Infect Control Hosp Epidemiol, 1997 Feb, 18(2), 115 - 21 A mixed foodborne outbreak with Salmonella heidelberg and Campylobacter jejuni in a nursing home; Layton MC et al.; OBJECTIVE: To investigate a mixed Salmonella heidelberg and Campylobacter jejuni foodborne outbreak in a nursing home . DESIGN: Retrospective cohort study with a nested case-control design . Cases were defined by positive stool-culture results . Controls needed to be both asymptomatic and culture-negative . SETTING AND PATIENTS: Residents of a 580-bed nursing home in Brooklyn, New York . RESULTS: Of the 580 residents, 119 (21%) developed illness . Of the 93 symptomatic patients who submitted specimens, cultures were positive for S heidelberg in 24 (26%), C jejuni in 14 (15%), and both microorganisms in 25 (27%) . Only the pureed diet was associated highly with infection by either Salmonella (odds ratio {OR}, 17.6; 95% confidence interval {CI95}, 4.8-68.7; P < .001), Campylobacter (OR, 13.3; CI95, 3.2-59.2; P < .001), or both organisms (OR, 8.9; CI95, 2.7-30.3; P < .001) . Among the 42 pureed foods served during the 5 days before the outbreak, five meat or poultry items were associated most strongly with culture positivity . Of these five meat items, only a chopped-liver salad was implicated by the two employees reporting illness . A reported food-handling error occurred when ground, cooked chicken livers were placed in a bowl containing raw chicken-liver juices . INTERVENTION: Recommendations for proper cleaning and sanitizing of kitchen equipment to prevent cross-contamination between raw and cooked foods . CONCLUSIONS: Mixed foodborne outbreaks occur rarely . During this outbreak, contamination of a single food item with multiple bacterial pathogens was the likely source of transmission . Improper food-handling techniques that promote growth of one microorganism also allow growth of other pathogens that may be present . Because different sources and routes of transmission may be implicated for different pathogens, specific preventive measures may vary depending on the organisms involved. APMIS, 1997 Feb, 105(2), 157 - 60 Feasibility of Helicobacter pylori identification by a slide agglutination test; Maeland JA et al.; Culture isolation and identification of Helicobacter pylori represents a considerable work load in clinical microbiology . The aim of this study was to test if antibody-mediated bacterial agglutination could be used for rapid identification of H . pylori . Rabbit antiserum against H . pylori strain I and against another strain, H . pylori 330, which was very weakly agglutinated (1+) by anti-H . pylori I serum, were mixed and used in a slide agglutination test . Of 107 consecutive clinical isolates tested, 101 (94%) strains showed 2+ or 3+ reaction using the antiserum mixture, whereas 6 (6%) strains could not be evaluated owing to autoagglutinability . Bacteria of a variety of other species, including Campylobacter spp., showed no agglutination with the antiserum mixture . The results support the notion that reliable identification of the majority of cultured H . pylori strains should be possible in less than 3 min by agglutination testing. Jpn J Antibiot, 1997 Feb, 50(2), 200 - 5 {Pharmacokinetic, bacteriological and clinical studies on azithromycin in children}; Tajima T et al.; Azithromycin (AZM) in fine granules was studied for its pharmacokinetics and clinical efficacies in eight child patients with ages between 1 month and 8 years . Informed consent was received from all of their parents . AZM was administered to the patients once a day at a dose of 10 mg/kg for 3 days . The clinical efficacies of AZM in 8 patients with microbial infections (pneumonia in one, Mycoplasma pneumonia in two, acute tonsillitis in one, pertussis in one, Campylobacter enteritis in one, infectious enteritis in one, Salmonella enteritis in one) were evaluated as "excellent" in five cases, "good" in two and "not evaluable" in one . As for the microbial efficacy, isolated strains were eradicated in 2 out of 3 patients . No adverse reaction was found except for one case with abnormal laboratory change, that is mildly increased GPT value . Plasma samples were collected from 3 cases . The elimination half-life of AZM was 45.8 hours . AUC0-infinity was 12.6 micrograms.hr/ml . Urine sample was collected from one . AZM concentration in urine was 35.0 micrograms/ml during a period between 48 and 72 hours after the start of treatment. Pediatr Neurol, 1997 Feb, 16(2), 149 - 51 Cranial polyneuropathy with elevated serum antiganglioside antibody; Matsubara K et al.; We report a 6-year-old girl with cranial polyneuropathy with elevated serum levels of antiganglioside antibodies . She manifested herpetic vesicles around the right upper eyelid and mouth without antecedent infection . She developed facial asymmetry and double vision 5 days after the first appearance of the vesicles . Neurological examination on admission disclosed palsies of the bilateral sixth and twelfth cranial nerves and right third and seventh cranial nerves, but limb muscle weakness, ataxia, and areflexia were not observed . Cerebrospinal fluid examination and MRI of the brain showed no abnormalities . Serum antibodies to gangliosides GQ1b and GT1b, but not GM1, and those to Campylobacter jejuni were significantly increased on admission and on the hospital day 14 . These observations suggest that the present case is a variant form of Miller Fisher syndrome or Bickerstaff's brainstem encephalitis subsequent to asymptomatic C . jejuni infection . We treated her with intravenous administration of high-dose methylprednisolone and acyclovir, but almost no effect was observed . All cranial nerve palsies, however, had resolved completely approximately 4 months later . This may be the first pediatric case in which cranial polyneuropathy and antiganglioside antibodies were associated. Zentralbl Bakteriol, 1997 Feb, 285(3), 368 - 78 Molecular biology in diagnosis and epidemiology of Helicobacter pylori: PCR for the detection and AP-PCR for characterization of patient isolates; Schwarz E et al.; Infection with Helicobacter pylori causes chronic active gastritis and has been associated with gastric and duodenal ulcer disease . In biopsy samples of 110 patients with clinical symptoms of active gastritis, H . pylori was detected by means of the polymerase chain reaction (PCR), using species-specific primers defining a 858 bp DNA fragment of H . pylori urease beta-subunit . Sensitivity and specificity of the PCR was compared with culture, histology and Warthin-Starry stain (WSs), detection of H . pylori urease antibodies in serum and urease testing with the Campylobacter-like organism (CLO) test . PCR yielded specific amplification products in 53 cases, whereas culture of the organisms was positive in a subset of 50 cases . Only direct detection in histological sections of biopsy specimens had a higher sensitivity, with 65 positive samples . In contrast, the CLO test was negative in eleven culture-positive and PCR-positive cases . Significant urease antibody titres were found in 39 patients with histologically confirmed diagnosis . These results placed the sensitivity of PCR between tat of the Warthin-Starry stain (WSs) and that of culture . Therefore, PCR can be proposed as a useful rapid and time-saving technique for the detection of H.pylori in gastritis . For epidemiological purposes, fingerprinting with arbitrarily chosen primers by AP-PCR was evaluated . Strain-specific patterns with up to 13 fragments were achieved with 10-nucleotide or longer primers (21-nt) with a G + C content > or = 55% . Thirty-five of 40 strains investigated by this method were distinguishable with a single primer . These results suggest a high level of DNA sequence diversity within this species with the possibility of confirming the clonality in consecutive isolates from a single individual . Alternatively, an increased in-vivo mutation rate could be responsible for DNA divergence, resulting in specific strains for each individual patient. J Med Microbiol, 1997 Feb, 46(2), 157 - 63 Lineages within Campylobacter jejuni defined by numerical analysis of pulsed-field gel electrophoretic DNA profiles; Gibson J et al.; Forty-seven Penner heat-stable (HS) serotype reference strains for Campylobacter jejuni and 47 serologically non-typable strains were examined by pulsed field gel electrophoresis (PFGE) DNA restriction analysis . The SmaI and KpnI digest profiles were compared by numerical analysis . Most strains grouped differently in the two analyses but strain lineages were inferred where the two agreed . Genetic relationships between reference strains in the cross-reacting HS4 complex were examined . Three clonal lines were evident and comprised: (i) HS4, HS13 and HS16; (ii) HS50 and HS65; (iii) HS43 . The majority of those C . jejuni expressing HS antigens not recognised by currently available antisera had > 50% PFGE DNA digest similarity to one or more Penner scheme reference strain(s) and so did not necessarily represent distinct genetic lineages . PFGE analysis provided a high level of discrimination amongst strains of C . jejuni but overall similarity estimates for defining types must be based on the analysis of more than one restriction pattern. Vet Microbiol, 1997 Feb, 54(2), 185 - 93 DNA fingerprinting of Campylobacter fetus using cloned constructs of ribosomal RNA and surface array protein genes; Denes AS et al.; DNA fragments coding for the ribosomal RNA and the surface array proteins of Campylobacter fetus have been cloned from a genomic library constructed in Escherichia coli . They were used in the molecular characterization of C . fetus (subsp . fetus; subsp . venerealis) strains by restriction fragment length polymorphism (RFLP) method . Ribotyping results showed that all strains of the two subspecies can be classified under one ribogroup implying very close relatedness . The sapA gene DNA marker, however, discriminated all the strains regardless of the subspecies when chromosomal DNA was restricted with HindIII, HaeIII, XbaI or EcoRV . These results illustrate that the sapA probe is potentially useful in fingerprinting C . fetus strains and in determining the relationships of strains for epidemiological purposes. Poult Sci, 1997 Feb, 76(2), 314 - 7 Campylobacter jejuni seasonal recovery observations of retail market broilers; Willis WL et al.; This study investigated possible seasonal trends in the Campylobacter jejuni carrier state of market broilers . In this study, broiler carcasses, 15 each of two major companies, were obtained from a local supermarket each month for an entire year to evaluate the presence of C . jejuni on the carcasses . Direct plating and the whole carcass rinse procedure were used for C . jejuni detection . Resuscitation of damaged cells and preenrichment of low numbers of micoorganisms were accomplished by Hunt's procedure . None of the carcasses tested positive from direct plating of skin flora in this study . After both Company A and Company B broiler samples were enriched, 69% (229/330) of the raw commercial broilers were, positive for C . jejuni . The highest recovery rates were obtained during the warmer months of the year, from May through October (93, 97, 97, 87, 87, and 93% respectively), and the lowest were obtained in December (7%) and January (33%) . Storage time, due to slow movement of broilers, appeared to affect the detectability of C . jejuni during December and January . This study shows that seasons of the year influence C . jejuni detectability and the carrier state in market broilers at retail level. Carcinogenesis, 1997 Feb, 18(2), 383 - 9 N-nitrosation of medicinal drugs catalysed by bacteria from human saliva and gastro-intestinal tract, including Helicobacter pylori; Ziebarth D et al.; Micro-organisms commonly present in human saliva and three DSM strains (Helicobacter pylori, Campylobacter jejuni and Neisseria cinerea), which can be isolated from the human gastro-intestinal tract, were assayed in vitro for their capacity to catalyse N-nitrosation of a series of medicinal drugs and other compounds . Following incubation at pH 7.2 in the presence of nitrate (or nitrite) for up to 24 (48) h, the yield of N-nitroso compounds (NOC) was quantified by HPLC equipped with a post-column derivatization device, allowing the sensitive detection of acid-labile and acid-stable NOC . Eleven out of the 23 test compounds underwent bacteria-catalysed nitrosation by salivary bacteria, the yield of the respective nitrosation products varying 800-fold . 4-(Methylamino)antipyrine exhibited the highest rate of nitrosation, followed by dichlofenac > metamizole > piperazine > five other drugs, whilst L-proline and L-thioproline had the lowest nitrosation rate . Ten drugs including aminophenazone, cimetidine and nicotine, did not inhibit bacterial growth, allowing transitory nitrite to be formed, but no N-nitroso derivatives were detected . Three drugs inhibited the proliferation of bacteria and neither nitrite nor any NOC were formed . Using metamizole as an easily nitrosatable precursor, two strains, Campylobacter jejuni and Helicobacter pylori, were shown to catalyse nitrosation in the presence of nitrite at pH 7.2 . As compared to Neisseria cinerea used as a nitrosation-proficient control strain, H . pylori was 30-100 times less effective, whilst C . jejuni had intermediary activity . The results of our sensitive nitrosation assay further confirm that bacteria isolated from human sources, possessing nitrate reductase and/or nitrosating enzymes such as cytochrome cd1-nitrite reductase (Calmels et al., Carcinogenesis, 17, 533-536, 1996), can contribute to intragastric nitrosamine formation in the anacidic stomach when nitrosatable precursors from exogenous and endogenous sources are present. Infect Immun, 1997 Feb, 65(2), 478 - 83 Purification and characterization of Campylobacter rectus surface layer proteins; Nitta H et al.; Campylobacter rectus is a putative periodontopathogen which expresses a proteinaceous surface layer (S-layer) external to the outer membrane . S-layers are considered to play a protective role for the microorganism in hostile environments . The S-layer proteins from six different C . rectus strains (five human isolates and a nonhuman primate {NHP} isolate) were isolated, purified, and characterized . The S-layer proteins of these strains varied in molecular mass (ca . 