Previous Article | Next Article 
Infection and Immunity, February 2001, p. 1101-1108, Vol. 69, No. 2
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.2.1101-1108.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Protective Effect of Lactobacillus casei Strain
Shirota on Shiga Toxin-Producing Escherichia coli
O157:H7 Infection in Infant Rabbits
Michinaga
Ogawa,1,2
Kensuke
Shimizu,1,2
Koji
Nomoto,1,2,*
Masatoshi
Takahashi,1
Masaaki
Watanuki,1
Ryuichiro
Tanaka,1
Tetsuya
Tanaka,2
Takashi
Hamabata,2
Shinji
Yamasaki,2,3 and
Yoshifumi
Takeda2,4
Yakult Central Institute for Microbiological Research, 1796 Yaho, Kunitachi, Tokyo 186-86501
Research Institute, International Medical Center of Japan,
1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655,2
School of Medicine, Tsukuba University, Tsukuba
305-8575,3 and National Institute of
Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo
162-8640,4 Japan
Received 24 July 2000/Returned for modification 8 September
2000/Accepted 17 November 2000
 |
ABSTRACT |
We examined colonization patterns of Shiga toxin-producing
Escherichia coli (STEC), concentrations of Shiga toxins
(Stxs) and specific immunoglobulin A (lgA) against Stxs and STEC
bacterial cell surface antigen in various portions of the
gastrointestinal tract in an infant rabbit infection model. After
inoculation of 3-day-old infant rabbits with STEC strain
89020087 at low doses (~103 CFU/body), numbers of
colonizing STEC bacteria and concentrations of Stxs in the intestine
increased dramatically and the animals developed diarrhea within a
couple of days after infection. Daily administration of
Lactobacillus casei from the day of birth dramatically decreased the severity of diarrhea and lowered STEC colonization levels
in the gastrointestinal tract 100-fold day 7 after infection. Both Stx1
and Stx2 concentrations in the intestines and histological damage to
the intestinal mucus induced by STEC infection were decreased by the
administration of L. casei. Examination of the concentrations of volatile fatty acids and pH of the intestinal contents revealed that the protective effect of L. casei
administration against STEC infection was not due to fermented products
such as lactic acid in the gastrointestinal tract. Administration of L. casei increased levels of lgAs against Stx1, Stx2, and
formalin-killed STEC cells in the colon approximately two-, four-, and
threefold, respectively, compared with those of the untreated controls
by day 7 after infection. These results suggest that administration of
L. casei strain Shirota enhances the local immune responses to STEC cells and Stxs and leads to elimination of STEC and thus decreases Stx concentrations in the intestines.
 |
INTRODUCTION |
Shiga toxin-producing
Escherichia coli (STEC) O157:H7 is characterized by
production of two kinds of Shiga toxins (Stxs), Stx1 and Stx2, which
cause hemorrhagic colitis followed, in some cases, by hemolytic-uremic
syndrome and central nervous system complications (4, 25, 45, 51,
57). The mechanism of infection, however, remains unclear; thus,
preventive and therapeutic measures have not been established.
A complex intestinal microflora provides protection against
colonization by many pathogenic infectious agents (for reviews, see
references 8 and 60). Increased susceptibility to STEC infection due to treatment of mice with antibiotics can be explained by
disruption of the normal indigenous intestinal microflora (15, 27, 32, 59, 61). A hypothesis that foods fermented by lactobacilli help maintain a balance between lactobacilli and the
indigenous intestinal flora, originally proposed by Metchnikoff (33) as early as 1908, has been supported by many
investigators (3, 12, 41, 54), and probiotic
Lactobacillus strains have been shown to protect against
infection by pathogens such as Shigella sonnei (2,
35), Listeria monocytogenes (39, 52,
53), E. coli (40), Salmonella
enterica serovar Typhimurium (13, 16) and rotavirus
(20, 29).
In this study, by using newborn rabbits as an experimental infection
model, the protective effects of oral administration of probiotic
Lactobacillus casei strain Shirota (24) against STEC infection were investigated.
 |
MATERIALS AND METHODS |
Bacterial strain and growth conditions.
Clinically isolated
STEC O157:H7 strain 89020087, which produces both Stx1 and Stx2, was
used throughout. Cells were grown overnight in Casamino Acids-yeast
extract (CA-YE) broth (11) at 37°C. L. casei
strain Shirota is a stock culture of the Yakult Central Institute for
Microbiological Research and was grown overnight anaerobically at
37°C in De Man-Rogosa-Sharpe (MRS) broth (Difco Laboratories,
Detroit, Mich.) which had been purged of oxygen with nitrogen.
Animals.
Specific-pathogen-free Japanese White rabbits
(pregnant for 24 days) were purchased from Kitayama Rabesu Co. Ltd.,
Ina, Japan. After parturition, neonatal rabbits 1 day old were isolated
from their dams and housed in a clean isolator system with automatic control of temperature (25 ± 0.5°C), humidity (55% ± 5%),
and light conditions (14 h of light and 10 h of darkness) and were kept individually in polypropylene cages (CLEA Japan, Inc., Tokyo, Japan) with stainless steel lids and sterilized paper bedding (CLEA).
They were fed 20% pasteurized (65°C, 30 min) artificial milk for pet
(PetAg, Inc., Hampshire, Ill.) intragastrically by a soft
polyethylene catheter tube (Fuchigami Co., Kyoto, Japan) attached
to a 5-ml syringe twice a day throughout the experiment (1, 34,
36).
Preparation of bacterial suspension and inoculation of infant
rabbits.
After two passages in CA-YE broth, STEC was grown
overnight in CA-YE broth at 37°C on a shaker for 18 h and the
bacterial cells were washed once with saline by centrifugation. The
precipitating bacterial cells were then suspended and diluted with
saline to an optical density at 600nm (OD600) of 0.1 as
determined with a spectrophotometer (U-2001; Hitachi Co. Ltd., Tokyo,
Japan). This bacterial suspension was then diluted 104-fold
with saline to make a suspension of ~2 × 103
CFU/ml. An aliquot of 500 µl of the suspension was given orally to
infant rabbits by using the catheter tube described above. For exact
enumeration of an inoculum, this bacterial suspension was serially
diluted with phosphate-buffered saline (PBS) and plated on Trypticase
soybean agar plates (BBL Microbiology Systems, Cockeysville, Md.) and
incubated overnight at 37°C.
Preparation of milk supplemented with L. casei.
