In vitro susceptibility of Escherichia coli O157 to several antimicrobial agents.

We evaluated the antimicrobial susceptibility of six strains of Escherichia coli O157 (E. coli O157) isolated from patients in Yamaguchi Prefecture between June and July, 1996. Seven antimicrobial agents that were expected to retain a high concentration in the intestine were selected. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of ciprofloxacin, polymyxin B, cefoperazone, and kanamycin for each strain were < or = 6.25 microg/ml. However, the MIC of fosfomycin was 3.13-100 microg/ml, and its MBC was > or = 100 microg/ml. The MIC of ampicillin and tetracycline was > 100 mcirog/ml in some strains. In a time-kill study of E. coli O157 at a drug concentration of 12.5 microg/ml, about 10(4) colony forming units/ml of E. coli O157 were eradicated within 10 min by ciprofloxacin, within 30 min by polymyxin B, within 4 h by cefoperazone, and within 16 h by kanamycin. These results suggest that the new quinolones with a poor absorption rate in the intestine (such as ciprofloxacin and norfloxacin) are effective against E. coli O157. When oral administration is impossible, bile excreting cephem antibiotics (such as cefoperazone, ceftriaxone, and cefotetan) may be useful.