Bacteriophages as an Alternative Method for Control of Zoonotic and Foodborne Pathogens.

The global increase in multidrug-resistant infections caused by various pathogens has raised concerns in human and veterinary medicine. This has renewed interest in the development of alternative methods to antibiotics, including the use of bacteriophages for controlling bacterial infections. The aim of this review is to present potential uses of bacteriophages as an alternative to antibiotics in the control of bacterial infections caused by multidrug-resistant bacteria posing a risk to humans, with particular emphasis on foodborne and zoonotic pathogens. A varied therapeutic and immunomodulatory (activation or suppression) effect of bacteriophages on humoral and cellular immune response mechanisms has been demonstrated. The antibiotic resistance crisis caused by global antimicrobial resistance among bacteria creates a compelling need for alternative safe and selectively effective antibacterial agents. Bacteriophages have many properties indicating their potential suitability as therapeutic and/or prophylactic agents. In many cases, bacteriophages can also be used in food quality control against microorganisms such as Salmonella, Escherichia coli, Listeria, Campylobacter and others. Future research will provide potential alternative solutions using bacteriophages to treat infections caused by multidrug-resistant bacteria.

Disseminated septic arthritis caused by Streptococcus equi infection.

We describe a rare case of bloodstream infection and disseminated septic arthritis in a relatively fit and well 73-year-old retired farmer and gamekeeper, due to the zoonotic organism Streptococcus equi The presence of the organism in multiple joints led to slow clinical response to treatment and was complicated by relapse of infection and lengthy disability. Source control was achieved with multiple joint washouts and spinal cord decompression. Following this, a 6-week course of intravenous antibiotics was required for complete clearance of infection. After a long period of rehabilitation, the patient made a good recovery. This case demonstrates that S. equi can cause life threatening and difficult to treat sepsis in humans and requires a high index of suspicion in people who have regular contact with equine species, cattle and unpasteurised milk.

Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review.

The severity of human infection by one of the many Shiga toxin-producing Escherichia coli (STEC) is determined by a number of factors: the bacterial genome, the capacity of human societies to prevent foodborne epidemics, the medical condition of infected patients (in particular their hydration status, often compromised by severe diarrhea), and by our capacity to devise new therapeutic approaches, most specifically to combat the bacterial virulence factors, as opposed to our current strategies that essentially aim to palliate organ deficiencies. The last major outbreak in 2011 in Germany, which killed more than 50 people in Europe, was evidence that an effective treatment was still lacking. Herein, we review the current knowledge of STEC virulence, how societies organize the prevention of human disease, and how physicians treat (and, hopefully, will treat) its potentially fatal complications. In particular, we focus on STEC-induced hemolytic and uremic syndrome (HUS), where the intrusion of toxins inside endothelial cells results in massive cell death, activation of the coagulation within capillaries, and eventually organ failure.