After
two passages in MRS broth at 37°C anaerobically, L. casei
strain Shirota was grown in MRS broth overnight and the culture was
centrifuged at 1,700 × g for 20 min (Kubota Co. Ltd.,
Tokyo, Japan). The bacterial pellet was resuspended in sterile
artificial milk to a concentration of 108 CFU/ml. For exact
enumeration of an inoculum, L. casei-supplemented milk was
serially diluted with PBS, plated on lactitol-LBS-vancomycin (LLV) agar
plates (66), and incubated aerobically for 48 h at 37°C. LLV agar contains the following (per liter): tryptic peptone (BBL), 10 g; yeast extract (Difco), 5 g;
KH2PO4, 6 g; triammonium citrate, 2 g; sodium acetate · 3H2O, 25 g;
MgSO4 · 7H2O, 0.58 g;
MnSO4 · 2H2O, 0.12 g;
FeSO4 · 7H2O, 0.034 g; Tween 80, 1 g; lactitol, 20 g; Bacto Agar (Difco), 15 g; vancomycin
hydrochloride (Sigma Chemical Co., St. Louis, Mo.), 10 mg. The pH of
the medium was adjusted to 6.1.
Experimental design.
Animals were divided into two groups.
One was fed sterilized artificial milk supplemented with L. casei strain Shirota at a concentration of 108 CFU/ml
(total number, 18), and the other was fed only sterilized artificial
milk (total number, 14). Feeding was carried out twice a day (10:00 am
and 6:00 pm), from day 1 after birth until the morning of the day the
animals turned 10 days old. Exactly the same amounts of the milk
preparations were given to the animals of both groups. The amounts were
as follows: 3.0 ml twice a day on days 1 and 2, 5 ml twice a day on
days 3 and 4, and 7.0 ml twice a day on days 5 and 6 and once in the
morning of day 7. When the animals became 3 days old, they were
individually inoculated with 0.5 ml of STEC suspension with a sterile
flexible polyethylene catheter tube. After infection, they were weighed
daily and checked for diarrhea until day 7 after infection. Diarrhea
was classified into the following severity groups: I, no diarrhea; II,
slight diarrhea (mixed soft and hard stools); III, mild diarrhea (feces stuck to perineum and hind legs); IV, severe diarrhea (feces stuck to
hind legs, wet tail, and prolapse of rectum).
On days 1, 4, and 7 after STEC inoculation, animals were sacrificed
under anesthesia with an intraperitoneal injection of sodium
pentobarbital (Dinabot Co., Ltd., Osaka, Japan) at a dose of 83 mg/kg
of body weight. One experiment was carried out for analysis on day 1 (three infants per group). Three experiments were carried out for
analysis on days 4 and 7 (11 infants in the control group and 15 infants in the L. casei-treated group). The gastrointestinal
tract was dissected in an aseptic manner for determinations of viable
STEC and L. casei counts, intestinal pH, and concentrations
of volatile fatty acids (VFA); Stx assay; titration of specific lgA
against Stx1, Stx2, and STEC intact cells, and histological
examinations. All experimental procedures were carried out in
accordance with the standards set forth in the Guide for
the Care and Use of Laboratory Animals (37).
Bacteriological examination.
The removed gastrointestinal
tracts were segmented into stomach, small intestine, cecum, and colon,
and each section was weighed and homogenized in 5 ml of ice-cold
saline. The suspension was centrifuged at 17,000 × g
for 15 min (Microfuge R; Beckman Instruments Inc., Palo Alto, Calif.),
and the pellet was washed once with PBS by centrifugation, resuspended
in PBS, and diluted 10-fold serially with PBS for evaluation of
bacterial CFU; 100-µl samples of the suspension were spread onto
sorbitol MacConkey agar plates (Eiken Chem. Co. Ltd., Tokyo, Japan) and
LLV agar plates for counting of STEC and L. casei strain
Shirota colonies, respectively. Sorbitol MacConkey agar plates and LLV
agar plates were incubated at 37°C overnight and for 48 h, respectively.
Gastrointestinal pH and concentrations of VFAs.
To examine
pH values and concentrations of VFAs in the gastrointestinal contents
of test animals, sections of gastrointestinal tracts were treated as
described above. After homogenization, samples were centrifuged at
1,700 × g for 30 min and supernatants were filtered
(pore size, 0.8 µm). The pH of filtrates was measured with a
hand-held pH meter (B-212; Horiba Ltd., Kyoto, Japan). For VFA
analysis, supernatants were mixed with 10% (vol/vol ratio, 9:1)
trichloroacetic acid, incubated overnight at 4°C, and centrifuged at
20,000 × g for 10 min. After filtration (pore size,
0.22 µm), samples were analyzed by high-pressure liquid
chromatography (TOA Electronics Ltd., Tokyo, Japan). The millimolar
concentration of lactic acid in an undissociated form was calculated by
the following formula: undissociated lactic acid = millimolar
total lactic acid/(1 + 10pH
pKa).
Stx assay.
Concentrations of Stx1 and Stx2 in intestinal
contents were assayed by a bead enzyme-linked immunosorbent assay
(ELISA) method described previously (42, 67). Briefly,
sections of gastrointestinal tracts were treated as described above.
After homogenization, samples were centrifuged at 1,700 × g for 30 min and the supernatants were filtered (pore size, 0.8 µm). The filtrates were diluted twofold with PBS supplemented with
2% bovine serum albumin (BSA; Nakalai Tesque Inc., Kyoto, Japan) and
0.02% NaN3. Solid-phase beads coated with rabbit
polyclonal lgG against purified Stx1 or Stx2 were added, and the
mixtures were incubated at 37°C for 1 h. After being washed
twice with PBS, the beads were incubated with goat anti-rabbit
lgG-Fab'-horseradish peroxidase (HRP) conjugate diluted in PBS
containing 2% BSA at 37°C for 1 h. After the beads had been
washed twice with PBS, the enzymatic activity of the HRP bound to the
beads was assayed by addition of 3, 3', 5, 5'-tetramethylbenzidine as a
substrate and the OD450 was measured with a
spectrophotometer. Stx concentrations in intestinal contents were
calculated relative to a standard curve of purified Stx1 or Stx2 and
expressed as nanograms per gram of tissue.
lgA assay.
Samples were prepared as described above.
Determination of lgA levels was performed as described by Keren et al.
