An Esp Pediatr, 1989 Jul, 31(1), 54 - 6 {Gastroenteritis caused by enteric adenovirus serotypes 40 and 41 . Preliminary study}; Reina Prieto J et al.; We present the preliminary results of a prospective study of childhood gastroenteritis associated with enteric adenovirus (AE-40 and AE-41) . In a period of five months we have studied 499 children with enteritis; 9 (1.8%) were positive for enteric adenoviruses (latex agglutination) . The mean age of the children was 16.2 months (extreme ages 10 days and 5 years) . The mean duration of diarrhoea was 2.8 days with 4-5 times daily . Respiratory symptoms were present in 44.4% of the patients and one patient was infected simultaneously with Campylobacter jejuni . All clinical syndromes were self-limiting and were treated with diet and rehydration. Eur J Clin Microbiol Infect Dis, 1989 Jul, 8(7), 597 - 602 Influence of media supplements on growth and survival of Campylobacter pylori; Hazell SL et al.; Experiments were designed to determine the role of heme and the importance of other factors in the growth of Campylobacter pylori . Campylobacter pylori strains were tested for their ability to synthesize porphyrin, for their ability to grow and be maintained on basal medium and basal medium supplemented with blood or blood products, and for the influence of bovine serum albumin and catalase on viability . Results indicated that Campylobacter pylori does not require heme as a source of porphyrin . Growth of Campylobacter pylori could not be sustained on media containing starch or hemoglobin, but was sustained on media containing erythrocytes, serum, bovine serum albumin or catalase . The ability to grow on media containing bovine serum albumin and catalase suggests that protection from toxic fatty acids and the prevention of toxic product formation may be important factors in the growth and survival of Campylobacter pylori in vitro . Both bovine serum albumin and catalase combined provide the minimum requirements which allow the spectrum of Campylobacter pylori present in a single culture to grow on blood-free media. Eur J Clin Microbiol Infect Dis, 1989 Jul, 8(7), 592 - 6 Seroepidemiological study of the immune response to Campylobacter pylori in potential risk groups; Reiff A et al.; To gain more understanding of the epidemiology of Campylobacter pylori infection, the immune response to the organism was studied in the following selected potential risk groups: endoscopy staff (n = 45), dental staff (n = 58), orphanage children (n = 24), psychiatric patients (n = 58), and family contacts of Campylobacter pylori-infected patients (n = 55) . The frequency of an IgG and IgA antibody response in the different groups was determined by the immunoblot method and compared with that in an appropriate control group (n = 189) . The frequency of a positive antibody response was dependent on age (p less than 0.0001) but not on sex . When results were corrected for age by logistic regression analysis, all groups, with the exception of dental staff and orphanage children, revealed a significantly raised frequency of an IgA and combined IgG/IgA immune response compared to controls . There was not a significant difference for the IgG response, except in orphanage children . It is concluded that endoscopy staff, family contacts of Campylobacter pylori-infected patients and people living in closed communities such as psychiatric patients and orphanage children must be considered as risk groups for Campylobacter pylori infection . The findings support the notion that person-to-person spread and a common source are the predominant modes of transmission of Campylobacter pylori in addition to endoscopes. J Am Diet Assoc, 1989 Jul, 89(7), 948 - 54 "New" food-borne pathogens of public health significance; Ryser ET et al.; Recent work by epidemiologists and microbiologists has uncovered several hitherto unrecognized food-borne bacterial pathogens of public health significance . One of these, Listeria monocytogenes, has attracted considerable attention because of two major cheese-related outbreaks of listeriosis that were characterized by cases of meningitis, abortion, and perinatal septicemia . Thus far, L . monocytogenes has been responsible for well over 300 reported cases of food-borne listeriosis, including about 100 deaths, and has cost the dairy industry alone more than 66 million dollars as a result of product recalls . The ability of L . monocytogenes to grow at refrigeration temperatures, coupled with appearance of the pathogen in raw and processed meats, as well as poultry, vegetables, and seafood, makes this bacterium a serious threat to susceptible consumers and to the entire food industry . Yersinia enterocolitica, another psychrotrophic food-borne pathogen of recent concern, was linked to several outbreaks of yersiniosis associated with consumption of both raw and pasteurized milk, as well as contaminated water . Food-borne infections involving Y . enterocolitica typically result in enterocolitis, which may be mistaken for acute appendicitis . Unfortunately, inadvertent removal of healthy appendixes from victims of food-borne yersiniosis is all too common . Although known for many years, Campylobacter jejuni has only recently been recognized as a food-borne pathogen and a leading cause of gastroenteritis in the United States . Notable outbreaks of campylobacteriosis linked to consumption of raw milk, cake icing, eggs, poultry, and beef have underscored the need for thorough cooking and proper handling of raw products.(ABSTRACT TRUNCATED AT 250 WORDS) G E N, 1989 Jul-Sep, 43(3), 182 - 4 {Entamoeba histolytica stained with Warthin-Starry stain}; Olavarria R et al.; The Warthin-Starry stain have been used for coloring a different microorganism like spirochetas, Donovan bodies and Campylobacter and also melanin granules demonstration in soft tissues tumors . We started using the stain, as we know it, in order to stain the Histolytica amebas . We observed parasite stained black and brown as well as a good differentiation between endoplasm and ectoplasm where granular appearance, bacterial remnants and red cells were apparent . The stain was also usefull in differentiating amebas from histiocytes . We advice its use in amebiasis since is inexpensive and easy to do. G E N, 1989 Jul-Sep, 43(3), 169 - 72 {The urease test for the diagnosis of Campylobacter pylori infection}; Urrestarazu de Garcia MI et al.; To evaluate the usefulness of urea media routinely applied in the diagnosis of Campylobacter pylori infection, 50 patients with gastroduodenal pathology were studied . Two biopsies of antral mucosa were taken; one of them was placed on Urea Agar Base (Difco) prepared without agar, and the other in saline for Gram staining and culture in selective and enriched media . In 39 patients Campylobacter pylori was found by Gram staining and/or culture . 38 of them were urease test positive, 24 (61.5%) during the first hour, 8 (20.5%) between the first and fourth hours and 6 (15.3%) between 4 and 24 hours . The sensitivity of the test increased from 61.5% at the first hour to 82.0% and 97.3% at 4 and 24 hours, respectively . The specificity was 100% for all the readings . We believe that the urease test with medium of Urea Agar Base is useful for the diagnosis of Campylobacter pylori infection . However, we recommend the selection of two or three combined methods for better confirmation of the infection. J Clin Microbiol, 1989 Jul, 27(7), 1527 - 30 Comparison of rapid urease tests, staining techniques, and growth on different solid media for detection of Campylobacter pylori; Coudron PE et al.; Thirty-nine single antral biopsies (phase 1) and 99 sets of six antral biopsies (phase 2) were collected from 132 patients, and 87 (63%) yielded positive cultures for Campylobacter pylori . Of several primary media tested in phase 1, tryptic soy agar and Skirrow agar, each supplemented with 10% whole sheep blood, supported relatively good growth of C . pylori . In phase 2, four of the six biopsies in each set were tested with different urease systems . Selective urea agar for rapid identification was the most sensitive (39 of 63 {62%} at 1 h) and specific (100%); however, the difference between this system and the CLOtest was not statistically significant . The remaining two biopsies, one transported in saline and the other transported in a supplemented tryptic soy broth, were ground separately and inoculated onto tryptic soy agar and Skirrow agar, each supplemented with 10% whole sheep blood . In selected instances, 10% horse serum or 10% horse serum and 5 mM urea or 1% cholesterol were also added to the media . Smears stained with a modified Gram stain or acridine orange detected 68% of 63 culture-positive biopsies; no false-positive results were reported . Skirrow agar supported better growth of C . pylori than did tryptic soy agar; the nonselective medium was also overgrown with contaminants in 25 to 30% of the positive cultures . Based on colony size, Skirrow agar supplemented with 10% whole sheep blood, 10% horse serum, and 1% cholesterol supported optimal growth of C . pylori . Fresh media supported better growth than did prepoured commercial media (P less than or equal to 0.004) . Saline was a convenient and satisfactory transport medium for antral biopsies. J Clin Pathol, 1989 Jul, 42(7), 727 - 32 Campylobacter pylori infection in biopsy specimens of gastric antrum: laboratory diagnosis and estimation of sampling error; Morris A et al.; Campylobacter pylori infection was sought in 382 consecutive patients referred for upper gastrointestinal endoscopy . Five antral biopsy specimens were taken from each patient: one was inserted into a CLO-test to detect the urease activity of C pylori, two were sent for histological analysis where multiple sections were stained by the Warthin-Starry silver method, and two were sent for microbiological evaluation by Gram stain and culture . A patient was deemed to be infected when C pylori was cultured or seen in either the histological sections or the Gram stain of the biopsy smear . One hundred and seventy four (46%) patients were infected . Culture, Gram stain, histological examination and the CLO-test showed sensitivities of 92%, 87%, 93% and 90%, respectively . In 27 (15%) infected patients an uneven distribution of C pylori was seen between samples in the biopsy pair sent for histology . Examination of multiple sections stained with Warthin-Starry silver was more sensitive at detecting infection (93%) than examination of multiple sections from only one biopsy specimen (84%) . Fifty seven of 80 patients, biopsied a median seven days (range 5 to 55) after completing colloidal bismuth subcitrate treatment, were still infected with C pylori . There was no decrease in the sensitivities of the above tests to detect infection after treatment . It is concluded that at least two antral biopsy specimens should be examined when attempting to diagnose C pylori infection by histological methods. Practitioner, 1989 Jun 22, 233(1471), 927 - 31 Exotic diarrhoeal problems and poliomyelitis; Cobden I; PIP: Diarrhea affects approximately 330,000 travelers from industrialized nations each year . Diarrhea is a reflection of inadequate hygiene or waste disposal in the countries visited, usually developing countries . The greatest incidence occurs in 20-29 years olds who take the most dietary risks . Some foods that pose the greatest risk in descending order include raw oysters, steak tartare, ice cubes, washed vegetables, cold milk, puddings, and sandwiches with mixed fillings . 40% of all travelers have a self limiting and rarely grave diarrheal illness caused by local enterotoxigenic Escherichia coli (ETEC) . Following an incubation period of 5-9 days, symptoms appear (cramps, fever, and 10 or more diarrheal episodes/day) . 