Campylobacter

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 milk, cheese, and ice cream contaminated with pathogenic bacteria, viz., Listeria monocytogenes, Yersinia enterocolitica, Campylobacter jejuni, and enteropathogenic Escherichia coli . This review presents information on characteristics of these pathogens and illnesses caused by them.

Appl Environ Microbiol, 1988 Oct, 54(10), 2365 - 70
Colonization of gastrointestinal tracts of chicks by Campylobacter jejuni; Beery JT et al.; Bacterial enumeration and histologic examination of organs and tissues of 8-day-old chicks 7 days after peroral inoculation with Campylobacter jejuni revealed that the organism colonized primarily the lower gastrointestinal tract . The principal sites of localization were the ceca, large intestine, and cloaca, where densely packed cells of C . jejuni were observed in mucus within crypts . Examination of C . jejuni-colonized crypts by transmission electron microscopy revealed that the campylobacters freely pervaded the lumina of crypts without attachment to crypt microvilli . Understanding the mechanism of colonization may lead to approaches that will reduce the incidence of C . jejuni carriage by poultry.

Gut, 1988 Oct, 29(10), 1386 - 91
Non-ulcer dyspepsia and short term De-Nol therapy: a placebo controlled trial with particular reference to the role of Campylobacter pylori; Rokkas T et al.; This double blind randomised study tested the effectiveness of colloidal bismuth subcitrate (De-Nol) in non-ulcer dyspepsia (NUD) and if any benefit is associated with clearance of Campylobacter pylori (C pylori) from the gastric mucosa . Sixty six patients with dyspepsic symptoms, normal abdominal ultrasound, and upper GI endoscopy, were randomly allocated to placebo or De-Nol for eight weeks . Antral biopsies were taken for bacteriological and histological examination, and endoscopies and clinical questionnaires were administered before and after treatment . Fifty two patients (25 on De-Nol and 27 on placebo) completed the trial . De-Nol cleared C pylori from 10 of the 12 C pylori positive patients (83.3%), whereas placebo did not clear C pylori from any of the eight C pylori positive patients (p less than 0.01) . In patients receiving De-Nol gastritis improved (p less than 0.01) and symptomatic response was better (p less than 0.001) compared with placebo . In the placebo group seven of the 19 C pylori negative patients became positive: this was associated with significant deterioration of symptoms, a phenomenon not seen in the De-Nol treated group.

J Clin Pathol, 1988 Oct, 41(10), 1093 - 8
Campylobacter-like organisms and Candida in peptic ulcers and similar lesions of the upper gastrointestinal tract: a study of 247 cases; Kalogeropoulos NK et al.; Campylobacter-like organisms were detected by light microscopy in association with 57 of 102 (56%) of gastric ulcers, all the gastric erosions associated with gastritis, three of five (60%) of gastric erosions without gastritis, five of 13 (39%) of mild superficial gastritis and two of 36 (6%) of normal gastric mucosa . They were also seen in four of 20 (20%) of duodenal ulcers, but not in duodenal erosions with duodenitis or normal duodenal biopsy specimens . They were seen in association with 12 of 64 (19%) of cases of Barrett's oesophagus . Moniliasis was seen in nine of 78 (12%) of the gastric ulcers in which campylobacter-like organisms were found, and the incidence of moniliasis was three of 15 (20%) in association with duodenal ulcers when ulcer debris was present in biopsy material, and in association with six of 25 (24%) of cases of Barrett's oesophagus . These findings do not support the hypothesis that campylobacter-like organisms cause inflammatory and ulcerative lesions of the upper gastrointestinal tract.

J Med Microbiol, 1988 Oct, 27(2), 125 - 30
Opsonophagocytosis of Campylobacter pylori; Das SS et al.; The opsonic activity of human serum from various sources against Campylobacter pylori was compared . All sera, whether from control subjects with no symptoms of gastritis or peptic ulceration, or from symptomatic patients from whom C . pylori had or had not been isolated, opsonised C . pylori equally well . Opsonisation depended on the alternative pathway of complement activation but not on antibody . These findings suggest that antibody plays no role in protection against C . pylori and that the presence of antibody in patients' sera is mainly of diagnostic value.

