Enteropathy treatment popular in Europe still groping


Hemodialysis treatments are not effective use of antibiotics "legislator"

The German suddenly bring in a large area of ​​infection O104H4 E. coli in the medical sector is still a mystery. Although this pathogen has been basically cracked the genetic code, but its pathogenesis people were unable to make a systematic and scientific description. The face of complex and rare disease, doctors can only groping forward a month for the clinical treatment of the scientific community provided a lot of clues.

Common EHEC infections usually cause abdominal cramps, diarrhea, bloody diarrhea, weight is causing kidney damage. However, in addition to leading to the outbreak of the bacteria causing these symptoms, but also caused more than half of German patients with neurological disorders.


At present the scientific community want to know is why O104H4 E. coli toxicity so big? Innsbruck Medical University microbiologist Wei Cina that the pathogen may be more destructive in the body where it can produce more toxins, intestinal adhesion because of its stronger.

By sequencing the scientific community has found that the combination of variant strains of EHEC adhesion of E. coli and intestinal bacteria of two kinds of genetic characteristics. Hamburg, Germany, death of the patient's anatomy doctors also found a number of bacteria in the large intestine gathered together to form biofilm adhesion phenomenon. Experts explained that the bacteria are also like people know that "unity is strength", by "hold together" is more prone to the formation of bacterial biofilm resistance to antibiotics.

It is involved in the clinical treatment of Wei Cina introduced to bring this epidemic is a new understanding of EHEC produce Shiga-like toxin not only directly damage the kidneys, the body's immune system will "complement system" overreacts , resulting in a large number of red blood cells are destroyed. The complement system is one of the body particularly effective protection mechanism, the body can use it to destroy pathogens and tumor cells.

At present, many hospitals in Germany attempts to patients injected monoclonal antibody Eculizumab, precisely because this antibody can prevent the complement system overreaction. Not long ago, a pregnant patient in the Hospital Fulda, Germany antibody has basically recovered after treatment, doctors have so far not been found in patients with possible side effects of antibody therapeutics. However, this antibody is currently in the treatment of EHEC infections have not been officially certified German license, need a large number of clinical validation of its efficacy and side effects.

Wei Cina pointed out that the efficacy of antibody treatment to date, said Ming-He seems like the impact of toxins on the immune system in its pathogenesis is an important factor, but it is not a good way to prevent the bacteria toxins directly damage the kidney. In addition, the medical profession has not yet fully understand why such a toxin would cause such a big impact on the central nervous system, resulting in patients with forgetfulness, language barriers, temporary numbness, convulsions, shock and other nervous system symptoms.

In this regard, the University of Greifswald, Germany, and Bonn University researchers give an explanation: Some patients with severe immune system against their own body will produce antibodies to normal cells. This "as the Friends of the enemies," possibly through the accumulation of one kind of antibody clotting factors, resulting in the patient's brain and adrenal insufficiency, and thus lead to nervous system disorders. Greifswald City doctor has four critically ill patients using a blood filter out this kind of a new antibody therapy in the treatment of patients within one day, their condition is improved. However, this experimental therapy also need to get a wider range of cases, treatment examination.

Currently, the German hospital for critically ill patients using standard therapy is still used to remove toxins in the blood of hemodialysis. However, although some patients had early in the course of dialysis, no improvement in their neurological status, and even some of the relevant condition deteriorating.

The beginning of the epidemic, a general reluctance to adopt the German hospital antibiotic treatment, because studies have found that antibiotics will lead to more emissions of EHEC toxins, and the epidemic of drug-resistant pathogens seem stronger. However, due to the lack of effective treatment, some hospitals in Germany was still bold on the part of patients with special antibiotics, the theoretical basis of timely use of antibiotics to bacteria in the body is still small, will not emit more toxins to kill the case . Hamburg, a hospital receiving antibiotic treatment, some patients do improve the situation, in which a patient has been discharged.

2011-06-16