Escherichia Coli ( E. Coli

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Escherichia coli (E. coli) is a member of the Enterobacteriaceae family of organisms. It is a non-spore forming, facultative anaerobic, gram negative rod capable of growing on a variety of media and, similar to other members of the Enterobacteriaceae family, contains the enterobacterial common antigen. Most E. coli are part of the normal flora of the human gastrointestinal tract, however some strains are pathogenic and capable of causing clinical disease. Epidemiologic classification of E. coli is based on the expression of certain surface antigens. The three of greatest importance are the somatic O polysaccharide (part of the lipopolysaccharide or Gram negative endotoxin), the K antigens (part of the capsule), and the H antigens (flagellin proteins). The bacteria regulate the expression of these antigens through antigenic phase variation. This process allows the organism to selectively express or not express the antigens, which aids in protection from antibody-mediated cell death. Enterohemorrhagic E. coli (EHEC) are strains that produce exotoxins (particularly verotoxins) that result in hemorrhage of the intestinal mucosa. There are several serotypes of EHEC; the most clinically significant is O157:H7.
All age groups can become infected with EHEC however, children and the elderly tend to be most susceptible to disease. O157:H7 is found in the gut of many animals, including cattle, goats, sheep, deer, and elk; cattle are the main source of human disease. Despite the tremendous clinical impact these organisms can have on the human host, in these animals the bacteria do not generally cause disease. Transmission of the bacteria is primarily through the fecal to oral route; transmission through direct contact with cattle can also oc...

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...tion is a crucial factor. A limitation of the Girard et al., study is the amount of time it will take for renal cells to decrease expression of Gb3. Miglustat was shown to be most protective after pre-treatment of renal cells for 48 hours [5]. In a clinical setting, this is impractical because treatment is sought after the person is already infected with bacteria and toxin is already being produced. Combination therapy may provide the best approach to reduce toxin-mediated damage. VNHs target the toxin itself, therefore their actions are more rapid and can be used during the acute infection. Miglustat, however, takes time. Rather than being used to treat the acute infection, it’s use may be best to prevent any further damage the toxin may cause. Taken together, these studies opened a new window of potential therapeutic options for individuals with O157:H7 infection.

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