(22) and MacQueen et al. (31). Briefly,
96-well polystyrene microtiter plates (Maxisorp; Nalge Nunc
International, Roskilde, Denmark) were coated with 100-µl portions of
purified Stx1 or Stx2 at a concentration of 2.5 µg/ml in carbonate
buffer (coating buffer), pH 9.6, or with a formalin-killed STEC
whole-cell suspension diluted with coating buffer to an
OD600 of 0.01. Purified Stx1 and Stx2 were prepared as
described previously (38, 43, 65). Intact STEC cells were
prepared as follows. STEC was cultured in CA-YE broth at 37°C for
18 h, washed twice with saline by centrifugation, suspended in
saline containing 0.5% neutralized formalin, stored at room
temperature for 3 days, and then washed three times with saline to
remove free Stxs. Plates were incubated overnight at 4°C in a moist
chamber to prevent evaporation. After incubation, wells were washed
three times with PBS containing 0.02% Tween 20 (PBST) to remove the
free Stx solution or STEC suspension. Wells were sequentially incubated
with samples, 1/500 goat anti-rabbit lgA (Nordic Immunological
Laboratories, Tilburg, The Netherlands) coupled to HRP, and finally a
2, 2'-azino+bis[3-ethylbenzthiazoline sulfonate (6)]
(ABTS) substrate (Sigma). Wells were washed with PBST three times
between incubations and reacted with PBST supplemented with 1% BSA at
37°C for 1 h before addition of the primary samples and before
addition of the secondary antibody conjugate to inhibit nonspecific
adherence. The OD405 of wells was measured in a microplate
reader (Inter Med Immunomini NJ-2300; Nalge Nunc International), and
results were expressed as OD405 units per gram of tissue.
The background OD405 for this ELISA was 0.2/g of tissue.
Histopathological examinations.
Segments of the ileum,
cecum, and distal colon were surgically removed, washed, and then fixed
in 4% buffered formalin, blocked in paraffin, and sectioned. Sections
were stained with hematoxylin and eosin, and examined under a
microscope for pathological changes such as exfoliation, necrosis,
edema, STEC cells attached to epithelial cells, and
pseudoeosinophil infiltration. In addition, immunohistochemical staining of STEC cells was performed using goat anti-E. coli
O157:H7 antibody (Kirkegaard & Perry Laboratories Inc., Gaithersburg, Md.), biotinylated rabbit anti-goat immunoglobulin, and 3, 3-diaminobenzidine in a chromogen solution (DAKO Japan, Kyoto, Japan).
Statistical examinations.
Statistical differences between
the control group and the L. casei-treated group were
evaluated with the cumulative chi-square test for the incidence of
diarrhea and with Student's t test for other benchmarks.
P < 0.05 was considered significant.
 |
RESULTS |
Clinical symptoms.
Most of the infected rabbits began to show
diarrhea within 3 days. No animal in either group developed bloody
diarrhea. By day 7 after infection, 77.3% of the rabbits in the
control group suffered from severe diarrhea whereas only 16.0% of the
rabbits in the L. casei-treated group showed severe diarrhea
(Table 1). On the whole, the severity of
diarrhea was less pronounced in the L. casei-treated group
than in the control group. L. casei did not delay the onset
of diarrhea. No clinical symptoms were observed in the group fed
L. casei alone (data not shown).
Colonization and distribution of STEC in the gastrointestinal
tract.
Viable STEC counts in the gastrointestinal tracts of mice
in the control group increased dramatically to
107~109 CFU/g of organ homogenate by
day 7 after infection (Fig.
1a). Although STEC
colonization levels in the L. casei-treated group were
similar to those in the control group by day 4 after infection, they
were approximately 100-fold lower than in the control group by day 7 after infection. Viable counts of L. casei in the
gastrointestinal tract were sustained at higher than 108
CFU/g of organ throughout the experimental period (Fig. 1b).

View larger version (41K):
[in this window]
[in a new window]
|
FIG. 1.
Viable counts of STEC O157:H7 strain 89020087 (a) and
L. casei (b) recovered from the gastrointestinal tract.
Control rabbits (hatched columns) were fed artificial milk only, and
L. casei-treated rabbits (white columns) were fed artificial
milk supplemented with L. casei. A total of
103 CFU of STEC strain 89020087 was fed to the rabbits, and
on day 1, 4, or 7 after infection, the rabbits were sacrificed and
regions of the gastrointestinal tract were removed and homogenized.
Viable counts of STEC (on days 4 and 7) and L. casei (on
days 1, 4, and 7) in each homogenate were assayed as described in
Materials and Methods. The bar at each point indicates the standard
error of the geometric mean number of CFU per gram of tissue. Three
rabbits from each group on day 1, 6 control and 7 L. casei-treated rabbits on day 4, and 11 control and 15 L. casei-treated rabbits on day 7 were tested. An asterisk indicates
a significant difference (P < 0.05) from the value for
the corresponding control group as calculated by Student's
t test.
|
|
pH and lactic acid concentration in the gastrointestinal
tract.
No differences in pH of the gastrointestinal contents on
day 7 after infection was observed between the control and
L. casei-treated groups (Table
2). In both groups, the pH of the stomach
contents was approximately 5.1 and was higher than 6.5 in other parts
of the intestine. Concentrations of lactic acid in the gastrointestinal tract were slightly higher in the L. casei-treated group
than in the control group (Table 2). In both groups, concentrations of
undissociated lactic acid in the gastrointestinal tract were less than
1.0 mM (data not shown).
Stx concentrations in the intestinal contents.
Concentrations
of both Stx1 and Stx2 in the cecum and colon in the control group
increased at day 4 after infection, and further significant increases
were observed at day 7. In contrast, Stx concentrations in the L. casei-treated group increased by day 4 after infection but
showed no further increase thereafter (Fig. 2). Stx concentrations in the small
intestine were quite low compared with those in the cecum and
colon in both groups.

View larger version (28K):
[in this window]
[in a new window]
|
FIG. 2.
Changes in concentrations of Stx1 (a) and Stx2 (b) in
the intestinal contents of control (hatched columns) and L. casei-treated (white columns) rabbits after STEC infection. A
total of 103 CFU of STEC strain 89020087 was given orally
to the rabbits. On day 1, 4, or 7 after infection, the rabbits were
sacrificed and portions of the gastrointestinal tract were removed and
homogenized. Concentrations of Stxs in each homogenate were assayed
with a bead ELISA as described in Materials and Methods. Three rabbits
from each group on day 1, 6 control and 7 L. casei-treated
rabbits on day 4, and 11 control and 15 L. casei-treated
rabbits on day 7 were tested. An asterisk indicates significant
difference (P < 0.05) from the value for the
corresponding control group as calculated by Student's t
test.
|
|
Specific IgA concentrations in the intestinal contents.