5% are infected with Giardia lamblia and 4% with Entamoeba histolytica . Giardiasis occurs worldwide and is characterized by grumbling diarrhea, cramps, and flatulence . E . histolytica causes a severe illness characterized by colitis with bloody stools, anorexia, malaise, sweats, weight loss, and epigastric pain . Only 10-100 Shigella bacteria are required by cause shigellosis . Symptoms include blood and mucus in the diarrhea and malaise . A traveler who ingests food with 100,000 Salmonella bacteria in it most likely will fall ill 48 hours after eating the contaminated food . Typhoid and paratyphoid fevers have an incubation period of about 12 days and may be fatal . Initial symptoms consists of headache, malaise, fever, and pain and 2 weeks later bloody diarrhea appears . Additional common diarrheal illnesses include cholera, post infectious tropical malabsorption, and those caused by Vibrio parahaemolyticus and Campylobacter species . Another disease common in areas of poor hygiene is poliomyelitis with fever, sore throat, and headache present in mild forms . If the virus invades the central nervous system, however, paralysis occurs . Schweiz Rundsch Med Prax, 1989 Jun 20, 78(25), 715 - 7 {Non-ulcer dyspepsia and Campylobacter pylori}; Restellini A et al.; Dyspepsia, defined as chronic vague upper abdominal symptoms, is a common condition . The pathogenesis of this syndrome remains poorly understood . The etiologic role of Campylobacter pylori and associated gastritis remain controversial though this organism colonizes the gastric antrum in one third to one half of patients with non-ulcer dyspepsia . Recent studies raise the prospect that treatment with bismuth improves gastritis and is successful in treating symptoms in the Campylobacter pylori positive and negative patients . To determine if Campylobacter pylori causes dyspepsia requires proof that long term eradication of the organism heals gastritis and abolishes symptoms. Orv Hetil, 1989 Jun 18, 130(25), 1325 - 9 {The significance of Campylobacter pylori infection in gastroenterologic and diabetic practice}; Simon L et al.; The presence of Campylobacter pylori was investigated in gastric antral biopsy specimens . In 50 consecutive patients undergoing upper gastrointestinal tract endoscopy microbiological cultures, histological examination and rapid urease test were parallel performed, and a 92 per cent sensitivity and 100 per cent specificity of rapid and cheap urease test were determined . Afterwards--in a prospective study--311 patients were examined for C . p . by the rapid urease test only . C . p . was detected in 92 per cent of duodenal ulcer patients, in 52 per cent of patients with gastric ulcer, in 67 per cent of non-ulcer dyspepsia, in 62 per cent of mixed diabetic patient material, and in 21 per cent only of asymptomatic volunteers . It has been found by the authors, that the rate of C . p . infection increased parallel with the continuance of diabetes and did not follow the increasing with age as in the general population . This is the first observation in the world literature concerning the correlation between C . p . and diabetes mellitus . Very close, significant correlation has been found between C . p . infection and chronic active gastritis . C . p . may play an important role in the recurrences of duodenal ulcer and in the pathogenesis of non-ulcer and diabetic dyspepsia . Further studies are planned to the correct evaluation of pathogeneity of Campylobacter pylori. CMAJ, 1989 Jun 15, 140(12), 1449 - 53 The prevalence of Campylobacter pylori gastritis among asymptomatic adults; Gregson DB et al.; To determine the prevalence of Campylobacter pylori colonization in the healthy population we studied 54 asymptomatic volunteers and 65 patients referred because of gastrointestinal symptoms . All subjects underwent gastroscopy and gastric biopsy . C . pylori was isolated from 6 volunteers (11%) and 36 patients (55%) . Histologic evidence of inflammation was present in 98% of the culture-positive subjects . Linear regression analysis revealed that the prevalence of C . pylori colonization increased with age . There was no difference in the isolation rate between the two groups when adjusted for age . Four of the six culture-positive volunteers underwent repeat endoscopy and gastric biopsy 1 year later; despite remaining asymptomatic, all still had positive culture results and histologic evidence of gastritis . We conclude that the prevalence of C . pylori-associated gastritis among symptomatic patients increases with age and that the organism may be present in the gastrointestinal tract for prolonged periods without symptoms or evidence of disease progression. Am J Med, 1989 Jun 9, 86(6A), 60 - 5 Effect of sucralfate and cimetidine on duodenal ulcer-associated antral gastritis and Campylobacter pylori; Hui WM et al.; The course of gastritis and Campylobacter pylori was studied in a single-blind randomized trial comparing cimetidine 200 mg three times a day and 400 mg at night and sucralfate 1 g four times a day orally for four weeks in 140 patients with proved duodenal ulcer . At least two antral biopsies were performed during endoscopy before entry and at the end of four weeks . The activity and the degree of chronic inflammation, as assessed histologically by the degree of infiltration of, respectively, polymorphs and chronic inflammatory cells, were graded blindly by two pathologists as nil, mild, moderate, or severe . The density of C . pylori, as assessed after Warthin-Starry stain, was similarly graded . Ulcer-healing rates were comparable in the cimetidine (73.2 percent) and sucralfate (79.7 percent) groups . Improvement of the activity of gastritis occurred significantly (p less than 0.05) more frequently in the sucralfate (33.3 percent) than in the cimetidine group (18.3 percent), and remained so (p less than 0.05) when only patients with healed ulcer were compared . The density of C . pylori decreased significantly in the sucralfate group after treatment (p less than 0.01) but not in the cimetidine group . The 12-month ulcer relapse rates were significantly (p less than 0.05) lower by life-table analysis in patients healed with sucralfate than in those healed with cimetidine and were unaffected by either the density of Campylobacter in either group or the improvement of the gastritis . It is concluded that sucralfate improves duodenal ulcer-associated antral gastritis and decreases the density of C . pylori, and that factors other than bacterial density and antral gastritis may be responsible for the advantage of sucralfate over cimetidine in ulcer relapse. Nippon Shokakibyo Gakkai Zasshi, 1989 Jun, 86(6), 1241 - 5 {Campylobacter pylori in gastro-duodenal diseases, with special reference to endoscopic diagnosis, histological inflammatory grading, and intestinal metaplasia}; Yoshida M et al.; To investigate the prevalence of Campylobacter pylori (CP) and its association with histological inflammatory grading and intestinal metaplasia, biopsies were carried out in 388 patients with gastro-duodenal diseases from 2 sites in the stomach (body and antrum) . In each case, 3 biopsy specimens were taken from each site for culture, acridine orange stain and urease test . CP was detected in 55% of 22 endoscopically normal patients, in 47% of 17 gastric cancer patients, in 73% of 205 gastritis patients in 91% of 99 gastric ulcer patients and in 100% of 45 duodenal ulcer patients . In gastric ulcer and duodenal ulcer patients, CP detection rate was significantly higher than in endoscopically normal patients (p less than 0.01) . There was no difference in CP detection rate irrespective of ulcer stage (active, healing or scar) . According to the histological gradings of inflammation (Warren's criteria), CP was detected in only 3% in grade 0-I, 20% in grade II and 83% in grade III . It was found that a close association between CP and histological gastritis with polymorphonuclear leukocytes infiltration exists (p less than 0.001) . In a few cases, CP was found even in the areas of intestinal metaplasia . But the number of CP in the areas of intestinal metaplasia were fewer than in the areas of surrounding inflamed gastric mucosa . In most cases, CP was not seen in the areas of intestinal metaplasia, but was found in the areas of surrounding inflamed gastric mucosa in the same biopsy specimen. J Clin Gastroenterol, 1989 Jun, 11(3), 271 - 7 The prevalence of Campylobacter pylori gastritis: a study of symptomatic nonulcer dyspepsia and bile gastritis; Tewari SN et al.; We assessed the prevalence of Campylobacter pylori in various forms of endoscopic gastritis, including ulcer and nonulcer dyspepsia and bile gastritis and correlated it with histological evidence of inflammation . Multiple biopsy specimens were taken from 120 patients, including four normal controls, who underwent upper gastrointestinal endoscopy for evaluation of upper abdominal pain and discomfort, nausea, bilious vomiting, weight loss, and anemia . The patients included 58 men and 62 women, with a mean age of 53 years . Of these, 16 patients had gastric ulcers, 19 had duodenal ulcers, 26 had reflux gastritis (after either gastric surgery or cholecystectomy), one had a gastric polyp, one had Barrett's esophagus, and the remaining 53 had gastritis due to unspecified causes . Campylobacter-like organisms were demonstrated by light and electron microscopy in 50 of 69 patients of the nonbile gastritis group (72%) and in seven of 15 patients of the bile gastritis group (47%) (p0.05) . The presence of bacteria in both groups correlated with histologically significant inflammation (particularly chronic active gastritis); similar histologic changes were noted in both major groups of nonbile gastritis and bile gastritis . Campylobacter pylori is common in all forms of gastritis in association with histologic inflammation. Mol Cell Probes, 1989 Jun, 3(2), 133 - 42 Rapid identification of Campylobacter species using oligonucleotide probes to 16S ribosomal RNA; Romaniuk PJ et al.; A comparison of the 16S ribosomal RNA sequences from various Campylobacter species was used to identify unique sequences which distinguish pathogenically significant campylobacters from other members of the genus . Oligonucleotides complementary to these sequences were synthesized, and under stringent conditions hybridization reactions using these probes and total RNA as the target nucleic acid displayed the desired species specificity . A simple, rapid lysis procedure was developed that allowed the specific detection of C . jejuni or C . coli from as few as 10(6) bacterial cells in less than eight hours . This method provides immediate advantages for the unequivocal identification of Campylobacter species in the microbiology laboratory, and demonstrates the potential for the use of these probes in a rapid diagnostic test of clinical samples for Campylobacter infection. Scand J Gastroenterol, 1989 Jun, 24(5), 522 - 8 Erosive prepyloric changes--a manifestation of stress? Nesland A, Oktedalen O, Opstad PK, Serck-Hanssen A, Aase S, Berstad A. To study the relationship between stress and the endoscopic diagnosis of erosive prepyloric changes (EPC), upper gastrointestinal endoscopy was performed twice in 19 cadets from the Military Academy, once in a 'non-stressed' situation and once after exposure to a standardized stress model . Five biopsy specimens per examination were obtained from the prepyloric mucosa, and the features of acute and chronic inflammation, erosion, and campylobacter-like structures (CLS) were evaluated . The endoscopy showed a significant (p less than 0.001) aggravation of EPC after stress . The histologic examination showed an increase of acute inflammation (p less than 0.05) and a higher density of CLS (p less than 0.01) after stress, as compared with the findings under non-stressed conditions . No association was observed between CLS and EPC . The study sheds new light on the pathogenesis of EPC, as it shows that EPC is aggravated during stress. Immun Infekt, 1989 Jun, 17(3), 83 - 90 {Campylobacter pylori: clinical correlations and prospective comparative studies of various diagnostic techniques}; Borsch G et al.; The diagnostic performance of two different urease tests and of histologic search after modified Giemsa staining to detect Campylobacter pylori (CP) colonization of the upper gastrointestinal tract was prospectively investigated in 215 esophagogastroduodenoscopies, by using a sensitive culture technique as reference . Single antral urease tests had a high specificity of 95-96%, but a limited sensitivity of 78-83%, which increased to 91-94%, when one antral and one additional body biopsy were submitted to the biochemical tests . Giemsa stains were very sensitive, but less specific . The rate of colonization was similar in antrum and body biopsies, and increased with age . There was a close association of Campylobacter pylori colonization with duodenal and to a lower degree with gastric ulcer disease, but especially with gastritic mucosal changes . CP was never detected in patients without gastritis . Therefore, submitting one antral and one body biopsy specimen to validated urease tests represents a sensitive (91-94%) and specific (93%) method to detect Campylobacter pylori colonization, which appears to be a diffuse phenomenon affecting antral and body mucosae with similar frequency. Immun Infekt, 1989 Jun, 17(3), 78 - 82 {Serodiagnosis of Campylobacter pylori}; Rolke J et al.; The colonization of gastric mucosa with Campylobacter pylori can be detected by serological methods . ELISA and immunoblot methods are currently being employed for detection of antibodies against Campylobacter pylori . In general, both tests will differentiate between Campylobacter pylori positive and Campylobacter pylori negative patients . However, 5-10% of persons with negative cultures for Campylobacter pylori have positive serological tests, but only very few patients with Campylobacter pylori associated with chronic gastritis have negative serological tests . This is true for tests detecting IgG and IgA antibodies . Tests for IgM antibodies have not been found to be useful . Immunoblot analyses have shown that detection of antibodies against a 100-120 KD antigen has a high specificity for Campylobacter pylori infection . In a small study we evaluated the possible use of serological testing for follow-up studies on patients after Campylobacter pylori therapy . We found that patients who became Campylobacter pylori negative after therapy showed a significant decline of serum IgG titers against Campylobacter pylori. J Clin Microbiol, 1989 Jun, 27(6), 1419 - 20 Effects of sample holding time, temperature, and atmosphere on the isolation of Campylobacter jejuni from dogs; Monfort JD et al.; Stool specimens were collected from 39 dogs, inoculated onto Campylobacter blood agar plates, and divided into four subsamples . Subsamples were held at 4 and 25 degrees C in room air and in a microaerobic environment and were reinoculated at 1, 2, 3, 4, 6, and 8 h . C . jejuni survived at least 3 h when it was held at 4 degrees C, but less than 2 h when it was held at 25 degrees C . The holding atmosphere was not associated with a difference in isolation rates. J Clin Microbiol, 1989 Jun, 27(6), 1397 - 8 Examination of human stomach biopsies, saliva, and dental plaque for Campylobacter pylori; Krajden S et al.; To examine