Bull Soc Pathol Exot Filiales, 1989, 82(5), 645 - 9 {Frequency and characteristics of Campylobacter jejuni-coli diarrhea in Tunisia}; Fendri C et al.; Because importance of Campylobacter jejuni/coli in human disease, we studied frequency, clinical and biological symptoms of Campylobacter enteritis . Investigation has been realised on 216 cases of diarrhoea seen outside the hospital and aged from 4 days to 60 years, and 512 cases of hospitalised diarrhoea . Outside the hospital, this bacteria has the same frequency as Shigella and Salmonella (3-5%) . Inside the hospital, it is rare . Outside the hospital, this bacteria is isolated in babies and children . Inside the hospital, it affects children and adults . In the hospital, clinical and biological symptoms of Campylobacter enteritis are more serious: Campylobacter predominant in stools, presence of leukocytes for all patients, and no other pathogenic organisms associated. Digestion, 1989, 44(3), 131 - 41 Value of serology (ELISA and immunoblotting) for the diagnosis of Campylobacter pylori infection; Pena AS et al.; Fifty-two unselected patients referred to for upper gastrointestinal endoscopy were evaluated in several ways to determine the presence of Campylobacter pylori . Antibodies against this microorganism were measured to assess the value of serology for the diagnosis of C . pylori infection . Five antral biopsy specimens were taken in each patient for culture and bacteriological determinations, histology {morphology and Warthin-Starry (WS) staining} and the urease test (2, 3 and 24 h) . Serum antibodies against a sonicate of 6 strains of microorganisms were assayed by enzyme-linked immunoassay (ELISA) and an immunoblotting technique . In 14 of the 52 patients the histology of the antrum was normal, 18 patients had chronic active gastritis and 20 had chronic gastritis without polymorphonuclear infiltration . In the group with normal histology, only 1 patient was positive for C . pylori with all methods, and 1 other subject was positive for IgG and 2 for IgA only with ELISA . In the group with chronic active gastritis, 14 were positive with all methods, 1 was negative by WS only and another was negative for IgA according to ELISA, WS and antibodies . Among the patients with chronic gastritis, 7 were positive and 7 negative with all tests; in the other 6 patients the results obtained with the various tests were divergent . Four serological tests were studied and validated against culture, WS and urease test which were considered to be the reference methods . The serological tests showed high sensitivity and specificity for the detection C . pylori-associated active chronic gastritis of the antrum, and can therefore serve as noninvasive methods to identify individuals with this condition. Mikrobiyol Bul, 1989 Jan, 23(1), 30 - 4 {Campylobacter bacteremia}; Baykal M et al.; In this article, Campylobacter bacteremia in a diabetic and last stage kidney patient has been reported. Zentralbl Chir, 1989, 114(24), 1540 - 3 {Reflections on the significance of detecting Campylobacter pylori in a biopsy of the stomach mucosa}; Thaler W et al.; The inevitable confrontation with Campylobacter pyloridis implicates the surgeon to take into consideration this germ . For that reason we have examinated Campylobacter-positive patients with regard to histological changes of the gastric mucosa and to clinical symptoms . Apart from the fact, that there was no Campylobacter colonisation in the healthy gastric mucosa, there were not found specific features for the germ. Acta Gastroenterol Belg, 1989 Jan-Apr, 52(1-2), 9 - 16 {Erosive duodenitis . Clinical study of 287 cases}; Gast P et al.; We relate here the results of a retrospective (1984-1987) investigation on 1043 protocols of gastroscopy, where the diagnosis of erosive duodenitis (ED) has been made 372 times in 287 patients . The presence of Campylobacter pylori was not investigated . ED endoscopic incidence was 5.6% . Patients were divided into three groups: 1 . ED alone: 15.7% . 2 . ED associated with duodenal ulcer (DU): 48.4% . 3 . E.D . associated with various diseases: 35.9% . There was a higher male/female ratio in the three groups, and mean ages were similar (50 years) . In the group ED alone, the first symptom was nonspecific epigastric pain in 61%; no risk factor appeared, and it did not recur . When associated with DU, ED preceded DU in 8.8% of the cases, followed DU in 18.9%, had the same course in 37.1%, appeared transiently in 2.5%, or during DU healing in 3.7% . The two diseases were unrelated in 28.3% of the cases . Only tobacco seemed to promote the association of DU with ED. Acta Gastroenterol Belg, 1989 Jan-Apr, 52(1-2), 3 - 8 Campylobacter pylori in gastric, duodenal and jejunal juices and mucosae of patients with duodenal ulcer; Debongnie JC et al.; The presence of Campylobacter pylori was investigated in biopsies and fluids obtained in the antrum, duodenal bulb and jejunum during jejunoscopy in 20 patients with an active duodenal ulcer . C . pylori was present in cultured antral biopsies in all patients, in the bulb of most patients (16/20), but was unusual in jejunal mucosa (2/20) . Using a non-contaminated sampling method of fluid, C . pylori was found in only two samples at each level . In conclusion, C . pylori is frequent in bulbar mucosa of duodenal ulcer patients, rare in jejunal mucosa and in fluid at each level, thus confirming the ecological mucosal niche of C . pylori. Scand J Gastroenterol Suppl, 1989, 167, 49 - 54 Does omeprazole improve antimicrobial therapy directed towards gastric Campylobacter pylori in patients with antral gastritis? A pilot study; Unge P et al.; This double-blind pilot study has been undertaken in order to investigate the effect of amoxicillin and pronounced suppression of gastric acid secretion on mucosal colonisation with Campylobacter pylori (CP) . Twenty four CP-positive patients were included in the study and assigned to 14 days of treatment in either one of the following three therapy groups: Group 1: Omeprazole 40 mg o.m . + Amoxicillin 750 mg b.i.d (9 pat); Group 2: Omeprazole 40 mg o.m . (8 pat); Group 3: Amoxicillin 750 mg b.i.d (7 pat) . Gastroscopy with biopsy for culture and histology was performed pre-entry, at cessation of therapy and four weeks later . In the group receiving omeprazole and amoxicillin in combination 5 out of 8 patients were negative for CP four weeks after stopping treatment, while in the amoxicillin and the omeprazole groups respectively one (1/7) and none (0/8) were negative . Except for one patient who was withdrawn because of severe diarrhoea, only minor adverse effects occurred. Scand J Gastroenterol Suppl, 1989, 167, 44 - 8 Campylobacter pylori and non-ulcer dyspepsia . 2 . A prospective study in a Swedish population; Gad A et al.; In a consecutive prospective series of 186 Swedish persons with the diagnosis of non-ulcer dyspepsia 71.5% were found to have gastritis and/or bulbar duodenitis in endoscopic biopsies . Gastroduodenitis was associated with campylobacter pylori (CP) in 83.5% of the cases . The double therapeutic approach using an antibiotic and a preparation containing bismuth in an uncontrolled therapeutic pilot trial resulted in improvement of the histological picture, disappearance of CP and amelioration of symptoms . It is concluded that CP-infection plays a central role in the pathogenesis of gastroduodenitis associated NUD. Scand J Gastroenterol Suppl, 1989, 167, 101 - 3 Rapid diagnosis of Campylobacter pylori by brush cytology; Gad A; Campylobacter pylori (CP) was demonstrated in 67.2% of 67 patients using cytology as compared to 65.7% by histology . Brush cytology is thus found to be superior to all other methods available to date for the detection of CP . It is rapid, simple, and has a high specificity. Digestion, 1989, 44(2), 101 - 4 Campylobacter-like organisms, nonsteroidal anti-inflammatory drugs and gastric lesions in patients with rheumatoid arthritis; Caselli M et al.; A histological study was performed in order to evaluate the prevalence of Campylobacter-like organisms (CLO) and gastric antral lesions in 85 rheumatoid arthritis (RA) patients using NSAIDs, and in 100 nonrheumatoid outpatients comparable in terms of sex and age, not using NSAIDs . Histological evidence of gastritis was a common finding both in RA patients (88.2%) and in nonrheumatoid outpatients (89.0%) . On the other hand, CLO were detected in a significantly lower proportion (p less than 0.001) of RA patients than outpatients (30.6 and 59.0%, respectively) . Considering each NSAID used separately (aspirin, diclofenac sodium and ketoprofen), no significant difference in the presence of CLO in the three groups was found; in the small group of patients treated with aspirin, however, bacteria were never detected . MICs of each NSAID used against 15 isolates of Campylobacter pylori were also determined. Arq Gastroenterol, 1989 Jan-Jun, 26(1-2), 28 - 32 Infectoepidemilogic and immunologic implications of Campylobacter coli enteritis in one newborn monozygotic twin pair; Fernandez H et al.; Since campylobacter infections in humans at early age have not been thoroughly documented yet, it seemed interesting to report the occurrence of two simultaneous cases of C . coli enteritis in one newborn monozygotic twin pair . Their clinical history, epidemiology and microbiological analysis, development of specific serum and mucosal immunity as well as total Ig synthesis are discussed on the basis of their close genetic and environmental relationships. Geogr Med Suppl, 1989, 5, 205 - 6 Serological investigations of children in Iran for Campylobacter, Yersinia and Shigella; Bashiribod H; Serological investigations for Campylobacter, Yersinia and Shigella in hospitalized children (different hospitals) in Iran revealed a contamination rate of 15% for Campylobacter, up to 19% for Yersinia and between 1 and 12% for the various strains of Shigellae . In diarrhoeal diseases the possibility of an infection with Campylobacter, Yersinia and Shigellae must be considered. Biomed Pharmacother, 1989, 43(6), 447 - 50 The source of Campylobacter pylori; Vaira D et al.; Sera from 98 abattoir workers were tested for IgG as well as for IgA to Campylobacter pylori, C . jejuni and Klebsiella . Clerical workers had significantly lower C . pylori and C . jejuni antibody levels than any of the groups in direct contact with freshly cut animal parts . No difference was found for antibodies to Klebsiella . Twenty-nine non-clerical workers with high IgG antibody levels against C . pylori consented to upper gastrointestinal endoscopy . C . pylori associated gastritis was found in all 29, and 4 weeks of colloidal bismuth subcitrate (240 mg/twice daily) was prescribed . On repeat testing at 3 months, all showed a decrease in IgG antibody levels to C . pylori but not to C . jejuni, whereas 18 untreated non-endoscoped workers showed no change . These findings raise the possibility that C . pylori infection is a zoonosis. Scand J Gastroenterol Suppl, 1989, 167, 81 - 5 Campylobacter pylori and gastroduodenal ulcer disease . A prospective study in a Swedish population; Gad A et al.; In a consecutive prospective series of 208 Swedish primary peptic ulcer patients, 146 gastric, 55 duodenal and 7 in both sites, gastroduodenitis was found in 97.6% of the cases . The mucosal inflammation was associated with CP in 87% and 91% of the gastric and duodenal ulcer cases respectively . No significant correlation was found between CP colonisation and the type or severity of mucosal inflammation . Gastric metaplasia was present in only 8% of 48 bulbar ulcer cases . Ulcer healing and eradication of CP was achieved in 52% of patients treated with bismuth subnitrate in combination with erythromycin or according to the triple approach. Rev Med Interna Neurol Psihiatr Neurochir Dermatovenerol Med Interna, 1989 Jan-Feb, 41(1), 49 - 56 {Campylobacter pylori infection in chronic gastritis and gastric cancer}; Andreica V et al.; The present paper analyses, in correlation with histologic lesions, the incidence of infection with Campylobacter pylori (CP) in patients with chronic gastritis, operated stomach, gastric neoplasm and healthy subjects . In chronic gastritis, incidence of infection with CP is 71.6%, significantly increased in comparison with the controls, in whom the positive percentage is 37.5 . The most of the patients in this group suffered from superficial chronic gastritis . In the group with operated stomach, the CP infection included 48% of the patients studied; all had superficial chronic gastritis . In gastric cancer, CP bacteria appeared in 50% of cases . CP may represent a pathogenetic ring that starts the gastric process. Scand J Gastroenterol Suppl, 1989, 160, 39 - 45 The potential impact of Campylobacter pylori on the treatment of duodenal ulcer disease; Miller JP et al.; In most studies the association between Campylobacter pylori infection, Type B gastritis and duodenal and gastric ulceration is extremely strong . The best evidence for it having an aetiological role is at present in Type B gastritis . It should be remembered, however, that serological studies show carriage of the organism to be common also in the general population . An attempt is made here to gain some idea of the clinical impact of C . pylori infection in duodenal ulcer disease by analysing clinical trials, and in particular relapse data, in which an agent which suppresses C . pylori is used (colloidal bismuth