Am J Gastroenterol, 1988 Oct, 83(10), 1081 - 4
Gastroduodenal complications of chronic NSAID therapy; Graham DY et al.; The fact that nonsteroidal anti-inflammatory drugs (NSAIDs) damage the gastroduodenal mucosa is no longer contested . Endoscopic studies in normal volunteers after NSAID administration have failed to predict which NSAIDs would be safest when administered chronically . NSAID use has been associated with a disproportionately high frequency of upper gastrointestinal bleeding and perforation of ulcers . All of the newer NSAIDs appear to be similar in their propensity to cause mucosal damage, including peptic ulceration . On any given day, more than 10% of patients receiving NSAIDs chronically will have a gastric ulcer, a point prevalence of ulcer disease at least 5 to 10 times higher than in patients who are not taking NSAIDs . The dose-response relationship between anti-inflammatory activity and untoward events, coupled with increased use of newer more potent NSAIDs, explains, in part, the increased incidence of NSAID-associated ulcer complication of bleeding and perforation . The possible association of the increase in prevalence of Campylobacter pylori gastritis with aging and the apparent increase in NSAID-associated complications in the elderly is discussed . The current status of nonsteroidal drug therapy can be summarized as follows: 1) new NSAIDs are not safer than the old NSAIDs, as far as major gastrointestinal side effects are concerned, 2) NSAIDs should be avoided when analgesia is the main goal, 3) if NSAIDs are required, the lowest possible dose that achieves pain relief should be used, 4) newer NSAIDs available only in relatively high anti-inflammatory activity dosages should be restricted to those patients in whom high levels of anti-inflammatory activity are desired.

Am J Clin Pathol, 1988 Oct, 90(4), 450 - 3
Evaluation of staining methods for identifying Campylobacter pylori; Madan E et al.; Campylobacter pylori has been implicated in the pathogenesis of peptide ulcer disease . The rapid identification of this organism may depend upon histologic diagnosis, because culture methods are complex and require a minimum of seven days in order to identify a negative specimen . The purpose of this study was to determine which stain used to identify this organism was the most cost-effective and easiest to perform and interpret on a routine basis . Sixty-one consecutive gastric antral biopsies were stained with hematoxylin and eosin, Giemsa, Brown-Brenn, and Warthin-Starry, with 23 of the cases stained by Brown-Hopps . Of the stains tested, the Wright-Giemsa was the easiest to perform . The organisms on the Wright-Giemsa showed a smooth, uniform purple color, whereas the Warthin-Starry gave the organism a granular appearance that at times could be confused for silver precipitate . Both the Wright-Giemsa and Brown-Hopps stain had the highest degree of identification of the organism (defined by percent positivity) . The routine use of the Wright-Giemsa stain for identification of C . pylori in antral biopsies is recommended.

Lancet, 1988 Sep 24, 2(8613), 725 - 6
Campylobacter pylori in abattoir workers: is it a zoonosis?
Vaira D, D'Anastasio C, Holton J, Dowsett JF, Londei M, Bertoni F, Beltrandi E, Grauenfels P, Salmon PR, Gandolfi L.
Sera from 98 abattoir workers were tested for IgG to Campylobacter pylori, C jejuni, and klebsiella . Clerical workers had significantly lower C pylori and C jejuni IgG titres than any of the groups in direct contact with freshly cut animal parts . No difference was found for antibodies to klebsiella . 28 non-clerical workers with high-titre C pylori IgG consented to upper gastrointestinal endoscopy . C pylori associated gastritis was found in all 28, and four weeks of colloidal bismuth subcitrate (240 mg twice daily) was prescribed . On repeat testing at three months all showed a decrease in IgG titres 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.

JAMA, 1988 Sep 2, 260(9), 1245 - 8
Etiology of diarrhea among travelers and foreign residents in Nepal; Taylor DN et al.; A bacterial pathogen was isolated from 47% of 328 expatriate patients with diarrhea seen at two medical clinics in Nepal in 1986 . Enterotoxigenic Escherichia coli (24%), Shigella (14%), and Campylobacter species (9%) were isolated most frequently . Enteroinvasive and adherence factor-positive E coli were isolated from 2% and 1% of patients, respectively . Giardia lamblia was detected in 12% of patients, rotavirus in 8%, and Cryptosporidium and Entamoeba histolytica each in 5% . Blastocystis hominis was present in 33% of patients but in only 9% of those who took trimethoprim-sulfamethoxazole . More than one enteropathogen was detected in 17% of patients . Patients with prolonged symptoms (longer than two weeks) were more likely to have Giardia (27%) and less likely to have Shigella (5%) than were patients with acute symptoms . The isolation rates of bacterial pathogens decreased with length of stay in Nepal . A wide variety of enteropathogens were detected in travelers to Nepal, and Shigella and protozoa were particularly important . Length of time abroad and duration of symptoms were important diagnostic considerations.