possible sources of Campylobacter pylori and to determine the routes by which it is transmitted to the human stomach, samples of dental plaque and saliva from 71 patients undergoing endoscopy in addition to stomach biopsies were collected and cultured on selective noninhibitory Skirrow medium . A total of 29 (40.8%) of the stomach biopsies yielded C . pylori . None of the saliva samples and only one of the dental plaque samples was found positive for C . pylori, and thus neither saliva nor dental plaque could be implicated as a significant reservoir of this organism. J Clin Microbiol, 1989 Jun, 27(6), 1377 - 9 Virulence of Campylobacter jejuni for chicken embryos; Mahajan S et al.; The pathogenicity of Campylobacter jejuni was examined in chicken embryos . In this system, mortality data and histopathological findings induced by organisms and by bacterium-free filtered broth were identical . The absence in chicken embryo tissues both of organisms and of an inflammatory infiltrate suggests a toxin etiology. J Clin Microbiol, 1989 Jun, 27(6), 1272 - 6 Enterotoxin production and serogroups of Campylobacter jejuni and Campylobacter coli from patients with diarrhea and from healthy laying hens; Lindblom GB et al.; Enterotoxin production, a possible virulence factor, was determined in Campylobacter jejuni and Campylobacter coli by two different techniques, the CHO cell test and the GM1 enzyme-linked immunosorbent assay . The frequency of enterotoxigenic Campylobacter strains was 32% in strains from both humans with acute enteritis and healthy laying hens, as measured by the CHO cell test . The CHO cell test was significantly more sensitive than the GM1 enzyme-linked immunosorbent assay in the detection of enterotoxigenic strains . Enterotoxin production was compared with the presence of heat-stable and heat-labile antigens . There was no significant correlation between enterotoxin production and serogroups for C . jejuni or C . coli . The difference in enterotoxigenicity between C . jejuni (34.1%) and C . coli (21.9%) was not significant. Gut, 1989 Jun, 30(6), 798 - 803 14C-urea breath test in C pylori gastritis; Rauws EA et al.; 14C-urea breath test was used to detect Campylobacter pylori colonisation in 129 consecutive non-ulcer dyspepsia patients . Fasting patients were given 3 microCi (110 kBq) of 14C-labelled urea after a test meal . Breath samples were collected at 10 minute intervals for 90 minutes and the C-14 activity was counted on a liquid scintillation analyser . Urea derived 14CO2 appears in the exhaled breath of Campylobacter pylori culture positive individuals within 20-30 minutes . Likelihood analysis revealed a most favourable cut off level of {0.07% dose 14C-urea/mmol CO2} multiplied by body weight at t = 40 minutes, to separate culture positive from culture negative subjects . Using this upper limit of normal, a positive likelihood ratio of 50 and a negative likelihood ratio of 0.05 was calculated . Sensitivity of the test was 95% and specificity 98% . The 14C-urea breath test is a simple, sensitive and non-invasive test, that detects viable C pylori microorganism and semiquantitatively assesses the bacterial load of C pylori colonisation . Administration of a single dose of colloidal bismuth subcitrate resulted in a rapid decrease in 14CO2 excretion, so this test can be used to confirm eradication of the bacterium in therapeutic trials without endoscopy, or need for culture. Gut, 1989 Jun, 30(6), 790 - 7 Campylobacter pylori, duodenal ulcer, and gastric metaplasia: possible role of functional heterotopic tissue in ulcerogenesis; Carrick J et al.; Multiple pinch biopsies were taken from the duodenum and antrum of 137 subjects (46 active duodenal ulceration; 44 healed ulcers; 47 'normal'), and examined for the presence and grade of gastritis, gastric metaplasia, and Campylobacter pylori . These factors, as well as age, sex, cigarette, and anti-inflammatory agent intake were evaluated as possible risk factors for duodenal ulceration . Pentagastrin induced Congo Red staining of the duodenal bulb was performed in an additional 43 cases, to determine the presence of functioning parietal cells in the duodenum . Ninety eight per cent of patients with duodenal infection with C pylori had active or healed duodenal ulcers . Bacteria were confined to areas of gastric metaplasia which was always infiltrated with inflammatory cells . The metaplastic tissue was usually superficial in type, although patients had C pylori associated with heterotopic tissue: this has not been previously described . Congo Red staining of the duodenal bulb showed that functioning endogenous acid producing tissue could be found most often at the edges of duodenal ulcers, but also in non-ulcer subjects . Cigarette smoking, age, sex, and ingestion of non-steroidal anti-inflammatory agents were not to be found to be significant risk factors for duodenal ulceration . In contrast, the presence of duodenal infection with C pylori proved to be a strong risk factor for duodenal ulceration (RR = 51), together with gastric metaplasia (RR = 6.2), and antral C pylori infection (RR = 7.6) . These data identify duodenal infection with C pylori as the strongest risk factor for development of duodenal ulceration . Our finding of endogenous acid production around the edges of duodenal ulcers suggests an active role for parietal cells in the duodenum . We postulate a synergistic role for duodenal C pylori and endogenous acid production in the development of duodenal ulceration. Rev Med Chil, 1989 Jun, 116(6), 503 - 8 {Campylobacter pylori in children and adults subjected to endoscopy, correlation of endoscopic, bacteriologic and histopathologic findings}; Prado V et al.; Campylobacter pylori has been associated to peptic ulcer and gastritis . We investigated the presence of C pylori in 17 children and 50 adults who needed endoscopy to investigate upper gastrointestinal symptoms . Gram stain, Whartin-Starry stain and the urease test were used to identify the germ; best results were obtained with the Gram stain . C pylori was present in 5.8% of children and 88% of adults, including all patients with peptic ulcer and 36 out of 39 with histologic evidence of gastritis . However, the germ was also found in 79% of patients with a normal mucosa . Our results suggest that C pylori is frequently present in gastric mucosa of children and adults with upper gastrointestinal problems . Further studies are needed to elucidate its possible pathogenic role in gastritis or peptic ulcer. Osaka City Med J, 1989 Jun, 35(1), 63 - 9 Cases of infective endocarditis caused by Campylobacter fetus; Usui N et al.; An 18-year-old man with infective endocarditis caused by Campylobacter fetus is reported . This bacterial species has long been of interest in veterinary medicine, and recently it has been reported to be one cause of infantile diarrhea . Infective endocarditis arising from campylobacter fetus is rare . This is the fourth case reported in Japan . The organism was resistant to several antibiotics, and large vegetations were found to involve the aortic valve . Emergency excision of the infected aortic valve and replacement with a valve prosthesis were successful . Current clinical treatment of infective endocarditis is discussed, and the literature briefly reviewed. Onderstepoort J Vet Res, 1989 Jun, 56(2), 143 - 4 The use of cephalothin and triphenyltetrazolium chloride impregnated filter paper strips in the identification of Campylobacter species; Pefanis SM et al.; Filter paper impregnated strips using cephalothin at 30 and 60 micrograms/ml and triphenyltetrazolium chloride at 20 mg/ml were prepared and used in the typing of catalase-positive Campylobacter species . There was no difference in the sensitivity of campylobacters to cephalothin at 30 micrograms/ml and 60 micrograms/ml . Results were as reported by other workers except for a C . jejuni strain which was resistant to the triphenyltetrazolium . The technique is nevertheless inexpensive and the results are consistent and easy to interpret. J Clin Pathol, 1989 Jun, 42(6), 585 - 91 New spiral bacterium in gastric mucosa; McNulty CA et al.; A new spiral bacterium, distinct from Campylobacter pylori, was found in the gastric mucosa of six patients with gastrointestinal symptoms . All patients had chronic active type B gastritis and four had oesophagitis . Culture and microscopy for C pylori infection was negative . These unculturable spiral organisms were probably an incidental finding in patients presenting for upper gastrointestinal endoscopy, but it is not possible to say from this small series whether these organisms cause chronic active gastritis . The organism is helical, 3.5-7.5 microns long and 0.9 micron in diameter with truncated ends flattened at the tips, and up to 12 sheathed flagella 28 nm in diameter at each pole . It is proposed that this spiral bacterium should be called "Gastrospirillum hominis Gen.nov., Sp.nov." Tex Med, 1989 Jun, 85(6), 40 - 3 Cryptosporidiosis in a day-care center; Nwanyanwu OC et al.; Cryptosporidiosis has typically been considered a disease of animals, and the occasional human case has been considered a rare zoonosis or evidence of immunoincompetence . In this report, person-to-person transmission is postulated for illness documented in two of five rooms of a day-care center . Of 46 persons (34 children and 12 staff members), 29 (63%) became ill, and 27 (58.7%) had Cryptosporidium in their stools . Symptoms in children included diarrhea (55%), weight loss (25%), flatulence (15%), and fever (10%) . Symptoms of cryptosporidiosis ceased without treatment, and three months later all previously infested children had negative stool specimens . Questionnaires administered to parents revealed no association with water, travel, or ill pets . Cultures for Salmonella, Shigella, and Campylobacter were negative; no viral cultures were done . All affected children and their parents were immunocompetent . It is presumed that this outbreak occurred as a result of person-to-person transmission of the protozoa in the day-care centers, primarily by staff with inadequate hygiene practices . Physicians should look for this organism in children or adults who present with diarrhea and gastroenteritis in which the pathogenic agent is not readily identifiable by the usual bacterial cultures. Arch Intern Med, 1989 Jun, 149(6), 1373 - 5 Prevalence of Campylobacter pylori in esophagitis, gastritis, and duodenal disease; Cheng EH et al.; The relationship between the presence of Campylobacter pylori and esophagitis was studied in patients undergoing paired biopsies of distal esophagus and gastric antrum during esophagogastroduodenoscopy . Biopsy specimens were examined for urease activity and for the presence of C pylori by culture and by histologic examination of hematoxylin-eosin- and Warthin-Starry-stained sections . Sixty-two patients were entered into the study . All esophageal biopsy specimens, regardless of histologic findings, were negative for the presence of C pylori by urease test, culture, and histologic examination . Of 35 patients with normal esophageal biopsy specimens, 11 (31%) had antral specimens that were positive for C pylori, while 11 (41%) of the 27 patients with esophagitis had antral specimens that were positive for the organism . Campylobacter pylori was detected in 14 (70%) of 20 patients with chronic gastritis, in 8 (67%) of 12 patients with endoscopically documented duodenal ulcers and erosions, but in only 3 (33%) of 9 patients with endoscopically defined duodenitis . We conclude that histologic esophagitis is not associated with increased prevalence of either gastric or esophageal C pylori . The well-described association of chronic gastritis and duodenal ulcers with C pylori was present in our study population. Am J Gastroenterol, 1989 Jun, 84(6), 643 - 6 Campylobacter pylori in patients with dyspeptic symptoms and endoscopic evidence of erosion(s); Elta GH et al.; The relationship between Campylobacter pylori (CP), histologic gastritis, and dyspeptic symptoms is becoming gradually clearer, but there is still a lack of knowledge of the natural history of treated or untreated gastritis . We examined serial biopsies from the gastric fundus, body, and antrum, and from the duodenum in 16 dyspeptic patients . Patients with concomitant peptic ulcers, alcoholism, or nonsteroidal anti-inflammatory drug use were excluded . CP was present in the biopsies of 50% of patients at presentation . When CP was present, the antrum was always infected, and often had the highest density of organisms . In the duodenum, CP was found only in areas of gastric metaplasia . The presence of CP was highly correlated with gastritis activity (neutrophilic infiltrate) . A 4-yr follow-up study of symptoms, endoscopic appearance, and histologic findings including the presence of CP was performed in 10 of the original 16 patients . After 4 yr, both the severity and frequency of epigastric pain remained the same in seven patients, worsened in one, and improved in two . All patients who had CP at initial presentation retained the organism (5/10), whereas none of the previously noninfected patients acquired the infection (5/10) . Both CP-positive and -negative patients were treated for 3 wk with 524 mg bismuth subsalicylate qid, and for the first 2 of 3 wk with 250 mg metronidazole qid . One patient who was CP positive was lost to follow-up . In three of the remaining four patients on this regimen, the organism was eradicated . Of the nine patients who completed the treatment program, two had no change in symptoms and seven improved . CP was present in three of seven with improved symptoms and in one of two with no change in symptoms . After treatment, the only change in histology was the disappearance of activity in the CP-positive patients who lost the organism . In conclusion, CP was present in 50% of dyspeptic patients with endoscopic evidence of at least one erosion . Both the symptoms and CP persisted for 4 yr . Dyspeptic symptoms improved after bismuth subsalicylate/metronidazole therapy, regardless of the presence or absence of CP, although the regimen did succeed in eradicating the organism in three of the four CP-positive patients who completed the study. Am J Gastroenterol, 1989 Jun, 84(6), 637 - 42 Prevalence of Campylobacter pylori in patients undergoing upper endoscopy; Schubert TT et al.; From August 1987 through July 1988, we evaluated antral biopsy specimens for Campylobacter pylori (CP) in 212 patients undergoing upper endoscopy . For those patients who had multiple endoscopies, the first endoscopy in which a urease test, histology, and culture were done was used to determine CP status . A patient was regarded as CP-positive if the culture was positive or if both a urease test and the histology were positive . Blacks had an increased CP positivity (61.2%) compared to whites (31.5%) . Among non-ulcer patients, CP positivity was 52% in black patients and 18% in white patients . Age and gender were unrelated to CP positivity among controls and those without ulcers . There was increased CP positivity in patients with duodenal ulcers (85%), compared with those without ulcers (37%), and a trend toward increased positivity in those with gastric ulcer (53%) and duodenitis (50%) . There was no increased CP positivity in patients with gastroesophageal reflux disease (28%), gastritis (29%), non-ulcer dyspepsia (43%), or the control patients with no gastroduodenal mucosal abnormalities (40%) . CP-negative DU patients were older (average 71 yr) than CP-positive DU patients (43 yr), and female DU patients had a lower CP positivity (71%) than males (94%). J Bacteriol, 1989 Jun, 171(6), 3031 - 8 Evidence for posttranslational modification and gene duplication of Campylobacter flagellin; Logan SM et al.; A gene encoding a flagellin protein of Campylobacter coli VC167 has been cloned and sequenced . The gene was identified in a pBR322 library by hybridization to a synthetic oligonucleotide probe corresponding to amino acids 4 to 9 of the N-terminal sequence obtained by direct chemical analysis (S . M . Logan, L . A . Harris, and T . J . Trust, J . Bacteriol . 169:5072-5077, 1987) . The DNA was sequenced and shown to contain an open reading frame encoding a protein with a molecular weight of 58,945 and a length of 572 amino acids . The deduced amino acid sequence was identical to the published N-terminal amino acid sequence of VC167 flagellin and to four internal regions whose partial sequences were obtained by direct chemical analysis of two tryptic and two cyanogen bromide peptides of VC167 flagellin . The C . coli flagellin protein contains posttranslationally modified serine residues, most of which occur within a region containing two 9-amino-acid repeating peptides separated by 34 unique amino acids . Comparisons with the sequences of flagellins from other bacterial species revealed conserved residues at the amino- and carboxy-terminal regions . Hybridization data suggest the presence of a second flagellin copy located adjacent to the first on the VC167 chromosome. Infect Immun, 1989 Jun, 57(6), 1825 - 33 Two-dimensional gel electrophoresis and immunoblotting of Campylobacter pylori proteins; Dunn BE et al.; Whole-cell, outer-membrane protein, flagellum-associated antigens and partially purified urease of Campylobacter pylori were analyzed by two-dimensional gel electrophoresis . C . pylori strains were readily distinguished from strains of Campylobacter jejuni, C . coli, and C . fetus by absence of major outer membrane proteins with Mrs of 41,000 to 45,000 . C . pylori strains also lacked the acidic surface-array proteins at Mr 100,000 to 149,000 identified previously in serum-resistant strains of C . fetus . Surface labeling of intact C . pylori cells with 125I revealed two common major proteins, which we have designated protein 2 (pI 5.6 to 5.8, Mr 66,000) and protein 3 (pI 5.2 to 5.5, Mr 63,000) . Proteins 2 and 3 were also the major components (subunits) observed in partially purified urease . Partially purified preparations of flagella consistently contained proteins 2 and 3 . Thus, urease appears to be associated with both outer membranes and flagella of C . pylori . C . pylori strains also possessed an antigen at Mr 59,000 which was cross-reactive with antiserum against flagella of C . jejuni . However, the antigen did not appear to be associated with flagella per se in C . pylori . Protein 2 was unique to C . pylori among the Campylobacter species studied . It was not recognized by antibody against whole cells of C . jejuni or C . fetus or flagella of C . jejuni . Protein 3 was cross-reactive with antiserum against whole cells of C . jejuni and C . fetus, as were several other major protein antigens . Because protein 2 is a major outer membrane protein that is apparently unique to C . pylori, development of monospecific antibodies against this antigen may be useful for the identification of C . pylori in tissues, and purified antigen may be useful for serologic tests for specific diagnosis of C . pylori infections. Radiology, 1989 Jun, 171(3), 819 - 21 Enlarged gastric folds in association with Campylobacter pylori gastritis; Morrison S et al.; Enlarged gastric folds in pediatric patients are uncommon . Fifteen patients with upper gastrointestinal (GI) tract symptoms of chronic epigastric abdominal pain, vomiting, or hematemesis underwent radiologic upper GI barium studies and were found to have Campylobacter pylori gastritis at endoscopic biopsy . Seven patients (47%) with C pylori gastric disease had radiologic evidence of enlarged folds . There was no clinical or pathologic evidence of Menetrier disease . Therefore, C pylori gastritis should be considered in the differential diagnosis of children with upper GI tract symptoms and radiologic evidence of enlarged folds. Kansenshogaku Zasshi, 1989 Jun, 63(6), 606 - 22 {Comparison of clinical efficacy of lomefloxacin (LFLX, NY-198) and pipemidic acid (PPA) in the treatment of infectious enteritis by a double-blind method . The Japan Research Committee of Lomefloxacin Research Group Enteritis}; Aoki T et al.; The clinical efficacy, safety and usefulness of lomefloxacin (LFLX, NY-198), a new quinolone antimicrobial agent, were compared with those of pipemidic acid (PPA) in the treatment of infectious enteritis (bacillary dysentery, enteropathogenic Escherichia coli enteritis and Campylobacter enteritis) by a double blind method . Daily dosage of LFLX and PPA was 600 mg and 2000 mg, respectively administered orally divided into 4 doses . The duration of the treatment was 5 days . Of 290 cases studied, 100 cases were excluded and 21 cases were dropped from analysis of effectiveness and usefulness . The effectiveness and usefulness was evaluated in 169 cases (LFLX group: 83, PPA group: 86) . There was no significance difference between the two groups in any background characteristics . The results obtained were as follows: 1 . In 73 symptomatic patients (LFLX group: 35, PPA group: 38) on the day of the beginning of administration, the clinical effect was 91.4% in the LFLX group and 84.2% in the PPA group with no significant difference between the two groups . 2 . In a total of 184 strains (LFLX group: 90, PPA group: 94), the bacteriological effects of LFLX (93.3%) was superior to that of PPA (80.9%) with significant difference (p = 0.0153) . 3 . In 169 evaluable patients, the global clinical effects of LFLX (92.8%) was superior to that of PPA (79.1%) with a significant difference (P = 0.0144) . 4 . Side effects were observed in 1 (0.7%) of the 141 patients in the LFLX group and none of the 143 patients in the PPA group . Abnormal laboratory test values were noted in 10 (7.6%) of the 132 patients treated with FLLX and 7 (5.1%) of the 136 patients treated with PPA, but they as no significant difference between the two groups . 5 . In 169 evaluable patients, the clinical usefulness of LFLX (91.6%) was superior to that of PPA (76.7%) with a significant difference (P = 0.0111) . From these results, LFLX is considered to be a clinically useful medicine in the treatment of infectious enteritis including bacillary dysentery. Kansenshogaku Zasshi, 1989 Jun, 63(6), 593 - 605 {Clinical trial of T-3262 on acute enteritis . Japan Research Committee of T-3262, Research Group for Acute Infectious Enteritis}; Aoki T et al.; For the purpose of evaluation of clinical efficacy, safety and usefulness on acute infectious enteritis (bacillary dysentery, and enteritis caused by Salmonella spp., Campylobacter spp., enteropathogenic E . coli, and so on), T-3262, a newly developed pyridone-carboxylic acid derivative, was administered to a total of 136 patients and carriers . In addition, in vitro antibacterial activity of T-3262 was determined against the clinical isolates, and compared with those of nalidixic acid (NA), pipemidic acid (PPA), enoxacin (ENX), norfloxacin (NFLX) and ofloxacin (OFLX) . The daily dose of 450 mg of T-3262 was administered orally three times after meals for 5 days, with the exception of 7 day administration against Salmonella enteritis . A total of 89 cases were evaluated; 23 with Shigella spp., 30 with Salmonella spp., 15 with Campylobacter spp., 6 with enteropathogenic E . coli, and 15 cases with the other pathogens or pathogen-negative . The efficacy on clinical symptoms judging from duration of fever, and duration of diarrhea and abnormal stool character was 100% in all the enteritis except enteropathogenic E . coli enteritis, in which it was 50% (n = 2) . Concerning bacteriological response, elimination of the causative organisms from the feces was 100% in Shigella spp . (n = 19), Salmonella spp . (n = 30), and enteropathogenic E . coli (n = 6), although 64.3% in Campylobacter spp . (n = 14) . As an adverse effect, epigastric discomfort was observed in one (0.8%) of 130 cases . Deteriorations in laboratory findings were seen in five (6.2%) of 81 cases, consisting of two with elevated GOT and GPT, two with elevated GPT, and one with increased eosinophils count, although they were all slight in degree . MICs of T-3262 which inhibited 90% of the isolates of Shigella spp, Salmonella spp., and Campylobacter spp., were 0.025, 0.05, and 0.78 microgram/ml, respectively . These values were lowest among the quinolone derivatives tested, except that the MIC90 against Campylobacter spp . was the same as that of ofloxacin. Rev Clin Esp, 1989 Jun, 185(1), 6 - 8 {Bacteremia caused by Salmonella non-typhi in patients infected with HIV}; Gonzalez Lahoz JM et al.; All the cases of HIV infected patients diagnosed in our department during 1987 of Salmonella bacteremia are included in this report . Out of a total of 10 patients with both conditions, six were diagnosed of AIDS, three of AIDS related complex, and one presented an asymptomatic HIV infection . The mean age was 32.9 years (range 22 to 56) . Eight of them were males, seven were intravenous drug addicts, and three were homosexual . Fever was observed in all cases and diarrhea in four of them . Salmonella enteritidis was isolated from the blood culture of nine patients and salmonella typhimurium from one . Salmonella enteritidis was isolated from the stool culture of 5 patients and Salmonella typhimurium and Campylobacter from the stool culture of one patient . Of the 10 patients 6 have died, 4 of them within the three weeks after the diagnosis of Salmonella non-typhi bacteremia, 2 have not relapsed and two patients were lost during follow up. J Clin Microbiol, 1989 Jun, 27(6), 1192 - 6 Etiology of childhood diarrhea in Korea; Kim KH et al.; To assess the role of recently recognized enteropathogens in childhood diarrhea in Korea, 231 children with diarrhea admitted to and 104 children without diarrhea seen at the well-baby clinic or the outpatient department of Hanyang University Hospital in Seoul, Korea, were evaluated during a 14-month period . Stools were cultured for bacterial pathogens, including enterotoxigenic (heat-labile and heat-stable enterotoxin-producing) and enteroadherent organisms . Only those stools obtained from patients with diarrhea were examined for rotavirus . All Escherichia coli isolates were screened for Shiga-like toxin (SLT) I, SLT-II, enterohemorrhagic E . coli fimbriae, and enteroinvasiveness by colony hybridization . One or more pathogens were identified in 75.8% of the children with diarrhea . Rotavirus was the most frequently identified pathogen, accounting for 47% of the cases . Other major enteropathogens were enterotoxigenic E . coli (22%), Clostridium difficile (16%), enteroadherent E . coli (15%), and enteropathogenic E . coli (6%) . Shigella spp., Campylobacter jejuni, Salmonella spp., SLT-I-and enterohemorrhagic-E . coli-fimbria-probe-positive E . coli serotype O26:H11 and enteroinvasive E . coli were isolated from only a few patients . Aeromonas hydrophila and E . coli O157 were not isolated . Compared with those of the controls, the isolation rates of heat-stable-enterotoxin-producing E . coli (P less than 0.05), C . difficile (P less than 0.025), and enteroadherent E . coli (P less than 0.05) were significantly higher in the patients with diarrhea . The greatest number of rotavirus, enterotoxigenic E . coli, and C . difficile cases were identified during the cool, dry months of October and November. J Clin Microbiol, 1989 Jun, 27(6), 1145 - 50 Rapid method to detect shiga toxin and shiga-like toxin I based on binding to globotriosyl ceramide (Gb3), their natural receptor; Ashkenazi S et al.; Shiga toxin and the closely related Shiga-like toxins produced by Escherichia coli represent a group of very similar cytotoxins that may play an important role in diarrheal disease and hemolytic uremic syndrome . These toxins have the same biologic activities and according to recent studies also share the same binding receptor, globotriosyl ceramide (Gb3) . They are currently detected, on the basis of their ability to damage several cell lines, by using expensive and tedious assays that require facilities for and experience with tissue cultures and are therefore most suitable for research laboratories . We have developed a rapid method to detect Shiga toxin and Shiga-like toxin I based on specific binding to their Gb3 natural receptor, which was coated onto microdilution plates . Bound toxin was then detected by enzyme-linked immunosorbent assay (ELISA) with monoclonal antibodies . The sensitivity of the Gb3 ELISA was 0.2 ng (2 ng/ml) of purified toxin . The assay was positive with sonic extracts of Shigella dysenteriae serotype 1 strain 6OR (a Shiga toxin producer), E . coli serotype O26:H11 strain H30, and E . coli serotype O157:H7 (both Shiga-like toxin I producers) . The assay was very specific in that no cross-reactivity was noted with purified cholera toxin, E . coli heat-labile and heat-stable enterotoxins, and Clostridium difficile cytotoxin, or sonic extracts of other cytotoxin-producing organisms, such as other shigellae, pathogenic and nonpathogenic E . coli, Salmonella spp., Campylobacter spp., and Aeromonas spp . These results were in complete agreement with a {3H}thymidine-labeled HeLa cell cytotoxicity assay and with detection of the structural genes by DNA hybridization studies with a Shiga-like toxin I probe . Quantitative analysis showed a high correlation between Gb3 ELISA and HeLa cell assay when fractions obtained at various stages of toxin purification were examined by both methods (r = 0.99, P < 0.01) . This rapid Gb3 ELISA is sensitive and specific and may be diagnostically useful in cytotoxin-related infections. J Infect Dis, 1989 Jun, 159(6), 1061 - 4 Enteroaggregative Escherichia coli associated with persistent diarrhea in a cohort of rural children in India; Bhan MK et al.; A cohort of 452 rural children was followed longitudinally for 13 mo to ascertain the role of HEp-2 cell adherent Escherichia coli and other pathogens in causing acute (less than or equal to 14 d) and persistent (greater than 14 d) diarrhea . Aeromonas, Campylobacter jejuni, E . coli manifesting localized adherence to HEp-2 cells and enterotoxigenic E . coli were significantly associated with acute diarrhea . E . coli strains that exhibit aggregative adherence, so-called enteroaggregative E . coli, a newly-described category of diarrheagenic E . coli distinct from enterotoxigenic, enteroinvasive, enterohemorrhagic, and enteropathogenic E . coli, were found significantly more often in patients with persistent diarrhea (29.5%) than with acute diarrhea (12.8%) (P = .0052) or controls (9.9%) (P = .0006). Aliment Pharmacol Ther, 1989 Jun, 3(3), 315 - 20 Natural history of Campylobacter pylori in duodenal ulceration treated with an H2-antagonist; Ho J et al.; Campylobacter pylori has been associated closely with active antral gastritis and duodenal ulcer but its pathogenetic role remains uncertain . The present longitudinal study examined, prospectively, the endoscopic antral biopsies of 45 patients with duodenal ulceration, taken before and after healing of the duodenal ulcer, during remission and at relapse . The biopsies were examined for the activity and degree of chronic inflammation of the gastritis and for the occurrence and density of C . pylori by Warthin-Starry stain . Before treatment the frequency of chronic active antral gastritis was 100% and the occurrence of C . pylori was 97% . Compared with the pre-treatment state, there was no significant change in either the frequency and severity of antral gastritis, or in the occurrence and density of the bacteria in the antral mucosa at the time the duodenal ulcer healed, during remission, or at relapse . The occurrence of the bacteria was significantly more frequent during remission, than at the time when the ulcer had healed initially (P less than 0.05) . These results suggest that the bacterium may not play an important pathogenetic role in ulcer healing and relapse, when patients are managed using an H2-blocker. Am J Vet Res, 1989 Jun, 50(6), 807 - 13 Antigenic and restriction enzyme analysis of isolates of Campylobacter fetus subsp venerealis recovered from persistently infected cattle; Wesley IV et al.; Thirty-two isolates of Campylobacter fetus subsp venerealis were obtained from 1 bull and 4 heifers with experimentally induced infection . When whole-cell antigens of isolates were cross titrated with antisera to the infecting strain, isolates from 3 heifers had limited antigenic variation, whereas whole-cell antigens of isolates from 2 cattle (the bull and a heifer) differed serologically from those of the infecting strain . Changes were detected specifically in 6 heat-labile antigens . Of the 6 heat-labile factors evaluated, all were initially present on the infecting parent strain, but not on early isolates obtained from 4 of the 5 cattle . Restriction enzyme analysis revealed minor variation in the DNA fingerprints of isolates obtained from individual cattle, thus implying stability of the Campylobacter genome once persistent infection is established . Isolates with identical restriction enzyme patterns expressed different heat-labile antigens . Correlation could not be found between the DNA electrophoretic pattern and the expression of heat-labile antigens. An Esp Pediatr, 1989 Jun, 30(6), 457 - 62 {Clinical evaluation of the stool culture in acute diarrhea}; Navarro Gonzalez J et al.; 173 children hospitalized with acute diarrhea are studied retrospectively with the object of finding clinico-analytic parameters suggestive of bacterial etiology . The 88 boys and 85 girls varied in age between 3 months and 10 years (only 20% were under a year) . The children were divided into 2 groups: group D (+) were 39 children with positive stool cultures (salmonellas, 64%; campylobacter, 25%, and shigellas, 11%), and group D (-) were 134 children with negative stool cultures, and served as a control group . Various parameters were analyzed in order to define the socio-economic and nutritional status, and psychomotor development . Careful analysis was made of the patients' histories and exploratory findings, with special emphasis on the characteristics of the feces . Using the chi-square statistical analysis, significant differences between the two groups were found in relation to length of hospital stay, which was longer in group D (+) (p less than 0.001), the appearance of blood in stool, more often in group D (+) (p less than 0.05) and in the number of children of group D (+) with band forms greater than 10% (p less than 0.05) . In accordance with our findings, the practice of stool cultures should be limited to those patients with acute febrile diarrhea presenting macroscopic blood in stool and leukocytosis with neutrophilia (excepting children under 3 months of age, those in a critical or malnourished state, immunodepressed or in a particular epidemic situation) . In this way the number of stool cultures and medical assistance costs would be markedly reduced and a more adequate cost/benefit relation would be obtained. Int J Biol Macromol, 1989 Jun, 11(3), 145 - 9 Studies on the chemical constitution of cell wall lipo-oligosaccharide from Campylobacter coli Labet 227; Adeyeye A et al.; The lipo-oligosaccharide (LOS) from Campylobacter coli Labet 227 was extracted by aqueous phenol . After delipidation and gel chromatography, two oligosaccharides were isolated . The higher molecular weight material OS (I) which was estimated to contain six to seven sugar units was found to contain glucose, galactose, 2-acetamido-2-deoxyglucose, 2-acetamido-2-deoxygalactose and heptose . Analysis of the partially methylated alditol acetates by g.c.-m.s . revealed the presence of terminal hexoses, a 1.3-linked hexose, a terminal heptose, a 1,2,3-linked heptose as well as smaller quantities of a 1,3,4-linked heptose . 1H-n.m.r . spectra showed signals corresponding to six anomeric protons . The signals which corresponded to the methyl protons of the acetamido side chain confirmed that the acetamido forms of both amino sugars were present in OS (I) . The lower molecular weight material OS (II) which was estimated to contain four sugar units was found to contain glucose, 2-acetamido-2-deoxy-galactose and very small quantities of heptose . It thus appears that OS (I) and OS (II) are the core oligosaccharides elaborated by this micro-organism . The possibility of a heterogeneous core is thus presented . The fatty acids present in the LOS were mainly 3-hydroxytetradecanoic acid, n-hexadecanoic acid and trace amounts of n-tetradecanoic acid and n-octadecanoic acid. Schweiz Med Wochenschr, 1989 May 27, 119(21), 765 - 7 {Campylobacter pylori colonization of the antrum: effect of gastrin, somatostatin, pancreatic polypeptide and neurotensin}; Staub P et al.; Campylobacter pylori (C.p.) infection is often found in patients with antral gastritis and peptic ulcer disease . Pathophysiological links are still unclear, and we therefore tested the hypothesis whether C.p . affects the gastrointestinal peptides and thus influences gastric acid secretion and protective factors . 94 patients were examined by upper GI endoscopy and blood analyzed for gastrin, somatostatin, pancreatic polypeptide and neurotensin . Biopsies of antral mucosa were investigated for C.p . in urease testing, culture and microscopy . C.p . was found in 42 patients (45%) . In microscopy all of these patients had chronic gastritis (100%) . A significant increase in gastrin uninfluenced by C.p . was found in patients with antral gastritis (normal: 6.4 +/- 0.7, {n = 27}; gastritis without C.p.: 18.4 +/- 5.9 {p less than 0.02}, {n = 7}; gastritis with C.p.: 10.7 +/- 2.2, {n = 22}) . Somatostatin, pancreatic polypeptide and neurotensin showed no difference. Lancet, 1989 May 27, 1(8648), 1182 - 5 Diagnostic value of an immunoassay to detect anti Campylobacter pylori antibodies in non-ulcer dyspepsia; Loffeld RJ et al.; An enzyme-linked immunosorbent assay (ELISA) for detection of IgG antibodies against Campylobacter pylori was used to examine sera from 70 patients with non-ulcer dyspepsia . 48 patients had C pylori associated gastritis according to culture or histology; mean optical density (OD) of the ELISA was significantly higher than that for the 22 patients with normal antral mucosa and absence of C pylori . Positive and negative predictive values for campylobacter-associated gastritis were 100% above OD 2.10 and below OD 1.00, respectively . Serology might replace endoscopy in the diagnosis of campylobacter-associated gastritis. Lancet, 1989 May 27, 1(8648), 1167 - 8 Campylobacter pylori and duodenal ulcers: the gastrin link; Levi S et al.; The possibility that Campylobacter pylori (CP) in the gastric antrum stimulates gastrin release in duodenal ulcer (DU) disease was examined in 31 patients . The 25 patients with antral colonisation with CP had higher basal and meal-stimulated plasma gastrin concentrations, and higher peak acid output (PAO), than did the 6 without CP in the autumn. J Am Vet Med Assoc, 1989 May 15, 194(10), 1435 - 6 Treatment of proliferative colitis in ferrets; Krueger KL et al.; Proliferative colitis associated with intracellular Campylobacter sp was diagnosed in 10 ferrets . The ferrets had a history of diarrhea (often blood-tinged or mucoid), dehydration, and chronic weight loss . Additional clinical signs included rectal prolapse, lethargy, fever, and a palpably thick colon . In 5 ferrets, the diagnosis was confirmed by colonic biopsy, via endoscopy . Supportive treatment in 5 ferrets did not alleviate the clinical signs or the proliferative intestinal disorder . oral chloramphenicol treatment (50 mg/kg of body weight, q 12 h for 10 to 21 days) resulted in marked clinical improvement and eradication of proliferative intestinal lesions in 5 ferrets. Wien Med Wochenschr, 1989 May 15, 139(9), 211 - 5 {Infectious diarrhea diseases}; Graninger W et al.; Gastroenteritis may be due to many agents, infectious or non infections . Most cases of infections diarrhea are selflimited--e.g . food born intoxications with 1 to 2 days duration or infections with enteropathogenic E . coli, Salmonella spp., Vibrio parahaemolyticus or rota virus . Even the majority of shigellosis, salmonella-gastroenteritis and infections with Campylobacter fetus cease without treatment within 4 days . Fever and diarrhea persisting for more than 4 days justify the use of antibiotics, favourably trimethoprim and quinolones . Fluid and electrolyte replacement is the mainstay of treatment . Antimotility agents worsen some forms of diarrhea (especially these due to enteroinvasic bacteria) by retarding the natural purgative effect of diarrhea. Tidsskr Nor Laegeforen, 1989 May 10, 109(13), 1405 - 7 {Campylobacter pylori . Determination of gastric colonization and its clinical relevance}; O'Leary D et al.; While evidence suggesting a statistical association between Campylobacter pylori and chronic