Importance of colicinogeny for the course of acute bacillary dysentery.

The development of acute bacillary dysentery was followed in 23 patients involved in two outbreaks and in three sporadic, mutually unrelated cases. Repeated cultivations performed at 2-day intervals for 10 days yielded 386 identifiable strains of "opportune intestinal flora". Escherichia coli colicinogenic activity is one of the significant factors of gastrointestinal tract protection. The period of shigella excretion is significantly reduced (p less than 0.02) if an appropriate colicinogenic E. coli strain is present. Analysis of the results suggested a working hypothesis of differentiated approach to bacillary dysentery treatment in outbreaks. In the absence of a suitable colicinogenic flora neomycin therapy should be administered since it does not damage the natural colonizing flora (bacteroids, bifidobacters, aerobic lactobacilli); in the presence of a suitable colicinogenic flora, no antibiotic should be used as this would abolish the coli-flora.