Am J Gastroenterol, 1988 Sep, 83(9), 974 - 80
Iatrogenic Campylobacter pylori infection is a cause of epidemic achlorhydria; Graham DY et al.; On a number of occasions, there have been descriptions of epidemic achlorhydria in subjects undergoing repeated gastric secretory studies, typically as part of research protocols . We observed a case in a 37-yr-old healthy man undergoing weekly gastric analyses, along with endoscopy and gastric biopsy, as part of a research protocol studying gastric adaptation to aspirin . In the middle of the 2nd wk of aspirin administration, he developed severe nausea and epigastric discomfort . Aspirin administration was discontinued, but, as per protocol, gastric analyses, endoscopies, and biopsies were continued . Compared to the week preceding the acute illness, biochemical analyses showed a transient 7.4-fold increase in basal gastric acid, 3.6-fold increase in pepsin secretion, 8.8-fold increase in DNA loss, 5.6-fold increase in mucus secretion, and 12-fold increase in gastric bleeding . Basal acid secretion was zero, and pepsin secretion was one-third of control during the 2nd wk of the infection . Endoscopy at the time of symptoms showed erosions in the gastric body and antrum, as well as numerous mucosal hemorrhages and an acute ulcer in the antrum . Endoscopy 7 days later revealed that the gastric mucosa had almost completely recovered, with only a shallow erosion seen at the site of the previous ulcer . Gastric biopsies were normal before and during the first 2 wk of aspirin ingestion . Gastric biopsies taken at the time of the acute illness (associated with increased basal acid secretion) showed marked acute inflammation of the antrum with many Campylobacter pylori bacilli . At that time, neither acute inflammation nor C . pylori were found in biopsies from the body of the stomach . Biopsies obtained 1 wk later (zero basal acid) showed acute inflammation of both the gastric body and antrum . One week later, biopsies from the gastric body showed mild focal acute inflammation, moderate chronic inflammation, and an occasional lymphoid follicle; the gastric antrum showed chronic inflammation . Antral biopsies obtained 2 yr later showed persistent chronic gastritis with prominent lymphoid follicles and scattered foci of acute inflammatory cells; C . pylori bacilli were still present, but were less apparent . We believe that the syndrome of acute (epidemic) gastritis is often iatrogenic C . pylori infection . Our case shows that increased basal acid and pepsin secretion occur before onset of basal acid hypochlorhydria in the acute phase of C . pylori infection.

J Bacteriol, 1988 Sep, 170(9), 4165 - 73
Structural and biochemical analyses of a surface array protein of Campylobacter fetus; Dubreuil JD et al.; Electron microscopic examination of ultrathin sections and freeze-etched and shadow cast preparations of a bovine prepuce isolate of Campylobacter fetus VC119 showed an S layer with subunits in an apparent linear arrangement . Surface radioiodination, enzyme digestion, low-pH extraction, and Western immunoblotting showed that the layer was composed mainly of one protein which is the predominant protein antigen of C . fetus . This protein was purified to homogeneity by gel filtration, ion-exchange chromatography, and high-performance liquid chromatography . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed an apparent molecular weight of 131,000 for this protein with a pI of 6.35, and no carbohydrate could be detected by a variety of techniques . Amino acid composition analysis showed that the protein contained approximately 1,304 residues per molecule, 41.2% of which were hydrophobic and approximately 22% of which were acidic . Cysteine and histidine were absent . Circular dichroism spectra showed that the prominent structure of the S layer protein was a beta-pleated sheet (36%) with aperiodic foldings (31%); a moderate amount of alpha-helix (28%) and a low amount of beta-turn (5%) were also present . The N-terminal amino acid sequence was determined for the first 18 residues . No sequence homology with other S layer proteins was found.

Gastroenterology, 1988 Sep, 95(3), 619 - 24
Antacids reduce Campylobacter pylori colonization without healing the gastritis in patients with nonulcer dyspepsia and erosive prepyloric changes; Berstad A et al.; Antral biopsy specimens from 89 consecutive patients with nonulcer dyspepsia and erosive prepyloric changes included in a prospective, randomized, double-blind 4-wk study of the effect of an aluminum-magnesium antacid (120 mmol/day) or pirenzepine (50 mg b.i.d.) vs . placebo were examined histologically . Campylobacter pylori (CP) was found by light microscopy of silver-stained sections in 25 patients (28%) . Campylobacter pylori-positive patients were on average older than CP-negative patients (p = 0.02) . There was a strong association between CP colonization and acute inflammation (p less than 0.001), both being rare in the absence of chronic inflammation . During treatment with antacids, the density of CP decreased (p less than 0.001) without any improvement of the inflammatory reaction . On the contrary, the number of patients with gastritis tended to increase after antacids as compared with placebo (p less than 0.10) . A separate analysis showed no symptomatic effect of the drugs . Thus, neither nonulcer dyspepsia nor erosive prepyloric changes are strongly associated with antral CP colonization or acute inflammation . Aluminum-magnesium antacids may suppress antral CP infection without healing the gastritis or relieving symptoms.