subcitrate) and compared with one which does not (an H2-receptor antagonist) . A mathematical model based on the data from these studies predicts that the prevalence of active duodenal ulceration will be twice as common in a group of subjects treated repeatedly upon relapse with an H2-receptor antagonist as in a group treated with colloidal bismuth . Other possible mechanisms are discussed but the ability of bismuth to suppress C . pylori infection is perhaps the best available explanation at present . Early data from several centres suggest that patients who can be rendered C . pylori negative over a prolonged period of time are relatively immune from relapse of their duodenal ulcers . If confirmed this observation may well transform the long-term management of duodenal ulcer disease. Scand J Gastroenterol Suppl, 1989, 157, 16 - 20; discussion 21-2 Colloidal bismuth in the treatment of duodenal ulceration: the benefit for the patient; Miller JP; Colloidal bismuth subcitrate (CBS) heals gastric and duodenal ulcers better than placebo and at rates similar to those observed with the commonly used H2-antagonists . Indeed, healing of duodenal ulcers may be more rapid than with cimetidine during the first month of treatment . When treatment is withdrawn, however, relapse is slower after CBS than after the H2-antagonists . The mechanism is uncertain but may be related to the ability of CBS to suppress Campylobacter pylori infection . The clinical implications of this difference in relapse rates are discussed . Preliminary data suggest that duodenal ulcer patients who are rendered C . pylori-negative for a prolonged period may be relatively immune to relapse . If confirmed, and if a suitably effective regimen can be found, this will transform the management of this difficult clinical problem. J Hosp Infect, 1989 Jan, 13(1), 87 - 90 Routine cleaning and the elimination of Campylobacter pylori from endoscopic biopsy forceps; Karim QN et al.; The effect of routine cleaning in removing Campylobacter pylori from the biopsy forceps of endoscopes has been examined in a series of 50 patients . Campylobacter pylori was isolated from the biopsies of 15 of the patients, while one of the 50 biopsy forceps washings yielded the organism after routine cleaning . This study suggests that there is a small chance of transmitting C . pylori by endoscopic equipment if cleaning is the only method of decontamination adopted. J Egypt Public Health Assoc, 1989, 64(5-6), 461 - 74 Detection of enteropathogens in diarrhoeal diseases among malnourished Egyptian infant and children; Hassan EM et al.; The influence of the Pre-existing malnutrition (PEM) on the severity of diarrhoea as well as the causative organisms was studied on 60 cases . The duration of diarrhoea was prolonged in cases with PEM . The stool purgative rate ranged from 4-15 times/day in PEM infant while it was 3-6 times in well nourished cases (WNC) (P less than 0.05) . Also vomiting and dehydration was more marked among PEM cases (52.9% and 32.4% of cases than in WNC cases (31.3% and 12.5% of cases) (P less than 0.05) . Rota virus and Candida albicans were the Commonest identified organisms in the stools of the PEM cases, they were detected in 52% and 38.2% of cases respectively while 25% of WNC had rota virus in their stool and non of them had Candida (P less than 0.02) . Giardia lamblia was detected in 23.5% and 18.8% of PEM and WNC while 10% of healthy controls had Giardia . Other bacterial enteropathogen were also found less frequently including Salmonella, Shigella, E . coli, Pseudomonas and Campylobacter . There was no statistical difference in the incidence between both groups . Multiple infections were detected in 47% and 18.7% of PEM cases and WNC (P less than 0.05) and correlated with the severity of illness. J Infect Dis, 1989 Jan, 159(1), 71 - 8 Human calicivirus-associated diarrhea in children attending day care centers; Matson DO et al.; We investigated human calicivirus (HCV)-associated diarrhea in children attending day care centers by using stool specimens collected in 1981-1983 . We used a screening enzyme-linked immunosorbent assay (ELISA) derived from reagents prepared against the Sapporo strain of HCV and confirmed positive results with a blocking ELISA and immunosorbent electron microscopy . HCV was detected in 11 (2.9%) of 375 diarrheal stools and in none of 86 stools from asymptomatic contacts . This incidence rate was half that noted for rotaviruses and higher than that noted for Campylobacter, Salmonella, and Shigella in the original study . HCV was found in stool specimens from children in nine day care centers; HCV-associated diarrhea was sporadic, occurred with greater frequency in young children, and had a summer-fall predominance . Our results indicate that HCV is an important cause of diarrhea in day care centers and that frozen stool samples can yield epidemiological data on HCV infection. Scand J Rheumatol Suppl, 1989, 78, 18 - 23; discussion 30-2 NSAIDs: new approaches to limiting gastropathy; Zeidler H et al.; An extensive literature search on non-steroidal anti-inflammatory drug (NSAID)-induced gastropathy in rheumatic conditions has been carried out . A reduced incidence of gastropathy has been observed among newly developed NSAIDs such as etodolac and the non-acidic nabumetone . An alternative prophylactic therapy to avoid NSAID-induced gastroduodenal mucosal damage which has been successfully tested in several trials is co-medication with the prostaglandin analogue misoprostol . The cytoprotective agent sucralfate also appears to be effective . Recent observations of Campylobacter pylori infections in NSAID-induced gastropathy introduces the question as to whether simultaneous antibacterial medication should be routinely administered during NSAID therapy . At present the invasive technique of endoscopy is used to ascertain gastroduodenal mucosal damage . However, a new technique which merely requires blood sampling is being investigated . This involves measurement of serum levels of the precursor molecules for the gastric enzyme pepsin, pepsinogen I and II . In future this assay could constitute a non-invasive method for detecting gastroduodenal mucosal damage. Tierarztl Prax, 1989, 17(2), 145 - 8 {The most frequent infectious causes of abortion in sheep in north Bavaria with special reference to Chlamydia and Salmonella infections}; Plagemann O; Between 1980 and 1987 1153 ovine fetuses and placentas were examined after abortion . In 68.5% of the cases a cause of abortion could be diagnosed as follows: 43.5% Chlamydia psittaci var . ovis, 10.7% Salmonella abortus ovis, 3.7% Coxiella burnetii, 3.3% Listeria monocytogenes and 0.4% Campylobacter fetus intestinalis . Hemolyzing Escherichia coli and Streptococci, Yersinia pseudotuberculosis, Salmonella typhimurium, Salmonella enteritidis, Corynebacterium pyogenes and other facultative pathogens isolated in pure culture out of fetal organs as well as non-infectious reasons (fetal deformities) were the causes of abortion in only 7%. Dakar Med, 1989, 34(1-4), 41 - 3 {Campylobacter pylori and the gastric mucosa . Apropos of the detection of Campylobacter pylori in 12 patients with gastric mucosa lesions}; Peghini M et al.; The authors report the results of systematic research on Campylobacter pylori during high endoscopy . Of the 60 patients examined, 12 were found to have the germ in their antral, gastric mucosa . All these patients had a history of chronic gastritis . They recall the role of this germ in creating chronic gastritis, and evoke the hypothesis that the mucosa becomes fragile facilitating the appearance of an ulcer. Dakar Med, 1989, 34(1-4), 157 - 60 {Bacterial etiologies of acute infantile diarrhea in Dakar}; Aidara A et al.; Systematic research into all the bacterial etiological agents responsible for acute diarrhoea was undertaken on 276 diarrhoea stools collected from children aged 0-5 years . Particular attention was given to finding bacterial agents usually overlooked during routine checks: Campylobacter, Vibrionaceae and Yersinia enterocolitica. J Gastroenterol Hepatol, 1989, 4 Suppl 2, 1 - 6 Peptic ulcer: from epidemiology to cause; Lam SK; Any postulate that attempts to explain the aetiology of peptic ulcer must take into consideration a number of established facts . (i) At the beginning of the 20th century there was a steep rise in the incidence of peptic ulcers . Over the past 2 decades, trends have shown a significant decline in some Western countries, such as the United Kingdom, and a significant rise in certain Asian countries, such as Hong Kong and Singapore . (ii) There are marked geographical variations in incidence (for example, it is five times more common in Hong Kong than in Sydney), male: female ratio (for example, 1:1 in USA and 17:1 in India), duodenal ulcer (DU): gastric ulcer (GU) ratio (for example, 0.8:1 in Japan and 32:1 in India), and placebo healing rates . (iii) There is genetic heterogeneity . (iv) A proportion of patients has gastric hyperacidity . (v) Ulcer healing is speeded up by the reduction of gastric acidity, but usually only when the stomach is made relatively hypochlorhydric . (vi) Chronic antral gastritic occurs in 90% of DU and 70% of GU cases . (vii) Ulcer occurs most commonly at the duodenal bulb for DU and at the incisura for GU . No single causative factor can explain these facts, and the aetiology must, therefore, be heterogeneous . Cigarette smoking, ingestion of aspirin and other non-steroidal anti-inflammatory agents and environmental stress are reasonably well-established factors . Current evidence indicates that Campylobacter pylori is causally related to antral gastritis but not to peptic ulcer.(ABSTRACT TRUNCATED AT 250 WORDS) Boll Ist Sieroter Milan, 1989, 68(2), 199 - 200 Campylobacter laridis bacteraemia in an AIDS patient; Dionisio D et al.; The likely first case of Campylobacter laridis bacteraemia in AIDS is reported . Microbiological, epidemiological and clinical characteristics of C . laridis human infection are also described. Boll Ist Sieroter Milan, 1989, 68(1), 42 - 4 Listeria SPP . and enteric pathogens in raw meat: a survey in the Ferrara area; Maini P et al.; The Authors report the results of a study performed on 113 samples of raw meat of 6 different animal species in order to evaluate the extent of contamination by some organisms responsible for food-borne infections . A total of 2 strains of Salmonella (1.7%), 36 of Yersinia (31.8%), 35 of Campylobacter (30.9%) and 13 of Listeria (11.5%) were isolated . The possible role of contaminated meat in cases of human listeriosis is pointed out. Enferm Infecc Microbiol Clin, 1989 Jan, 7(1), 8 - 11 {Campylobacter pylori's sensitivity to the bactericidal action of human serum}; Reina J et al.; The sensitivity to the bactericidal power of the human serum was evaluated on 8 strains of C . pylori, 8 strains of C . jejuni, 2 strains of C . coli and 2 strains of C . fetus . Each of them was incubated at 37 degrees C in the presence of a complete pool of human sera, the same pool after inactivation of the complement, and trypticase soy broth (control) . After 0, 15, 30 and 60 minutes the capacity to grow in blood agar plates (count of colonies) incubated in microaerophillic conditions for 3 days was evaluated . In this experimental study it was shown that C . pylori has a rapid and complete sensitivity to the human serum and, particularly, to the complement; this could be one of the factors that determine its lack of invasive capacity. G Batteriol Virol Immunol, 1989 Jan-Dec, 82(1-12), 3 - 7 {Old and new pathologies proposed by epidemiology}; Zardi O et al.; The results of a study made in the areas of Central Italy on a random community on the significant presence of cases with seroantibodies against Campylobacter, Yersinia, Legionella Pneumophila, Francisella Tularensis and Rotavirus confirm the hypothesis on the presence in the territory of microorganisms responsible . These positivities in man are not only single but also contemporaneous for at least two microorganisms . Hence the hypothesis of the presence in the environment (animals, soil, surface waters) of the microorganisms (Campylobacter, Yersinia, Legionella Pneumophila, Francisella Tularensis, and Rotavirus) responsible for the zoonoses of interest for man. Arch Inst Pasteur Alger, 1989, 57, 255 - 66 {Enteritis caused by enteropathogenic Campylobacter . Preliminary study (January 1988 to June 1989)}; Drioueche D et al.; Campylobacter enteritis appears to be a frequent cause of bacterial diarrhoea, especially among children . The species isolated in our study are C . jejuni and C . coli . The clinical characteristics are acute diarrhoea (sometimes with blood) and abdominal pain . The evolution is usually favorable without treatment . In serious and prolonged cases, the treatment is based on Erythromycin which was active against all the strains. Scand J Gastroenterol Suppl, 1989, 160, 19 - 24 The reliability of urease tests, histology and culture in the diagnosis of Campylobacter pylori infection; Deltenre M et al.; The accuracy of various staining techniques for immersion microscopy, of five media for culture and five urease test modalities for the detection of Campylobacter pylori infection is reported . It was found that 2% urea unbuffered gel preparation is the most accurate urease test (sensitivity: 89%, specificity: 98%) but a minimal amount of 10,000 CFU/ml is necessary to observe positivity