Escherichia coli infection resistance

Bullen, J.J., Rogers, H.J., and Leigh, L. 1972. Iron-binding proteins in milk and resistance to Escherichia coli infections in infants. Br. Med. J. 1, 69—75. 

Chitin has been used in columns to isolate pure lectins and determine their structure [94], Chitin and 6-O-carboxymethylchitin activate peritoneal macrophages in vivo, suppress the growth of tumour cells in mice and stimulate nonspecific host resistance against Escherichia Coli infection [95]. Chitin is used for biological activity as mentioned previously oligomers were claimed as anticancer drug and the DP = 5 is active to control the photosynthesis of maize and soybean [96]. 

Tinospora cordifolia has been evaluated in several animal models for immunosuppression. In a model of irreversible cholestasis, Escherichia coli sepsis was created [22]. Rats from the Tinospora cordifolia-lrtdXtd groups resisted Escherichia coli infection and mortality was only 16.7%. Blood cultures of the surviving animals were sterile. In comparison, the control rats showed a mortality of 77.8 % and the blood culture of surviving animals from these groups showed the presence of Escherichia coli. 

Empiric antibiotic therapy is an appropriate approach to traveler s diarrhea. Eradication of the causal microbe depends on the etiologic agent and its antibiotic sensitivity. Most cases of traveler s diarrhea and other community-acquired infections result from enterotoxigenic (ETEC) or enteropathogenic (EPEC) Escherichia coli. Routine stool cultures do not identify these strains primary empiric antibiotic choices include fluoroquinolones such as ciprofloxacin or levofloxacin. Azithromycin may be a feasible option when fluoroquinolone resistance is encountered. 

Perfetto EM, Gondek EK. Escherichia coli resistance in uncomplicated urinary tract infection a model for determining when to change first-line empirical antibiotic choice. Manag Care Interface 2002 6 35M2. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

For infections frequently encountered outside hospitals, e.g. uncomplicated urinary tract infection in young women, surveillance of resistance data of the most likely pathogens Escherichia coli) allows physicians to prescribe empiric therapy without performing cultures in the individual patient. However, in severely ill hospitalised patients, it is necessary to take samples for culture before starting empiric therapy. Microscopy of the Gram stained smear can help fine-tune empiric therapy at an early stage. Whether the infection is community-acquired or hospital-acquired, and whether the patient has been exposed to previous antimicrobial therapy should also be taken into account when choosing empiric therapy. 

Most infections are caused by gram-negative bacteria, mostly Escherichia coli. In recurrent UTI, after repeated courses of antimicrobial therapy, other organisms and antibiotic resistance can be expected. 

Nitrofurantoin is bacteriostatic and bactericidal for many gram-positive and gram-negative bacteria but P aeruginosa and many strains of proteus are resistant. There is no cross-resistance between nitrofurantoin and other antimicrobial agents and resistance emerges slowly. As Escherichia coli resistant to trimethoprim-sulfamethoxazole and fluoroquinolones has become more common, nitrofurantoin has become an important alternative oral agent for treatment of uncomplicated urinary tract infection. 

Mellata, M., Dho-Moulin, M., Dozois, C.M., Curtiss, R., 3rd, Brown, P.K., Arne, P., Bree, A., Desautels, C., Fairbrother, J.M. Role of virulence factors in resistance of avian pathogenic Escherichia coli to serum and in pathogenicity. Infect Immun 71 (2003) 536-540. 

Goettsch W, van Pelt W, Nagelkerke N, Hendrix MG, Buiting AG, Petit PL, Sabbe LJ, van Griethuysen AJ, de Neehng AJ. Increasing resistance to fluoroquinolones in Escherichia coli from urinary tract infections in the nether-lands. J Antimicrob Chemother 2000 46(2) 223-8. 

Kanamycin can be used for short-term treatment of severe infections caused by susceptible strains (for example Escherichia coli, Proteus species, Enterobacter aerogenes, Klebsiella pneumoniae, Serratia marcescens, and Mima-Elerellea) that are resistant to other less ototoxic aminoglycosides. It is not indicated for long-term therapy, for example in tuberculosis. 

Penicillins Ampicillin Amoxicillin-clavulanic acid Carbenicillin indanyl Ampicillin is the standard penicillin that has broad-spectrum activity. Increasing Escherichia coli resistance has limited amoxicillin use in acute cystitis. Drug of choice for enterococci sensitive to penicillin. Amoxicillin-clavulanate is preferred for resistance problems. Carbenicillin indanyl is only indicated for the treatment of urinary tract infections. 

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