Ann Inst Pasteur Microbiol, 1988 Sep-Oct, 139(5), 527 - 34
GC content of DNA of Campylobacter pylori and other species belonging or related to the genus Campylobacter; Beji A et al.; DNA of type strain Campylobacter pylori NCTC 11637 and 32 other strains of C . pylori recovered from gastric biopsy specimens was examined by thermal denaturation for its guanine-plus-cytosine (GC) content . The GC content of strain NCTC 11637 was 35.6 mol % (standard deviation (SD) 0.3), and the GC content of the 32 other C . pylori strains ranged from 34.1 to 37.5 mol % (average value 35.2, SD 1.0) . A total of 14 type strains of other Campylobacter and Wolinella species were included in this study and the results obtained were compared with those cited in the literature.

Can J Microbiol, 1988 Sep, 34(9), 1069 - 74
Effect of incubation temperature, ageing, and bisulfite content of unsupplemented Brucella agar on aerotolerance of Campylobacter jejuni; Lee MH et al.; A mutant strain of Campylobacter jejuni ATCC 29428 was isolated that grows on unsupplemented Brucella agar at O2 levels as high as 21% at 37 degrees C . While measuring the degree of aerotolerance of this mutant on unsupplemented Brucella medium and comparing it with that of the wild type, we found considerable variation among our estimates . As measured by colony counts on unsupplemented Brucella agar incubated at various oxygen levels, the degree of aerotolerance was affected by incubation temperature and the age of the medium . Aerotolerance was consistently higher on plates incubated at 42 degrees C than at 37 degrees C . When the commercial dehydrated Brucella medium that was used to prepare the Brucella agar was stored in a beaker for 2.5 months, the degree of aerotolerance of C . jejuni was decreased . Addition of 0.01% sodium bisulfite reversed this inhibition . Storage of bottles of hydrated Brucella agar for 1.5 months also resulted in a decreased aerotolerance; again, in addition of 0.01% bisulfite reversed the effect . Aerotolerance was greatly decreased when Brucella agar was prepared from all its individual components except 0.01% bisulfite . The results indicate that the bisulfite component of Brucella agar deteriorates during storage of the dehydrated and hydrated media, and that this deterioration can affect measurements of aerotolerance.

J S Afr Vet Assoc, 1988 Sep, 59(3), 139 - 40
Trichomoniasis and campylobacteriosis in bulls in the Republic of Transkei; Pefanis SM et al.; Trichomonas foetus was demonstrated in 23/87 (26.4%) and Campylobacter fetus in 25/87 (28.7%) of bulls tested in Transkei . A total of 16/87 (18.39%) of bulls tested were positive for both Trichomonas foetus and Campylobacter fetus . Bulls from 14 sites in Transkei were tested and Trichomonas foetus was isolated at 9 of these sites . Campylobacter fetus was isolated at 10 of the 14 sites . The results indicate that both Trichomonas foetus and Campylobacter fetus are widespread throughout the cattle population in the Republic of Transkei and may account for infertility problems.

Onderstepoort J Vet Res, 1988 Sep, 55(3), 165 - 8
The first isolations of Campylobacter mucosalis from pigs in South Africa; van der Walt ML et al.; The first isolations of Campylobacter mucosalis in South Africa are described . Isolations were made from a 6-week-old weaner pig with necrotic enteritis and from 2 gingival swabs of suckling piglets from herds with histories of porcine intestinal adenomatosis . The isolates were serologically identified as being serotype A strains.

