|MIR, RAIES - Orise Fellow|
Submitted to: Zoonoses and Public Health
Publication Type: Review Article
Publication Acceptance Date: 10/8/2018
Publication Date: 1/25/2019
Citation: Mir, R.A., Kudva, I.T. 2019. Antibiotic resistant Shiga toxin-producing Escherichia coli: An overview of prevalence and intervention strategies. Zoonoses and Public Health. 66:1-13. https://doi.org/10.1111/zph.12533.
Interpretive Summary: Cattle are the primary reservoirs of Shiga toxin producing Escherichia coli (STEC), which cause severe infections in humans but can live asymptomatically in the hindgut of cattle. Numerous outbreaks of foodborne illnesses due to STEC have been reported since their first association with human disease in 1982 and the recent discovery of antibiotic resistance genes in STEC further emphasizes the need to effectively manage and prevent STEC infections. Presence of resistance genes on mobile genetic elements like plasmids enhances the chance of spreading antibiotic resistance among STEC bacteria as well as other bacteria while minimizing possible therapeutic options for human infections. In this review article, we have summarized studies in the literature to understand the incidence and importance of antibiotic resistance in STEC, mechanism of transmission of resistance among STEC and control strategies being explored to curtail STEC colonization of cattle.
Technical Abstract: Shiga toxin-producing Escherichia coli (STEC) are foodborne pathogens that can cause severe disease in humans, including bloody diarrhea and kidney failure, while remaining harmless to its primary reservoir hosts, cattle. Antibiotics such as azithromycin, fosfomycin and meropenem are being used and recommended in the treatment of early stage STEC (mainly E. coli O157:H7) infections, as these are reportedly effective in preventing Shiga toxin release and kidney failure while eliminating the pathogen. However, antibiotic resistance among STEC isolates could negatively impact these and other similar treatment options while contributing towards the spread of antibiotic resistance genes especially if encoded on mobile genetic elements like plasmids. Antibiotic resistance among STEC isolates recovered from animals and patients is being reported globally. A comprehensive understanding of the prevalence of antibiotic resistant-STEC (AR-STEC), and the mechanisms promoting this resistance among these bacteria could help direct therapies and develop strategies to effectively reduce/eliminate these pathogens. Here, we have reviewed literature from the past three decades to gain insights on this prevalence and its impact on human infections. In addition, we have reviewed various strategies proposed by researchers to control STEC that in turn would be applicable to AR-STEC as well.