In the
small intestine, concentrations of IgA against Stx and STEC cells
remained low and no differences were observed between the control and
L. casei-treated groups (Fig.
3). In the colon, in contrast,
concentrations of IgAs against Stx1, Stx2, and intact STEC cells in the
L. casei-treated group increased approximately two-, four-,
and threefold, respectively, over those in the control group.

View larger version (25K):
[in this window]
[in a new window]
|
FIG. 3.
Changes in concentrations of IgAs against Stx1 (a), Stx2
(b), and STEC cells (c) in the intestinal contents of control (hatched
columns) and L. casei-treated (white columns) rabbits.
Concentrations of anti-Stx and anti-STEC bacterial cell surface antigen
IgA in each homogenate were assayed as described in Materials and
Methods. Three rabbits from both groups on day 1 after infection, 6 control and 7 L. casei-treated rabbits on day 4, and 8 control and 11 L. casei-treated rabbits on day 7 were
examined. An asterisk indicates significant difference (P < 0.05) from the value for the corresponding control group as
calculated by Student's t test.
|
|
Histopathology.
In the control group, STEC infection led to
vacuolation of epithelial cells (arrows) with attached STEC cells
(arrowhead) on top of the villi and necrosis due to massive growth of
STEC cells (asterisk) in the small intestine (Fig.
4A), exfoliation of epithelial cells
(large arrows), pseudoeosinophil infiltration (arrowheads),
and mitotic activity (small arrow) in the cecum (Fig. 4B), and
exfoliation and necrosis (arrow) in the colon due to STEC cells
attached to epithelial cells (arrowheads) (Fig. 4C). In contrast, no
notable pathological changes except for low mitotic activity in the
cecum and slight exfoliation of the epithelium in the colon were
observed in the L. casei-treated group (Fig. 4D to F).

View larger version (145K):
[in this window]
[in a new window]
|
FIG. 4.
Histopathological examination of intestinal segments of
infant rabbits infected with STEC O157:H7 strain 89020087 on day 7 after infection. Hematoxylin-and-eosin staining of the small intestine
(A, D), cecum (B, E), and colon (C, F) from a control rabbit (A to C)
and an L. casei-treated rabbit (D to F). (CI) Immunostaining
of STEC O157 in a colon section from a control rabbit. Magnifications
in both groups: small intestine ×260; cecum, ×390; colon, ×520. For
details, see the text.
|
|
 |
DISCUSSION |
A number of experimental animal models have been proposed to study
the pathogenicity of STEC (63), including gnotobiotic mice
(17, 18, 64), streptomycin-treated mice (15, 27, 32,
61, 62), gnotobiotic piglets (14, 59), newborn
chickens (5), and infant rabbits (26, 36, 44,
50). While mouse models have been used most frequently to date,
most are not appropriate because high doses of inoculum, more than
107 CFU/body, are usually required for establishment of
STEC infection, and often mice do not develop diarrhea even when they
are inoculated with such high doses of STEC (21, 23). On
the contrary, the rabbit model has the major advantages of the
reproducibility of diarrhea and susceptibility to STEC infection and
Stx toxicity (7, 26, 36, 44, 50, 55). In this study, we
used the infant rabbit model with administration of a lower number of
bacteria (~103 CFU/body) than reported previously
(36, 44, 50).
STEC infection in the infant rabbit model occurs reproducibly with an
inoculum as small as 103 CFU/body (Table 1). Concentrations
of Stxs in the gastrointestinal tract also increased in proportion to
the time (days) after infection (Fig. 2). Both the number of colonizing
bacteria and the concentration of Stxs were higher in the large
intestine than in the small intestine. In particular, the concentration
of Stx2 was significantly lower in the small intestine than in the
cecum and the colon. Histological studies also showed that damage to
the intestinal epithelium was more pronounced in the cecum and the
colon than in the small intestine (Fig. 4). These findings are in
agreement with the previously reported results that showed that the
major colonization site of STEC in rabbit is the large intestine rather
than the small intestine (36, 44, 50).
In rabbits administered L. casei strain Shirota, although
levels of STEC colonization increased to levels similar to those of the
control group by day 4 after infection, thereafter they remained
unchanged or even decreased 100-fold by day 7 (Fig. 1). Concentrations
of Stx1 and Stx2 were also lower in the L. casei-treated group, in parallel with decreased STEC colonization, compared with the
controls (Fig. 2). Stx2 levels, in particular, were significantly lower
in rabbits given L. casei in addition to STEC. The
differences in diarrhea severity (Table 1) and mucosal damage in the
intestines (Fig. 4) between the two groups was closely related to the
differences in STEC colonization and Stx levels in the gastrointestinal tract.
Probiotics, including lactobacilli, are known to produce short-chain
VFAs such as lactic acid (3, 12, 58). It has been reported
that VFAs possess potent bactericidal activity and that the
bactericidal activity of the organic acids depends mainly on their
undissociated form (6, 10). Undissociated organic acids
can permeate the cell membrane by diffusion and release protons in the
cell. The influx of protons is thought to induce acidification of the
cytoplasm and dissipate the membrane proton potential (
pH) (6,
9, 10). In a recent report, we demonstrated that L. casei strain Shirota exerts a bactericidal effect on STEC strains
during coculture and that this effect is dependent on the lactic acid
produced by L. casei during culture (M. Ogawa, K. Shimizu,
K. Nomoto, R. Tanaka, T. Hamabata, S. Yamasaki, T. Takeda, and Y. Takeda, submitted for publication). In this study, there were no
differences in the pH of the gastrointestinal contents between the
control and L. casei-treated groups (Table 2).
Concentrations of undissociated lactic acid in the gastrointestinal
tract were less than 1.0 mM in both groups (data not shown). We
previously showed that undissociated lactic acid at a concentration of
more than 3.2 mM is required to inhibit the growth of STEC strain
89020087 (Ogawa et al., submitted). These results suggest that lactic
acid produced by L. casei strain Shirota in the intestines
may not contribute to its inhibitory effect on STEC in the
gastrointestinal tract in infant rabbits.
