapy. However, when the definition of the pathogen requires sophisticated laboratory studies, the etiology of enteritis is not known early in illness. Empirical therapy may be dangerous if the child is infected with a Shiga toxin-producing Escherichia coli (STEC) strain because antimicrobials may increase Shiga toxin (Stx) release, resulting in increased risk of microangiopathic hemolytic anemia with acute renal failure (hemolytic-uremic syndrome [HUS]) and death. There is a need for antimicrobials that would be effective against multiple bacterial enteropathogens yet not induce Stx release or increase the risk of HUS. Rifaximin has been evaluated in adults for treatment of bacterial enteritis and has a good record for safety and efficacy, but it has not been evaluated extensively in children with gastroenteritis. We therefore evaluated rifaximin's potential for phage induction, drug-induced bacteriolysis, and toxin release in 57 STEC strains (26 O157 and 31 non-O157 strains). Growth in ciprofloxacin, a known Stx phage inducer, caused bacteriolysis and release of toxin in 25/26 (96%) O157 strains and 15/31 (48%) non-O157 strains. In contrast, rifaximin did not induce phage replication or lysis in any strain. Toxin release in the presence of rifaximin was not different from release in the absence of antibiotic. Rifaximin, unlike many antibiotics used to treat pediatric gastroenteritis, does not induce phage-mediated bacteriolysis and Stx release.

* Corresponding author. Mailing address: University of Texas School of Public Health, Center for Infectious Diseases, P.O. Box 20186, Houston, TX 77225. Phone: (713) 500-5714. Fax: (713) 500-5688. E-mail: Thomas.G.Cleary{at}uth.tmc.edu

{triangledown} Published ahead of print on 25 May 2007.

Antimicrobial Agents and Chemotherapy, August 2007, p. 2837-2841, Vol. 51, No. 8
0066-4804/07/$08.00+0     doi:10.1128/AAC.01397-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • DuPont, H. L. (2009). Bacterial Diarrhea. NEJM 361: 1560-1569 [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»