active antral gastritis is convincing, the role which the organism may play in the pathogenesis of this condition and in the case of peptic ulcer remains to be elucidated . The development of safe, non-invasive diagnostic tests suitable for population studies greatly facilitates this investigative process . This article presents a brief review of currently available methods of diagnosing C pylori colonization in the stomach and discusses their possible application in the field of clinical gastroenterology. S Afr Med J, 1989 May 6, 75(9), 417 - 9 The association of Campylobacter pylori with mucosal pathological changes in a population at risk for gastric cancer; Jaskiewicz K et al.; In the study of a group of 178 unselected patients (105 men, 73 women, mean age 44.5 years), from a population at high risk for gastric carcinoma, who presented with chronic dyspepsia, a minimum of 8 gastric and oesophageal biopsy specimens were taken during upper gastro-intestinal endoscopy, and examined histologically and histochemically for the presence of Campylobacter pylori and other pathological lesions . Gastric colonisation by C . pylori was found in 75% of men and 68.4% of women . In 90% of patients with duodenal or gastric ulcer and in 71.6% of patients with non-ulcer and non-cancer dyspepsia there was a moderate or severe degree of bacterial colonisation . Association between C . pylori colonisation and microscopic evidence of type B gastritis, gastric or duodenal ulcer, gastric cancer, oesophagitis and oesophageal glycogenic acanthosis was found. Res Microbiol, 1989 May-Jun, 140(4-5), 281 - 90 Cloning of Ureaplasma urealyticum DNA sequences showing genetic homology with urease genes from gram-negative bacteria; Blanchard A et al.; DNA chromosomic sequences from Ureaplasma urealyticum were shown, by DNA hybridization, to possess homology with Providencia stuartii urease genes . The homologous ureaplasma DNA fragment was cloned in Escherichia coli and a DNA probe, designated IC61 probe was specific for only the urease-producing U . urealyticum among the Mollicutes . Genetic homology shown between the IC61 probe and urease genes from Campylobacter pylori, E . coli and P . stuartii suggests that (1) the cloned DNA fragment from U . urealyticum contains urease encoding sequences, and that (2) the urease genes possess conserved sequences among phylogenetically distant prokaryotes. Diagn Microbiol Infect Dis, 1989 May-Jun, 12(3 Suppl), 35S - 39S Lomefloxacin activity against 2,813 clinical isolates: a collaborative study at three medical centers in Brazil; Magalhaes M et al.; The in vitro activity of lomefloxacin was compared to norfloxacin and two parenteral drugs against 2,813 clinical isolates at three medical centers in Brazil . Considering MICs less than or equal to 4 micrograms/ml as the criterion, lomefloxacin inhibited 97.9% of all enterobacteriaceae, 100% of staphylococci, 100% of Neisseria gonorrhoeae, 100% of Campylobacter pylori, 81% of Pseudomonas aeruginosa, and 79% of Streptococcus spp . Norfloxacin was generally comparable in potency and spectrum, but cefotaxime and gentamicin were less effective because of high-resistance prevalence in some species . The highest rates of fluoro-quinolone resistance among the Enterobacteriaceae were in the Proteus-Providencia group of species. Scand J Gastroenterol, 1989 May, 24(4), 396 - 400 Increased incidence of Campylobacter pylori infection in gastroenterologists: further evidence to support person-to-person transmission of C . pylori; Mitchell HM et al.; The mode transmission of Campylobacter pylori is still unknown, although several studies have suggested person-to-person transmission . In this study the incidence of active C . pylori infection in an endoscopy staff was compared with that in general practitioners and normal blood donors . Since endoscopy workers are in close contact with patients, many of whom would be likely to have active C . pylori infection, it was likely that there would be an increased incidence of active C . pylori infection in endoscopists if the organism can spread from person to person . The incidence of active C . pylori infection in the group of gastroenterologists was 52%, compared with 21% in an age-matched group of blood donors . This finding was statistically significant (p less than 0.01) . In comparison, the incidence of active C . pylori infection in the endoscopy nurses and general practitioners was not statistically different from that in the normal population. Dig Dis Sci, 1989 May, 34(5), 677 - 80 Campylobacter pylori in alcoholic hemorrhagic "gastritis"; Laine L et al.; Previously we have shown that alcohol-associated subepithelial hemorrhages histologically represent localized superficial mucosal hemorrhage, with edema in the surrounding mucosa . We studied the relationship between Campylobacter pylori (CP) and histology in gastric subepithelial hemorrhages from 20 actively drinking alcoholic patients . Biopsies of the hemorrhagic lesions and adjacent mucosa 1 and 3 cm away were taken with a "jumbo" forceps . Biopsy slides were coded and randomized before histologic scoring and examination for CP . CP was present in 15/20 (75%) biopsies of subepithelial hemorrhages and in 32/40 (80%) biopsies from surrounding mucosa . The mean hemorrhage score was not significantly different in biopsies of subepithelial hemorrhages with and without CP (2.7 +/- 0.4 vs 3.2 +/- 0.4) and the edema scores in adjacent, nonhemorrhagic mucosa were similar in specimens with and without CP (2.0 +/- 0.3 vs 1.6 +/- 0.5) . The inflammatory cell density was significantly greater in CP-positive biopsies than in CP-negative specimens (2.0 +/- 0.2 vs 0.5 +/- 0.2, P less than 0.05) with the mononuclear cell and neutrophil scores contributing equally to the overall inflammatory cell score . Almost a quarter of CP-positive specimens (11/47) had no inflammation . The mean score for lining epithelial abnormalities was also significantly higher in biopsy specimens positive for CP (1.7 +/- 0.2 vs 0.5 +/- 0.3, P less than 0.05) . In conclusion, CP is present in 75% of alcohol-associated subepithelial hemorrhages, but its prevalence is similar in adjacent, nonhemorrhagic mucosa . No relationship exists between the presence of CP and the characteristic histologic abnormalities of these subepithelial hemorrhages.(ABSTRACT TRUNCATED AT 250 WORDS) Zentralbl Bakteriol, 1989 May, 271(1), 91 - 103 The gnotobiotic piglet as a model for the pathogenesis of Campylobacter jejuni infection; Vitovec J et al.; The pathogenesis of enteric changes was studied in gnotobiotic piglets which, after hysterectomy had been infected orally with Campylobacter jejuni on the first day of their life . The involvement of the entire large intestine became clinically manifest by scouring on days post infection (DPI) 4 to DPI 5, and pathomorphologically, by simultaneous inflammation and severe edema of the intestinal wall . Histology and SEM revealed inflammatory edema with abundant neutrophils, microulcerations, focal propagation and activation of goblet cells, and a presence of mucin-positive material within the intestinal lumen . TEM examination revealed disconnected interdigitating folds and wide dilated intercellular spaces between enterocytes . The endothelial cells of small blood vessels in the lamina propria showed hypertrophy with increase in the thickness of their basal lamina . Ultrastructural lesions of the large intestinal microcirculation also support the hypothesis that disturbances in the vascular system are responsible for edema in the cecum and colon . Gnotobiotic piglets may be used as a suitable animal model to study colitis induced by C . jejuni. J Rheumatol, 1989 May, 16(5), 599 - 603 The presence of Campylobacter pylori in nonsteroidal antiinflammatory drug associated gastritis; Iglehart IW 3rd et al.; Although Campylobacter pylori has recently been causally linked to active chronic gastritis and peptic ulcer disease, its relationship to nonsteroidal antiinflammatory drug (NSAID) associated gastritis is unclear . We performed a case-control study of 100 patients who had undergone gastritis biopsy . Blinded review of Giemsa stained slides demonstrated the presence of C . pylori in 32% of 19 NSAID treated cases with active chronic gastritis vs 3% of 36 controls with chronic gastritis not taking NSAID, and 69% of 45 "positive" controls with active chronic gastritis not taking NSAID (p less than 0.001) . Our results suggest a possible multifactorial etiology of NSAID associated gastritis. Dtsch Tierarztl Wochenschr, 1989 May, 96(5), 271 - 7 {The "diseased" or "dead" guillemots (Uria aalge), three-toed gulls (Rissa tridactyla), silver gulls (Larus argentatus) and laughing gulls (Larus ridibundus) found in the area of the German Bay, 1982-1985}; Petermann S et al.; Between 1982 and 1985 the cadavers of 50 Guillemots (Uria aalge), 41 Kittiwakes (Rissa tridactyla), 26 Herring Gulls (Larus argentatus) and 34 Black-headed Gulls (Larus ridibundus) were examined pathological, bacteriological and virological . The probable cause of death was established . Parasitosis were particularly prevalent in Herring Gulls (49%), where the main infection--as in Black-headed Gulls--was with Cestoides . In Kittiwakes and Guillemots mainly Spiruroideae were recorded . The commonest bacterium isolated in organs and intestinal tract was Escherichia coli, followed by Aeromonas hydrophila and Clostridium perfringens . Salmonella were found in the organs of 5% and in the intestinal tract of 3% of the birds . The species of Salmonella most frequently isolated was Salmonella typhimurium varieties copenhagen . Also recorded were Yersinia intermedia Serovar 0:17 (1x), Pseudomonas spp . (2x), bacteria of the Haemophilus-Pasteurella-Actinobacillus group (1x), Pasteurella multocida (2x), Moraxella septicaemiae (1x), Campylobacter spec . (1x), Mycoplasma spec . (6x), DNase positive Staphylococcus spec . (4x) and Streptococcus spec . (6x) . Less in evidence among the birds examined were fungus diseases with Aspergillus spec . (4x) and Blastomyces spec . (4x) . As for viruses one Guillemot was found to have an Adenovirus and another one to have a Paramyxovirus . From one of the Herring Gulls there also was isolated a Paramyxovirus, from a second one to a Reovirus . Three other species isolated have get to be identified . The chief cause of sickness and death in the Guillemots was oil-contamination . The majority of the examined Kittiwakes and Herring Gulls were victims of pathogenic agents . Many of the Black-headed Gulls died through traumata as gunshots or road traffic etc . In order to establish the causes of sickness and death in seabirds and to ascertain the importance of the various species as possible carriers of infectious diseases, a systematic series of investigation will be necessary . Without this it will not be possible to assess their epidemiological relevance for other wild birds, domestic poultry and humans. Antimicrob Agents Chemother, 1989 May, 33(5), 781 - 4 Comparative in vitro activity of ceftibuten (Sch 39720) against bacterial enteropathogens; Shawar R et al.; Ceftibuten is a new orally active cephalosporin with significant bioavailability . Its in vitro activity was compared with those of other agents against 383 strains of enteric pathogens derived from clinical specimens . Ceftibuten was very active against the strains of the family Enterobacteriaceae tested (overall MIC for 90% of strains tested, 0.25 microgram/ml) but was less active against Campylobacter jejuni (MIC for 90% of strains, 16 micrograms/ml) . The MBC was one to two dilutions higher than the corresponding MICs for most pathogens tested. J Clin Microbiol, 1989 May, 27(5), 1072 - 6 Identification of Campylobacter jejuni and C . coli by gel electrophoresis of the outer membrane proteins; Derclaye I et al.; Analysis of the electrophoretic profiles of the outer membrane proteins could be used to differentiate Campylobacter jejuni (16 strains) from Campylobacter coli (10 strains) . This observation was confirmed by the study of DNA homology obtained by a quantitative filter hybridization method . The hippurate hydrolysis test gave a poor correlation with the results of differentiation obtained by DNA homology studies and outer membrane protein profile. J Pediatr Surg, 1989 May, 24(5), 443 - 7 Pediatric upper gastrointestinal endoscopy: a 13-year experience; Tam PK et al.; This report describes a series of 553 flexible upper gastrointestinal (GI) endoscopies performed on 382 children in two surgical centers between 1975 and 1987 . Indications included abdominal pain (180), reassessment of known disease (149), upper GI bleeding (99), foreign body ingestion (77), vomiting (14), dysphagia (10), and miscellaneous (24) . Findings were chronic peptic ulcer (47), gastritis/duodenitis (63), healing disease (92), nonhealing disease (22), recurrent disease (32), foreign body impaction (22), stricture (9), esophagitis (7), varices (7), mass (6 {3 polyp, 1 lymphoma, 1 fungus ball, 1 inflammation}), normal (209), and miscellaneous (37) . Endoscopic diagnosis was uniformly correct except on two occasions, when the presence of recurrent tracheoesophageal fistula in small infants was missed due to use of an inadequate instrument . A pathologic lesion is likely to be identifiable in GI bleeding (84.8%) . Endoscopic surveillance for progress of known disease was found to be valuable, particularly in peptic ulcer management, as both incomplete healing after standard therapy as well as recurrence are frequent . The recent practice of routine antral biopsy in children with severe "nonspecific abdominable pain" enabled four cases of Campylobacter pylori colonization in the stomach to be diagnosed, thus allowing appropriate treatment . Endoscopy was therapeutic on 61 occasions: injection sclerotherapy (32), foreign body removal (20), polypectomy (3), and stricture dilatation (6) . Endoscopy-guided bougienage, in particular, represents a recent major advance . There was no morbidity or mortality in the entire series . It is concluded that pediatric upper GI endoscopy performed by experienced surgeons is safe and effective . As a result of better understanding and technological advances, a changing trend of wider and more rational applications of the procedure is now evident. Gut, 1989 May, 30(5), 573 - 8 Comparison of gastric body and antral pH: a 24 hour ambulatory study in healthy volunteers; McLauchlan G et al.; Simultaneous ambulatory records of gastric antral and body pH were made over 24 hours in nine healthy volunteers by means of endoscopically positioned and anchored glass electrodes . Intragastric pH was temporarily raised after the endoscopy with the median pH value 30 minutes after the procedure being 3.9 (range 1.5-7.0) for the antrum and 4.1 (range 1.5-7.0) for the body . Daytime pH (median pH value between 12 00 h and 23 00 h) was lower in the antrum (median = 1.9, range 1.6-2.6) than in the body (median = 2.7, range 1.8-4.5) (p less than 0.05) and this was because of the rise in pH on eating being less marked in the antrum than in the body . The median peak pH recorded during the evening meal was only 4.1 (range 2.4-6.2) in the antrum compared with 6.3 (range 4.4-6.7) in the body (p less than 0.01) . Preprandial pH (median value over the hour prior to the evening meal) was similar in the antrum (median = 1.9, range 1.2-2.5) and body (median = 1.9, range 1.3-2.8) . Night-time pH (median pH value between 23 00 h and 05 00 h) in six subjects remained low and was similar in the antrum (median = 1.4, range 1.2-1.7) and body (median = 1.3, range 1.1-1.7) . In two subjects, however, there were episodes of raised night-time pH which were more marked in the antrum than in the body . Antral biopsies showed gastritis in four of the nine normal volunteers, which in three was associated with the presence of campylobacter-like organisms . This study shows the significant regional variations in day and night-time intragastric pH. Lab Anim Sci, 1989 May, 39(3), 219 - 21 Diversity of serotypes of Campylobacter jejuni and Campylobacter coli isolated in laboratory animals; Taylor NS et al.; One hundred nineteen isolates of Campylobacter jejuni and Campylobacter coli from nine laboratory animal species were serotyped using antisera to 20 Penner serotypes commonly isolated from cases of human enteric infections . Although C . jejuni and C . coli were isolated from laboratory animals with diarrhea, the majority were cultured from asymptomatic animals (81%) . Seven of twenty-two isolates from animals with diarrhea were serotype 4 (32%) and three were serotype 1 (14%) . Sixty-one of the 119 isolates (51%) were typeable using the 20 Penner antisera indicating that many of the isolates obtained from 29 nonhuman primates (five species), 20 ferrets, 7 hamsters, 15 cats and 48 dogs are serotypes commonly associated with human enteritis . Among typeable strains, 13 different serotypes were identified . Two particular serotypes, 4 and 19 were isolated from several species of animals and comprised 24% of the isolates studied . Since asymptomatic laboratory animals of several different species harbor serotypes of C . jejuni and C . coli that are potentially pathogenic to man, appropriate precautions should be instituted to minimize exposure of personnel to the organisms in laboratory animal feces . If suspected cases of zoonotic-related enteric campylobacteriosis involving laboratory animals do occur, serotyping of isolates would be a useful epidemiologic marker in studying the outbreak. Am J Gastroenterol, 1989 May, 84(5), 511 - 3 Patterns of physical modes of contact between Campylobacter pylori and gastric epithelium: implications about the bacterial pathogenicity; Caselli M et al.; Since the exact mechanisms of the pathogenicity of Campylobacter pylori are not known, we performed an ultrastructural study with the aim of focusing on patterns of possible physical contact between C . pylori and gastric epithelium, and of considering them in relation to the bacterial pathogenicity . Among 20 random consecutive patients referred for routine gastroscopy, we studied ultrathin sections from the 11 patients with Campylobacter-like organisms, and recognized three patterns of physical contact between bacteria and epithelial cells . These patterns seem in accord with published data of C . pylori toxicity, and they could represent different evolutive stages of the infection. Arch Pathol Lab Med, 1989 May, 113(5), 470 - 2 Absence of Campylobacter-like organisms in Barrett's esophagus; Houck JA et al.; Barrett's esophagus is a chronic condition in which the normal squamous mucosal lining is replaced by columnar mucosa . Campylobacter-like organism (CLOs) are implicated in the pathogenesis of gastritis and peptic ulcer disease and have been identified in Barrett's esophagus . The purpose of this study was to examine the incidence of CLOs in Barrett's esophagus and to consider their role, if any, in the pathogenesis of the disease . None of the bacteria were identified in 38 specimens obtained from 34 patients with Barrett's esophagus . It is concluded that the incidence of CLOs in Barrett's esophagus must be low and that CLOs do not contribute to the natural history of the disease. Infect Immun, 1989 May, 57(5), 1432 - 7 Population genetics of human and animal enteric Campylobacter strains; Aeschbacher M et al.; A total of 125 strains of Campylobacter jejuni and Campylobacter coli from human and animal hosts were analyzed by multilocus enzyme electrophoresis . Ten genetic loci were characterized by the electrophoretic mobilities of their products, and all were found to be polymorphic . The nine loci considered for genetic analysis had an average allele number of 6.9 and a mean genetic diversity of 0.634 . The strains were grouped into 64 electrophoretic types (ETs) forming two principal clusters; the first cluster consisted of 50 ETs represented by 104 isolates of C.jejuni, and the second included 14 ETs represented by 21 isolates of C . coli . The genetic distance between the two species was 0.939 . The data support the conclusions that (i) campylobacteriosis caused by C . jejuni and C . coli is a zoonosis, (ii) human and animal strains do not constitute subpopulations, and (iii) every animal strain may be considered a potential human pathogen . The frequency of intraspecies gene transfer seems to be moderately high whereas interspecies gene transfer is very rare at best, which suggests the existence of a biological barrier between C . jejuni and C . coli. Infect Immun, 1989 May, 57(5), 1380 - 3 Campylobacter-Wolinella group organisms are the only oral bacteria that form arylsulfatase-active colonies on a synthetic indicator medium; Wyss C; Most oral bacteria tested formed colonies on a chemically defined medium with a chromogenic arylsulfatase substrate . Arylsulfatase activity was, however, restricted to Campylobacter-Wolinella group organisms, including Wolinella recta, a possible periodontopathogen . W . recta was the only arylsulfatase-active species against which consistently high levels of antibody were detected in human sera. Acta Gastroenterol Belg, 1989 May-Aug, 52(3-4), 320 - 3 Campylobacter pylori as possible factor in peptic ulcer recurrence; Rauws EA; The author reviews the literature up to 1988 about the close association of Campylobacter pylori with chronic active gastritis, duodenitis and peptic ulcer disease . No firm data however demonstrate that Campylobacter pylori causes duodenal ulcer but long term eradication of this bacterium prevents duodenal ulcer relapse. Acta Gastroenterol Belg, 1989 May-Aug, 52(3-4), 311 - 9 {Campylobacter pylori gastritis: review of diagnostic methods}; Debongnie JC et al.; The presence of Campylobacter pylori in gastric mucosa is a proof of active gastritis . Diagnostic methods are based on endoscopy: culture--histology--cytology--urease test, or on noninvasive tests: C14 urea breath test and serology . The principles, results (sensitivity--specificity), advantages and problems of each test are discussed as well as the choice of a diagnostic method . In practice, we recommend the use of two methods, a morphological one (histology or cytology) and another based on bacterial activity (urease test or culture). Vet Pathol, 1989 May, 26(3), 260 - 4 Early lesions of proliferative enteritis in pigs and hamsters; McOrist S et al.; Gnotobiotic pigs and conventional hamsters were given suspensions of intestinal mucosa from a pig with proliferative hemorrhagic enteropathy and killed 10 or 21 days later . Affected animals had evidence of marked proliferation of immature enterocytes in the intestinal crypts . Numerous Campylobacter-like organisms were in the cytoplasm of enterocytes, and in some instances, bacteria were closely associated with enterocytes . Some intracellular bacteria lying below the microvillous border were within membrane-bound structures . Immunofluorescence and electron immunogold staining with specific antibodies indicated that these organisms were antigenically different from curved bacteria in the crypt lumen of early lesions . This study indicates that the life cycle of the intracellular organisms may involve entry into crypt enterocytes from the intestinal lumen with subsequent intracellular multiplication. Acta Gastroenterol Belg, 1989 May-Aug, 52(3-4), 324 - 35 Morphological evidence of Campylobacter pylori pathogenicity in chronic gastritis and peptic ulcer; Fiocca R et al.; Campylobacter pylori (CP) were found in 84% of 384 patients with chronic gastritis and in none of 49 subjects without inflammation . CP were present in similar percentages among patients with active (90%) or healed peptic ulcer (84%), as well as in non-ulcerous dyspepsia complicated by gastritis (91%) . Cytoplasmic vacuolization and swelling of foveolar-superficial cells with adhering bacteria, micropapillae and microerosions were commonly found in CP-infected mucosa . In 100 cases with gastritis both intraepithelial granulocytes and epithelial lesions were prominent features of heavily CP-infected antral mucosa . The occurrence of some cases with abundant, adhering CP but lacking epithelial lesions is in keeping with the different ability of various CP-strains to produce cytotoxins . In 16 of 19 children with type B chronic gastritis antibacterial therapy eradicated CP . This was followed by resolution or striking improvement of gastritis and disappearance of epithelial lesions . These data provide further morphological evidence of direct cytotoxic activity of CP toward gastric mucosal cells. J Assoc Physicians India, 1989 May, 37(5), 307 - 10 Rapid diagnostic test of Campylobacter pylori infection in patients of gastritis, duodenal ulcer and gastric ulcer . A study of 100 cases; Nanivadekar SA et al.; Campylobacter pylori has been cultured from 85-90% of antral biopsies of patients of gastritis, duodenal ulcer and gastric ulcer at different centres in the world . It has been now firmly implicated in the aetiology of active gastritis as well as suspected to cause repeated recurrences of peptic ulcers . However, the organism is very fastidious and is difficult to grow by standard culture methods as a result of which low positivity is often obtained even in well equipped centres . The rapid biopsy urease test for the diagnosis of C pylori infection, in which the biopsy is directly cultured in a solid medium containing urea, is a very simple test . A change in colour indicates the growth of the organism . This test is 100% specific and 98% sensitive . We performed this test in 100 patients; 93 of gastritis, 6 of DU and 1 of GU during a three month period . 