150 to 166 kDa) as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . They all reacted with monospecific rabbit antiserum to the purified S-layer of C . rectus 314, but a quantitative enzyme-linked immunosorbent assay demonstrated a strong antigenic relationship among the five human strains, while the NHP strain, 6250, showed weaker reactivity . Amino acid composition analysis showed that the S-layers of four C . rectus strains contained large proportions of acidic amino acids (13 to 27%) and that >34% of the amino acid residues were hydrophobic . Amino acid sequence analysis of six S-layer proteins revealed that the first 15 amino-terminal amino acids were identical and showed seven residues of identity with the amino-terminal sequence of the Campylobacter fetus S-layer protein SapA1 . CNBr peptide profiles of the S-layer proteins from C . rectus 314, ATCC 33238, and 6250 confirmed that the S-layer proteins from the human strains were similar to each other and somewhat different from that of the NHP isolate (strain 6250) . However, the S-layer proteins from the two human isolates do show some structural heterogeneity . For example, there was a 17-kDa fragment unique to the C . rectus 314 S-layer . The amino-terminal sequence of this peptide had homology with the C . rectus 51-kDa porin and was composed of nearly 50% hydrophobic residues . Thus, the S-layer protein from C . rectus has structural heterogeneity among different human strains and immunoheterogeneity with the NHP strain. Infect Immun, 1997 Feb, 65(2), 428 - 33 Examination of diarrheagenicity of cytolethal distending toxin: suckling mouse response to the products of the cdtABC genes of Shigella dysenteriae; Okuda J et al.; Some strains of Escherichia coli, Shigella spp., and Campylobacter spp . that have been implicated in diarrheal disease produce cytolethal distending toxin (CDT) . CDT induces unique morphological changes in Chinese hamster ovary cells, but its association with diarrheal disease is unclear . We studied the diarrheagenicity of CDT using the cdt genes that we originally cloned from Shigella dysenteriae . The cdt genes were subcloned into a high-copy-number plasmid in E . coli JM109 to achieve high-level CDT production into the culture supernatant . An isogenic CDT- derivative was constructed by deletion of the 0.9-kb sequence internal to the cdt genes . A suckling mouse model was established, in which the intragastrically administered culture supernatant of the CDT+ E . coli strain induced excretion of loose and/or watery feces more often than did that of the CDT- strain in 24 h . The partially purified CDT preparation induced profuse watery diarrhea by 12 h in this model . High-level intestinal fluid accumulation in 4 h appeared to be related to the watery diarrhea . The results indicate that CDT is diarrheagenic to suckling mice and suggest that diarrheagenicity is dependent on CDT level . The preparations containing wild-type CDT induced tissue damage (necrosis and reparative hyperplasia) in the descending colon, whereas the tissues of the small intestines remained apparently intact . Association between the colonic damage and diarrhea is unclear and needs further investigation. J Clin Microbiol, 1997 Feb, 35(2), 462 - 7 Identification of Serpulina species associated with porcine colitis by biochemical analysis and PCR; Fellstrom C et al.; A PCR system for the detection and identification of group IV spirochetes (Serpulina pilosicoli) was designed to complement biochemical tests, e.g., the hippurate hydrolysis and beta-glucosidase tests, and to verify the accuracy of a previously proposed biochemical classification system . The PCR assay was based on amplification of a segment of the 16S rRNA gene . Both primers were constructed to selectively amplify the 16S rRNA gene of Serpulina pilosicoli . All analyzed Serpulina strains exhibiting the capacity to hydrolyze hippurate and lacking beta-glucosidase activity, including the type strain for spirochetal diarrhea, P43, were amplified with the PCR system . All other tested strains, including type and field strains of different phenotypes of Serpulina species, as well as Salmonella species, Campylobacter species, and Escherichia coli strains, were negative in the assay . Among the tested strains were 18 Scottish field isolates originating from the mucosae of pigs with colitis . A simple classification scheme, suitable for routine classification of porcine intestinal spirochetes, is also presented . The scheme is based on hemolysis, indole production, and the hippurate hydrolysis test. Gene, 1997 Jan 31, 185(1), 63 - 7 Identification of a functional homolog of the Escherichia coli and Salmonella typhimurium cysM gene encoding O-acetylserine sulfhydrylase B in Campylobacter jejuni; Garvis SG et al.; The final step of L-cysteine biosynthesis in Escherichia coli and Salmonella typhimurium consists of the formation of L-cysteine from O-acetylserine and sulfide . This reaction can be catalyzed by two enzymes, O-acetylserine sulfhydrylase A and O-acetylserine sulfhydrylase B, the former of which has been more rigorously characterized . In contrast to O-acetylserine sulfhydrylase A, O-acetylserine sulfhydrylase B is preferentially used for cysteine biosynthesis during anaerobic growth and is able to utilize thiosulfate as a substrate . Campylobacter jejuni is a micro-aerophilic, Gram-negative bacterium, and a member of the epsilon subdivision of eubacteria . We have cloned, sequenced, and expressed a gene from C . jejuni that encodes a protein of 299 aa with a calculated molecular mass of 32,367 Da . Complementation analysis of an E . coli cysteine auxotroph with the pMEK34-14 recombinant plasmid containing a 1.2-kb insert of chromosomal DNA from C . jejuni revealed that transformants were capable of growth in medium containing either sulfide or thiosulfate as sole sulfur sources . These data indicate that the cloned C . jejuni gene is a functional homolog of the cysM gene that codes for O-acetylserine sulfhydrylase B in E . coli and S . typhimurium. World Health Stat Q, 1997, 50(1-2), 57 - 66 Economic costs and trade impacts of microbial foodborne illness; Buzby JC et al.; This article presents the economic costs of foodborne diseases for selected countries, the approaches used to calculate these costs, and a discussion on the interaction between microbial food safety issues and international trade in food . The human illness costs due to foodborne pathogens are estimated most completely in the United States of America, where, each year, 7 foodborne pathogens (Campylobacter jejuni, Clostridium perfringens, Escherichia coli O157:H7 . Listeria monocytogenes, Salmonella, Staphylococcus aureus, and Toxoplasma gondii) cause an estimated 3.3-12.3 million cases of foodborne illness and up to 3900 deaths . These 7 pathogens are found in animal products and cost the United States an estimated $6.5-$34.9 billion (1995 US$) annually . The presence of foodborne pathogens in a country's food supply not only affects the health of the local population, but also represents a potential for spread to pathogens to visitors to the country and to consumers in countries which import food products . With more complete data on foodborne illnesses, deaths, costs and international trade rejections in each country, indicators could be developed by which changes in food safety can be monitored. Pediatr Med Chir, 1997 Jan-Feb, 19(1), 31 - 5 {Evaluation of pediatric patients hospitalized for acute diarrhea from 1990 to 1996}; Casini T et al.; Infectious diarrhea is a common disorder in children in Italy, which may lead to hospitalization especially during infancy . In order to obtain data about epidemiology and clinic pictures of acute diarrhea, the carts of 1295 paediatric outpatients, hospitalized for this pathology in the time between 1990-1996 at the Children's Hospital "Meyer" of Florence, were analyzed . An offending organism could be isolate in 43.3% of patients; Rotaviruses are the leading cause of diarrhea, followed by salmonella spp . Furthermore the role of Campylobacter as common bacterial pathogen worldwide has been clarified. Acta Vet Hung, 1997, 45(3), 317 - 29 Novel approaches to control of bacterial infections in animals; Barrow PA; Bacterial infections of poultry remain of great importance world-wide in terms of economic effects and public health . They include infections caused by Salmonella, Escherichia coli, Campylobacter and Pasteurella . Through the introduction of rigid hygienic measures it is possible to breed and rear poultry free of these pathogens . However, the cost to the industry would be prohibitive and economically disastrous . Biological measures have been introduced albeit in a relatively empirical way . Antibiotic therapy and prophylaxis is used extensively with the associated problems of development of resistance . Killed vaccines are used but are not usually very effective . Live vaccines are increasingly becoming acceptable and studies are under way to increase our understanding of the pathogenesis of these infections so that vaccine development may become less empirical . Work with live vaccines to be used against Salmonella has shown that they may be administered orally to newly-hatched chicks . The vaccine strain colonises the gut extensively and prevents re-infection by other Salmonella strains by a genus-specific mechanism which is similar to that which occurs during down-regulation of bacterial growth in stationary-phase nutrient broth cultures . The mechanism of this phenomenon is currently being studied . This approach may also be applied to control Campylobacter infections . Bacteria of the Pasteurella group and E . coli may produce septicaemic infections in poultry . Recent work with K1+ E . coli infections in mice has shown that virulent bacteriophages may be used to treat or prevent septicaemias and meningitides . This work has been extrapolated to chickens with a similar degree of success and it suggests that some infections of this sort in animals and man may be amenable to this approach . In-bred lines of chickens have been found to vary greatly in their susceptibility to systemic Salmonella infections . This is probably mediated by one gene and the effect is dominant and not linked to sex or MHC . The mouse natural resistance gene (NrampI) does not appear to contribute greatly to this effect . Differences in the extent of gut colonisation by Salmonella in in-bred and out-bred lines can also be detected . These results are very exciting and open up opportunities for disease control for the future. Acta Vet Hung, 1997, 45(3), 307 - 15 Safe poultry meat production in the next century; Mulder RW; The revolutionary industrialisation of the poultry industry in the last 30 years has made the food poultry meat available for large groups of consumers . Due to its nutritional, sensory and economical characteristics, poultry meat is by far the most popular animal food product world-wide . Epidemiological reports, however, incriminate poultry meat as a source for outbreaks of human food poisoning . The organisms involved are Salmonella spp., Campylobacter spp . and, to a lesser extent, Listeria monocytogenes, Escherichia coli, Staphylococcus aureus, Yersinia enterocolitica, Clostridium perfringens and Aeromonas spp . Contamination of the end-product with pathogenic microorganisms is a reflection of the contamination of the live birds and, therefore, measures to be taken by industry to avoid contamination of the consumer-ready product should start at that level . In terms of the critical control point approach of the HACCP concept, the quantitative contribution of critical phases in the production chain towards end-product contamination should be estimated in order to take the necessary intervention or corrective steps . To guarantee the production of safe poultry meat, knowledge of the capability of microorganisms to colonise the gastrointestinal tract is needed and the use of vaccines, antimicrobials and competitive exclusion microfloras as well as the implementation of new processing technology should be encouraged. Microbiol Immunol, 1997, 41(6), 461 - 7 Overproduction of Campylobacter ferritin in Escherichia coli and induction of paracrystalline inclusion by ferrous compound; Wai SN et al.; The ferritin gene (cft) of Campylobacter jejuni was overexpressed in cells of Escherichia coli using a T7 RNA polymerase expression system . Many round particles which were the same size as the ferritin particles purified from C . jejuni were observed in the lysate of the cft-overexpressed E . coli cells . Since most of them were devoid of a central electron dense core consisting of ferric irons, the Campylobacter ferritins over-produced in E . coli seemed to be apoferritin . When large amounts of ferrous iron (supplied as FeSO4) were added to culture medium, the cft-overexpressed cells formed large inclusion bodies of paracrystalline arrays comprised of ferritin particles with central electron dense cores . The addition of ferric irons did not produce paracrystalline inclusion. Adv Exp Med Biol, 1997, 412, 1 - 19 Comparative histopathology of intestinal infections; Moon HW; Intestinal infections are characterized by a range of histologic changes . Some examples (moving progressively deeper into the tissue from the intestinal lumen) are: 1) Enterotoxigenic E . coli infections are characterized by layers of E . coli adherent to villous epithelium, usually with little or no apparent structural damage to the mucosa . 