It has been shown that probiotics, such as lactobacilli or
bifidobacteria, can enhance specific and total IgA secretion when used
as an oral adjuvant (19, 28, 30, 41, 49). Perdigon et al.
reported that L. casei had a protective effect on intestinal infections with S. enterica serovar Typhimurium and E. coli by enhancing the secretion of specific IgA (47,
48). In this study, secretion of specific IgA antibodies against
Stx1, Stx2, and STEC cells in the colon was enhanced locally by
L. casei administration by 4 days after infection (Fig. 3).
The most marked increase in the level of IgA was observed in the colon,
where high levels of Stxs were detected. It has been reported that when
antigens such as RDEC-1 (rabbit diarrheal E. coli) or Shiga
toxin are used to inoculate rabbits by the oral route, mucosal IgA
levels in the intestines increase within 7 days (22, 31,
56). The levels of IgA against Stxs and STEC cells in the colon
in the L. casei-treated rabbits increased over the same
period when STEC colonization and Stxs levels were reduced (days 4 to 7 after infection). It was also observed that levels of total IgA in the
colon were increased by the administration of L. casei
strain Shirota during STEC infection (data not shown). Paton et al.
reported that antibody specific to STEC cells, especially
lipopolysaccharide, inhibited the adherence of STEC to a human
intestinal epithelial cell line (46). Therefore, a local
increase in secretion of IgA, including specific IgA against Stxs and
STEC bacterial cell surface antigen, by administration of L. casei strain Shirota may lead to the elimination of STEC and thus
decrease the Stx concentration in the intestines.
In conclusion, the results obtained in this study suggest that
preventive administration of probiotic lactobacilli to infants may lead
to enhanced resistance to acute STEC infection due to acceleration of a
specific humoral immune response to STEC, as well as Stxs.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Yakult Central
Institute for Microbiological Research, 1796 Yaho, Kunitachi, Tokyo 186-8650, Japan. Phone: 81 (42) 577 8962. Fax: 81 (42) 577 3020. E-mail: koji-nomoto{at}yakult.co.jp.
Editor:
A. D. O'Brien
 |
REFERENCES |
| 1.
|
Akuzawa, M.,
N. Matsunuma, and Y. Suzuki.
1978.
Hand-rearing of rabbits using rabbit milk and commercial milk powder, Teo Milk.
Jikken Dobutsu
27:427-429[Medline].
|
| 2.
|
Apella, M. C.,
S. N. Gonzalez,
M. E. Nader de Macias,
N. Romero, and G. Oliver.
1992.
In vitro studies on the growth of Shigella sonnei by Lactobacillus casei and Lact. acidophilus.
J. Appl. Bacteriol.
73:480-483[Medline].
|
| 3.
|
Beck, C., and H. Necheles.
1961.
Beneficial effects of administration of Lactobacillus acidophilus in diarrhoeal and other intestinal disorders.
Am. J. Gastroenterol.
35:522-530[Medline].
|
| 4.
|
Bell, B. P.,
M. Goldoft,
P. M. Griffin,
M. A. Davis,
D. C. Gordon,
P. I. Tarr,
C. A. Bartleson,
J. H. Lewis,
T. J. Barrett,
J. G. Wells,
R. Baron, and J. Kobayashi.
1994.
A multistate outbreak of Escherichia coli O157:H7-associated bloody diarrhea and hemolytic uremic syndrome from hamburgers.
JAMA
272:1349-1353[Abstract].
|
| 5.
|
Berry, J. T.,
M. P. Doyle, and J. L. Schoeni.
1985.
Colonization of chicken cecae by Escherichia coli associated with hemorrhaghic colitis.
Infect. Immun.
49:310-315.
|
| 6.
|
Brocklehurst, T. F., and B. M. Lund.
1990.
The influence of pH, temperature and organic acids on the initiation of growth of Yersinia enterocolitica.
J. Appl. Bacteriol.
69:390-397[Medline].
|
| 7.
|
Cavanagh, J. B.,
J. G. Howard, and J. L. Whitby.
1956.
The neurotoxin of Shigella shigae: a comparative study of the effects produced in various laboratory animals.
Br. J. Exp. Pathol.
37:272-278[Medline].
|
| 8.
|
Clasener, H. A. L.,
E. J. Vollaard, and H. K. F. van Saene.
1987.
Long-term prophylaxis of infection by selective decontamination in leukopenia and in mechanical ventilation.
Rev. Infect. Dis.
9:295-328[Medline].
|
| 9.
|
Cramer, J. A., and J. H. Prestegard.
1977.
NMR studies of pH-induced transport of carboxylic acids across phospholipid vesicle membranes.
Biochem. Biophys. Res. Commun.
75:295-301[CrossRef][Medline].
|
| 10.
|
Eklund, T.
1983.
The antimicrobial effect of dissociated and undissociated sorbic acid at different pH levels.
J. Appl. Bacteriol.
54:383-389[Medline].
|
| 11.
|
Evans, D. J.,
D. G. Evans, and S. L. Gorbach.
1973.
Production of vascular permeability factor by enterotoxigenic Escherichia coli isolated from man.
Infect. Immun.
8:725-730[Abstract/Free Full Text].
|
| 12.
|
Feresu, S., and H. Nyati.
1990.
Fate of pathogenic and non-pathogenic Escherichia coli strains in two fermented milk products.
J. Appl. Bacteriol.
69:814-821[Medline].
|
| 13.
|
Fichera, G. A.,
C. Pappalardo,
P. M. Furneri,
M. R. Gismondo, and G. Nicoletti.
1987.
Evaluation of antiinfective activity of an association Bifidobacterium/Lactobacillus in mouse intestine.
G. Batteriol. Virol. Immunol.
80:189-205.
|
| 14.
|
Francis, D. H.,
R. A. Moxley, and C. Y. Andraos.
1989.
Edema disease-like brain lesions in gnotobiotic piglets infected with Escherichia coli serotype O157:H7.
Infect. Immun.
57:1339-1342[Abstract/Free Full Text].
|
| 15.
|
Fujii, J.,
T. Kita,
S. I. Yoshida,
T. Takeda,
H. Kobayashi,
N. Tanaka,
K. Ohsato, and Y. Mizuguchi.
1994.
Direct evidence of neuron impairment by oral infection with verotoxin-producing Escherichia coli O157:H in mitomycin-treated mice.
Infect. Immun.
62:3447-3453[Abstract/Free Full Text].
|
| 16.
|
Hudault, S.,
V. Lievin,
M. F. Bernet-Camard, and A. L. Servin.
1997.
Antagonistic activity exerted in vitro and in vivo by Lactobacillus casei (strain GG) against Salmonella typhimurium C5 infection.