and the sensitivity of urease tests drops to 52% in patients under antimicrobial treatment . For histological diagnosis, modified Giemsa staining was shown to be slightly superior to H&E . The most valuable diagnosis technique is culture when the biopsy specimen is transported and processed under appropriate conditions . A 94% sensitivity rate was observed with 'BCC agar', a new medium containing brain heart infusion, activated charcoal and horse serum. Lab Delo, 1989, (6), 54 - 6 {Detection of Campylobacter pylori in children with chronic gastritis}; Aleksandrova NZ et al.; Examinations of the gastric mucosa biopsy specimens from 38 children suffering from chronic gastritis have revealed Campylobacter bacteria in 21 (55.3%) . Studies of the cultural, morphologic, and biochemical characteristics of the isolated strains have identified them as C . pylori. Lab Delo, 1989, (6), 52 - 4 {A method of determining Campylobacter pylori in the gastric mucosa in peptic ulcer and chronic gastritis}; Grigor'ev PIa et al.; An original method is described for the detection of Campylobacter pylori in gastric mucosa biopsy specimens in chronic gastritis and gastroduodenal ulcers . The method is based on the detection (by a special test) of extremely high urease activity of C . pylori . The method has been employed in examinations of 211 patients . The results and prospects for the use of this technique for the detection of C . pylori in patients with gastroduodenal diseases are discussed. Lab Delo, 1989, (1), 57 - 8 {Isolation of C . pyloridis from children}; Spirina TS et al.; The authors analyze the findings of gastroduodenal biopsies in 25 children aged 6 to 15 years suffering from mucosal inflammations and functional abnormalities of the upper portions of the digestive tract . Chocolate agar with various bases, one of which has been suggested by the authors, has been used for the isolation of C . pyloridis . Five cultures have been isolated . Microscopic examinations and biochemical identification of the isolates have lead the authors to a conclusion that campylobacter infections of the upper digestive tract may be diagnosed with certainty only after a comprehensive bacteriologic examination. Infect Immun, 1989 Jan, 57(1), 191 - 5 Experimental production of proliferative ileitis in Syrian hamsters (Mesocricetus auratus) by using an ileal homogenate free of Campylobacter jejuni; Stills HF Jr et al.; The role of Campylobacter jejuni in the pathogenesis of proliferative ileitis of Syrian hamsters (Mesocricetus auratus) has been uncertain . C . jejuni has been implicated as the etiologic agent on the basis of the campylobacter-type morphology of the intracellular organism and the repeated microbiologic isolation of C . jejuni from hamsters with proliferative ileitis . The inability to reproduce the disease with pure culture inocula, coupled with immunohistochemical studies, however, has suggested that although C . jejuni may be present in the ilea of infected hamsters, its involvement in the pathogenesis of proliferative ileitis is questionable . In this study hamsters were inoculated with infective ileal homogenates prepared from ilea which were extensively washed to remove the ileal contents before grinding . The ilea from hamsters inoculated with this homogenate were also washed before being ground and used to experimentally inoculate a second group of hamsters . Of the 20 hamsters from this second group, 12 developed lesions typical of proliferative ileitis . Extensive microbiologic cultures from these hamsters were negative for C . jejuni . Immunofluorescence studies with a C . jejuni-specific monoclonal antibody were also negative . The use of a Campylobacter genus-specific monoclonal antibody, however, revealed numerous campylobacter-type organisms within the ileal epithelial cells of the crypts and villi . The presence of C . jejuni is therefore apparently not necessary for the production of proliferative ileitis in hamsters, and the intracellular campylobacter-type organism present in the ileal epithelial cells of infected hamsters is probably not C . jejuni. Lancet, 1988 Dec 24-31, 2(8626-8627), 1437 - 42 Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori; Marshall BJ et al.; 100 consecutive patients with both duodenal ulcer and Campylobacter pylori infection were followed up to see whether eradication of C pylori affected ulcer healing or relapse . Patients were randomly assigned to 8 weeks of treatment with cimetidine or colloidal bismuth subcitrate (CBS), with tinidazole or placebo being given concurrently from days 1 to 10, inclusive . Endoscopy, biopsy, and culture were done at entry, in weeks 10, 22, 34, and 62, and whenever symptoms recurred . There was no maintenance therapy . C pylori persisted in all of the cimetidine-treated patients and in 95% of those treated with cimetidine/tinidazole, but was eradicated in 27% of the CBS/placebo group and 70% of the CBS/tinidazole group . When C pylori persisted, 61% of duodenal ulcers healed and 84% relapsed . When C pylori was cleared 92% of ulcers healed (p less than 0.001) and only 21% relapsed during the 12 month follow-up period (p less than 0.0001). Gene, 1988 Dec 15, 73(1), 185 - 91 Cloning and expression of the Campylobacter jejuni glyA gene in Escherichia coli; Chan VL et al.; Genetic studies of Campylobacter jejuni are greatly hampered by the lack of genetic markers and an established classical gene transfer mechanism between strains of this species . To facilitate future genetic studies and to provide a recombinant DNA approach for analyzing genes of C . jejuni, we constructed an extensive genomic library of a pathogenic C . jejuni strain TGH9011 (serotype 0:3) using pBR322 . We report the isolation of a number of recombinant plasmids containing the complete structural gene of glyA, that encodes serine hydroxymethyltransferase (SHMT) of C . jejuni . Escherichia coli cells containing this multicopy recombinant plasmid with the glyA gene produce high levels of SHMT . The SHMT-encoding fragment was identified by subcloning and functional complementation . The expression of the C . jejuni glyA gene was probably via transcription initiated from its own promoter. Schweiz Med Wochenschr, 1988 Dec 10, 118(49), 1850 - 3 {Which are the most frequently occurring enteropathogenic bacteria in clinical practice?}; Rohrbach M et al.; Diarrhea is an increasingly frequent clinical finding in Swiss medical practice . One reason is the volume of tourism in countries with different climatic and social circumstances . To obtain an overview of the enteropathogenic bacteria spectrum as a cause of diarrhea, we analyzed 11,163 stool specimens from a representative group of patients throughout Switzerland . Enteropathogenic bacteria were found in 15.2% of all specimens; 50% were Campylobacter jejuni/coli, 35% Salmonella spp., 8% Aeromonas hydrophila group, 4% Shigella spp . and 3% Yersinia enterocolitica . This distribution is taken for all age groups and for both sexes . In the infant age there was a maximum evidence of enteropathogenic bacteria of the female sex . In childhood this maximum concerned to the male sex . Patients older than fifty had no positive stool specimens . As expected the most frequent positive stool specimens were in summer. Med J Aust, 1988 Dec 5-19, 149(11-12), 604 - 9 The use of serology to diagnose active Campylobacter pylori infection; Mitchell HM et al.; A serological test that predicts accurately active Campylobacter pylori infection in the human stomach has been developed and validated by means of serum from 189 patients who were undergoing endoscopy in Sydney . Our enzyme-linked immunosorbent assay (ELISA) has a sensitivity of 100% and a specificity of 94% . An important part of the test is the inclusion of a simple absorption step with C . jejuni for those sera whose results are close to the cut-off point for positivity . This has been shown to be particularly relevant in epidemiological studies on populations that are likely to be exposed to C . jejuni continually . For example, by means of the ELISA test without an absorption step, the infection rate in Papua New Guineans was shown to be 56%, whereas use of the validated test showed the infection rate to be 25% . Compared with an age-matched normal control group of Australians, this still is higher . These studies suggest a need for the reappraisal of some of the reported epidemiological data . The development of a validated diagnostic test that is a highly-accurate predictor of active C . pylori infection will be useful for epidemiological studies, particularly for comparative studies among populations that are known to differ significantly in the incidence of stomach disease . However, routine use of this test in diagnosis in general practice awaits the definition of more precise markers of C . pylori-associated symptomatology and the development of improved regimens for the treatment of C . pylori infections. S Afr Med J, 1988 Dec 3, 74(11), 563 - 6 Incidence of Campylobacter pylori in patients with upper gastro-intestinal symptoms; Miller NM et al.; Antral mucosal biopsy specimens were examined microbiologically and histologically for the presence of Campylobacter pylori in 224 patients with upper gastrointestinal symptoms . The gastric mucosa of 183 patients (82%) were found to harbour C . pylori . C . pylori was strongly associated with the presence of histological gastritis (93%) and was detected in only 10% of 30 patients in whom histological examination of gastric biopsy specimens was negative . Endoscopically diagnosed duodenal lesions were more strongly associated with the presence of C . pylori than gastric lesions (P less than 0.001) . The histological demonstration of spiral bacteria in biopsy specimens was a more sensitive method for the diagnosis of C . pylori than culture (80% v . 65%). Int J Food Microbiol, 1988 Dec, 7(3), 173 - 83 The response of Campylobacter jejuni and Campylobacter coli in the Sydney rock oyster (Crassostrea commercialis), during depuration and storage; Arumugaswamy RK et al.; Sydney Rock Oysters, when allowed to feed in waters containing approximately 10(4) cfu of Campylobacter cells per ml, concentrated between 10(2) and 10(3) cfu of the organism per g of oyster tissue, within 1 h . When these contaminated oysters were subjected to depuration, they were effectively cleaned in 48 h . The survival of Campylobacter jejuni and Campylobacter coli was also investigated . Oysters contaminated by feeding and injection were processed as half shells and bottled oysters and were held at 3 and 10 degrees C . Half shells were also stored at -20 to -24 degrees C . At all these temperatures the organism survived for periods varying between 8 to 14 days and in oysters contaminated by feeding, the survival was substantially greater . Survival was better at 3 than at 10 degrees C in half-shelled oysters . Campylobacter survived better in bottled oysters than in half shells stored at the same temperature . In frozen half shelled oysters previously contaminated by feeding, the organisms were viable for months . In contaminated unopened oysters stored at 20 and 30 degrees C, C . jejuni and C . coli failed to multiply as expected . They survived for periods varying from 2 to 9 days. Lab Anim Sci, 1988 Dec, 38(6), 711 - 4 Prevalence of Campylobacter in infant, juvenile and adult laboratory primates; Russell RG et al.; A cross-sectional study of Campylobacter spp . infection was conducted on 125 infant (Macaca nemestrina and Macaca fascicularis) in an infant primate nursery housing infants from birth to 18 months of age, and 145 M . nemestrina aged from 4 months to 15 years at another facility (Primate Field Station) housing animals from birth to aged adults . The objective was to determine the prevalence of Campylobacter spp . in various age groups and to investigate the correlation with diarrhea . In the Infant Primate Research Laboratory approximately 70% of infants were infected at 18 months-old . Campylobacter coli was isolated from approximately two-thirds of the infected infants . One-third were Campylobacter jejuni and occasional infants were infected with a naladixic acid resistant, hippurate negative (NAR) Campylobacter spp . At the Primate Field Station virtually all animals cultured in 4-6 month-old, 16-20 month-old, and 3-5 year-old age groups were positive . Approximately one-third of middle-aged adults (10-15 years old) were positive with C . coli or NAR Campylobacter spp . Environmental factors such as location and movement of animals may provide an explanation for the prevalence data obtained in the two facilities and different age groups of animals . An etiologic role of Campylobacter spp . in diarrhea of laboratory primates was not established in this study. Ann Surg, 1988 Dec, 208(6), 694 - 701 Ménétrier's disease . A trivalent gastropathy; Sundt TM 3rd et al.; Current conceptions of Menetrier's disease only obliquely resemble those originally described . Bona-fide cases are so uncommon that, of 125 cases diagnosed as Menetier's disease, hypertrophic gastritis, or protein-losing gastropathy treated at the Massachusetts General Hospital during the 26-year period of 1962-1987, only six cases merited an unequivocal anatomic diagnosis . Two other cases previously described proved on review to be nondiagnostic in one instance and Campylobacter pylori gastritis in the other . Because abnormalities in the secretion of gastric acid and in the loss