2) The term enteropathogenic E . coli infection designates a disease characterized by E . coli attached intimately to the epithelial cell surface membrane with effacement of brush border microvilli . 3) Rotavirus infections are characterized by destruction of villous epithelial cells . Parvovirus infections are characterized by destruction of crypt epithelial cells . 4) Some intracellular infections with Campylobacter-like organisms are characterized by epithelial cell hyperplasia . 5) Hemorrhagic colitis in humans, caused by enterohemorrhagic E . coli strains, is characterized by mucosal hemorrhage and edema indicative of vascular necrosis . 6) Most of these lesions are accompanied by some degree of inflammation . Neurophils and lymphocytes mediate some of the structural and functional changes characteristic of these infections . Some changes are mediated directly by microbial products . Additional examples of the complexity of these diseases are: 1) Edema disease of swine is characterized both by adherent E . coli and vascular necrosis (each process mediated by a different bacterial virulence attribute) . 2) Rotavirus infections are characterized both by destruction of villous epithelial cells and compensatory hyperplasia of crypt epithelial cells . 3) There is suggestive evidence that enterohemorrhagic E . coli infections may involve: a) destruction of epithelial brush border by attaching-effacing E . coli, b) neutrophil mediated epithelial cell destruction, c) Shiga-like toxin mediated epithelial cell destruction and d) Shiga-like toxin mediated vascular necrosis which in turn causes ischemic damage to epithelium. Scand J Infect Dis, 1997, 29(2), 197 - 8 Campylobacter fetus subsp . fetus cholecystitis in a patient with advanced hepatocellular carcinoma; Takatsu M et al.; Acute cholecystitis due to Campylobacter fetus subsp . fetus is very uncommon . We report a case of cholecystitis and obstructive jaundice in which cultured bile grew this organism . The patient had a 4-year history of hepatocellular carcinoma, resulting in common bile duct obstruction due to abdominal lymph node metastasis . Microscopic examination of her bile showed multiple Gram-negative curved organisms and C . fetus subsp . fetus was isolated under microaerophilic conditions . Therefore, we should be aware of this organism and use microaerophilic culture in association with the result of microscopic examination of bile specimens. Rinsho Shinkeigaku, 1997 Jan, 37(1), 41 - 3 {A case of Guillain-Barré syndrome after the travel in southeast Asia--isolation of Campylobacter jejuni PEN 5 serotype}; Koide T et al.; A 57-year-old man, while on travel in Malaysia, suffered from diarrhea after he ate fruits . He developed limbs weakness without sensory disturbance after his return to Japan . Serum from the patient had high IgG anti-GM1 antibody titer . Campylobacter jejuni was isolated from his stool . The serotype belonged to PEN 5 . The patient received double-filtration plasmapheresis 7 times during from days 6 to 17 . Muscle strength began to recover gradually on day 10, and returned to normal 5 months after the onset of neurologic symptoms . Repeated neurophysiologic studies indicated that the axonal degeneration of motor nerves was predominant process . This case suggests that Guillain-Barre syndrome is a complication of traveler's diarrhea. J Med Assoc Thai, 1997 Jan, 80(1), 26 - 33 Acute diarrhea in under five-year-old children admitted to King Mongkut Prachomklao Hospital, Phetchaburi province; Suwatano O; A prospective epidemiological and clinical study of acute diarrhea in children under 5 years old was done at King Mongkut Prachomklao Hospital in order to provide baseline data for health officers to make a strategic plan to reduce the diarrheal mortality and morbidity, which is one of the mid-decade goals for children . There were 105 cases of acute diarrhea patients admitted to the Pediatric ward between May 1995 and April 1996 . Seventy-six per cent of them were in the younger age group (> 1 month-2 years old) while 23.8 per cent were in the older age group (2-5 years old) . Causative pathogens were identified in 64 patients (61%) . Younger patients had a higher percentage of identifiable pathogens (66.7%) than older patients (44.4%) . Rotavirus was the most common pathogen isolated (17.2%) . The other common pathogens identified were Eschericia coli (14.1%), Campylobacter jejuni (14.1%), Shigella (12.5%), Entamoeba histolytica (7.8%) and Salmonella (3.1%) . Mixed infections were reported in 31.3 per cent of these patients . Clinical presentations and stool characteristics were difficult to distinguish from most of the pathogens . However, Rotavirus was highly suspected if a younger child presented with fever, watery to loose stool with the predominant symptom of vomiting . Mucous, mucous-bloody stool gave a clue to the diagnosis of Shigella and Entamoeba histolytica . Most cases had at least mild to moderate dehydration, so oral rehydration solution (ORS) was successfully given in only 31.4 per cent of patients . Antibiotics were prescribed to 51.4 per cent of patients in this study . Healthcare personnel should emphasize to parents and caretakers about good hygienic behavior to reduce the episodes of diarrhea and the use of ORS every time when their children have diarrheal episodes to reduce the disease severityPIP: A prospective epidemiological and clinical study of acute diarrhea among children under age 5 years was conducted at King Mongkut Prachomklao Hospital to provide baseline data for health officers developing a strategic plan to reduce levels of diarrheal morbidity and mortality . 105 cases of acute diarrhea were admitted to the pediatric ward between May 1995 and April 1996 . 76% were aged 1 month to 2 years; the rest were 2-5 years old . Causative pathogens were identified among 64, with pathogens identified among 66.7% of the younger children and 44.4% of the older children . Rotavirus was the most common pathogen isolated (17.2%), followed by Escherichia coli (14.1%), Campylobacter jejuni (14.1%), Shigella (12.5%), Entamoeba histolytica (7.8%), and Salmonella (3.1%) . Mixed infections were reported in 31.3% of the patients . There was not much difference between clinical presentations and stool characteristics for most of the pathogens . Since most cases had at least mild to moderate dehydration, oral rehydration solution was successfully given in only 31.4% of cases and antibiotics were prescribed to 51.4% of patients . J R Coll Physicians Lond, 1997 Jan-Feb, 31(1), 53 - 6 Postinfective diarrhoea and bile acid malabsorption; Niaz SK et al.; Postinfective irritable bowel syndrome with diarrhoea and idiopathic bile acid malabsorption remains an enigma . We examined the records of 84 patients whose 75SeHCAT scans were indicative of bile acid malabsorption (< 15% one week retention) . Identifiable causes of bile acid malabsorption were: previous ileal surgery (7), Crohn's disease (22), radiation enteritis (13), vagotomy, gastrectomy or cholecystectomy (10) and miscellaneous (3) . Sixteen of 29 patients with apparently idiopathic bile acid malabsorption gave a clear history of acute gastroenteritis before the onset of chronic diarrhoea lasting from 0.25-18 years until their positive 75SeHCAT scan . Only four cases of campylobacter, and one each of shigella and salmonella were documented . Extensive investigation failed to detect other possible pathologies . In response to bile acid sequestrants, mean stool frequency fell from 7.2 per day to 2.1 per day (p < 0.001) . We have observed that postinfective chronic diarrhoea is associated with chronic bile acid malabsorption, which can be successfully treated with bile acid sequestrants such as cholestyramine. Immunol Invest, 1997 Jan-Feb, 26(1-2), 55 - 65 Rapid diagnosis of periodontal infections: findings in AIDS patients; Zambon JJ; A small number of bacterial pathogens in the human oral cavity cause the different forms of periodontal disease . Of the approximately two hundred different oral bacterial species, about a dozen have been associated with these diseases including localized juvenile periodontitis, rapidly progressing periodontitis, and adult periodontitis . These species include Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, Porphyromonas gingivalis, and Prevotella intermedia . Several rapid methods have been developed to detect these species in clinical samples . These include immunologic methods such as immunofluorescence, nucleic acid assays such as DNA-DNA hybridization in dot blots and enzyme assays . Immunofluorescence microscopy has been used to determine the prevalence and relative proportions of these pathogens in dental plaque samples from 194 subjects including HIV-infected and uninfected male homosexuals and intravenous drug users. J Vet Med Sci, 1997 Jan, 59(1), 85 - 7 Direct detection of Campylobacter jejuni in chicken cecal contents by PCR; Chuma T et al.; Campylobacter jejuni in chicken feces was detected by PCR and Southern blot hybridization (SBH) . The detection limits of C . jejuni in chicken feces were 34,000 cells by PCR and 340 cells by SBH . Some cecal contents of chickens up to 3 weeks old were C . jejuni positive by SBH whereas all of them were negative by PCR . Two of 51 cecal contents of 18-day-old chicken embryos were C . jejuni positive by PCR and SBH; but, C . jejuni were not isolated from the samples by conventional culture with selective enrichment. Indian J Med Res, 1997 Jan, 105, 9 - 14 Rapid identification of Campylobacter jejuni strains by polymerase chain reaction & their restriction fragment length polymorphism analysis; Mahendru M et al.; A polymerase chain reaction (PCR) technique was developed for specific identification of C . jejuni . A primer pair of a conserved region of flagellin A (fla A) gene identified all 15 strains of C . jejuni isolated from human faeces . None of the control strains like Helicobacter pylori, Vibrio cholerae Escherichia coli and Salmonella typhimurium except C . coli exhibited any amplified product by PCR . A predicted 450 bp could also be amplified from 4 chicken caecal contents positive for C . jejuni-C coli by culture . The caecal contents remained positive for C . jejuni-C . coli by PCR after preservation at 4 degrees C for one week when no viable organism could be detected . Restriction fragment length polymorphism analysis (RFLP) of fla A amplified product by using Bgl II enzyme classified 15 strains into 5 types . Three C . jejuni strains isolated from the same patient over a period of 3 wk showed the same RFLP pattern . The present study indicates that PCR is specific for C . jejuni-C . coli and it has the potential for rapid diagnosis of infection . RFLP can be a good epidemiological marker for C . jejuni infection. Int J Food Microbiol, 1997 Jan, 34(1), 79 - 88 Genotypic diversity of Campylobacter lari isolated from mussels and oysters in The Netherlands; Endtz HP et al.; In order to gain insight into the epidemiology of Campylobacter lari infection in The Netherlands due to the consumption of raw mussels and oysters, batches of these shellfish were screened for the presence of Campylobacter spp . during a 6 month period in 1993-1994 . Apparently, 41 out of 59 batches of mussels and 11 out of 41 batches of oysters were colonized with Campylobacter spp . A subset of the isolates was further characterized by additional phenotypic tests, numerical analysis of electrophoretic protein patterns, and genotyping by random amplification of polymorphic DNA (RAPD) . Protein electrophoretic analysis of 39 Campylobacter spp . cultured from 24 batches of mussels and oysters, revealed that all isolates, except two, were C . lari . Two strains with an aberrant protein pattern were identified as C . coli and C . hyointestinalis, respectively . Nalidixic acid susceptible campylobacters (NASC) and urease-positive thermophylic campylobacters (UPTC) did not form separate clusters and should be considered biovars only . Several strains were both urease positive and nalidixic acid susceptible, which represents a new biovar within C . lari . The results of RAPD demonstrated the presence of 3 distinct genetic variants, implying that even within a single batch of shell fish, relatively extensive DNA polymorphisms can be found . It is therefore apparent that this complex group of C . lari is characterized by a high degree of genetic diversity, implying the presence of a heterogenous population of C . lari in crustacean organisms living in marine waters in a restricted area in The Netherlands. Lett Appl Microbiol, 1997 Jan, 24(1), 59 - 64 Isolation and characterization of a novel catalase-negative, urease-positive Campylobacter from cattle faeces; Atabay HI et al.; Forty-four strains of a phenotypically unique Campylobacter were isolated from the faeces of 26 of 45 cows in a single herd . Isolation involved enrichment and membrane filtration onto blood agar or plating onto cefoperazone amphotericin teicoplanin agar . The strains exhibited phenotypic characteristics typical for Campylobacter species . However, they were unusual in that they produced urease and copious H2S in triple sugar iron (TSI) medium, but did not produce catalase . They did not grow aerobically . None of the strains grew on