Appl. Environ. Microbiol.
63:513-518[Abstract].
|
| 17.
|
Isogai, E.,
H. Isogai,
K. Takeshi, and T. Nishikawa.
1998.
Protective effect of Japanese green tea extract on gnotobiotic mice infected with an Escherichia coli O157:H7 strain.
Microbiol. Immunol.
42:125-128[Medline].
|
| 18.
|
Isogai, E.,
H. Isogai,
K. Kimura,
S. Hayashi,
T. Kubota,
N. Fujii, and K. Takeshi.
1998.
Role of tumor necrosis factor alpha in gnotobiotic mice infected with an Escherichia coli O157:H7 strain.
Infect. Immun.
66:197-202[Abstract/Free Full Text].
|
| 19.
|
Kaila, M.,
E. Isolauri,
E. Soppi,
E. Virtanen,
S. Laine, and H. Arvilommi.
1992.
Enhancement of the circulating antibody secreting cell response in human diarrhea by a human Lactobacillus strain.
Pediatr. Res.
32:141-144[Medline].
|
| 20.
|
Kaila, M.,
E. Isolauri,
M. Saxelin,
H. Arvilommi, and T. Vesikari.
1995.
Viable versus inactivated Lactobacillus strain GG in acute rotavirus diarrhoea.
Arch. Dis. Child.
72:51-53[Abstract].
|
| 21.
|
Karpman, D.,
H. Connell,
M. Svensson,
F. Scheutz,
P. Alm, and C. Svanborg.
1997.
The role of lipopolysaccharide and Shiga-like toxin in a mouse model of Escherichia coli O157:H7 infection.
J. Infect. Dis.
175:611-620[Medline].
|
| 22.
|
Keren, D. F.,
J. E. Brown,
R. A. McDonald, and J. S. Wassef.
1989.
Secretory immunoglobulin A response to Shiga toxin in rabbits: kinetics of the initial mucosal immune response and inhibition of toxicity in vitro and in vivo.
Infect. Immun.
57:1885-1889[Abstract/Free Full Text].
|
| 23.
|
Kurioka, T.,
Y. Yunou, and E. Kita.
1998.
Enhancement of susceptibility to Shiga toxin-producing Escherichia coli O157:H7 by protein calorie malnutrition in mice.
Infect. Immun.
66:1726-1734[Abstract/Free Full Text].
|
| 24.
|
Lee, Y. K.,
K. Nomoto,
S. Salminen, and S. L. Gorbach.
1999.
Role of probiotics in health and diseases, p. 67-146.
In
Y. K. Lee, K. Nomoto, S. Salminen, and S. L. Gorbach (ed.), Handbook of probiotics. John Wiley & Sons, Inc., New York, N.Y.
|
| 25.
|
Levin, M.
1987.
Escherichia coli that cause diarrhea: enterotoxigenic, enteropathogenic, enteroinvasive, enterohemorrhagic, and enteroadherent.
J. Infect. Dis.
155:377-389[Medline].
|
| 26.
|
Li, Z.,
C. Bell,
A. Buret,
R. Robins-Browne,
D. Stiel,
E. O'Loughlin,
C. M. Rademaker,
L. Martinez,
E. J. Perea,
M. Jansze,
A. C. Fluit,
J. H. Glerum, and J. Verhoef.
1993.
The effect of enterohemorrhagic Escherichia coli O157:H7 on intestinal structure and solute transport in rabbits.
Gastroenterology
104:467-474[Medline].
|
| 27.
|
Lindgren, S. W.,
A. R. Melton, and A. D. O'Brien.
1993.
Virulence of enterohemorrhagic Escherichia coli O91:H21 clinical isolates in an orally infected mouse model.
Infect. Immun.
61:3832-3842[Abstract/Free Full Text].
|
| 28.
|
Link-Amster, H.,
F. Rochat,
K. Y. Saudan,
O. Mignot, and J. M. Aeschlimann.
1994.
Modulation of a specific humoral immune response and changes in intestinal flora mediated through fermented milk intake.
FEMS Immunol. Med. Microbiol.
10:55-63[CrossRef][Medline].
|
| 29.
|
Majamaa, H.,
E. Isolauri,
M. Saxelin, and T. Vesikari.
1995.
Lactic acid bacteria in the treatment of acute rotavirus gastroenteritis.
J. Pediatr. Gastroenterol. Nutr.
20:333-338[Medline].
|
| 30.
|
Malin, M.,
H. Suomalainen,
M. Saxelin, and E. Isolauri.
1996.
Promotion of IgA immune response in patients with Crohn's disease by oral bacteriotherapy with Lactobacillus GG.
Ann. Nutr. Metab.
40:137-145[Medline].
|
| 31.
|
McQueen, C. E.,
E. C. Boedeker,
M. Le,
Y. Hamada, and W. R. Brown.
1992.
Mucosal immune response to RDEC-1 infection: study of lamina propria antibody-producing cells and biliary antibody.
Infect. Immun.
60:206-212[Abstract/Free Full Text].
|
| 32.
|
Melton-Celsa, A. R.,
S. C. Darnell, and A. D. O'Brien.
1996.
Activation of Shiga-like toxins by mouse and human intestinal mucus correlates with virulence of enterohemorrhagic Escherichia coli O91:H21 isolates in orally infected, streptomycin-treated mice.
Infect. Immun.
64:1569-1576[Abstract].
|
| 33.
|
Metchnikoff, E.
1908.
The prolongation of life.
G. P. Putnam's Sons, New York, N.Y.
|
| 34.
|
Myers, L. L.,
D. S. Shoop,
J. E. Collins, and W. C. Bradbury.
1989.
Diarrheal disease caused by enterotoxigenic Bacteroides fragilis in infant rabbits.
J. Clin. Microbiol.
27:2025-2030[Abstract/Free Full Text].
|
| 35.
|
Nader de Macias, M. E.,
M. C. Apella,
N. C. Romero,
S. N. Gonzalez, and G. Oliver.
1992.
Inhibition of Shigella sonnei by Lactobacillus casei and Lact. acidophilus.
J. Appl. Bacteriol.
73:407-411[Medline].
|
| 36.
|
Nakazawa, M., and K. Itoh.
1995.
Experimental infection of infant rabbits with verocytotoxin-producing Escherichia coli of bovine origin.
Jap. J. Infect. Dis.
69:772-776.
|
| 37.
|
National Institutes of Health.
1985.