of protein from the stomach may coexist, a representation of each case in semiquantitative terms can be described on triaxial coordinates . Three patients had a hypercoagulable state, one in association with gastric carcinoma . One other case of gastric carcinoma and one of esophageal carcinoma coexistant with Menetrier's disease were identified . Administration of subcutaneous heparin during the perioperative period to patients with Menetrier's disease is appropriate regardless of whether or not hypercoagulation or carcinoma is manifest . If treatment with anticholinergic drugs and inhibitors of gastric acid secretion fails, total gastrectomy is the best solution, because it stops protein loss, eliminates hyperchlorhydria, prevents development of gastric carcinoma, and permits anastomotic reconstruction between normal esophagus and normal small bowel. Postgrad Med J, 1988 Dec, 64(758), 935 - 6 Rapid urease test provides specific identification of Campylobacter pylori in antral mucosal biopsies; Szeto ML et al.; In a prospective study, three antral biopsies were taken from 175 dyspeptic patients during routine endoscopy . One biopsy was inserted immediately into a gel-containing well of a CLOtest slide and two biopsies were sent to histopathology . Using the CLOtest, 84 of the 175 samples (48%) detected urease activity in the gastric biopsy, suggesting infection with Campylobacter pylori . Histopathological examination by two independent observers reported that 93 (52%) of the biopsies contained Campylobacter-like organisms . The CLOtest was found to have a specificity of 1.0 and sensitivity of 0.91, providing a rapid identification of most patients harbouring the organism in their gastric mucus. NIPH Ann, 1988 Dec, 11(2), 47 - 52 Antibodies against Campylobacter jejuni/coli in patients suffering from campylobacteriosis or inflammatory bowel disease; Melby K et al.; Sera from 74 patients from the Oslo area and 21 from Northern Norway with compylobacteriosis were analysed for antibodies against an antigen mixture comprising seven Campylobacter jejuni/coli strains including a PEN 0:6,7 isolate representing the most common serotype in Northern Norway . Seventy-seven per cent of the campylobacter patients from the Oslo area and 86% from Northern Norway had elevated antibody levels . Thirty-seven out of 57 (65%) seropositive patients from Oslo and 12 out of 18 (67%) from Northern Norway were positive in more than one immunoglobulin class . None of the patients, all from Northern Norway (N = 56), with inflammatory bowel disease i.e . Mb . Crohn or ulcerative colitis diagnosed for the first time, had elevated antibody levels in two immunoglobulin classes . Apparently campylobacteriosis is not associated with the precipitation of these diseases . Two sets of blood donor sera, from Oslo (N = 28) and Tromso (N = 37) respectively, served as reference . The IgG antibody levels against C . jejuni/coli antigens in the blood donor group from Tromso were higher than in the Oslo group. Antimicrob Agents Chemother, 1988 Dec, 32(12), 1793 - 6 Occurrence of the Campylobacter resistance gene tetO in Enterococcus and Streptococcus spp; Zilhao R et al.; The distribution of nucleotide sequences related to tetK, tetL, tetM, and tetO was studied by dot blot hybridization in 178 strains of Streptococcus and Enterococcus spp . that were resistant to tetracycline . The tetO gene, which is responsible for tetracycline resistance in Campylobacter spp., was detected in six Streptococcus strains and two Enterococcus strains, in which it was borne by similar plasmids . This observation confirms our previous proposal that tetO originated in gram-positive cocci . tetM, the most prevalent resistance gene, was present alone in 109 strains and associated with tetL in 33 strains in which the two genes contributed cooperatively to high-level tetracycline resistance . tetL was present alone in five Enterococcus strains, and tetK was detected in a single Streptococcus strain . The existence of 22 strains that did not hybridize to the probes suggest that tetracycline resistance in streptococci and enterococci involves additional gene classes as well. J Clin Microbiol, 1988 Dec, 26(12), 2678 - 9 Isoelectric focusing of ureases from Campylobacter pylori and related organisms; Tompkins DS et al.; Agarose gel isoelectric focusing was used to determine the isoelectric points of ureases from strains of gastric campylobacterlike organisms isolated from ferrets (pI 5.4), baboons (pI 5.7), and pigs (pI 5.9) and from isolates of Campylobacter pylori in humans (pI 5.9) . This technique may help differentiate these closely related bacteria. J Clin Microbiol, 1988 Dec, 26(12), 2659 - 60 Campylobacter hyointestinalis: an opportunistic enteropathogen? Minet J, Grosbois B, Megraud F. A new case of Campylobacter hyointestinalis-associated diarrhea in a human is reported . The medical history of the patient was significant for immunodeficiency because of an evolutive chronic myeloid leukemia . The diarrhea rapidly stopped after administration of oral erythromycin . No other enteropathogenic agent was found by routine examination of stools . Although neither serology nor autopsy was available, this observation appears to be suggestive of the possible enteropathogenicity of C . hyointestinalis for patients at risk. J Clin Microbiol, 1988 Dec, 26(12), 2480 - 3 Role of the 92.5-kilodalton outer membrane protein of Campylobacter jejuni in serological reactions; Jin T et al.; Outer membrane proteins from 12 strains of Campylobacter jejuni were examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting with rabbit antisera prepared against Formalin-treated cell suspensions of three of the strains . The 92.5-kilodalton protein was confirmed to be a minor outer membrane protein and exhibited serological heterogeneity . Serological specificities of the proteins, however, were found not to correlate with serotypic specificities of the strains, as demonstrated by slide agglutination tests with whole-cell suspensions . The results suggested that the 92.5-kilodalton proteins were not likely to be participating antigenic determinants in the immunological reactions that give rise to agglutination of live-cell suspensions in the slide test. J Clin Microbiol, 1988 Dec, 26(12), 2469 - 73 Campylobacter cryaerophila isolated from a human; Tee W et al.; Campylobacter cryaerophila was recovered from a single stool specimen of a 35-year-old homosexual man who presented with intermittent diarrhea for 4 to 6 months . The isolate was identified as C . cryaerophila by using biochemical reactions and confirmed by DNA-DNA hybridization and gas-liquid chromatograph profiles . The base composition of DNA of the isolate was found to be 31.1 +/- 1 mol% (G+C) . C . cryaerophila was previously reported to be associated with bovine and porcine abortions in animals . We believe this is the first report of recovery of C . cryaerophila from human stool. J Clin Pathol, 1988 Dec, 41(12), 1316 - 21 Campylobacter pylori: clinical, histological, and serological studies; Musgrove C et al.; The presence of Campylobacter pylori, histologically diagnosed gastritis, and antibodies to C pylori were determined in a series of 113 patients undergoing endoscopy . Paired biopsy specimens from the fundus, body, and antrum were collected from 59 patients and from the antrum of 54 patients . The presence of C pylori was confirmed by either culture or silver stain in 30 of 59, 31 of 59, and 54 of 103 biopsy specimens from the fundus, body, and antrum, respectively . Of the specimens which contained C pylori 20 of 30 (66%) from the fundus, 25 of 31 (80%) from the body, and 54 (100%) from the antrum showed gastritis . C pylori and gastritis were shown in seven of nine (78.1%) of patients with gastric ulcers and in nine of 11 (82%) of patients with duodenal ulcers . Using an enzyme linked immunosorbent assay (ELISA) technique to detect IgG antibody to C pylori, all patients with histologically diagnosed gastritis and organisms present had titres of greater than or equal to 640; eight of 39 (21%) of patients without gastritis and without organisms gave similar titres . Hence the presence of C pylori was associated with gastritis and with raised titres of IgG antibody. J Clin Pathol, 1988 Dec, 41(12), 1313 - 5 Retrospective study of Campylobacter-like organisms in patients undergoing partial gastrectomy; Loffeld RJ et al.; One hundred and five stoma biopsy specimens and 108 corpus biopsy specimens from 108 patients who had undergone a partial gastrectomy because of peptic ulcer disease were examined retrospectively for the presence of Campylobacter-like organisms and gastritis . In the corpus biopsy specimens Campylobacter-associated gastritis was found in 55 (71%) of the cases and in 42 (48%) of the stoma biopsy specimens . It is concluded that Campylobacter-like organisms have a role in gastritis after partial gastrectomy, although this role is more prominent in the corpus region . The role of Campylobacter pylori in peptic ulcer disease is not clinically important. Appl Environ Microbiol, 1988 Dec, 54(12), 3023 - 33 Survival of coliforms and bacterial pathogens within protozoa during chlorination; King CH et al.; The susceptibility of coliform bacteria and bacterial pathogens to free chlorine residuals was determined before and after incubation with amoebae and ciliate protozoa . Viability of bacteria was quantified to determine their resistance to free chlorine residuals when ingested by laboratory strains of Acanthamoeba castellanii and Tetrahymena pyriformis . Cocultures of bacteria and protozoa were incubated to facilitate ingestion of the bacteria and then were chlorinated, neutralized, and sonicated to release intracellular bacteria . Qualitative susceptibility of protozoan strains to free chlorine was also assessed . Protozoa were shown to survive and grow after exposure to levels of free chlorine residuals that killed free-living bacteria . Ingested coliforms Escherichia coli, Citrobacter freundii, Enterobacter agglomerans, Enterobacter cloacae, Klebsiella pneumoniae, and Klebsiella oxytoca and bacterial pathogens Salmonella typhimurium, Yersinia enterocolitica, Shigella sonnei, Legionella gormanii, and Campylobacter jejuni had increased resistance to free chlorine residuals . Bacteria could be cultured from within treated protozoans well after the time required for 99% inactivation of free-living cells . All bacterial pathogens were greater than 50-fold more resistant to free chlorine when ingested by T . pyriformis . Escherichia coli ingested by a Cyclidium sp., a ciliate isolated from a drinking water reservoir, were also shown to be more resistant to free chlorine . The mechanism that increased resistance appeared to be survival within protozoan cells . This study indicates that bacteria can survive ingestion by protozoa . This bacterium-protozoan association provides bacteria with increased resistance to free chlorine residuals which can lead to persistence of bacteria in chlorine-treated water . We propose that resistance to digestion by predatory protozoa was an evolutionary precursor of pathogenicity in bacteria and that today it is a mechanism for survival of fastidious bacteria in dilute and inhospitable aquatic environments. Lab Anim Sci, 1988 Dec, 38(6), 715 - 21 The serodiagnosis of Campylobacter infection in infant cynomolgus monkeys (Macaca fascicularis) 2 to 18 weeks old by enzyme-linked immunosorbent assay; Kohno A et al.; We established the enzyme-linked immunosorbent assay (ELISA) for detecting antibodies to Campylobacter and applied it in defining the period of the primary infection of Campylobacter in infant cynomolgus monkeys (Macaca fascicularis) . The antibody to Campylobacter spp . could be detected with only 0.25 mul of serum by using commercially available antigens and anti-cynomolgus monkey IgG antibody conjugated with alkaline phosphatase . The inhibition experiments using extracts of C . jejuni, C . fetus and Yersinia enterocolitica demonstrated that the established ELISA system could detect species-specific anti-C . jejuni and anti-C . fetus antibodies . The levels of antibodies to both C . jejuni and C . fetus were high in 2 weeks old infant cynomolgus monkeys, rapidly decreasing until 6 to 14 weeks of age . This result indicates that the antibodies detected in 2 week old infants were IgG antibodies of maternal origin transferred through placenta . The C . jejuni was isolated from infants when the level of maternal antibody became the lowest . Infant cynomolgus monkeys obviously developed IgG antibodies to C . jejuni within 4 weeks after infection . On the other hand, no antibody response to C . jejuni was found in two infants from which it could not be isolated throughout the observation period . As regards C . fetus infection, infants showed a poor antibody response although it was more frequently isolated than C . jejuni . In conclusion, the ELISA system established in the present study is useful for the serological diagnosis of C . jejuni infection during infancy in the cynomolgus monkey. APMIS, 1988 Dec, 96(12), 1089 - 96 Surface charge and hydrophobicity of Campylobacter jejuni strains in relation to adhesion to epithelial HT-29 cells; Walan A et al.; Hydrophobicity and surface charge of clinical isolates of Campylobacter jejuni strains were investigated by aqueous two-phase partitioning (one-step and counter-current distribution), ion exchange chromatography and hydrophobic