modified cefoperazone charcoal deoxycholate agar (mCCDA) . Macrorestriction profiles of chromosomal DNA were prepared for 15 strains using pulsed-field gel electrophoresis (PFGE) . Twelve of 15 profiles were identical and all appeared to be closely related . These catalase-negative, urease-positive campylobacters (CNUPC) represent a group not previously reported . Their sensitivity to antibiotics normally used in selective media for campylobacters might explain why they have not previously been encountered . Their ecological significance and importance with respect to human and animal disease remain to be assessed. J Med Microbiol, 1997 Jan, 46(1), 34 - 8 Application of the Mast resistotyping scheme to Campylobacter jejuni and C . coli; Owen RJ et al.; The Mast resistotyping scheme was assessed with 228 strains of Campylobacter jejuni and C . coli from enteric infections in man and from a diverse selection of other sources (livestock, chickens and river water) . Most (153 of 158) C . jejuni examined were of the three most common Penner (heat stable, HS) serotypes, HS1, HS2 and HS4 complex . Fourteen resistotypes were identified in the 158 strains of C . jejuni and 16 in the 70 isolates of C . coli . The predominant codes were 00 (44% of C . jejuni; 33% of C . coli) and 40 (21% of both species) . The scheme was simple to use but reproducibility and interpretation of sensitivity zones--notably for fluorouracil, triphenyltetrazolium chloride and metronidazole--was occasionally problematic . Overall, resistotypes did not correlate with Penner HS serotypes or with three key genomic markers (ribotype, PFGE macrorestriction-type and fla-type) . Although resistotyping offers a rapid means for distinguishing between some strains of C . jejuni and C . coli, discrimination for common resistotypes can be achieved only in combination with other typing methods. J Neuroimmunol, 1997 Jan, 72(1), 59 - 66 IgM anti-GM1 antibodies in the Guillain-Barré syndrome: a serological predictor of the clinical course; Bech E et al.; It has been suggested that antibodies against GM1 are involved in the pathogenesis of the Guillain-Barre syndrome (GBS) . Recently, we have developed a standardized ELISA assay for anti-GM1 antibodies of IgM type well-suited for longitudinal patient studies . The relationship between serum antibodies against GM1 and Campylobacter jejuni was investigated in patients with GBS and in patients with C . jejuni infection . Patients with a short-lasting anti-GM1 elevation had a fast recovery, whereas patients with slow recovery had a long-lasting anti-GM1 elevation . A linear relationship was found between significant clinical recovery and the time until the anti-GM1 peak was halved (R = 0.9, p < 0.01) . The absolute level of anti-GM1 did not predict the length of the recovery nor was the level of anti-GM1 related to the clinical disability at its nadir . Our data indicate that monitoring of the IgM anti-GM1 level can predict clinical recovery in GBS patients. Eur Radiol, 1997, 7(1), 3 - 9 Infectious ileocecitis caused by Yersinia, Campylobacter, and Salmonella: clinical, radiological and US findings; Puylaert JB et al.; Yersinia, Campylobacter, and Salmonella are pathological microorganisms which incidentally may specifically infect the ileocecal area (infectious ileocecitis) . In such cases pain in the right lower quadrant is the predominant symptom, and diarrhea is absent or only mild . This symptomatology can lead to an unnecessary laparotomy for suspected appendicitis . At surgery a normal appendix is removed, while there is edematous thickening of ileum and cecum, and enlarged mesenteric lymph nodes . These ileocecal abnormalities give rise to a fairly characteristic US image, enabling the radiologist to rapidly differentiate infectious ileocecitis from appendicitis, thus preventing an unnecessary laparotomy . Infectious ileocecitis caused by Yersinia, Campylobacter, and Salmonella is a common mimicker of appendicitis, and its incidence at this moment is grossly underestimated . Ultrasound is presently the only means to prevent an unnecessary operation for this condition which is principally self-limiting and innocuous. Clin Infect Dis, 1997 Jan, 24 Suppl 1, S67 - 73 Trends in bacterial resistance to fluoroquinolones; Acar JF et al.; The emergence of resistance to fluoroquinolones in virtually all species of bacteria was recognized soon after the introduction of these compounds for clinical use more than 10 years ago . Various resistance mechanisms, often interdependent, may explain different levels of resistance . Epidemiological factors, local antibiotic policies, patients' characteristics, origin of the strains, and geographic location are among the factors contributing to highly variable resistance rates . During the last several years, resistance to fluoroquinolones has remained very high among methicillin-resistant Staphylococcus aureus strains and in intensive care unit patients, and it has increased among nosocomial isolates of Klebsiella pneumoniae, Serratia marcescens, and Pseudomonas aeruginosa . More worrisome are recent reports of an overall increase in resistance to fluoroquinolones among bacteria responsible for community-acquired infections, such as Escherichia coli, Salmonella species, Campylobacter species and Neisseria gonorrhoeae. Fortschr Med, 1996 Dec 20, 114(35-36), 485 - 7 {Importation of cholera from Turkey . Case report of cholera acquired in Istanbul}; Burkhardt U et al.; Following a short holiday in Istanbul, a 41-year-old man developed severe infectious enteritis accompanied by exsiccosis, hypokalemia and renal insufficiency . The patient was initially treated symptomatically under the assumption that he had traveller's diarrhea or Campylobacter enteritis . Finally, cholera vibrios were detected in several stool samples . Although Turkey is not considered to be endemic for cholera, a number of cases originating there have now been diagnosed in Germany . For the diagnosis of cholera, special microbiological expertise and techniques are required, and these are apparently not available in every medical laboratory . In view of the increasing spread of cholera worldwide, and the penchant of the German population for travelling abroad, diarrhea occurring after a visit to a foreign country should always prompt the physician to consider the possibility of cholera and to request relevant microbiological examinations of stool samples in a specialized laboratory. FEMS Microbiol Lett, 1996 Dec 15, 145(3), 469 - 72 Outer membrane characteristics of Campylobacter jejuni grown in chickens; Chart H et al.; A type of in vivo phenotype of Campylobacter jejuni was obtained by maintaining bacteria in the peritoneal cavities of chickens for one week . These bacteria, which had not been subcultured on laboratory media, were used to prepare outer membranes for comparison with C . jejuni grown in vitro . Flagella with subunits of 65 kDa and a single porin with a protein subunit of 49 kDa were expressed constitutively; however, outer membrane proteins of 55, 35 and 20 kDa, and intermediate-chain lipopolysaccharide were only expressed by bacteria maintained in chickens. Ned Tijdschr Geneeskd, 1996 Dec 14, 140(50), 2517 - 9 {Campylobacter infections in pregnancy}; Corel LJ et al.; In two pregnant women aged 39 and 35, who presented with fever and diarrhoea, Campylobacter was cultured from a blood sample . They were treated with antibiotics . One had a healthy neonate, in the other intrauterine foetal death had occurred . Campylobacter species have increasingly been recognized as possible causes of septic abortion, premature labour and neonatal sepsis . Early recognition and treatment of maternal Campylobacter infection may reduce the risk of serious foetal or neonatal complications. Gene, 1996 Dec 12, 183(1-2), 219 - 24 Characterization of Campylobacter upsaliensis fur and its localization in a highly conserved region of the Campylobacter genome; Bourke B et al.; Despite increasing recognition of the importance of Campylobacter upsaliensis in human disease little is known about either the virulence properties or genetics of this enteric pathogen . The complete coding sequence of a C . upsaliensis gene has yet to be published . We have cloned and sequenced the complete iron-uptake regulatory (fur) gene from the type strain of this species . The C . upsaliensis fur homolog was isolated from a genomic library of C . upsaliensis ATCC 43954 constructed in phage lambdaGEM-11 . The open reading frame identified encodes a polypeptide consisting of 156 amino acids . The 5'-flanking region of the C . upsaliensis fur gene contains 3 putative Fur-binding sequences and two catabolite activator-binding sequences indicating the potential for autogenous and cAMP-mediated regulation, respectively . Primer extension analysis identified a single transcription start site 262 nt upstream from the AUG initiation codon . Sequence analysis indicates that the Fur protein of C . upsaliensis is highly homologous (87% amino acid identity) to Campylobacter jejuni Fur . Furthermore, the arrangement of the lysS and glyA genes downstream of fur is precisely conserved in both C . upsaliensis ATCC 43954 and C . jejuni TGH9011 . Using the polymerase chain reaction close linkage of fur with lysS and glyA was also observed among multiple isolates of C . upsaliensis, C . jejuni and C . coli suggesting a possible functional relevance for this conserved genetic arrangement in campylobacteria. Commun Dis Rep CDR Rev, 1996 Dec 6, 6(13), R179 - 83 Risk factors for outbreaks of infectious intestinal disease linked to domestic catering; Ryan MJ et al.; The epidemiology of general outbreaks of infectious intestinal disease associated with domestic catering for large numbers is described and compared with foodborne outbreaks in other settings . From 1 January 1992 to 31 December 1994, the PHLS Communicable Disease Surveillance Centre identified 101 foodborne general outbreaks of infectious intestinal disease associated with domestic catering in England and Wales (16% of all foodborne outbreaks) . Salmonella species were associated with 77 of the 101 outbreaks and S . enteriditis phage type 4 accounted for 57 . Small round structured viruses were implicated in five outbreaks, Clostridium perfringens in four, Bacillus cereus in two, and Campylobacter sp and Escherichia coli in one each . No pathogen was identified in 11 outbreaks . Outbreaks occurred most commonly in summer . The commonest vehicles implicated were poultry/eggs in 44 outbreaks, desserts in 13, and meat/meat products in nine . Salad/vegetables, sauces, and fish/shellfish were each implicated in eight outbreaks . Raw shell eggs were implicated in a fifth of outbreaks . Inappropriate storage was the commonest fault, reported in association with 50 outbreaks (ambient temperature for long periods before serving in 29), inadequate heat treatment was reported in 35, cross contamination in 28, an infected food handler in 11, and other faults in 14 . Outbreaks associated with catering on domestic premises were independently more likely than outbreaks in other settings to be associated with salmonellas, inappropriate storage of food, and consumption of poultry, eggs, or sauces . Public health services need to direct messages about the use, preparation, and storage of food to those who cater on domestic premises. Med J Aust, 1996 Dec 2-16, 165(11-12), 672 - 5 Foodborne disease: current trends and future surveillance needs in Australia; Crerar SK et al.; Review of 128 outbreaks of foodborne disease (affecting almost 6000 people, with six deaths) between 1980 and 1995 and available surveillance data showed that foodborne disease in Australia is similar to that in other industrialised countries . Campylobacter spp . and non-typhoidal Salmonella spp . were the most commonly reported pathogens . However, Australia, unlike the UK and US, lacks a comprehensive national surveillance system for foodborne diseases . This is essential to improve control of these diseases. J Diarrhoeal Dis Res, 1996 Dec, 14(4), 255 - 9 Adherence, invasion and cytotoxin assay of Campylobacter jejuni in HeLa and HEp-2 cells; Prasad KN et al.; Campylobacter jejuni is an important human enteropathogen worldwide . Chickens are the major reservoir and source of campylobacter infection . Ten clinical isolates from human and five chicken strains were tested for the adherence, invasion and cytotoxin assay in HeLa and HEp-2 cells . All human strains adhered to both the HeLa (10(3) to 3 x 10(4) bacteria/mL of cell lysate) and HEp-2 cells (2 x 10(3) to 4 x 10(4) bacteria/mL of lysate) . All chicken strains also adhered to the HEp-2 cells (10(2) to 10(3) bacteria/mL), but only two strains adhered to the HeLa cells . Six clinical and none of the chicken strains invaded the mammalian cells . Both the adherence and invasion were better observed in HEp-2 than in HeLa cell lines . All three isolates from patients having invasive diarrhoea and only one strain from a patient having watery diarrhoea produced cytotoxin . All three invasive strains also adhered to polystyrene surface after the localised destruction of the HEp-2 cells, a phenomenon not reported earlier . Adherence was markedly inhibited by the whole cell lysate and the acid glycine extracts, and the results were comparable . This study indicates that the clinical isolates of C . jejuni are more virulent than the chicken strains, HEp-2 is better for the adherence/invasion assay and HeLa is better for cytotoxin assay . The acid glycine extracts probably contain the key adhesins for C . jejuni. Oral Dis, 1996 Dec, 2(4), 263 - 71 Matrix metalloproteinases-1, -3 and -8 and myeloperoxidase in saliva of patients with human immunodeficiency