Guide for the care and use of laboratory animals. National Institutes of Health publication no. 85-23.
National Institutes of Health, Bethesda, Md.
|
| 38.
|
Noda, M.,
T. Yutsudo,
N. Nakabayashi,
T. Hirayama, and Y. Takeda.
1987.
Purification and some properties of Shiga-like toxin from Escherichia coli O157:H7 that is immunologically identical to Shiga toxin.
Microb. Pathog.
2:339-349[CrossRef][Medline].
|
| 39.
|
Nomoto, K.,
S. Miake,
S. Hashimoto,
T. Yokokura,
M. Mutai, and Y. Yoshikai.
1985.
Augmentation of host resistance to Listeria monocytogenes infection by Lactobacillus casei.
J. Clin. Lab. Immunol.
17:91-97[Medline].
|
| 40.
|
Nomoto, K.,
T. Yokokura,
M. Mitsuyama, and Y. Yoshikai.
1992.
Prevention of indigenous infection of mice with Escherichia coli by nonspecific immunostimulation.
Antimicrob. Agents Chemother.
36:361-367[Abstract/Free Full Text].
|
| 41.
|
Norton, P. M.,
H. W. Brown, and R. W. Le Page.
1995.
Mucosal and systemic responses following enteric exposure to lactic acid bacteria.
Adv. Exp. Med. Biol.
371b:1559-1562.
|
| 42.
|
Oku, Y.,
Y. Uesaka,
T. Hirayama, and Y. Takeda.
1988.
Development of a highly sensitive bead-ELISA to detect bacterial protein toxins.
Microbiol. Immunol.
32:807-816[Medline].
|
| 43.
|
Oku, Y.,
T. Yutsudo,
T. Hirayama,
A. D. O'Brien, and Y. Takeda.
1989.
Purification and some properties of a Vero toxin from a human strain of Escherichia coli that is immunologically related to Shiga-like toxin II (VT2).
Microb. Pathog.
6:113-122[CrossRef][Medline].
|
| 44.
|
Pai, C. H.,
J. K. Kelly, and G. L. Meyers.
1986.
Experimental infection of infant rabbits with verotoxin-producing Escherichia coli.
Infect. Immun.
51:16-23[Abstract/Free Full Text].
|
| 45.
|
Paton, A. W.,
R. M. Ratcliff,
R. M. Doyle,
J. Seymour-Murray,
D. Davos,
J. A. Lanser, and J. C. Paton.
1996.
Molecular microbiological investigation of an outbreak of hemolytic-uremic syndrome caused by dry fermented sausage contaminated with Shiga-like toxin-producing Escherichia coli.
J. Clin. Microbiol.
34:1622-1627[Abstract].
|
| 46.
|
Paton, A. W.,
E. Voss,
P. A. Manning, and J. C. Paton.
1998.
Antibodies to lipopolysaccharide block adherence of Shiga toxin-producing Escherichia coli to human intestinal epithelial (Henle 407) cells.
Microb. Pathog.
24:57-63[CrossRef][Medline].
|
| 47.
|
Perdigon, G.,
M. E. Nader de Macias,
S. Alvarez,
G. Oliver, and A. A. Pesce de Ruiz Holgado.
1990.
Prevention of gastrointestinal infection using immunobiological methods with milk fermented with Lactobacillus casei and Lactobacillus acidophilus.
J. Dairy Res.
57:255-264[Medline].
|
| 48.
|
Perdigon, G.,
S. Alvarez, and A. Pesce de Ruiz Holgado.
1991.
Immunoadjuvant activity of oral Lactobacillus casei: influence of dose on the secretory immune response and protective capacity in intestinal infections.
J. Dairy Res.
58:485-496[Medline].
|
| 49.
|
Perdigon, G.,
S. Alvarez,
M. Rachid,
G. Aguero, and N. Gobbato.
1995.
Immune system stimulation by probiotics.
J. Dairy Sci.
78:1597-1606[Abstract].
|
| 50.
|
Potter, M. E.,
A. F. Kaufmann,
B. M. Thomason,
P. A. Blake, and J. J. Farmer, III.
1985.
Diarrhea due to Escherichia coli O157:H7 in the infant rabbit.
J. Infect. Dis.
152:1341-1343[Medline].
|
| 51.
|
Rowe, P. C.,
E. Orrbine,
H. Lior,
G. A. Wells,
E. Yertisir,
M. Clulow, and P. N. McLaine.
1998.
Risk of hemolytic uremic syndrome after sporadic Escherichia coli 0157:H7 infection: results of a Canadian collaborative study. Investigators of the Canadian Pediatric Kidney Disease Research Center.
J. Pediatr.
132:777-782[CrossRef][Medline].
|
| 52.
|
Sato, K.
1984.
Enhancement of host resistance against Listeria infection by Lactobacillus casei: role of macrophages.
Infect. Immun.
44:445-451[Abstract/Free Full Text].
|
| 53.
|
Sato, K.,
H. Saito, and H. Tomioka.
1988.
Enhancement of host resistance against Listeria infection by Lactobacillus casei: activation of liver macrophages and peritoneal macrophages by Lactobacillus casei.
Microbiol. Immunol.
32:689-698[Medline].
|
| 54.
|
Shornikova, A. V.,
I. A. Casas,
E. Isolauri,
H. Mykkanen, and T. Vesikari.
1997.
Lactobacillus reuteri as a therapeutic agent in acute diarrhea in young children.
J. Pediatr. Gastroenterol. Nutr.
24:399-404[CrossRef][Medline].
|
| 55.
|
Sjogren, R.,
R. Neill,
D. Rachmilewitz,
D. Fritz,
J. Newland,
D. Sharpnack,
C. Colleton,
J. Fondacaro,
P. Gemski, and E. Boedeker.
1994.
Role of Shiga-like toxin I in bacterial enteritis: Comparison between isogenic Escherichia coli strains induced in rabbits.
Gastroenterology.
106:306-317[Medline].
|
| 56.
|
Smith, J. W.,
W. L. Hand, and J. P. Sanford.
1971.
Synthesis and secretion of local immunoglobulin by the intestinal tract of newborn rabbits.
J. Infect. Dis.
124:494-498[Medline].
|
| 57.
|
Tarr, P. I.
1995.
Escherichia coli O157:H7: clinical, diagnostic, and epidemiological aspects of human infection.
Clin. Infect. Dis.
20:1-8[Medline].
|
| 58.
|
Trammer, J.
1966.