87 of 93 cases of gastritis (90%) and all 6 cases of DU (100%) were positive . The single case of gastric ulcer was negative . Treatment of C pylori positive cases showed that they responded poorly to 4 weeks therapy with tinidazole; 33% were cured after 2 weeks of 1.5 g amoxycillin daily, but all responded when the therapy was continued for 4 weeks. Nippon Shokakibyo Gakkai Zasshi, 1989 May, 86(5), 1025 - 30 {Distribution and prevalence of Campylobacter pylori in the stomach}; Yoshida M et al.; We investigated the distribution and prevalence of Campylobacter pylori in the stomach and duodenum . In this study, 500 biopsy specimens were obtained from 245 patients . In each case, biopsy specimens were taken from more than 2 sites . C . pylori was detected by culture, urease test and acridine-orange stain . C . pylori was not detected on the intestinal metaplasia, gastric cancer tissue and duodenal mucosa without gastric metaplasia . In 21% of cases, C . pylori was detected in only one site . Because of the patchy distribution of C . pylori, more than 2 biopsy specimens from different sites were needed to avoid sampling error . Detection rate of C . pylori was almost equal in antrum, angle and body as well as in male and female . H2 receptor antagonists did not affect the detection rate of C . pylori . According to the endoscopic diagnosis of the biopsied site, C . pylori was detected in 87% of gastric ulcer, 60% of duodenal ulcer (duodenal mucosa with gastric metaplasia), 73% of chronic gastritis and 62% of endoscopically normal gastric mucosa. Int J Food Microbiol, 1989 May, 8(2), 165 - 74 Antibacterial effect of the glucose oxidase-glucose system on food-poisoning organisms; Tiina M et al.; The antibacterial effect of the glucose oxidase-glucose system was studied on food-poisoning organisms including Staphylococcus aureus, Salmonella infantis, Clostridium perfringens, Bacillus cereus, Campylobacter jejuni, Listeria monocytogenes and Yersinia enterocolitica using automated turbidometry . The bacteria were grown in sterile-filtered meat medium which was either raw or heat-denaturated . The results showed a clear growth inhibition with combinations of 0.5-1.0 mg/ml glucose and 0.5-1.0 IU/ml glucose oxidase . The growth inhibition was more effective in the heat-denaturated meat medium . The most resistant pathogens were Campylobacter jejuni and Listeria monocytogenes, however growth inhibition was still evident . The possible application of the glucose oxidase-glucose system in food products inhibiting the growth of pathogens and spoilage organisms is discussed. Zentralbl Veterinarmed B, 1989 May, 36(3), 217 - 25 {The occurrence of Escherichia coli, Aeromonas hydrophila, Plesiomonas shigelloides and Clostridium perfringens in the intestinal flora of gray herons (Ardea cinerea)}; Glunder G; The flora of the large intestine of 92 grey herons was examined for the frequency of aerobic and microaerobic growing bacteria . Clostridium perfringens, Aeromonas hydrophila, Plesiomonas shigelloides and E . coli were isolated from 55%, 48%, 14% and 35% of the birds, respectively . It could be demonstrated that the findings of these bacteria in the intestinal flora are depending on the age of the birds . The percentage of carriers of Clostridium perfringens, Aeromonas hydrophila and Plesiomonas shigelloides was highest in nestlings younger than 18 days, less high in older nestlings and lowest in adult grey herons . Contrary to those bacteria, E . coli was found more often in the intestinal flora at increasing age of the birds . Salmonella spp . were isolated from 6 birds . Two birds yielded positive for Yersinia enterocolitica and Campylobacter spp., respectively . Other aerobic and microaerobic bacteria play a less significant role as part of the intestinal flora. J Am Vet Med Assoc, 1989 May 1, 194(9), 1273 - 80 Efficacy of viral components of a nonabortigenic combination vaccine for prevention of respiratory and reproductive system diseases in cattle; Talens LT et al.; Efficacy and safety of components of an IM-administered vaccine for prevention of infectious bovine rhinotracheitis virus (IBRV), parainfluenza type-3 (PI-3) virus, bovine viral diarrhea virus (BVDV), and respiratory syncytial virus (RSV) infections and campylobacteriosis and leptospirosis were evaluated in cattle, including calves and pregnant cows . Challenge of immunity tests were conducted in calves for IBRV, PI-3 virus, or BVDV vaccinal components . All inoculated calves developed serum-neutralizing antibodies and had substantially greater protection (as measured by clinical rating systems) than did controls after challenge exposure to virulent strains of IBRV, PI-3 virus, BVDV, or RSV . In in utero tests, IBRV or bovine RSV vaccinal strains were inoculated into fetuses of pregnant cows . Histologic changes or abortions did not occur after fetal inoculation of the RSV vaccinal strain, and 10 of 14 fetuses responded serologically . Of 9 fetuses, one responded serologically to the IBRV vaccinal strain after in utero inoculation and was aborted 3 weeks later . In an immunologic interference test, 10 calves vaccinated with 2 doses of the multivalent vaccine, containing the 4 viral components and a Campylobacter-Leptospira bacterin, developed serum-neutralizing antibodies to IBRV, PI-3 virus, BVDV, and RSV without evidence of serologic interference . Under field conditions, 10,771 cattle, including 4,543 pregnant cows, were vaccinated . Vaccine-related abortions did not occur. Rofo, 1989 May, 150(5), 551 - 5 The role of radiology in Campylobacter enterocolitis; Demaerel P et al.; A series of 18 patients with diarrhoea and positive stool cultures for Campylobacter jejuni is presented . The most important radiological features were thickening of ileal mucosal folds, of interhaustral indentations and of the ileocaecal valve, lymphoid hyperplasia and microulcerations . Radiology, as well as endoscopy, are both nonspecific in Campylobacter jejuni enterocolitis . The importance of radiology is to exclude more typical features of other causes of inflammatory bowel diseases . Moreover, before the result of the stool culture is available, the radiological features should suggest the suspicion of an acute infectious enterocolitis by Campylobacter jejuni as possible diagnosis. APMIS, 1989 May, 97(5), 472 - 4 DNA-DNA hybridization incompatibility of Campylobacter pylori with other Campylobacter and Wolinella species; Bukholm G et al.; DNA-DNA hybridization in solution was used to characterize 23 human isolates of Campylobacter pylori . The 23 isolates showed DNA affinity with the type strain (NCTC 11637) . The relative binding ratios varied between 0.83 and 1 . Type strains of C . coli (NCTC 11366), C . jejuni (NCTC 11351), C . laridis (NCTC 11352), C . sputorum subsp . sputorum (ATCC 35980), Wolinella recta (NCTC 11489) and W . succinogenes (ATCC 29543) showed relative binding ratios less than 0.01 compared to the C . pylori type strain . The results suggest that C . pylori is a homogenous taxonomic unit distinctly separated from these other species. J Med Microbiol, 1989 May, 29(1), 55 - 62 Use of the mouse for the isolation and investigation of stomach-associated, spiral-helical shaped bacteria from man and other animals; Dick E et al.; Spiral-helical shaped bacteria other than Campylobacter pylori have been shown to infect the human stomach . The characteristic helical morphology of these bacteria appears to be similar to that of bacteria found in the stomachs of many other animal species . Early reports on gastric bacteria suggested that rodents may be useful for investigation and isolation of stomach-associated bacteria . Therefore, anaesthetised mice were given, through a stomach tube, a heavy suspension of a spiral-helical bacterium from a cat, scrapings of gastric mucus from primates, or a homogenised whole-antral biopsy from a human patient . At intervals after inoculation, gastric biopsies were examined by lightmicroscopy and electronmicroscopy for the presence of spiral-helical bacteria . Significant colonisation was observed in 40% of mice 1 week, and in 80% of mice 11 weeks, after inoculation with suspensions of the cat isolate . Mice were also successfully colonised by spiral bacteria present in homogenised human biopsy material and by other spiral bacteria from a monkey . These observations suggest that mice may prove to be useful animals for the study of gastric bacteria that are, as yet, non-cultivable and for analysis of some of the attributes commonly thought to be involved in colonisation. Ann Ig, 1989 May-Aug, 1(3-4), 729 - 40 {Stationary and migratory avifauna as reservoirs of Salmonella, Yersinia and Campylobacter}; Levre E et al.; Domestic and wild animals have been always considered very important as reservoir of agents of human infections . Particularly birds, because of their great mobility from a continent to another or within the limits of the same ecosystem may transfer pathogenic micro-organisms . The present survey was undertaken in order to evaluate the presence of Campylobacter, Yersinia and Salmonella in migratory and permanent birds . During the period October 1986 to March 1988 intestinal loops were collected from a total of 217 birds representing 17 different species shot, during hunting seasons, in the inland of Versilia in the district of Lucca . Each sample was divided into three parts and examined for the presence of Campylobacter, Yersinia and Salmonella . Campylobacter was isolated from 74 of the 217 birds examined (34.10%) . Yersinia was recovered from 26 birds (11.98%), while only 8 birds (3.68%) harboured Salmonella . Most of the samples carried only one of the three bacterial genera investigated while 9 harboured at the same time Yersinia and Campylobacter, 1 Salmonella and Campylobacter, and 1 Salmonella, Yersinia and Campylobacter . Campylobacter spp.: On the ground of Lior's biotyping scheme, the 74 strains, isolated from 16 of the 17 species of birds examined, have assigned to three biochemically different species . C . coli was the most commonly isolated followed by C . jejuni and C . laridis . Of the 54 isolates of C . coli 30 belonged to biotype I and 24 to biotype II . 19 C . jejuni organisms were differentiated into 5 belonging to biotype I and 14 to biotype II . The only C . laridis isolated belonged to biotype I . Yersinia spp.: 37 strains belonging to the genus Yersinia were isolated from 26 birds . In 10 samples different types of Yersinia were identified . Most of the strains could be ascribed to Yersinia enterocolitica (28 strains), 3 to Yersinia frederiksenii, 3 to Yersinia intermedia and 1 to Yersinia pseudotuberculosis . 2 strains were identified as atypical Yersinia . Salmonella spp.: 8 strains belonging to the genus Salmonella were isolated from 3 different species of birds . The isolates were identified as Salmonella typhi-murium (7 strains) and Salmonella blockley (1 strain) . Salmonella has been isolated from 8 birds, six of which were pheasants shot during the same day in the same area and probably coming from the same breeding . In fact, in Tuscany, pheasants are bred and then set free in many hunting areas.(ABSTRACT TRUNCATED AT 400 WORDS) J Clin Microbiol, 1989 May, 27(5), 1040 - 4 Prospective study of Campylobacter jejuni infection in Chilean infants evaluated by culture and serology; Figueroa G et al.; A prospective study of Campylobacter jejuni infection was performed during a 6-month period in a cohort of 198 Chilean infants . Surveillance was based on biweekly home visits by a team of trained nurses . C . jejuni colonization was studied by culturing stool samples from diarrheal episodes and paired asymptomatic controls and by performing an enzyme-linked immunosorbent assay developed to measure C . jejuni outer membrane protein polyvalent antibodies in a representative group of infants . C . jejuni was isolated from 30 of 299 diarrheal episodes (10%) and from 17 of 304 samples from asymptomatic infants (6%) . Significantly higher (P less than 0.05) C . jejuni illness/infection ratios were found in infants less than 9 months old . Polyvalent antibodies to C . jejuni were found in 27 of 89 serum samples (30%) . The lowest prevalence (4%) was observed among infants less than 9 months old, and the highest was found in patients older than 15 months (63%; P less than 0.01) . Data obtained by analysis of paired serum samples revealed a significant increase in the number of seropositive individuals, from 8% on admission to 50% at the end of the protocol (P less than 0.001) . The change in the immune status of these infants was associated with symptomatic infection in 9 of 18 cases . The antibody rise found in the remaining nine infants suggested the presence of asymptomatic C . jejuni infections . This inference was documented by the isolation of C . jejuni from stools of two of these infants when the infants were randomly studied while asymptomatic . This study points out the impact of C . jejuni-associated diarrheal episodes and the high frequency with which asymptomatic infections elicit specific antibodies in infants living in areas such as Chile. Am J Gastroenterol, 1989 May, 84(5), 506 - 10 Colloidal bismuth subcitrate (De-Nol) inhibits degradation of gastric mucus by Campylobacter pylori protease; Sarosiek J et al.; There is increased awareness that infection with Campylobacter pylori could be a major factor in the pathogenesis of gastric disease . Here, we present evidence that the extracellular protease elaborated by this bacteria, which causes degradation of gastric mucus, is inhibited by an antiulcer agent, colloidal bismuth subcitrate (CBS; De-Nol) . The study was conducted with C . pylori cultured from antral mucosal biopsy specimens of patients undergoing gastroscopy . The grown colonies of bacteria were washed with saline, filtered through sterilization filter, dialyzed, and lyophilized . The powder was used as the enzyme source for proteolytic activity assay employing pig gastric mucus as substrate . Optimum enzymatic activity was obtained at 37 degrees C and at pH 7.0 . The apparent Km of C . pylori protease with gastric mucus was 0.71 g/L . Analyses of the degradation products indicated that the protease caused extensive proteolysis of mucus glycoprotein polymer . Introduction of CBS to the incubation mixtures led to a reduction of the rate of mucus degradation . The rate of proteolysis inhibition was proportional to CBS concentration up to 1 X 10(-1) g/L, at which point a 37% reduction in mucus proteolysis was obtained . The Km value for proteolytic degradation of mucus by C . pylori protease in the presence of CBS was 1.25 g/L . The results suggest that CBS is capable of counter-acting the proteolysis of the protective gastric mucus layer by C . pylori. Ugeskr Laeger, 1989 Apr 24, 151(17), 1030 - 3 {Antibacterial treatment of Campylobacter pylori-associated gastritis and peptic ulcer}; Andreasen JJ et al.; On the basis of possible etiological or pathogenetic significance of Campylobacter pylori for the development, maintenane og recurrence of gastritis and peptic ulceration, a review based on the literature is presented for the sensitivity of the