virus infection; Mellanen L et al.; OBJECTIVE: Human immunodeficiency virus (HIV)-seropositive patients have frequently severe gingival inflammation and/or attachment loss . In addition many infectious diseases affect their periodontium with varying clinical manifestations . Matrix metalloproteinases seem to play a key role in physiological periodontal remodelling and pathological tissue destruction . The aim of the present study was to characterize the presence, molecular forms, cellular sources, activities, and relative amounts of fibroblast-type (matrix metalloproteinase {MMP}-1) and neutrophil (MMP-8) collagenases, as well as their potential activator stromelysin-I (MMP-3) and myeloperoxidase in saliva of HIV-seropositive patients at different phases of HIV-infection . HIV-seronegative, healthy, age-matched patients served as controls . PATIENTS AND METHODS: Saliva samples were characterized by Western blotting using antibodies specific for MMP-1, MMP-3 and MMP-8 . Interstitial collagenase activities were measured using quantitative sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis/laser densitometry assay . Myeloperoxidase was analysed using quantitative dot blotting . RESULTS: Clinical and microbiological evaluation of HIV-seropositive patients' periodontium showed the presence of putative periodontopathogens ie Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Peptostreptococcus micros (Psm) and Campylobacter rectus (Cr) in their periodontal pockets . The amount of Candida increased with the severity of HIV-infection . Clinical and microbiological findings of HIV-seropositive patients suggested that they have a tendency to develop periodontal disease . Interstitial collagenase activities were found to be increased in saliva of different phases of HIV-infected patients compared to the controls . Independent of the phase of HIV-infection saliva samples contained pro- and active forms of MMP-1, -3 and -8 using Western blotting . Saliva samples from healthy controls were found to contain hardly any immunoreactivities for MMP-1 or MMP-8, but considerable amounts of MMP-3 were detected . Quantitative dot blotting demonstrated increased amounts of myeloperoxidase in HIV-patients' saliva relative to controls . CONCLUSION: The present results showed increased amounts of MMP-1, -3, -8 and myeloperoxidase in HIV-patients' saliva . MMP-1 and -8 may have been activated by MMP-3 and/or oxidants generated by myeloperoxidase . The increased amounts of MMPs and myeloperoxidase may reflect and directly participate in HIV-infection associated periodontitis. Antimicrob Agents Chemother, 1996 Dec, 40(12), 2891 - 3 Identification of the tetracycline resistance gene, tet(O), in Streptococcus pneumoniae; Widdowson CA et al.; Five isolates of Streptococcus pneumoniae resistant to tetracycline but lacking tet(M) were studied . The tetracycline resistance gene, tet(O), was detected for the first time in the pneumococcus . The gene was amplified and sequenced and found to share 99% nucleotide sequence identity and 99, 99, and 98% deduced amino acid sequence identity with the tet(O) resistance genes of Streptococcus mutans, Campylobacter coli, and Campylobacter jejuni, respectively. Neurologia, 1996 Dec, 11 Suppl 5, 75 - 80 {Antiganglioside antibodies in neuropathies and motor neuronopathies}; Gallardo E et al.; The presence of antiganglioside antibodies is associated with several neurologic disorders . These antibodies recognize several epitopes, generally saccharides present in these glucolipids . The presence of antiGM antibodies has been described in certain clinical syndromes, the main one being multifocal motor neuropathy with and without conduction blocks . The frequency of antiGM1 class IgM antibody falls between 20 and 80% in this disease . Axon predominant Guillain-Barre syndrome is also associated with high titers of antiGM1 antibodies, although in this case class IgG is implicated . The most important association to date has been established between Miller-Fisher syndrome and the presence of antiGQ1b antibodies . Several authors have reported molecular similarities among these gangliosides and bacterial lipopolysaccharides, mainly Campylobacter iejuni . The principal aims in the study of antiganglioside antibodies are to establish their pathogenic role as well as the clinical usefulness of analyzing for them, and to discover new specificities that aid in the diagnosis and classification of neuropathies, whether they are predominantly motor disorders or chronic sensory ones. Kansenshogaku Zasshi, 1996 Dec, 70(12), 1227 - 33 {Evolution of susceptibilities of Campylobacter jejuni isolated from diarrhoeal cases to fluoroquinolones in Tokyo}; Tadano K et al.; Recently, the increase in the number of resistant strains of Campylobacter jejuni to fluoroquinolone has been reported in European countries . We also studied antimicrobial susceptibilities of 600 clinical isolates of Campylobacter jejuni isolated during a 6 year period from 1989 through 1994 in four Tokyo Metropolitan Hospitals . The susceptibility to 6 antimicrobial agents, norfloxacin (NFLX), ofloxacin (OFLX), ciprofloxacin (CPFX), nalidixic acid (NA), erythromycin (EM) and tetracycline (TC) were examined . The overall resistant rates were as follows: NFLX, 45 strains (7.5%); OFLX, 45 strains (7.5%); CPFX, 44 strains (7.3%); NA, 62 strains (10.3%); EM, 4 strains (0.6%) and TC, 259 strains (43.2%) . The number of resistant strains to fluoroquinolones and NA has increased significantly since 1993 in Japan, but the susceptibility to erythromycin has still remained the same level during the past 6 years . The susceptibility to TC was variable, and MICs gave a bimobal distribution, as pointed out previously . The resistance pattern of NFLX, OFLX, CPFX and NA were observed most frequently in those isolates. Lab Anim Sci, 1996 Dec, 46(6), 623 - 7 Proliferative enteropathy of rabbits: the intracellular Campylobacter-like organism is closely related to Lawsonia intracellularis; Hotchkiss CE et al.; The intracellular Campylobacter-like organism associated with proliferative enteropathy of rabbits is closely related to Lawsonia intracellularis, the primary pathogen in porcine intestinal adenomatosis . Polymerase chain reaction primers based on the 16S rRNA gene of L . intracellularis were used to amplify DNA harvested from intestinal tissues of rabbits with severe proliferative intestinal lesions containing curved argentophilic intracellular bacteria . Sequencing of a 180-nucleotide DNA fragment of the 550-base pair-amplified polymerase chain reaction product revealed >98% similarity between the organism associated with the rabbit disease and the homologous sequence found in L.intracellularis. J Vet Med Sci, 1996 Dec, 58(12), 1181 - 5 Incidence of diarrhea with antibiotics and the increase of clostridia in rabbits; Hara-Kudo Y et al.; Rabbits were treated with a single intravenous injection of various antibiotics . More than 40 per cent of the animals showed diarrhea after being treated with sulbactam/cefoperazone, cefmetazole, clindamycin, piperacillin or aspoxicillin . Clostridium difficile was isolated from sulbactam/cefoperazone-treated diarrheic rabbits, with their cecal contents showing positive reaction in a latex agglutination test for C . difficile enterotoxin . However, 27 cefmetazole-induced diarrheic cases were not associated with C . difficile . Other enteropathogenic bacteria, such as Campylobacter spp., Bacillus cereus, enteropathogenic Escherichia coli, coagulase positive Staphylococcus aureus, Salmonella spp., Vibrio spp., Clostridium perfringens and Clostridium spiroforme, were not isolated from either of diarrheic rabbit . However, the counts of clostridia remarkably increased in the intestine of cefmetazole-associated diarrheic rabbits . This was ascribed to the overgrowth of Clostridium innocuum and Clostridium sporogenes . There were no remarkable differences in changes in other bacterial population between diarrheic and non-diarrheic rabbits. FEMS Immunol Med Microbiol, 1996 Dec 1, 16(2), 105 - 15 Molecular mimicry of host structures by bacterial lipopolysaccharides and its contribution to disease; Moran AP et al.; The core oligosaccharides of low-molecular-weight lipopolysaccharide (LPS), also termed lipooligosaccharide (LOS), of pathogenic Neisseria spp . mimic the carbohydrate moieties of glycosphingolipids present on human cells . Such mimicry may serve to camouflage the bacterial surface from the host . The LOS component is antigenically and/or chemically identical to lactoneoseries glycosphingolipids and can become sialylated in Neisseria gonorrhoeae when the bacterium is grown in the presence of cytidine 5'-monophospho-N-acetylneuraminic acid, the nucleotide sugar of sialic acid . Strains of Neisseria meningitidis and Haemophilus influenzae also express similarly sialylated LPS . Sialylation of the LOS influences susceptibility to bactericidal antibody, may decrease or prevent phagocytosis, cause down-regulation of complement activation, and decrease adherence to neutrophils and the subsequent oxidative burst response . The core oligosaccharides of LPS of Campylobacter jejuni serotypes which are associated with the development of the neurological disorder, Guillain-Barre syndrome (GBS), exhibit mimicry of gangliosides . Cross-reactive antibodies between C . jejuni LPS and gangliosides are considered to play an important role in GBS pathogenesis . In contrast, the O-chain of a number of Helicobacter pylori strains exhibit mimicry of Lewis(x) and Lewis(y) blood group antigens . The role of this mimicry remains to be investigated, but may play a role in bacterial camouflage, the induction of autoimmunity and immune suppression in H . pylori-associated disease. J Neuroimmunol, 1996 Dec, 71(1-2), 155 - 61 Antibody to GalNAc-GD1a and GalNAc-GM1b in Guillain-Barré syndrome subsequent to Campylobacter jejuni enteritis; Yuki N et al.; N-Acetylgalactosaminyl GD1a (GalNAc-GD1a) is a proposed target molecule for serum antibody in some patients with Guillain-Barre syndrome (GBS) (Kusunoki et al., 1994) . We examined autoantibody to GalNAc-GD1a in sera from 58 GBS patients . Eight GBS patients had high IgG anti-GalNAc-GD1a antibody titers, 3 of whom also had high IgM anti-GalNAc-GD1a antibody titers . These 8 patients had experienced gastrointestinal infection before the onset of their neurological symptoms . Campylobacter jejuni was isolated from 4 of them . An absorption test indicated the presence of the GalNAc-GD1a epitope in lipopolysaccharides of C . jejuni . Sera that had anti-GalNAc-GD1a antibody reacted with several acidic glycolipids in bovine peripheral nerve, one of which was identified as N-acetylgalactosaminyl GM1b (GalNAc-GM1b) . Serum binding to GalNAc-GM1b was decreased by absorption with GalNAc-GD1a . The presence of GalNAc-GM1b as well as GalNAc-GD1a has been reported in human peripheral nerves . We assume that C . jejuni, which bears the {GalNAc beta 1-4 (NeuAc alpha 2-3) Gal beta 1-3 GalNAc beta 1-} epitope, is the immunogen and that the glycoconjugates with the epitope are target molecules for the autoantibody in peripheral nerves of some GBS patients. Eur J Gastroenterol Hepatol, 1996 Dec, 8(12), 1219 - 21 Campylobacter jejuni peritonitis in a patient with liver cirrhosis; Vermeij CG et al.; A 56-year-old man with alcoholic liver cirrhosis (Child-Pugh class C), ascites and hepatocellular carcinoma developed acute diarrhoea and fever . Ascites granulocyte count was 5760 per microliters . Campylobacter jejuni grew in cultures from faeces, blood and ascites . The patient was successfully treated with erythromycin . Although the incidence of bacterial infections including peritonitis is high in patients with end-stage liver cirrhosis, this is one of very few cases in which Campylobacter jejuni has been identified as the causative microorganism. Gastrointest Endosc, 1996 Dec, 44(6), 663 - 6 Results of culture form colonoscopically obtained specimens for bacteria and fungi in HIV-infected patients with diarrhea; Beaugerie L et al.; BACKGROUND: The aim of our study was to determine the diagnostic yield of culture for bacteria and fungi from colonic biopsy specimens in 290 consecutive HIV-infected patients with diarrhea . METHODS: During each colonoscopy, three biopsy specimens were homogenized and cultured on media for Salmonella and Shigella and for Campylobacter and Yersinia, on Loewenstein medium and on Sabouraud medium . RESULTS: Cultures were found positive for one (n = 32) or two (n = 5) infectious agents in 37 cases, i.e., in 12.8% of the patients . Bacteria were isolated in 24 cases, and identified as Campylobacter jejunl-coli (n = 14), Salmonella (n = 2), Shigella (n = 1), or Pseudomonas aeruginosa (n = 7) . Among the 14 patients with C . jejuni-coli intestinal infection, 11 had normal-appearing mucosa at colonoscopy, and 3 had a concomitant stool culture negative for Campylobacter . Mycobacterial cultures were positive for Mycobacterium avium intracellulare in 6 patients, who were already known as having a disseminated M . avium intracellulare infection from positive blood cultures . Fungal cultures were positive for Candida in 10 cases, without clear clinical significance . CONCLUSIONS: The overall yield of culture for bacterial pathogens from colonic tissue in HIV-infected patients with diarrhea is low, but some individual cases of C . jejuni-coli infections may be detected from colonic tissue culture and not diagnosed by concomitant stool culture. Epidemiol Infect, 1996 Dec, 117(3), 463 - 70 Experimental studies on the infectivity of non-culturable forms of Campylobacter spp . in chicks and mice; van de Giessen AW et al.; The significance of non-culturable forms of