Inhibitory effect of Lactobacillus acidophilus.
Nature
211:204-205[CrossRef][Medline].
|
| 59.
|
Tzipori, S.,
I. K. Wachsmuth,
C. Chapman,
R. Birden,
J. Brittingham,
C. Jackson, and J. Hogg.
1986.
The pathogenesis of hemorrhagic colitis caused by Escherichia coli O157:H7 in gnotobiotic piglets.
J. Infect. Dis.
154:712-716[Medline].
|
| 60.
|
Vollaard, E. J., and H. A. Clasener.
1994.
Colonization resistance.
Antimicrob. Agents Chemother.
38:409-414[Free Full Text].
|
| 61.
|
Wadolkowski, E. A.,
J. A. Burris, and A. D. O'Brien.
1990.
Mouse model for colonization and disease caused by enterohemorrhagic Escherichia coli O157:H7.
Infect. Immun.
58:2438-2445[Abstract/Free Full Text].
|
| 62.
|
Wadolkowski, E. A.,
L. M. Sung,
J. A. Burris,
J. E. Samuel, and A. D. O'Brien.
1990.
Acute renal tubular necrosis and death of mice orally infected with Escherichia coli strains that produce Shiga-like toxin type II.
Infect. Immun.
58:3959-3965[Abstract/Free Full Text].
|
| 63.
|
Whipp, S. C.,
M. A. Rasmussen, and W. C. Cray, Jr.
1994.
Animals as a source of Escherichia coli pathogenic for human beings.
J. Am. Vet. Med. Assoc.
204:1168-1175[Medline].
|
| 64.
|
Xin-He, L.,
J.-G. Xu, and B.-Y. Liu.
1991.
Experimental infection of specific-pathogen-free mice with enterohemorrhagic Escherichia coli O157:H7.
Microbiol. Immunol.
35:515-524[Medline].
|
| 65.
|
Yamasaki, S.,
Z. Lin,
H. Shirai,
A. Terai,
Y. Oku,
H. Ito,
M. Ohmura,
T. Karasawa,
T. Tsukamoto,
H. Kurazono, and Y. Takeda.
1996.
Typing of verotoxins by DNA colony hybridization with poly- and oligonucleotide probes, a bead-enzyme-linked immunosorbent assay, and polymerase chain reaction.
Microbiol. Immunol.
40:345-352[Medline].
|
| 66.
|
Yuki, N.,
K. Watanabe,
A. Mike,
Y. Tagami,
R. Tanaka,
M. Ohwaki, and M. Morotomi.
1999.
Survival of a probiotic, Lactobacillus casei strain Shirota, in the gastrointestinal tract: selective isolation from feces and identification using monoclonal antibodies.
Int. J. Food Microbiol.
48:51-57[CrossRef][Medline].
|
| 67.
|
Yutsudo, T.,
N. Nakabayashi,
T. Hirayama, and Y. Takeda.
1987.
Purification and some properties of a Vero toxin from Escherichia coli O157:H7 that is immunologically unrelated to Shiga toxin.
Microb. Pathog.
3:21-30[CrossRef][Medline].
|
Infection and Immunity, February 2001, p. 1101-1108, Vol. 69, No. 2
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.2.1101-1108.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
This article has been cited by other articles:
-
Lievin-Le Moal, V., Servin, A. L.
(2006). The Front Line of Enteric Host Defense against Unwelcome Intrusion of Harmful Microorganisms: Mucins, Antimicrobial Peptides, and Microbiota. Clin. Microbiol. Rev.
19: 315-337
[Abstract]
[Full Text]
-
Fayol-Messaoudi, D., Berger, C. N., Coconnier-Polter, M.-H., Lievin-Le Moal, V., Servin, A. L.
(2005). pH-, Lactic Acid-, and Non-Lactic Acid-Dependent Activities of Probiotic Lactobacilli against Salmonella enterica Serovar Typhimurium. Appl. Environ. Microbiol.
71: 6008-6013
[Abstract]
[Full Text]
-
Sherman, P. M., Johnson-Henry, K. C., Yeung, H. P., Ngo, P. S. C., Goulet, J., Tompkins, T. A.
(2005). Probiotics Reduce Enterohemorrhagic Escherichia coli O157:H7- and Enteropathogenic E. coli O127:H6-Induced Changes in Polarized T84 Epithelial Cell Monolayers by Reducing Bacterial Adhesion and Cytoskeletal Rearrangements. Infect. Immun.
73: 5183-5188
[Abstract]
[Full Text]
-
Ritchie, J. M., Waldor, M. K.
(2005). The Locus of Enterocyte Effacement-Encoded Effector Proteins All Promote Enterohemorrhagic Escherichia coli Pathogenicity in Infant Rabbits. Infect. Immun.
73: 1466-1474
[Abstract]
[Full Text]
-
LeBlanc, J., Fliss, I., Matar, C.
(2004). Induction of a Humoral Immune Response following an Escherichia coli O157:H7 Infection with an Immunomodulatory Peptidic Fraction Derived from Lactobacillus helveticus-Fermented Milk. CVI
11: 1171-1181
[Abstract]
[Full Text]
-
Sgouras, D., Maragkoudakis, P., Petraki, K., Martinez-Gonzalez, B., Eriotou, E., Michopoulos, S., Kalantzopoulos, G., Tsakalidou, E., Mentis, A.
(2004). In Vitro and In Vivo Inhibition of Helicobacter pylori by Lactobacillus casei Strain Shirota. Appl. Environ. Microbiol.
70: 518-526
[Abstract]
[Full Text]
-
Mizoguchi, K., Morita, M., Fischer, C. R., Yoichi, M., Tanji, Y., Unno, H.
(2003). Coevolution of Bacteriophage PP01 and Escherichia coli O157:H7 in Continuous Culture. Appl. Environ. Microbiol.
69: 170-176
[Abstract]
[Full Text]
-
Stevens, M. P., van Diemen, P. M., Dziva, F., Jones, P. W., Wallis, T. S.
(2002). Options for the control of enterohaemorrhagic Escherichia coli in ruminants. Microbiology
148: 3767-3778
[Full Text]
-
Asahara, T., Nomoto, K., Watanuki, M., Yokokura, T.
(2001). Antimicrobial Activity of Intraurethrally Administered Probiotic Lactobacillus casei in a Murine Model of Escherichia coli Urinary Tract Infection. Antimicrob. Agents Chemother.
45: 1751-1760
[Abstract]
[Full Text]