Doctors treating the world’s deadliest E. coli outbreak have little beyond water and dialysis machines to help them clear the infection from patients, according to infectious disease specialists.
The new strain of E. coli, which has killed at least 18 people in Europe, produces a poisonous bi-product called shiga toxin that damages the kidneys of some patients and requires the use of dialysis to scrub the blood clean. Some patients need transfusions after the bacteria dissolve their red blood cells, said Robert Tauxe, deputy director of food-borne illness at the U.S. Centers for Disease Control and Prevention.
Germany, alone, has reported 520 cases of the kidney ailment. Overall, 1,823 cases of E. coli infection have been confirmed, according to the World Health Organization in Geneva. In less severe cases, doctors use fluids to maintain hydration and stream the diarrhea-causing toxins through the body. Antibiotics don’t help, and can worsen the illness.
“It’s clearly a more severe disease than is normally seen because of this kidney failure association,” said Stephen Calderwood, chief of the infectious disease division at Massachusetts General Hospital in Boston. “There is some data if you keep the patient hydrated it may lessen the kidney disease. What is recommended is supportive treatment -- no antibiotics but maintain hydration.”
Antibiotics can’t be used because they increase the release of toxins into the bloodstream, compounding kidney damage, Calderwood said. The one class of antibiotics that doesn’t do this, known as carbapenems, is unlikely to help with E. coli, though they may be useful for patients who are simultaneously fighting additional infections, he said.
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