Campylobacter spp., especially with regard to the epidemiology of this organism in poultry flocks, was explored . Two different experiments were conducted to produce non-culturable Campylobacter spp . and test their ability to colonize the animal gut . In the first experiment a mixture of 28 different strains of Campylobacter spp . from various sources was inoculated in both sterilized surface water and potassium phosphate buffer and stored at 4 degrees C . After Campylobacter spp . were no longer detectable by culture in the microcosms, the mixtures of non-culturable cells were used to challenge both chicks and mice . Recovery of non-culturable Campylobacter spp . from the animals was not successful at 4 weeks after administration . In the second experiment the survival of six individual strains of Campylobacter spp . in sterilized surface water at 4 degrees C was studied and the resulting non-culturable cells were used to challenge chicks . None of the campylobacter strains could be recovered from the chicks at 2 weeks after administration . We conclude that occurrence of non-culturable forms of Campylobacter spp . capable of colonizing chicks is not a common phenomenon and that non-culturable forms of Campylobacter spp . are likely to be insignificant for importantly to the epidemiology of the organism in Dutch broiler flocks. Epidemiol Infect, 1996 Dec, 117(3), 457 - 62 A milk-borne campylobacter outbreak following an educational farm visit; Evans MR et al.; After a nursery school trip to a dairy farm, 20 (53%) of 38 children and 3 (23%) of 13 adult helpers developed gastrointestinal infection . Campylobacter jejuni was isolated from 15 primary cases and from 3 of 9 secondary household cases . A cohort study of the school party found illness to be associated with drinking raw milk (relative risk 5.4, 95% confidence interval 1.4-20.4, P = 0.001) . There was a significant dose response relationship between amount of raw milk consumed and risk of illness (chi 2-test for linear trend 12.1, P = 0.0005) but not with incubation period, severity of symptoms or duration of illness . All 18 human campylobacter isolates were C . jejuni resistotype 02 and either biotype I (number 16) or biotype II (number 2) . Campylobacter was also isolated from samples of dairy cattle and bird faeces obtained at the farm but these were of different resisto/biotypes . Educational farm visits have become increasingly popular in recent years and this outbreak illustrates the hazard of exposure to raw milk in this setting. J Appl Bacteriol, 1996 Dec, 81(6), 635 - 40 Heat-stable serotyping antigens expressed by strains of Campylobacter jejuni are probably capsular and not long-chain lipopolysaccharide; Chart H et al.; The role of lipopolysaccharide (LPS) in the serotyping of Campylobacter jejuni based on heat-stable antigens was examined using SDS-PAGE and a silver stain for carbohydrate . None of the 32 type strains of Camp . jejuni expressed long-chain LPS . Rabbit antibodies, prepared to 10 selected strains of Camp . jejuni, reacted with surface-exposed carbohydrate antigens, which were not LPS . This study suggests that the heat-stable antigens of Camp . jejuni, which form the basis for the established Penner serotyping scheme, are probably capsular and not LPS. FEMS Microbiol Lett, 1996 Dec 1, 145(2), 209 - 14 Degradation of lactoferrin by periodontitis-associated bacteria; Alugupalli KR et al.; The degradation of human lactoferrin by putative periodontopathogenic bacteria was examined . Fragments of lactoferrin were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and measured by densitometry . The degradation of lactoferrin was more extensive by Porphyromonas gingivalis and Capnocytophaga sputigena, slow by Capnocytophaga ochracea, Actinobacillus actinomycetemcomitans and Prevotella intermedia, and very slow or absent by Prevotella nigrescens, Campylobacter rectus, Campylobacter sputorum, Fusobacterium nucleatum ssp . nucleatum, Capnocytophaga gingivalis, Bacteroides forsythus and Peptostreptococcus micros . All strains of P . gingivalis tested degraded lactoferrin . The degradation was sensitive to protease inhibitors, cystatin C and albumin . The degradation by C . sputigena was not affected by the protease inhibitors and the detected lactoferrin fragments exhibited electrophoretic mobilities similar to those ascribed to deglycosylated forms of lactoferrin . Furthermore a weak or absent reactivity of these fragments with sialic acid-specific lectin suggested that they are desialylated . The present data indicate that certain bacteria colonizing the periodontal pocket can degrade lactoferrin . The presence of other human proteins as specific inhibitors and/or as substrate competitors may counteract this degradation process. Appl Environ Microbiol, 1996 Dec, 62(12), 4614 - 20 Microbial ecology of Campylobacter jejuni in a United Kingdom chicken supply chain: intermittent common source, vertical transmission, and amplification by flock propagation; Pearson AD et al.; A study of Campylobacter jejuni on a broiler chicken farm between 1989 and 1994 gave an estimated isolation rate of 27% (3,304 of 12,233) from a 0.9% sample of 1.44 million broiler chickens from six to eight sheds over 32 consecutive rearing flocks comprising 251 broiler shed flocks . During the study, C . jejuni was found in 35.5% of the 251 shed flocks but only 9.2% (23 of 251) had Campylobacter isolates in successive flocks, with 9 of those 23 sheds having the same serotype between consecutive flocks, indicating a low level of transmission between flocks . Analysis of a systematic sample of 484 of 3,304 (14.6%) C . jejuni isolates showed that 85% were of 10 serotype complexes but 58% were of 3 serotype complexes, indicating a high degree of strain similarity throughout the entire study . The three commonest types were detected in 8 of 32 flocks during the 5-year study period, suggesting an intermittent common external Campylobacter source . This hypothesis was tested by a retrospective cohort analysis of C . jejuni rates and types by reference to hatchery supplier of the 1-day-old chicks . Isolation rates of C . jejuni and frequency distribution of types were determined in 6-week-old broiler chickens identified by the hatchery supplying the original chicks . The isolation rate of C . jejuni in broilers, supplied by hatchery A, was 17.6%, compared to 42.9% (P < 0.0001) for broilers reared from chicks supplied by hatchery B . In two instances, when both hatcheries were used to stock the same farm flock, Campylobacter isolates were found only in those sheds with chicks supplied by hatchery B . Thus, the frequency distribution of Campylobacter types for chickens supplied by the two hatcheries over the 5-year period showed marked dissimilarity . These findings suggest that the isolation rate and type of Campylobacter isolates in broiler chickens was associated with the hatchery supplying chicks . The lack of diversity of types and the intermittent high positivity of sheds is evidence for a common source of C . jejuni introduced by vertical transmission rather than contamination at the hatchery or during transportation. Infect Immun, 1996 Dec, 64(12), 4933 - 9 Murine intranasal challenge model for the study of Campylobacter pathogenesis and immunity; Baqar S et al.; Campylobacter jejuni infection of mice initiated by intranasal administration was investigated as a potential model for studies of pathogenesis and immunity . By using a standard challenge (5 x 10(9) CFU), C . jejuni 81-176 was more virulent for BALB/c (72% mortality) than for C3H/Hej (50%), CBA/CAJ (30%), or C58/J (0%) . Intranasal challenge of BALB/c was used to compare the relative virulence of three reference strains; C.jejuni 81-176 was more virulent (killing 83% of challenged mice) than C . jejuni HC (0%) or C . coli VC-167 (0%) . The course of intranasally initiated C . jejuni 81-176 infection in BALB/c was determined . C . jejuni was recovered from the lungs, intestinal tract, liver, and spleen at 4 h after challenge, the first interval evaluated . After this initial interval, three distinct patterns of infection were recognized: (i) a progressive decline in number of C . jejuni CFU (stomach, blood, lungs), (ii) decline followed by a second peak in the number of organisms recovered at 2 or 3 days postchallenge (intestine, liver, mesenteric lymph nodes), and (iii) persistence of approximately the same number of C.jejuni CFU during the course of the experiment (spleen) . Intranasally induced infection initiated with a sublethal number of bacteria or intranasal immunization with killed Campylobacter preparations resulted in both the generation of Campylobacter antigen-specific immune responses and an acquired resistance to homologous rechallenge . The model was used to evaluate the relative virulence of nine low-in vitro-passage (no more than five passages) isolates of C . jejuni species from patients with diarrhea . The patient isolates were differentially virulent for mice; one killed all exposed mice, three were avirulent (no deaths) and the remainder showed an intermediate virulence, killing 17 to 33% . Mouse virulence of Campylobacter strains showed a trend toward isolates originating from individuals with watery diarrhea; however, no association was found between mouse virulence and other signs or symptoms . There were no observed relationships between mouse virulence and bacterial Lior serotype or Fla polymorphic group . Intranasal challenge of BALB/c with C . jejuni is a useful model for the study of infection and vaccination-acquired immunity to this agent. J Clin Microbiol, 1996 Dec, 34(12), 3129 - 37 Differentiation of bacterial 16S rRNA genes and intergenic regions and Mycobacterium tuberculosis katG genes by structure-specific endonuclease cleavage; Brow MA et al.; We describe here a new approach for analyzing nucleic acid sequences using a structure-specific endonuclease, Cleavase I . We have applied this technique to the detection and localization of mutations associated with isoniazid resistance in Mycobacterium tuberculosis and for differentiating bacterial genera, species and strains . The technique described here is based on the observation that single strands of DNAs can assume defined conformations, which can be detected and cleaved by structure-specific endonucleases such as Cleavase I . The patterns of fragments produced are characteristic of the sequences responsible for the structure, so that each DNA has its own structural fingerprint . Amplicons, containing either a single 5'-fluorescein or 5'-tetramethyl rhodamine label were generated from a 620-bp segment of the katG gene of isoniazid-resistant and -sensitive M . tuberculosis, the 5' 350 bp of the 16S rRNA genes of Escherichia coli O157:H7, Salmonella typhimurium, Salmonella enteritidis, Salmonella arizonae, Shigella sonnei, Shigella dysenteriae, Campylobacter jejuni, staphylococcus, hominis, Staphylococcus warneri, and Staphylococcus aureus and an approximately 550-bp DNA segment comprising the intergenic region between the 16S and 23S rRNA genes of Salmonella typhimurium, Salmonella enteritidis, Salmonella arizonae, Shigella sonnei, and Shigella dysenteriae serotypes 1, 2, and 8 . Changes in the structural fingerprints of DNA fragments derived from the katG genes of isoniazid-resistant M . tuberculosis isolates were clearly identified and could be mapped to the site of the actual mutation relative to the labeled end . Bland patterns which clearly differentiated bacteria to the level of genus and, in some cases, species were generated from the 16S genes . Cleavase I analysis of the intergenic regions of Salmonella and Shigella species differentiated genus, species, and serotypes . Structural fingerprinting by digestion with Cleavase I is a rapid, simple, and sensitive method for analyzing nucleic acid sequences and may find wide utility in microbial analysis. Gene, 1996 Nov 28, 181(1-2), 109 - 12 The aroA gene of Campylobacter jejuni; Wosten MM et al.; The gene for 5-enolpyruvylshikimate-3-phosphate (EPSP) synthase (aroA) cloned from Campylobacter jejuni (Cj) strain 81116 was identified by complementation of an Escherichia coli (Ec) auxotrophic aroA mutant . The Cj aroA gene has been sequenced . It encodes an enzyme of 428 amino acids (aa), that is homologous to other bacterial EPSP synthases, especially that of Bacillus subtilis with which it has a 39% aa identity . The transcriptional start point was mapped . It is present in an upstream open reading frame (ORF) that has a strong homology to the gene encoding phenylalanine tRNA synthetase (pheS) . Downstream from aroA another ORF is present which is homologous to the lytB gene of Ec . The stop codon of the aroA gene overlaps the start codon of lytB. Tidsskr Nor Laegeforen, 1996 Nov 20, 116(28), 3366 - 9 {Water-borne campylobacter infection--probably caused by pink-footed geese . Two outbreaks in Nord-Trøndelag, Stjørtdal in 1994 and Verdal in 1995}; Varslot M et al.; The authors describe two water-borne outbreaks of Campylobacter gastroenteritis that occurred in central Norway in 1994 and 1995 . The epidemics were probably caused by contamination of drinking water by the stools of Pink-footed geese on the way from Svalbard to Germany-Netherlands . Campylobacter jejuni from the stools of the geese was transmitted to the population via untreated drinking water, causing disease in 50% of the population . About 1,000 persons suffered from gastroenteritis caused by contaminated drinking water in these two epidemics. Diagn Microbiol Infect Dis, 1996 Nov-Dec, 26(3-4), 103 - 8 Comparison of polymerase chain reaction and pulsed-field gel electrophoresis for the epidemiological typing of Campylobacter jejuni; Shi ZY et