Mice that had been treated with cyclophosphamide and ampicillin were fed with . These procedures induced an endogenous septicaemia under conditions mimicking the pathophysiology of the disease in man. This model was used to compare the mortality rates in mice infected with isolates from various clinical sources. Mortality rates in mice given isolates from blood cultures had a broad range (0–100%), but the mean rate was significantly higher than with isolates from other infection sites. Moreover, blood isolates persisted in the intestines of mice after oral inoculation, whereas most isolates from other sources were gradually eliminated. Most isolates from blood culture produced significantly higher levels of exotoxin A and total proteases than isolates from other infection sites. Amongst the blood isolates, all but one of the lethal strains produced large quantities of exotoxin A or total proteases or both. Taken together, the results suggest that the ability of to adhere to the intestinal tract and to produce high levels of exo-enzymes may contribute to the development of fatal septicaemia.


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