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Crohn's E. coli strain LF82 relies on SOS and stringent responses to tolerate antibiotics within macrophages.

The Crohn’s disease-associated Escherichia coli strain LF82 relies on SOS and stringent responses to survive, multiply and tolerate antibiotics within macrophages.

PSL Research University Paris, France
Université Clermont Auvergne, France

November 14, 2019

Gaëlle Demarre ,Victoria Prudent ,Hanna Schenk,Emilie Rousseau,Marie-Agnès Bringer,Nicolas Barnich,Guy Tran Van Nhieu,Sylvie Rimsky,Silvia De Monte,Olivier Espéli

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The question why they actively colonize macrophages in the first place is intersting. Most bacteria are taken up by macrophages when the enter tissue and the lamina propria, but they don't have a niche that involves actively colonizing the macrophage itself.

They suggest AIEC use macrophages as a temporary storage, to avoid the compeition with other bacteria....I assume they are referring to lumen bacteria that would compete with AIEC for nutrients...and they avoid the stresses from non-macrophage penetrating antibiotics.

AIEC actively entering tissue macrophages for their own survival, helps explain why trying to modulate the microbiome (with for example probiotics) seems so useless in studies.
 
Cipro has the highest remission rates of all commonly used anitbiotics in crohn's disease patients.

Cipro and rifaximin are both effective to treat gram neg E coli infections, but only cipro is able to penetrate the activated macrophage in tissue.

Yet AIEC can quickly build up resistance to these antibiotics, which limits their use in crohn's disease. Relapse is frequent.

Only bacteriophages or Fim-H blockers are solutions.


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Gastros are much too careless when prescribing antibiotics for extraintestinal manifestations and infections in crohn's disease patients.

We have established crohn's disease as an immunodeficiency disease and enterobacteriaceae, AIEC and fungi are actively involved in perpetuating and maintaining the inflammation.

You can not just prescribe antibiotics to crohn's disease patients without taking into account that crohn's disease patients are dealing with a chronic infection of intestinal and highly resistant bacteria chronically invading the intestinal wall.
 
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