al.; Seventeen sporadic Campylobacter jejuni enteritis cases occurred in Taichung City, Taiwan between July 1995 and September 1995 . Pulsed-field gel electrophoresis (PFGE) and enterobacterial repetitive intergenic consensus (ERIC-1) primed polymerase chain reaction (PCR) techniques were compared for the epidemiological typing of the 17 C . jejuni isolates . Fourteen distinct PFGE fingerprint patterns were observed . Fifteen distinct PCR fingerprint patterns were demonstrated . Two clusters of isolates (isolates 5 and 6; isolates 10, 11 respectively) were found to be genetically indistinguishable by both methods . In conclusion, we consider that PFGE is a highly reproducible method for determining the relatedness among the C . jejuni isolates in this study, although their limited numbers of restriction fragments may reduce the discriminatory power . Although less reproducible than PFGE typing, ERIC-1 primed PCR can be used as a simple and rapid tool to discriminate different strains of C . jejuni. J Dent Res, 1996 Nov, 75(11), 1901 - 8 Plaque pH and microflora of dental plaque on sound and carious root surfaces; Aamdal-Scheie A et al.; Given the hypothesis that root caries is the result of acid formation by acidogenic micro-organisms, the present study was performed to relate sucrose-induced pH response of dental plaque on root surfaces to the microbial composition of the overlying plaque . Seventeen caries-active elderly Chinese with poor oral hygiene and with both sound and carious root surfaces were examined . Plaque pH was measured before and up to one hour after a controlled sucrose mouthrinse . Plaque samples for microbiologic analyses were collected from 2 sound and 2 or 3 carious pH-measurement sites in each subject . The prevalence of the following micro-organisms was assessed as % of total viable counts on Brucella agar: Prevotella intermedia, Prevotella melaninogenica, Fusobacterium nucleatum, Campylobacter rectus, Capnocytophaga spp., Actinomyces viscosus, Actinomyces naeslundi, Streptococcus spp., S . sanguis, S . mitis, S . mutans, S . sobrinus, Lactobacillus spp., and Candida spp . There was no difference in plaque pH response on sound and carious root surfaces . The plaque pH response was more pronounced in the maxilla than in the mandible for both sound and carious sites . There was no difference in microbial composition of dental plaque on sound and carious root surfaces . The pH response to sucrose was the same regardless of the presence or absence of mutans streptococci . Our results thus do not readily support the traditional concept of caries formation. Berl Munch Tierarztl Wochenschr, 1996 Nov-Dec, 109(11-12), 434 - 9 {Helicobacter pylori: antibodies in sera of pigs and calves}; Seidel KE et al.; 64 sera of pigs and 22 sera of calves were investigated in a Helicobacter pylori-ELISA . The test system was validated with positive and negative reference sera . In contrast to other investigations it was tried to exclude false positive results by absorbing the sera with Wolinella succinogenes, Campylobacter jejuni subsp.jejuni, E . coli and Proteus mirabilis . This proved to be necessary, as the extinctions of some sera were reduced considerably . Using this technique sera of 5 pigs and 6 calves could be identified, which fulfilled the following criteria: 1 . The extinctions were statistically significant above the mean value of the corresponding group after absorption with Campylobacter jejuni subsp.jejuni . 2 . After absorbing the sera of pigs with 3 and the sera of calves with 4 bacteria the extinctions were above 50% of that of the human positive serum . 3 . The extinctions of these sera were-like the positive reference sera-nearly not influenced by the absorption . These results indicate the presence of serum antibodies in pigs and calves, which react with epitops from Helicobacter pylori. J Periodontol, 1996 Nov, 67(11), 1164 - 9 The adherence of periodontopathogens to periodontal probes . A possible factor in intra-oral transmission? Papaioannou W, Bollen CM, Van Eldere J, Quirynen M. Periodontal probes have previously been shown to harbor several bacterial types or species after probing periodontally diseased pockets . This study aims to identify and quantify periodontopathogens that may adhere to a periodontal probe by culturing techniques . It also examines the probe's roughness on its capability to collect bacteria, comparing Merrit-B probes (with deep indentations) with TPS probes (with smooth surfaces) . From the differential phase contrast microscopy findings it was seen that, while paper-points harbored nearly 50% motile rods or spirochetes, the periodontal probes were just at, or below, the 20% threshold level for pathogenicity (23.6% for the Merrit-B probe and 11.3% for the TPS probe) . The cultural data showed that paper-points had significantly higher (P < 0.05) numbers of anaerobic bacteria than the 2 probe types, which still harbored up to 10(7) CFU . No significant differences could be detected between the probes . When specific periodontopathic species were considered, it was seen that for all species, even for Actinobacillus actinomycetemcomitans or Porphyromonas gingivalis, the detection frequency was comparable for the 3 sampling devices . However, the levels of Prevotella intermedia and Campylobacter rectus was significantly higher in samples from paper-points (P < 0.05), but still their numbers reached even 10(5) on the probes . Differences among the 2 probe types were again negligible . Periodontal probes harbor relatively high numbers of bacteria found in periodontal pockets and may be able to carry them over to other sites . Further studies are needed to determine if, and to what extent, transmission occurs during periodontal probing. FEMS Immunol Med Microbiol, 1996 Nov, 16(1), 45 - 9 A combined polymerase chain reaction and restriction endonuclease enzyme assay for discriminating between Campylobacter coli and Campylobacter jejuni; Comi G et al.; A combined polymerase chain reaction and restriction endonuclease (RE) enzyme assay was developed to discriminate between Campylobacter coli and Campylobacter jejuni . Amplimers of the FlaA gene obtained by PCR were digested with AluI and HinfI to distinguish C . coli from C . jejuni . With AluI digestion C . jejuni-specific bands were observed at 110, 140 and 160 bp and C . coli-specific bands at 293 and 147 bp . C . jejuni-specific bands of 349 and 109 bp were found by HinfI digestion but HinfI did not digest the FlaA amplimer of C . coli . This combined technique is fast and easy to perform, and distinguishes the two campylobacters unequivocally. Clin Diagn Lab Immunol, 1996 Nov, 3(6), 669 - 77 Development of a rapid and specific colony-lift immunoassay for detection and enumeration of Campylobacter jejuni, C . coli, and C . lari; Rice BE et al.; Contamination of retail poultry by Campylobacter spp . is a significant source of human diarrheal disease . We have developed a colony-lift immunoassay (CLI) for the detection of Campylobacter jejuni, C . coli, and C . lari isolated from such sources and grown on selective agar medium or on filter membranes . This technique has been successfully utilized to quantify Campylobacter colonies within 18 to 28 h after sampling . Hydrophobic, high-protein-binding membranes were prewet with methanol and used to imprint bacterial cells from the agar or filter membrane, while leaving colonies intact and viable . The membranes were air dried, peroxidase neutralized, blocked with bovine serum albumin in phosphate-buffered saline, and hybridized for 5 min with an affinity-purified, horseradish peroxidase-labeled goat anti-Campylobacter antibody preparation (Kirkegaard and Perry Laboratories) . The membranes were washed briefly, exposed to a 3,'5,5'-tetramethylbenzidine membrane substrate, rinsed in deionized water, and allowed to dry . Lifted colonies of Campylobacter were identified by a blue color reaction on the membrane . Replicas of the membranes were made by marking the location of the Campylobacter colonies on clear transparencies, which were subsequently utilized to locate the original colony on the filter membrane or agar plate . The specificity of this antibody preparation has been evaluated against a wide range of Campylobacter spp., including American Type Culture Collection type and references strains, retail poultry isolates, and isolates obtained from cloacal swabs of live commercial broiler chickens . Specificity against numerous non-Campylobacter spp . obtained from the same sources was also evaluated . The CLI provided a rapid and simple means for detection and enumeration of enteropathogenic Campylobacter organisms . We have successfully combined this CLI procedure with methods recently developed in our laboratories for retail meat and poultry sampling . Potentially, broader applications for use of this technique include detection and enumeration of campylobacters from clinical, veterinary, and environmental samples. South Med J, 1996 Nov, 89(11), 1123 - 4 Transient Campylobacter bacteremia in a healthy child; Smally AJ et al.; A 7-month-old immunocompetent child was brought to the emergency department with fever and diarrhea . Blood and stool cultures grew Campylobacter species . Campylobacter bacteremia resolved without treatment. Presse Med, 1996 Oct 5, 25(29), 1331 - 2 {Campylobacter fetus meningitis in adults}; Wilhelm JM et al.; Campylobacter fetus is an uncommon cause of meningitis in the adult . We report a case observed in an 84-year-old man with alcoholic cirrhosis . The patient presented fever, jaundice and a state of mental confusion . Blood and cerebrospinal fluid cultures identified Campylobacter fetus sensitive to several antibiotics . Ciprofloxacine-ceftriaxone combination replaced the antibiotics prescribed empirically prior to identification and led to regression of the fever and normal mental status within 4 days . Spinal tap on day 7 showed 20 white cells, 85% lymphocytes and normal protein level . Unfortunately, the patient later developed edema and ascitis with major jaundice . Oligo-anuria could not be controlled and the patient died two weeks after admission . Campylobacter fetus meningitis is predominantly seen in men, mean age of onset 50 years . Clinical signs are not specific and diagnosis can only be obtained on the basis of cerebrospinal fluid results . Adapted antibiotics are required. Res Microbiol, 1996 Oct, 147(8), 641 - 9 Flagellin gene profiling of Campylobacter jejuni heat-stable serotype 1 and 4 complex; Santesteban E et al.; Flagellin gene (flaA) sequence polymorphisms were used to discriminate amongst 167 strains of Campylobacter jejuni serotype HS1 and the HS4 complex . Direct PCR of cell suspensions provided a rapid method for analysing DNase-negative strains, whereas purified DNA was necessary for the DNase-positive strains . Nine different PCR-RFLP patterns (genotypes) were identified by analysis with Hinfl and 12 with Ddel, giving a total of 19 combined flaA profile types . The most common combined fla types were H1D1 (35%) and H1D2 (20%) for serotype HS1, and H1D2 (23%) and H4D7 (43%) for serotype HS4 . Comparison of flaA typing with other key subtyping methods for C . jejuni showed it to be less discriminatory than pulsed field gel electrophoretic (PFGE) profiling, but more so than ribotyping . Fla types provided a useful indication of strain diversity, but as some were conserved across different serotypes, ribotypes and PFGE types, the same fla type could not be used as the sole basis for grouping strains . We provide evidence for several distinct subgroups based on conserved multiple genomic criteria within the HS1 and HS4 strains, and conclude that monitoring of such subgroups could provide a novel basis for future epidemiological surveillance of C . jejuni. Aust N Z J Public Health, 1996 Oct, 20(5), 457 - 62 Haemolytic-uraemic syndrome in the Hunter: public health implications; Miles TA et al.; Three cases of haemolytic-uraemic syndrome in the Hunter area were reported in February 1995 . An investigation was initiated to identify any verocytotoxic Escherichia coli in clinical samples that could be associated with the development of the disease . Escherichia coli O6:H- and O2:H7 were isolated from Case 1 . No organisms were identified for Case 2, and Case 3 samples yielded Campylobacter jejuni . In addition, efforts were made to trace sources of any such pathogens in food samples or in the environment generally . Shiga-like toxins were found in meat products sampled from butchers' shops patronised by the families of the three cases . However, it was not found possible to match stool samples with samples of food from sources used by the families of the children . Environmental factors seemed likely to have played a significant role in the development of haemolytic-uraemic syndrome in Case 3 . It is suggested that the incidence of the disease may be reduced by increasing the frequency of testing of meat products for Shiga-like toxins I and II and through educational and research programs. Jpn J Antibiot, 1996 Oct, 49(10), 917 - 25 {Clinical evaluation of azithromycin in pediatric infections}; Nishimura T et al.; Azithromycin (AZM) was studied for its clinical efficacy in pediatric infections . The study on AZM was carried out in 43 patients whose diagnoses were given as follows: pharyngitis in five cases, tonsillitis in one, bronchitis in four, pneumonia in four, Mycoplasma pneumonia in 14, scarlet fever in nine, impetigo in four, pyodermia in one and Campylobacter enteritis in one . The patients received AZM once daily at 1.6 approximately 20.0 mg/kg body weight for three to five days . Effectiveness of AZM was evaluated in 39 cases and the drug was rated "excellent" in 