interaction chromatography . There was a good correlation between the different physico-chemical methods reflecting the same bacterial property . All strains were negatively charged and exposed a hydrophobic surface, but to a varying extent . Bacteria with a high negative surface charge and a weak hydrophobic surface adhered better to human intestinal HT-29 cells than strains with less charge and a more hydrophobic surface . Highest adhesion was shown by a strain differing from all the others in charge properties . It was also found that the tendency to aggregate was higher among the strains showing the greatest degree of adherence. Am J Infect Control, 1988 Dec, 16(6), 246 - 9 Yield of stool cultures, ova and parasite tests, and Clostridium difficile determinations in nosocomial diarrheas; Yannelli B et al.; Stool cultures for bacterial pathogens, ova and parasites, and Clostridium difficile are usually ordered for patients with nosocomial diarrhea . In the interest of cost containment we undertook an 18-month retrospective study to assess the cost/benefit of performing each of these three tests . During the study period nosocomial diarrhea developed in 118 patients . Of 452 bacterial stool cultures ordered, only one was positive for Campylobacter jejuni and none for ova and parasites . However, of 126 cultures examined for C . difficile, 47 showed positive results . We conclude that bacterial stool culture and ova and parasite identification are not indicated for patients with nosocomial diarrhea . Elimination of these unnecessary stool tests (bacterial/ova and parasite) would have saved the hospital approximately +7530 in the 18-month study period. Mayo Clin Proc, 1988 Dec, 63(12), 1258 - 60 Campylobacter pylori and Barrett's esophagus; Graham DY; Occurrence of C . pylori infection of mucosa outside of the stomach might provide an ideal opportunity to examine C . pylori-mucosal interactions apart from the effects of acid and pepsin . Techniques previously used to examine Barrett's epithelium (for example, special mucin stains or scanning and transmission electron microscopy) might be particularly useful for exploration of new associations and formulation of new hypotheses . Whether C . pylori has a role in development of Barrett's ulcer or adenocarcinoma as a complication of Barrett's esophagus remains unanswered . Most of the current data about C . pylori are primarily observational; further studies are needed for clarification of important microbegut interactions. Mayo Clin Proc, 1988 Dec, 63(12), 1176 - 80 Campylobacter pylori and Barrett's esophagus; Talley NJ et al.; Campylobacter pylori is thought to be confined to gastric mucosa; when detected in the duodenum in association with duodenal ulceration, the organism infects only areas of gastric metaplasia . Barrett's esophagus is a metaplastic condition of the esophagus, in which areas or islands of "gastric-type" epithelium are found . To determine whether C . pylori colonized the esophagus of patients with Barrett's esophagus, we studied retrospectively 23 unselected patients who had endoscopic and biopsy evidence of Barrett's esophagus . Mucosal biopsy specimens were stained by the Warthin-Starry silver technique and reviewed by an experienced, "blinded" histopathologist . Of the 23 patients, 12 (52%) had C . pylori in the esophagus . Patients with and those without C . pylori were of similar age and gender, had similar scores for acute and chronic inflammation, and had similar lengths of tubular esophagus with metaplastic gastric mucosa . These observations suggest that C . pylori commonly infects Barrett's esophagus . The clinical importance of this finding is unknown. Am J Gastroenterol, 1988 Dec, 83(12), 1368 - 70 Distribution of Campylobacter pylori and gastritis in the stomach of patients with and without duodenal ulcer; Queiroz DM et al.; The presence of Campylobacter pylori and histological changes of gastric mucosa were studied in 50 consecutive patients with gastric complaints . C . pylori was isolated from the antrum, body, and fundus of 40 patients with (n = 20) and without (n = 20) duodenal ulcer . The incidence of gastritis was not significantly different in the antrum of C . pylori-positive patients with and without ulcer . Otherwise, oxyntic mucosa of both body and fundus regions exhibited gastritis in 64.1% of the C . pylori-positive non-ulcer patients, whereas those with duodenal ulcer presented oxyntic mucosa that was histologically normal or near normal. Am J Clin Pathol, 1988 Dec, 90(6), 711 - 4 Prevalence of gastric metaplasia, inflammation, and Campylobacter pylori in the duodenum of members of a normal population; Fitzgibbons PL et al.; Mucosal biopsies were obtained from 116 asymptomatic volunteers (50% were male; mean age, 46 years; age range, 19-91 years) to study the prevalence of duodenal gastric metaplasia (GM) and its association with inflammation and Campylobacter pylori in a normal population . GM was identified in 25 subjects (22%) . Eighty-three subjects (72%) had histologic duodenitis, but in only 10 did the infiltrate include neutrophils (grade 2 duodenitis) . C . pylori was found in the stomach in 36 subjects (31%), all of whom had gastritis, but was not identified histologically in the duodenum . There were no significant differences between the overall frequency of duodenitis and either GM or antral C . pylori . Although the frequency of severe (grade 2) duodenitis was not significantly different between those with and those without GM, grade 2 duodenitis was found in 9 of 36 subjects with antral C . pylori but in only 1 of 80 without antral C . pylori (P less than 0.001) . These findings suggest that gastric metaplasia is a common finding in the normal population and that grade 1 duodenitis is most likely clinically unimportant, whereas grade 2 duodenitis is usually associated with antral C . pylori. Infect Immun, 1988 Dec, 56(12), 3329 - 33 In vitro model for Campylobacter pylori adherence properties; Neman-Simha V et al.; The adherence of 12 strains of Campylobacter pylori was studied on four cell lines . Immunofluorescence and scanning and transmission electron microscopy were used to visualize the bacteria . A heavy adherence to the epithelial cell line HEp-2 and to the intestinal cell line Int-407 was noted . By transmission electron microscopy, a close association between bacteria and cells in the form of cup-like structures was observed, but pedestals were not present. J Appl Bacteriol, 1988 Dec, 65(6), 455 - 61 The growth of potential food poisoning organisms on chicken and pork muscle surfaces; Mattila T et al.; Muscle surfaces of pork were inoculated with a mixture of Yersinia enterocolitica and Staphylococcus aureus, and chicken muscle with Campylobacter jejuni or a mixture of Salmonella typhimurium and Staph . aureus . The surface growth at 20 degrees C was followed microscopically . Organisms grew as discrete colonies bound together by a glycocalyx which differed between bacterial species . On prolonged incubation colonies spread peripherally and tended to coalesce, while still retaining their colony structure . Staphylococcus aureus colonies were very small and remained so . The glycocalyx was considered critical in maintaining the dense populations of bacteria on the meat surfaces. J Dairy Sci, 1988 Dec, 71(12), 3230 - 6 Thermal inactivation of Campylobacter species, Yersinia enterocolitica, and hemorrhagic Escherichia coli O157:H7 in fluid milk; D'Aoust JY et al.; Heat treatment of raw milk in an HTST pasteurizer operated at 60.0 to 72.0 degrees C for a minimum holding time of 16.2 s rapidly inactivated mixtures of hemorrhagic Escherichia coli O157:H7, Yersinia enterocolitica and Campylobacter spp . (C . fetus, C . coli, and C . jejuni) . Each of the three genera in the mixture was inoculated at a level of approximately 1.0 x 10(5) cfu/ml . At 60.0 degrees C, hemorrhagic E . coli showed a maximum 2 log10 reduction in counts and no viability at greater than or equal to 64.5 degrees C . Yersinia enterocolitica and Campylobacter spp . showed greater heat sensitivity with a 4 log10 reduction in counts at 60.0 degrees C and absence of viable cells at greater than or equal to 63.0 degrees C . These findings reiterate the need for stringent control of thermal processes in the manufacture of dairy products from raw or heat-treated (non-pasteurized) milk. Ann Trop Paediatr, 1988 Dec, 8(4), 262 - 7 Enteropathogens isolated from children with gastro-enteritis at Ga-Rankuwa Hospital, South Africa; Steele AD et al.; A prospective 3-year study for enteric pathogens associated with diarrhoea in children was undertaken at Ga-Rankuwa Hospital, South Africa . Rotavirus was the most commonly isolated pathogen (24%), showing a marked seasonal distribution, with an autumn peak in activity . Enterotoxigenic and enteropathogenic Escherichia coli were frequently identified, and Salmonella, Shigella and Campylobacter were also isolated . Cryptosporidium and Giardia lamblia were the most frequently seen parasites . Rotavirus, E . coli, Salmonella and Campylobacter occurred predominantly in children less than 1 year old, whilst Shigella and the parasites were prevalent at all ages. Antimicrob Agents Chemother, 1988 Nov, 32(11), 1710 - 9 Comparative in vitro activities of new 14-, 15-, and 16-membered macrolides; Hardy DJ et al.; The in vitro activities of several 14-, 15- and 16-membered macrolides were compared with that of erythromycin . In general, 14-membered macrolides such as erythromycin, clarithromycin, and flurithromycin were more active against streptococci and Bordetella pertussis than was the 15-membered macrolide azithromycin, which was more active than 16-membered macrolides such as miocamycin and rokitamycin . Clarithromycin was the most active compound against Streptococcus pyogenes, pneumococci, Listeria monocytogenes, and Corynebacterium species . Legionella pneumophila was most susceptible to miocamycin, clarithromycin, and rokitamycin . Branhamella catarrhalis, Neisseria gonorrhoeae, and Haemophilus influenzae were most susceptible to azithromycin . Azithromycin and dirithromycin were the most active compounds against Campylobacter jejuni . MICs of 16-membered macrolides for strains expressing inducible-type resistance to erythromycin were less than or equal to 1 microgram/ml, whereas none of the compounds had activity against strains expressing constitutive-type resistance . The MICs of roxithromycin, miocamycin, rokitamycin, and josamycin increased in the presence of human serum, whereas MICs of the other compounds either were unchanged or decreased. Poult Sci, 1988 Nov, 67(11), 1568 - 72 Incidence and level of Campylobacter jejuni in broiler processing; Izat AL et al.; The distribution and level of Campylobacter jejuni throughout broiler processing was evaluated . Six trials were conducted at three broiler processing plants to determine the occurrence of C . jejuni on commercial broilers as affected by specific processing functions . Counts were determined at specific sampling stations throughout the plants, and patterns of counts among sampling stations and plants were observed . Between 1,100 and 5,500 C . jejuni/1,000 cm2 skin surface (represents half the skin surface area of one defeathered broiler) were found on birds entering the three plants . Increases in C . jejuni levels were associated with both the picking and evisceration operations . Broiler carcasses ready for packaging contained approximately 50 organisms/1,000 cm2 . Campylobacter jejuni was also recovered from gizzard samples, carcass and gizzard chill water, and swab samples taken of selected equipment surfaces. Equine Vet J, 1988 Nov, 20(6), 417 - 20 A method for reproducing fatal idiopathic colitis (colitis X) in ponies and isolation of a clostridium as a possible agent; Prescott JF et al.; Severe colitis was induced in two ponies after oral pretreatment with clindamycin and lincomycin, followed by intestinal content from two horses which had died from naturally-occurring idiopathic colitis . Two ponies treated with antibiotic alone, and two ponies treated with intestinal content alone, were unaffected . In a further study, three ponies treated on separate occasions with lincomycin, administered orally, died or were destroyed 67 to 72 h after initial treatment . No established salmonella, yersinia or campylobacter pathogens were isolated from these ponies, but a clostridium closely resembling Clostridium cadaveris was isolated as the predominant clostridium from them all and from the colonic content of one of six horses which died from naturally-occurring idiopathic colitis . It was not isolated from six horses with non-fatal diarrhoea . This clostridium is a candidate as an agent of some cases of fatal colitis in horses. J Antimicrob Chemother, 1988 Nov, 22(5), 729 - 38 Inhibitory antimicrobial concentrations against Campylobacter pylori in gastric mucosa; McNulty CA et al.; Gastric mucosal concentrations of erythromycin, amoxycillin, ampicillin and ciprofloxacin were determined in patients at upper gastrointestinal endoscopy 38-480 min after a 500 mg dose of erythromycin ethyl succinate, erythromycin stearate, amoxycillin, pivampicillin or ciprofloxacin . All the agents attained concentrations greater than the MIC 90 for Campylobacter pylori . The macrolides attained the lowest concentrations . There was no significant difference between concentrations attained with erythromycin ethyl succinate and stearate . High concentrations were attained by amoxycillin (range 14.6-322 mg/kg) and pivampicillin (range 47.5-209 mg/kg) . Ciprofloxacin attained very high concentrations (range 35-1762 mg/kg); inhibitory concentrations 35 mg/kg) were still present at 6 h after the dose . Ciprofloxacin and erythromycin are ineffective in vivo despite these high gastric mucosal concentrations . Penetration into the gastric mucus and crypts where C . pylori is found will be determined by physicochemical properties of the antimicrobials, such as pKa, stability, activity over a wide range of pH, and lipid solubility. J Antimicrob Chemother, 1988 Nov, 22(5), 631 - 6 Susceptibility of Campylobacter pylori to macrolides and fluoroquinolones; Hardy DJ et al.; The in-vitro activities of several 14-, 15- and 16-membered macrolides and fluoroquinolones against Campylobacter pylori were determined . In general, 14-membered macrolides, such as clarithromycin and flurithromycin, were more active than the 15-membered macrolide, azithromycin, which was more active than 16-membered macrolides, such as miocamycin and rokitamycin . Fluoroquinolones, except ciprofloxacin and A-61827, were less active than macrolides . Clarithromycin was the most active of the new compounds against C . pylori and was as active as ampicillin . MICs of all compounds at pH 5.5 were increased when compared to MICs determined at pH 7.3 . All compounds had MBCs which were the same as or within one two-fold dilution of their MICs . Frequencies of spontaneous resistance development by C . pylori NCTC 11637 at four and eight times the MIC of the compounds were low and ranged from less than 1 x 10(-9) to 1 x 10(-7). Minerva Med, 1988 Nov, 79(11), 957 - 60 {Campylobacter pylori colonization and gastroduodenal pathology}; Gullini S et al.; 355 patients suffering from dyspepsia with an endoscopic pathological picture were examined . Campylobacter pylori was sought histologically and by culture . Histological and cultural results were compared . There were no bacteria on the gastric mucosa of 46 patients who had no histopathological evidence of lesions . Cultural studies were performed in 40 cases on endoscopic instruments used during the examination, before and after standard sterilization . Campylobacter pylori was found on the gastric mucosa of 224 patients (63.09%); 91.93% with duodenal ulcer; 71.87% with gastric ulcer; 54.23% with erosive duodenitis; 56.71% with erosive gastritis and 54.81% with chronic gastropathy . The agreement between the two techniques was 75.39%, with a male prevalence (p = 0.05) . Campylobacter pylori was present on the gastric mucosa of 10.86% of patients without histopathological evidence of lesions . Standard sterilization with alkyl-dimethyl-benzyl ammonium eliminated the campylobacter in 100% of cases. J Pediatr, 1988 Nov, 113(5), 908 - 12 Treatment of Campylobacter pylori-associated antral gastritis in children with bismuth subsalicylate and ampicillin; Drumm B et al.; We evaluated the efficacy of medical therapy, consisting of liquid bismuth subsalicylate prescribed either in combination with oral ampicillin (n = 15) or alone (n = 1), in the clearing of bacterial colonization on the antrum in 16 children with Campylobacter pylori-associated antral gastritis . We also examined the effects of medical treatment on altering the severity of associated antral inflammation . Eight patients had upper gastrointestinal tract hemorrhage, two had acute gastric outlet obstruction, and 10 had symptoms of episodic epigastric abdominal pain . Duodenal ulcers were demonstrated in 10 of the 16 patients; in the other six, C . pylori-associated antral gastritis was documented without evidence of acute peptic ulceration . Seven days after a 6-week course of medical therapy, repeat upper endoscopy plus mucosal biopsy specimens showed that C . pylori colonization of the antrum had cleared in 12 of the 16 (75%) patients . Inflammation in the antrum improved in all patients in whom colonization by C . pylori was eradicated . In contrast, in the four with persistent colonization of the antrum, the severity of antral gastritis had not improved (p less than 0.01) . Clinical symptoms improved in 9 of 12 patients in whom C . pylori colonization was no longer present, whereas subjective symptoms were unaffected in those with continued bacterial colonization of the antrum (p less than 0.05) . We conclude that oral bismuth subsalicylate, in conjunction with ampicillin, can eradicate C . pylori colonization of the antrum, and that clearing of C . pylori is correlated with an improvement in the associated antral gastritis and clinical symptoms . These findings provide additional support for the hypothesis that these gastric organisms could play an etiologic role in primary antral gastritis and peptic ulcer disease. Am J Public Health, 1988 Nov, 78(11), 1451 - 5 Drinking water source, diarrheal morbidity, and child growth in villages with both traditional and improved water supplies in rural Lesotho, southern Africa; Esrey SA et al.; This study examined the growth and morbidity rates of young children in relation to exclusive and non-exclusive use of improved water supplies in rural Lesotho, southern Africa . Data were collected for 247 children 60 months of age and under between July 1984 and February 1985 in 10 villages that had an improved water supply at least one year prior to investigation . Children whose families relied exclusively on the new water supply for their drinking and cooking needs grew 0.438 cm and 235 g more in six months than children whose families supplemented the new water supply with the use of contaminated traditional water for drinking and cooking . The difference in growth was greater among children over 12 months of age at the start of the evaluation than among infants . This may be explained partly by lower rates for Giardia lamblia, the most commonly identified pathogen in stools in older children . Among infants, similar rates of Campylobacter, the most commonly isolated pathogen among infants, may have prevented larger differences . Results suggest that improved drinking water supplies can benefit preschool children's health after infancy, but only if they are functioning and utilized exclusively for drinking and cooking purposes. Am J Dis Child, 1988 Nov, 142(11), 1149 - 52 Campylobacter pylori--associated gastritis and peptic ulcer disease in children; Kilbridge PM et al.; Specimens obtained at gastric biopsies performed for suspected acid peptic disease in patients 5 through 17 years of age were retrospectively reviewed for the presence of Campylobacter pylori (CP), a gram-negative bacillus associated with chronic gastritis and peptic ulcer disease in adults . Of 98 patients who underwent antral biopsy (the most reliably colonized site in the stomach), 40 had chronic gastritis histologically . Of those 40 patients, 22 (55%) had CP present on the gastric surface . None of the 58 patients without gastritis present in biopsy specimens had CP . The gastritis in children with CP was more severe than in those without the organism: 86% of those with moderate gastritis and 92% of those with severe gastritis had CP . Eight patients with duodenal ulcers and one patient with a gastric ulcer had CP on biopsy . Among those patients without CP, only one had a duodenal ulcer and eight had gastric ulcers . An additional nine patients found to have CP on gastric fundic biopsy were identified, for a total of 31 patients with CP identified by either antral (22) or fundic (nine) biopsy . Initial resolution of symptoms with standard acid-antagonist therapy was noted in the 25 of 31 CP(+) patients so treated, but a high relapse rate was noted within one to two years in the patients who also had gastritis and duodenal ulcer . These findings support a strong association between CP colonization of the stomach and the presence of chronic gastritis and duodenal ulcer disease in children. Infect Immun, 1988 Nov, 56(11), 2994 - 6 Gastric colonization by Campylobacter pylori subsp . mustelae in ferrets; Fox JG et al.; Campylobacter pylori subsp . mustelae was cultured from both normal and inflamed gastric mucosa of ferrets . Examination of neonatal, juvenile, and adult ferrets established that the gastric mucosa in the majority of preweanling (age, less than 6 weeks) ferrets sampled were not colonized with C . pylori subsp . mustelae, whereas the gastric mucosa of 100% of adult ferrets were colonized with this gastric organism . C . pylori subsp . mustelae was isolated from the gastric mucosa on a sequential basis from nine ferrets during a several-month period, inferring either persistent colonization or frequent reinfection with C . pylori subsp . mustelae. Infect Immun, 1988 Nov, 56(11), 2843 - 50 Isolation of a spiral-shaped bacterium from the cat stomach; Lee A et al.; A spiral- or helix-shaped bacterium that colonizes the stomachs of cats has been isolated in pure culture for the first time . The organism is tightly coiled with tufts of 10 to 17 polar flagella positioned slightly off center at the end of the cell . The body of the cell is entwined with unique periplasmic fibrils that usually occur in pairs, although groupings of one and three fibrils were also seen . The organism is strongly urease, catalase, and oxidase positive and is likely to belong to an as yet unclassified group of bacteria that are specifically adapted to the ecological niche provided by gastrointestinal mucus . Isolation of this organism will allow study of the factors influencing colonization of gastric mucosae, information relevant to the association of another mucus colonizer, Campylobacter pylori, with the human stomach . Recent reports of the isolation of other bacteria with the characteristic periplasmic surface structures suggests that the group may be more widespread than was hitherto thought . Bacteria with the morphology of the organisms seen in the cat stomach have been seen in gastric biopsies from humans . The organism whose isolation is reported here has been used in previous serological studies to support the hypothesis that spiral bacteria from animals can colonize the human stomach. Gastroenterology, 1988 Nov, 95(5), 1185 - 97 Relationship between Campylobacter pylori and gastritis in healthy humans after administration of placebo or indomethacin; Peterson WL et al.; Endoscopic and microscopic appearances of antral and fundic mucosa were correlated with the presence or absence of Campylobacter pylori--and with plasma immunoglobulin G antibodies to that organism--in 23 healthy volunteers, 12 of whom had received indomethacin and 11 of whom had received no medication . Antral C . pylori, found in 9 of 23 biopsy specimens (3 of 11 controls, 6 of 12 indomethacin-treated patients; not significantly different), correlated strongly with histologic evidence of active superficial antral gastritis (p less than 0.005), but not with the endoscopic appearance of the antrum . In contrast to the antrum, fundic C . pylori, found in 14 of 23 biopsy specimens (61%), were frequently associated with histologically and endoscopically normal fundic mucosa . Campylobacter pylori-associated active antral gastritis occurred only in subjects whose fundus harbored this organism . Plasma immunoglobulin G antibody titers to C . pylori were highest in subjects with Campylobacter-associated antral gastritis and lowest in subjects without gastric Campylobacter . These studies suggest that healthy humans may harbor C . pylori in their proximal stomach without apparent ill effects . In some of these individuals, the organism also involves the antrum and is associated with active gastritis. J Clin Microbiol, 1988 Nov, 26(11), 2246 - 7 Comparison of broth enrichment and direct plating for the isolation of Campylobacter jejuni from dogs; Monfort JD et al.; Two techniques for the isolation of Campylobacter jejuni from feces, direct plating and thioglycolate broth enrichment, were compared . A total of 272 rectal swab cultures were performed on 156 laboratory dogs . Campylobacter blood agar plates and Campylobacter thioglycolate broth were inoculated immediately upon sampling of the dogs . After incubation at 4 degrees C for 12 to 16 h, material from the Campylobacter thioglycolate medium was inoculated onto Campylobacter blood agar plates . A total of 157 samples were positive for C . jejuni; 154 were positive by the direct method and 112 were positive by the enrichment technique . Forty-five samples which were negative by the enrichment were positive by the direct method, and three samples which were negative by the direct method were positive for C . jejuni by the enrichment method . The use of the enrichment step resulted in an increase in the isolation rate from 56.6 to 57.7%. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Nov, 269(3), 284 - 97 Numerical classification of campylobacters by DNA-restriction endonuclease analysis; Bruce D et al.; Reference strains from five different species of Campylobacter were examined by DNA-restriction endonuclease analysis . The DNA profiles were resolved as absorbence peaks and converted to numerical values which were analysed by a Sirius microprocessor . The percentage similarity between each profile was calculated and the strains clustered together by the computer on shared similarities and the results displayed as an abbreviated dendrogram . Each of the species of Campylobacter were clearly separated from each other and the different biotypes within a species could also be differentiated. Am J Gastroenterol, 1988 Nov, 83(11), 1226 - 30 Campylobacter pylori and gastroduodenal disease: a prospective endoscopic study and comparison of diagnostic tests; Chodos JE et al.; A series of 72 adult patients undergoing 76 upper gastrointestinal (GI) endoscopies because of GI signs or symptoms were studied for the presence of Campylobacter pylori by culture, histology, and rapid urease determination of gastric antral biopsy specimens . C . pylori was found by culture or histology in all 10 cases of gastric and duodenal ulcer, and in 77% of endoscopies with histologically proven active gastritis . Positive culture for C . pylori was highly correlated pathologically with active gastritis, but not endoscopically, and was rarely seen in the absence of acute inflammation on biopsy . There was no correlation between C . pylori and alcohol ingestion, smoking, age, sex, antibiotics, or nonsteroidal anti-inflammatory drug use . The rapid urease test was positive in 70% of cases with positive cultures and 89% with positive cultures or acridine orange stains . Acridine orange-stained histological samples were positive in 97% of cases with positive cultures . In addition, 31% of endoscopies with negative cultures were also positive by acridine orange stain . Acridine orange stain, culture, and urease reaction of antral mucosal biopsies all are effective methods for demonstration of mucosal C . pylori-like organisms . However, of the three methods used, acridine orange staining is positive in the largest group of patients and is the most sensitive method for detecting colonization of gastric antral mucosa . In general, positive urease and culture identify those patients with larger numbers of organisms on the mucosa . Differences in urease and culture positivity from case to case suggest that factors other than numbers of organisms, such as viability and urease levels, affect the results . All these results support a role for C . pylori as an aggressive factor in peptic ulcer disease and gastritis. J Infect Dis, 1988 Nov, 158(5), 1011 - 6 Immune response to acute diarrhea seen as circulating antibody-secreting cells; Kantele AM et al.; We studied the immune response to acute diarrhea by examining antibody-secreting cells among peripheral blood lymphocytes, which are believed to be derived from the intestinal mucosa and to be on their way back there . In 23 of 24 patients, a dramatic increase in the total number of cells actively secreting immunoglobulins was detected one week after onset of diarrhea, and most of the cells were secreting IgA . Cells secreting antibody specific to the pathogen (Campylobacter jejuni or Salmonella spp.) also appeared at this time but accounted for only a part of the total response . The data suggest that diarrhea induces a vigorous, apparently polyclonal response, including antibodies to normal intestinal flora . The response to the infective agent was outstanding and suggests that this method can be used to identify the causative agent of an infection. Gastroenterology, 1988 Nov, 95(5), 1178 - 84 Nitrofurans in the treatment of gastritis associated with Campylobacter pylori . The Gastrointestinal Physiology Working Group of Cayetano Heredia and The Johns Hopkins Universities; Morgan D et al.; We conducted a double-blind, placebo-controlled, randomized treatment study in Peruvian adults with antral gastritis associated with Campylobacter pylori . Patients received either 400 mg of furazolidone (n = 14), 400 mg of nitrofurantoin (n = 24), or a placebo (n = 31) for 14 days . Endoscopy was carried out at baseline, 1 day after ceasing therapy, and 6 wk after the end of treatment to verify colonization by C . pylori and determine the extent of gastric inflammation . Treatment with nitrofurantoin or furazolidone markedly reduced or, in some cases, cleared C . pylori from the antrum (p less than 0.0005 compared with placebo) . Resolution of acute gastric inflammation, as evidenced by decreased polymorphonuclear leukocyte infiltration and regeneration of the mucus layer, paralleled the reduction in bacterial colonization (p less than 0.005 compared with placebo) . A high percentage of patients experienced relapse (recolonization by C . pylori and return to pretreatment levels of gastritis) within 6 wk after cessation of treatment . Significant relief of dyspeptic symptoms was not evident during the study. Ann Inst Pasteur Microbiol, 1988 Nov-Dec, 139(6), 665 - 76 Genetic characterization of kanamycin resistance in Campylobacter coli; Taylor DE et al.; The restriction map of plasmid pIP1433 from Campylobacter coli BM2509, isolated in France, was constructed and the location of the kanamycin (Km) and tetracycline (Tc) resistance markers determined using probes for aphA-3 and tetO genes, respectively . These DNA probes were used to study a second Km- and Tc-resistant strain C . coli UA696, isolated in Canada . In this strain, the Km resistance determinant was located in the chromosome . Like pIP1433, the Km resistance determinant in C . coli UA696 specified a 3'-aminoglycoside phosphotransferase of type III whereas the tetO gene was located on a non-transmissible plasmid. Vet Pathol, 1988 Nov, 25(6), 456 - 67 Necropsy findings in rhesus monkeys experimentally infected with cultured simian immunodeficiency virus (SIV)/delta; Baskin GB et al.; Lesions induced in rhesus monkeys by different isolates of simian immunodeficiency virus (SIV)/Delta were studied at necropsy . Four groups of monkeys were inoculated with SIV/Delta isolated from other experimentally infected rhesus monkeys, while one group was inoculated with SIV/Delta from an asymptomatic mangabey monkey . Three rhesus isolates and the mangabey isolate were virulent, killing 75-100% of infected monkeys . One rhesus isolate, which had been extensively passaged in vitro, was attenuated but was restored to virulence by single animal passage . Clinically, infected monkeys had lymphadenopathy, splenomegaly, diarrhea, and a rash . Most monkeys died of enteric disease . The following lesions were seen: weight loss, thymic atrophy, lymphoid atrophy, bone marrow hyperplasia, encephalitis, colitis, amyloidosis, hepatitis, glomerulosclerosis, and the presence of syncytial cells . One Rh Epstein-Barr virus (EBV)-related lymphoma occurred . Opportunistic agents were identified: cytomegalovirus, adenovirus, Cryptosporidia, and Pneumocystis . Shigella and Campylobacter often caused colitis. J Gen Microbiol, 1988 Nov, 134 ( Pt 11), 2925 - 32 Comparison of methods used to separate the inner and outer membranes of cell envelopes of Campylobacter spp; Page WJ et al.; The outer membrane of Campylobacter coli, C . jejuni and C . fetus cell envelopes appeared as three fractions after sucrose gradient centrifugation . Each outer membrane fraction was contaminated with succinate dehydrogenase activity from the cytoplasmic membrane fraction . Similarly the inner membrane fraction was contaminated with 2-ketodeoxyoctonate and outer membrane proteins including the porin(s) . The separation of these two membranes was not facilitated by variations in lysozyme treatment, cell age, presence or absence of flagella, or longer lipopolysaccharide chain length . Sodium lauroyl sarcosinate extraction resulted in an outer membrane fraction which contained some inner membrane contamination and produced multiple bands upon sucrose gradient centrifugation . Triton X-100 extraction removed the inner membrane from the outer membrane and Triton X-100/EDTA treatment extracted lipopolysaccharide-rich regions of the outer membrane which contained almost exclusively the Campylobacter porin(s) . These data indicated that the inner and outer membranes of the Campylobacter cell envelope were very difficult to separate, possibly because of extensive fusions between these two membranes. Am J Clin Pathol, 1988 Nov, 90(5), 606 - 9 Rapid diagnosis of Campylobacter pylori by Gram's stain; Montgomery EA et al.; Campylobacter pylori (CP) is implicated as a probable pathogen in gastritis and peptic ulcer disease . A blinded prospective study of 112 subjects evaluated how Gram's-stained touch preparations of mucosal biopsies compared with culture, routinely processed hematoxylin and eosin (H and E) and Warthin-Starry (WS) staining in confirming the presence of CP . At endoscopic examination, two mucosal biopsies were taken from the gastric antrum and two from the fundus of each subject . One biopsy from each site was Gram's stained and cultured and the other submitted for H and E and WS . Fifty of the 112 subjects had positive results for CP by at least two of the tests (44.6%) . Histologically, 48 (96%) of the CP-positive subjects showed the presence of gastritis . Of 55 subjects who had gastritis, 50 had CP (91%) . If both sites in the stomach were taken into account, the sensitivity and specificity of Gram's staining in detecting CP were 92% and 100%, respectively . These results are comparable to H and E and WS and slightly better than culture . The diagnosis of CP can be made accurately, rapidly, and inexpensively by Gram's stained touch preparations of mucosal biopsies. Infect Immun, 1988 Nov, 56(11), 2933 - 41 Shigella flexneri invasion plasmid antigens B and C: epitope location and characterization with monoclonal antibodies; Mills JA et al.; Invasion plasmid antigens B (IpaB) and C (IpaC) are associated with the ability of shigellae to invade cultured mammalian cells . Monoclonal antibodies against IpaB and IpaC polypeptides were produced and used in a whole-cell enzyme-linked immunosorbent assay to show that both IpaB and IpaC polypeptides were exposed on the surface of virulent shigellae . Moreover, these surface epitopes were shown to be highly conserved among different serotypes of Shigella spp . and enteroinvasive Escherichia coli . Cross-reactive epitopes were not found on noninvasive Shigella strains or on other enteric bacteria including Salmonella, Yersinia, Campylobacter, Vibrio, and Aeromonas spp . and various pathogenic strains of E . coli . The monoclonal antibodies were used in competitive binding assays to define three unique epitopes of the IpaB polypeptide and four unique epitopes of the IpaC polypeptide . Epitope locations and their corresponding DNA-encoding regions were defined by examining the IpaB and IpaC products expressed by lambda gt11 recombinants and by constructing a genetic map of the insert DNAs of these recombinants . Three IpaB epitopes (2F1, 1H4, 4C8) were found to be encoded on three contiguous DNA regions comprising a 700-base-pair (bp) segment that corresponded to the amino-terminal end of the IpaB polypeptide . Similarly, a 640-bp DNA segment that corresponded to the amino-terminal end of the IpaC polypeptide was found to encode three clustered IpaC epitopes (5H1, 9B6, 5B1) . Approximately 50 bp downstream from this region a fourth IpaC epitope-encoding region (2G2) was found . The effect of the monoclonal antibodies on plaque formation by virulent Shigella flexneri on a monolayer of cultured mammalian cells (a sensitive measure of invasiveness) was determined . Only the IpaB-specific monoclonal antibody 2F1 was able to reduce the plaque-forming capacity by greater than 50%, suggesting that this epitope of the IpaB polypeptide is involved in the invasion process. Infect Immun, 1988 Nov, 56(11), 2896 - 906 N-acetylneuraminyllactose-binding fibrillar hemagglutinin of Campylobacter pylori: a putative colonization factor antigen; Evans DG et al.; Campylobacter pylori is the causative agent of gastritis and possibly of peptic and duodenal ulcers in adults . Histological observations show C . pylori attached to gastric epithelium as well as in the mucus layer of the stomach . We found that clinical isolates of C . pylori possess a cell-bound hemagglutinin detectable with human erythrocytes (all phenotypes tested) and those of a variety of animal species . The C . pylori hemagglutinin is antigenic, heat sensitive, and destroyed by pronase and papain but resistant to pepsin and trypsin . The hemagglutinin has fibrillar morphology; C . pylori-erythrocyte interaction displays very intimate contact, which is typical of fibrillae-mediated attachment . Fibrillae were removed from C . pylori by solubilization with N-octylglucose . After partial purification and removal of N-octylglucose by dialysis, the protein reaggregated, with the assembly of fibrillar structures . Hemagglutination inhibition was observed with the sialoproteins fetuin, alpha 2-macroglobulin, and glycophorin A but not with asialofetuin or asialoglycophorin A . The erythrocyte receptor was more sensitive to destruction by a neuraminidase specific for the N-acetylneuraminyl-alpha(2-3)-galactopyranosyl {NeuAc(2-3)Gal} sequence than one specific for NeuAc(2-6)Gal . Hemagglutination-inhibition assays with N-acetylneuraminyl-alpha(2-3)-lactose {NeuAc(2-3)-lactose} and NeuAc(2-6)-lactose confirmed that the C . pylori hemagglutinin preferentially binds to the NeuAc(2-3)Gal isomer of NeuAc-lactose . Based upon the above-described properties of the C . pylori fibrillar hemagglutinin, we conclude that this antigen should be designated as a putative colonization factor antigen. N Z Med J, 1988 Oct 26, 101(856 Pt 1), 651 - 4 Treatment of Campylobacter pylori gastritis: a pilot study using pirenzepine dihydrochloride (Gastrozepin) and three formulations of colloidal bismuth subcitrate (De-Nol); Morris A et al.; Antral biopsies were obtained to detect Campylobacter pylori infection in 382 patients referred for gastroscopy . One hundred and seventy four patients (46%) were infected . Infection was strongly associated with histological gastritis (p less than 0.001), but there was no association between histological antral gastritis and the appearance of the gastric antrum during gastroscopy . Because it has been suggested that the lower relapse rate for duodenal ulcer following colloidal bismuth subcitrate (CBS) is due to suppression of C pylori we investigated different formulations and dosing of CBS for their efficacy in clearing C pylori . Seventy four infected patients were prospectively assigned to therapy with pirenzepine (11 patients) or one of four regimens of CBS; one swallow tablet 4 times a day (11 patients); two swallow tablets twice daily (16 patients); two buffered swallow tablets twice daily (14 patients); or two chew tablets twice daily (22 patients) . All patients treated with pirenzepine and one CBS swallow tablet 4 times a day were still infected after treatment . Infection was not detected in 16 patients taking twice daily doses of CBS; 8 (50%), 3 (21%) and 5 (23%) patients taking two standard, buffered or chew tabs twice daily respectively . Improvement of histological gastritis was observed only in those patients apparently cleared of C pylori (p less than 0.01) and this was due to a decrease in polymorphonuclear leukocytes . Nine patients apparently cleared of the infection were rebiopsied 44-137 days following treatment and 6 (66%) were found again to be infected . This study suggests that suppression of C pylori may vary with the formulation and dosing of CBS.(ABSTRACT TRUNCATED AT 250 WORDS) BMJ, 1988 Oct 22, 297(6655), 1036 - 8 Risk factors for persistent diarrhoea; Shahid NS et al.; With a systematically sampled population of children aged under 5 attending this centre for diarrhoeal disease research during 1983-5 a retrospective analysis of persistent diarrhoea (defined as greater than 14 days' duration) was performed to identify the possible risk factors for this syndrome . Of the 4155 children included in the analysis, 410 (10%) gave a history of persistent diarrhoea . A comparison with children with acute diarrhoea matched for age showed that 11 factors were correlated with persistent diarrhoea, and strongly associated factors were stools with blood or mucus, or both, lower respiratory tract infection, malnutrition, vitamin A deficiency, and antibiotic use before presentation . The peak age was 2 years, and there was no sex difference . Deaths occurred more often in the group with persistent diarrhoea . Although Shigella spp, Campylobacter jejuni, and Giardia lamblia were frequently identified, their rates of isolation were not significantly higher among patients with persistent diarrhoea . No seasonal variation was observed in the rates of persistent diarrhoea . Although the introduction of family food to the diet was associated with higher rates, this factor was difficult to separate from the age dependent risks. Am J Gastroenterol, 1988 Oct, 83(10), 1168 - 71 Acute presentation of Campylobacter pylori gastritis; Frommer DJ et al.; A 46-yr-old male was admitted to hospital with profuse vomiting, epigastric pain, and an infiltrative gastric lesion . Evidence is presented supporting the proposition that the symptoms were the product of an acute inflammatory response in the stomach induced by the bacterium Campylobacter pylori . The progress of the patient was monitored over a 2-yr period by endoscopic examination and serology for C . pylori . A significant rise in IgG antibody to C . pylori was seen only at 14 wk. Med Interne, 1988 Oct-Dec, 26(4), 297 - 303 Campylobacter pylori infection in gastric and duodenal ulcer; Andreica V et al.; The incidence of infection with Campylobacter pylori (CP) in gastric ulcer (GU) and duodenal ulcer (DU) and its correlation with the gastritis lesions associated to the two diseases, was investigated . In GU the incidence of CP infection was 76.3%, close to that in DU (71.4), but different from controls (33.3%) . Chronic gastritis associated to gastric or duodenal ulcer is of variable severity, CP infection being the more often encountered the higher the severity of gastritis . Presence of CP was also observed in 75% of the cases associated also with intestinal metaplasia from UG . The diameter of CP-positive GU was significantly increased as compared with that in CP-negative GU . Type I GU was associated with CP infection in 81.8% of the cases . The results obtained allowed the conclusion that in GU and DU the incidence of CP infection is significantly higher as compared with that in controls but the pathogenetic relationship ulcer-bacterium is not yet elucidated. Clin Exp Rheumatol, 1988 Oct-Dec, 6(4), 385 - 90 Antibacterial antibody pattern in seronegative spondyloarthropathies (SNSA); Lapadula G et al.; The occurrence of some anti-bacterial antibodies was studied in sera from 31 healthy donors (HD) and 101 patients with different rheumatic diseases . The cases investigated included 7 Psoriatic Arthritis (PA), 35 Rheumatoid Arthritis (RA), 17 Undifferentiated Seronegative Spondyloarthritis (U-SNSA), 13 Behcet's syndrome, 18 Enteric Arthropathies (EA), 7 Ankylosing Spondylitis (AS) and 4 Reiter's syndrome . A complement fixation test was carried out to detect the presence and to evaluate the titer of the specific antibodies against the relative bacterial antigens . The antigens used were prepared for the complement fixation test by Virion Laboratories: Yersinia Enterocolitica 0:3 type (YEC), Yersinia Pseudotuberculosis (YPT), Campylobacter Jejuni (CJ) and Campylobacter Intestinalis (CI), Chlamydia Trachomatis (CT) . The results indicate a statistically significant difference between the HD group and the seronegative polyarthritis one (PA, U-SNSA, Behcet, EA, AS, Reiter as a whole) as far as antibody production against YEC, CI and YPT is concerned . On the contrary, a significant difference between the HD group and RA patients for specific anti bacterial antibodies was only found against CT . Further detailed analysis of the behavior of the antibody pattern in any disease groups was carried out to identify a possible specific and featured antibody profile for some given rheumatic disorder. Can J Microbiol, 1988 Oct, 34(10), 1142 - 7 Selective association and transport of Campylobacter jejuni through M cells of rabbit Peyer's patches; Walker RI et al.; M cells in the Peyer's patches may facilitate transport of pathogens such as Campylobacter jejuni from the intestine . We evaluated this hypothesis by using electron microscopy to examine Peyer's patches in ligated adult rabbit ileal loops inoculated with 5-mL suspensions of 10(9) cfu/mL of Campylobacter jejuni . Peyer's patches taken at intervals from 15 min to 2 h after inoculation of loops in anaesthetized rabbits provided evidence that Campylobacter jejuni selectively adhered to M cells as opposed to absorptive epithelial cells and was transported, apparently intact, into the M cell follicle . Although intercellular organisms were seen within the follicle, many others were phagocytosed by lymphoid cells . The proximity of the lymphatic and blood circulatory systems to the M cell follicle makes this a probable route for systemic spread of Campylobacter jejuni. Poult Sci, 1988 Oct, 67(10), 1431 - 5 Incidence of Campylobacter jejuni in processed egg products; Izat AL et al.; Egg samples were obtained from two commercial egg-processing facilities to determine if Campylobacter jejuni could be isolated from the raw product or from further-processed egg products intended for human consumption . No C . jejuni were detected in any of the egg or egg-product samples or from water samples collected from the overflow of the egg washer . Campylobacter jejuni was recovered from all control samples, which had been inoculated at the plants . These findings suggest that properly processed egg products are an extremely unlikely source of C . jejuni contamination. J Clin Microbiol, 1988 Oct, 26(10), 2193 - 4 Isolation of Campylobacter jejuni from the bile of a cholecystic patient; Drion S et al.; Described is the isolation of Campylobacter jejuni from the bile of a cholecystic patient admitted for abdominal pain to an intensive care unit . A cholecystectomy was performed, and the patient responded to erythromycin therapy . Details of this uncommon isolation are given. Epidemiol Infect, 1988 Oct, 101(2), 295 - 300 The pathogenicity of environmental campylobacters--a human volunteer experiment; Mawer SL; Three human volunteer experiments were performed in which river water expected to contain campylobacter organisms was ingested . Despite the ingestion of over 44,000 organisms in one experiment, the subject did not suffer any symptoms, nor were campylobacter organisms excreted, nor was an antibody response to the ingested strains detected . The campylobacter organisms ingested resembled Campylobacter jejuni on colonial and microscopic morphology but were hippurate negative, and were distinct from C . coli . These environmental campylobacter strains appear to be non-pathogenic, however they may be mistaken for C . jejuni or C . coli if they are not fully identified. Epidemiol Infect, 1988 Oct, 101(2), 287 - 94 Campylobacters in man and the environment in Hull and East Yorkshire; Mawer SL; Campylobacter organisms isolated from water samples taken weekly from ponds and land-drains in the City of Hull were compared with isolates from humans . Of 314 campylobacter organisms isolated from patients, 237 (75.5%) of the strains were identified as typical Campylobacter jejuni, whilst of 125 identified strains isolated from the water samples, 85 (68%) resembled C . jejuni in most respects but were hippurate hydrolysis negative by the Hwang and Ederer method . The ponds and land drains in the city were therefore not a source of campylobacteriosis in the people living near these water courses . The atypical C . jejuni strains isolated from the environment may be mistaken for the C . jejuni strains which cause human infection . It is therefore essential that such strains are fully identified before attributing human and animal infections to their ingestion. Epidemiol Infect, 1988 Oct, 101(2), 269 - 78 The characterization and pathological significance of gastric Campylobacter-like organisms in the ferret: a model for chronic gastritis? Tompkins DS, Wyatt JI, Rathbone BJ, West AP. Gastric campylobacter-like organisms (CLO) were isolated from gastric tissues removed at sacrifice from 17 mature ferrets; all animals were colonized, but no macroscopic mucosal lesions or histological features of chronic gastritis were seen . The isolates resembled Campylobacter pylori in many cultural and biochemical characteristics, and produced substantial urease activity, but there were sufficient differences from C . pylori to suggest that ferret gastric CLO represents a separate species . Comparison of human C . pylori and ferret gastric CLO may help to elucidate the pathogenicity of the former in patients with gastritis, and the ferret may serve as a useful animal model for the study of C . pylori infection. J Med Microbiol, 1988 Oct, 27(2), 153 - 9 Immunoblot fingerprinting of Campylobacter pylori; Burnie JP et al.; One hundred and fifty isolates of Campylobacter pylori were divided into nine groups by immunoblot fingerprinting . All isolates were typable and reproducibility between immunoblots was good provided both antigen and antibody preparation were standardised . Discrimination was a problem as Groups 1 and 2 accounted for 66% of isolates . Recurrence after bismuth treatment was due to indistinguishable strains in five patients and different strains in three patients. Clin Pharm, 1988 Oct, 7(10), 746 - 59 Management and prevention of bacterial diarrhea; Suarez J et al.; The etiology, pathogenesis, transmission and communicability, diagnosis, and management of infectious diarrhea are reviewed . Infectious diarrhea is common in both industrialized and unindustrialized areas of the world . Better understanding of the etiology and pathogenesis and identification of "new" enteric pathogens has resulted in the use of a variety of drugs to relieve symptoms or to effect a clinical cure . Both host and microbial virulence factors are key in the acquisition of diarrheal illness . Host factors such as extreme age, a dysfunctional gastrointestinal tract, or underlying immunodeficiency enhance the risk of illness after ingestion of a pathogen or its toxins . Microbial virulence factors (the pathogen's ability to invade or produce enterotoxins, neurotoxins, or cytotoxins) characterize the type of illness manifested and the symptom complex (e.g., acute watery diarrhea versus chronic dysentery) . Supportive care is indicated in the majority of cases of infectious enteritis, and rehydration is considered the mainstay of therapy in any diarrheal illness accompanied by dehydration . Antimicrobial therapy is beneficial in the treatment of severe diarrhea caused by Shigella, Campylobacter spp., Vibrio cholerae, Escherichia coli, and Clostridium difficile . Infectious diarrhea is common but is often self-limited and of short duration . Therapy frequently consists of symptomatic relief and fluid replacement. J Dairy Sci, 1988 Oct, 71(10), 2809 - 16 Pathogenic bacteria in milk--a review; Vasavada PC; Pathogenic bacteria are transmissible to humans through milk and milk products . Recently, attention is focused on