15, "good" in 19, "fair" in one, "poor" in four, resulting in an efficacy rate of 87.2% . Twenty bacterial isolates were identified as causative isolates in 19 patients: Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, Campylobacter jejuni and Mycoplasma pneumoniae . AZM eradicated 16 isolates but four persisted after therapy . One patient complained of loose stool, while two patients were found with decreases in white blood cell counts, and seven showed increases in eosinophils . However, no serious case of adverse event was reported. Avian Dis, 1996 Oct-Dec, 40(4), 945 - 9 Isolation of paramyxovirus serotype 7 from ostriches (Struthio camelus); Woolcock PR et al.; Paramyxovirus serotype 7 (PMV-7) was isolated from pooled intestinal contents of two 5-month-old ostriches (Struthio camelus) . The pathogenicity of the virus was comparable with lentogenic strains of Newcastle disease virus (PMV-1) in chicken and chicken embryo pathogenicity tests . The relationship of the virus to the observed pathology of proliferative nonsuppurative enteritis is unknown; the Campylobacter jejuni isolated was presumably the primary pathogen . To our knowledge, this is the first report of an isolation of PMV-7 from ostriches. Infect Immun, 1996 Oct, 64(10), 4060 - 6 Adherence to lipids and intestinal mucin by a recently recognized human pathogen, Campylobacter upsaliensis; Sylvester FA et al.; Campylobacter upsaliensis is a recently recognized human enteric pathogen associated with enteritis, colitis, bacteremia, and sepsis . Very little is known about the mechanisms of pathogenesis of this organism . The goals of this study were to determine whether C . upsaliensis binds to epithelial cells and whether there are specific lipid molecules that might serve as cell membrane receptors . In addition, we also explored C . upsaliensis binding to purified human small-intestinal mucin, since the mucus gel overlying the epithelium provides an initial contact surface for the bacteria and must be penetrated for the organisms to reach their cell receptors . Binding of C . upsaliensis to model epithelial cells was shown by microscopy adhesion assays, and binding to lipids was detected by thin-layer chromatography-overlay assays . Bacteria bound to phosphatidylethanolamine (PE), gangliotetraosylceramide (Gg4), and, more weakly, to phosphatidylserine (PS) . There was no binding to ceramide, cholesterol, phosphatidylcholine, and globosides . Using receptor-based microtiter well immunoassays, we observed binding to be equal, specific, and saturable for PE and Gg 4 but low and nonspecific for PS . At least five bacterial surface proteins (50 to 90 kDa) capable of PE binding were identified by a lipid-silica affinity column technique . In slot blot overlay assays, biotin-labeled C . upsaliensis also bound in a concentration-dependent fashion to purified human small-intestinal mucin, implying that these microorganisms also express an adhesin(s) recognizing a specific mucin epitope(s) . We speculate that binding to mucins may influence access of the bacteria to cell membrane receptors and thereby influence host resistance to infection. Trop Med Int Health, 1996 Oct, 1(5), 679 - 83 Aetiology of acute diarrhoea in hospitalized children in Hong Kong; Biswas R et al.; To determine the role of enteric pathogens in acute childhood diarrhoea in Hong Kong, 388 children with diarrhoea and 306 children of similar age without diarrhoea were evaluated in a hospital-based study during a one-year period from August 1994 to July 1995 . Of the diarrhoeal cases, 55% were under 1 year and 95% were below 5 years of age . On admission, 22% had some dehydration but none was severely dehydrated . All children were well nourished . Oyer 60% of children with diarrhoea had one or more pathogens in their stool . Rotavirus was the most commonly isolated pathogen (34.6%), followed by Salmonella (23.3%), Campylobacter (4.7%) and Shigella (2.1%) . Rotavirus was not assessed in the controls and was detected mainly during the winter months December to February . Bacterial pathogens were identified more commonly in diarrhoea patients (30%) than in controls (5.6%) (P < 0.001) . Despite rapid recent socioeconomic development in Hong Kong, non-typhoidal Salmonella diarrhoea remains a significant local problem in infants under 1 year . Further detailed assessment of the transmission and prevention of this infection is required. Microb Pathog, 1996 Oct, 21(4), 299 - 305 Host signal transduction and endocytosis of Campylobacter jejuni; Wooldridge KG et al.; Caveolae are plasma membrane invaginations found in a variety of mammalian cells and are implicated in clathrin-independent endocytosis and signal transduction . Here we show that pretreatment of Caco-2 cell monolayers with filipin III, which disrupts caveolae by chelating cholesterol, significantly reduces the ability of Campylobacter jejuni to enter these cells . Furthermore inhibitors of host protein tyrosine phosphorylation, the phosphatidylinositol-3 kinase (Pl 3-kinase) inhibitor wortmannin, and cholera toxin, all significantly reduced invasion of Caco-2 cells by C . jejuni. J Appl Bacteriol, 1996 Oct, 81(4), 425 - 32 A probability matrix for the identification of campylobacters, helicobacters and allied taxa; On SL et al.; A probabilistic identification matrix for campylobacteria, comprising 76 phenotypic characters and 37 taxa, is described . The accuracy and integrity of the matrix was evaluated using established computer-assisted methods . Certain taxa (for example, Campylobacter concisus and Camp . gracilis) demonstrated significant phenotypic diversity; previous data corroborated these findings . Differentiation between a few pairs of taxa proved difficult, although discriminatory characteristics were noted in each of these cases . The results indicate that most campylobacteria can be identified accurately and objectively with phenotypic tests when probabilistic methods of data assessment are employed. Pediatr Infect Dis J, 1996 Oct, 15(10), 876 - 83 Enteropathogens associated with childhood diarrhea in Italy . The Italian Study Group on Gastrointestinal Infections; Caprioli A et al.; BACKGROUND: Infectious diarrheal diseases remain an important cause of childhood morbidity in industrialized countries . The knowledge of the etiology and epidemiology of childhood diarrhea in a given area is needed to plan any measure designed to prevent or ameliorate diarrheal illness and to develop practice guidelines for the most appropriate stool examination procedures . METHODS: We evaluated 618 children with diarrhea and 135 controls prospectively for viral, bacterial and parasitic enteric pathogens . Diarrheagenic Escherichia coli was identified by gene probes specific to different virulence factors . Stool filtrates were examined for the presence of free bacterial toxins by a cell culture cytotoxicity assay . Clinical and epidemiologic data were recorded and analyzed in relation to microbiologic findings . RESULTS: Enteropathogens were identified in 59% of children with diarrhea and in 10.4% of asymptomatic controls . The agents mainly associated with disease were rotavirus (23.6%), Salmonella (19.2%) and Campylobacter (7.9%) . Rotavirus was significantly more frequent among children observed as inpatients whereas Campylobacter was significantly more common in outpatients . Infections with diarrheagenic E . coli, Shigella flexneri, yersinia enterocolitica, Cryptosporidium and Giardia were observed in a limited number of patients . The clinical presentation of children was not sufficiently characteristic to permit presumptive diagnosis of a specific pathogen . conversely the presence of blood and/or leukocytes in stools had a high positive predictive value for Salmonella or Campylobacter infection . CONCLUSION: The results of this study will be useful for planning strategies to prevent and control diarrheal diseases in our country. Curr Opin Neurol, 1996 Oct, 9(5), 329 - 33 The immunopathology of Guillain-Barré syndrome; Saida K; Identification of new antigens in different patterns of Guillain-Barre syndrome has led to new pathophysiological concepts of Guillain-Barre syndrome and the related Miller-Fisher syndrome . Patients with Guillain-Barre syndrome occurring after Campylobacter jejuni infection have been found to develop more frequently axonal and motor forms of the syndrome . Anti-GM1 antibodies decreased Na+ current in the presence of complement . In acute axonal Guillain-Barre syndrome, macrophages were found in the periaxonal space without damaging myelin sheath . Important epitopes may be localized on the axolemma, but further studies are needed to confirm these observations. Ann Pharmacother, 1996 Oct, 30(10), 1141 - 9 Dirithromycin: a new macrolide; Wintermeyer SM et al.; OBJECTIVE: To review the clinical microbiology and therapeutic use of dirithromycin, emphasizing comparative data between dirithromycin and the standard macrolide erythromycin, as well as clarithromycin and azithromycin . DATA SOURCES: A MEDLINE search of English-language literature during the years 1966-1996, and an extensive review of journals were conducted to prepare this article . DATA EXTRACTION: The data on pharmacokinetics, adverse effects, and drug interactions were obtained from open and controlled studies . Controlled single- or double-blind studies were evaluated to assess the efficacy of dirithromycin in the treatment of various upper and lower respiratory tract infections, as well as skin and soft tissue infections . DATA SYNTHESIS: The spectrum of activity of dirithromycin is similar to that of erythromycin, clarithromycin, or azithromycin, with some notable exceptions . Dirithromycin was more active in vitro against Campylobacter jejuni and Borrelia burgdorferi than was erythromycin or clarithromycin, but in general demonstrated less activity than erythromycin, clarithromycin, or azithromycin against a majority of microorganisms . The pharmacokinetic profile of dirithromycin offers the advantages of once-daily dosing and high and prolonged tissue concentrations; dosing adjustments are not needed in the elderly or in patients with renal or mild hepatic impairment . Clinical efficacy and bacteriologic eradication rates with dirithromycin and erythromycin are comparable for the treatment of respiratory and skin and soft tissue infections due to susceptible pathogens . Dirithromycin appears to have adverse effect profiles similar to those of the other macrolides, with reported problems most often related to the gastrointestinal tract . Dirithromycin does not seem to cause clinically important interactions with drugs such as theophylline, oral contraceptives, cyclosporine, or terfenadine . CONCLUSIONS: Dirithromycin offers some attractive pharmacokinetic properties . The long elimination half-life of dirithromycin allows once-daily dosing and higher and more prolonged tissue concentrations than are achievable with erythromycin . The spectrum of activity, adverse effect profile, clinical efficacy, and bacteriologic eradication rate of dirithromycin may be similar to those of erythromycin . No significant drug interactions with dirithromycin have been reported . Based on available data, dirithromycin may not offer any unique clinical advantage over clarithromycin or azithromycin . Future clinical trials may reveal a special role for dirithromycin in patient care. J Neurol Neurosurg Psychiatry, 1996 Oct, 61(4), 362 - 8 Isolation and characterisation of T lymphocytes from sural nerve biopsies in patients with Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy; Ben-Smith A et al.; OBJECTIVES: To characterise cultured T lymphocytes from nerve biopsies in patients with Guillain-Barre syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP) . METHODS: Sural nerve biopsies, obtained from six patients with Guillain-Barre syndrome, four with CIDP, and six controls with other neuropathies, were cultured with 20 U/ml recombinant interleukin-2 (IL-2) for eight weeks . Flow cytometry was used to determine the phenotype of cultured T lymphocytes . Their proliferative responses to a range of bacterial antigens were also examined . RESULTS: T cell lines were established from four of six patients with Guillain-Barre syndrome, one of four with CIDP, one patient with peripheral nerve vasculitis, and none of five controls with non-inflammatory neuropathies . One of these T cell lines from a patient with Guillain-Barre syndrome, preceded by Campylobacter jejuni infection, consisted entirely of gamma delta TCR+ T lymphocytes . The peripheral blood of this patient also contained an increased frequency of gamma delta T cells when stimulated with C jejuni . The nerve derived T cell lines failed to show a proliferative response to bacterial antigens or to a preparation of myelin proteins . CONCLUSIONS: A new technique to isolate T cells from nerve biopsies in patients with Guillain-Barre syndrome and CIDP is reported . This technique may prove to be a useful tool in the investigation of the pathogenesis of other inflammatory neuropathies such as peripheral nerve vasculitis . The isolation of a gamma delta TCR+ nerve T cell line is of interest because of the possibility that these cells might respond to glycolipid epitopes common to C jejuni and peripheral nerve gangliosides. J Clin Microbiol, 1996 Oct, 34(10), 2479 - 82 Helicobacter canis isolated from a dog liver with multifocal necrotizing hepatitis; Fox JG et al.; On the basis of biochemical, phenotypic, and 16S rRNA analysis, a novel gram-negative bacterium, isolated from normal and diarrheic dogs as well as humans with gastroenteritis, has been recently named Helicobacter canis . A 2-month-old female crossbred puppy was submitted to necropsy with a