J Pediatr Gastroenterol Nutr, 1988 Sep-Oct, 7(5), 766 - 8
Barrett's ulcer and Campylobacter-like organisms infection in a child; De Giacomo C et al.; Barrett's esophagus is a gastrointestinal metaplasia of the esophageal epithelium occurring frequently in adults with long-standing peptic esophagitis . Recent reports of Barrett's esophagus in children with gastroesophageal reflux (GER) showed that also at the pediatric age intestinal metaplasia of the esophagus may occur in association with peptic esophagitis . Recently a close association between Campylobacter-like organisms (CLOs) and gastritis has been found in the stomach of both adults and children with a variety of peptic diseases, but evidence of such infection in specimens of Barrett's epithelium has never been described in children . We report here a child with Barrett's esophagus and GER, treated with H2 blockers, who showed a Barrett's ulcer in association with CLO infection . The addition of amoxicillin to antireflux treatment was accompanied by healing of the ulcer, suggesting that bacterial infection of Barrett's epithelium may have an important role in determining its inflammation and possibly ulceration.

J Infect, 1988 Sep, 17(2), 171 - 6
An outbreak of food-borne Campylobacter jejuni infection and the possible role of cross-contamination; Brown P et al.; A point-source outbreak or campylobacter infection affected 24 of 51 delegates attending a business lunch . Failure to detect any specific vehicle for the infection led to observations of kitchen practice . Experiments demonstrated that cross-contamination as a result of handling raw and cooked food consecutively was a possible cause of the outbreak.

J Infect, 1988 Sep, 17(2), 107 - 14
The microbial causes of diarrhoea in patients infected with the human immunodeficiency virus; Dryden MS et al.; Diarrhoea is common in patients infected with the human immunodeficiency virus (HIV) . We sought the cause of diarrhoea in all HIV antibody-positive patients with diarrhoea who presented at St Stephen's Hospital, London over a period of 15 months . Altogether, 441 specimens from 179 patients were examined . Infective causes were found in 86 (48%) patients . Protozoa were the most common infecting organisms (30% patients) . Of these, Cryptosporidium sp . was the most frequent (9.5% patients), followed by Entamoeba histolytica and Giarda lamblia . 'Non-pathogenic' protozoa (NPP) were also common (15% patients), often in the absence of generally recognised pathogens . A case controlled study failed to show a significant difference in the rate of isolation of NPP in HIV antibody-positive patients with diarrhoea compared with HIV antibody-positive patients without diarrhoea . Bacterial causes of diarrhoea were found as follows: Salmonella spp., Campylobacter spp . and Shigella sonnei; Mycobacterium avium-intracellulare (MAI) was isolated from the faeces of eight (4.5%) patients . Isolation of MAI from faeces was associated with disseminated MAI infection . This study has shown that two commonly isolated pathogens, namely Cryptosporidium sp . and MAI, can be identified quickly and reliably by the same modified Ziehl-Neelson staining of concentrated faeces.

J Clin Microbiol, 1988 Sep, 26(9), 1725 - 8
Campylobacter pylori isolated from the stomach of the monkey, Macaca nemestrina; Bronsdon MA et al.; Campylobacter pylori was isolated from the gastric mucosa in 6 of 24 pigtailed macaques (Macaca nemestrina) examined by gastric biopsy and culture; 3 isolates were recovered during gastroendoscopy, and 3 were recovered at necropsy . The isolates were morphologically and biochemically similar to the human type strain NCTC 11638, differing only in colony diameter, pigmentation, and rate of growth . Identity of the isolates was confirmed by whole-genomic DNA-DNA hybridization with the type strain . Colonization of the monkey stomachs was associated with hypochlorhydria and histologic features resembling type B chronic gastritis in humans . Host animals exhibited no morbid clinical effects of colonization, although endoscopy revealed inflammation, erythema, and friable tissue in some animals . The discovery of C . pylori occurring spontaneously in M . nemestrina extends the known range of the hosts of the organism and offers the possibility of a natural or experimental model of the infection in monkeys.

J Med Microbiol, 1988 Sep, 27(1), 41 - 4
Isolation of a gastric campylobacter-like organism from the stomach of four rhesus monkeys, and identification as Campylobacter pylori; Newell DG et al.; Campylobacter-like organisms, isolated from the gastric antrum of Rhesus monkeys, were compared with Campylobacter jejuni and C . pylori . They were similar to C . pylori by light microscopy, in ultrastructural morphology, in enzymic, fatty-acid-methyl-ester, and protein-profile analysis, and in antigenic reactivity with rabbit antisera to C . jejuni and C . pylori and with C . pylori-specific monoclonal antibody . Because this natural infection of the Rhesus monkey is associated with chronic gastritis, resembling the disease in humans colonised with C . pylori, we recommend the animal as a model for the investigation of human gastritis.

J Med Microbiol, 1988 Sep, 27(1), 33 - 40
The urease enzymes of Campylobacter pylori and a related bacterium; Ferrero RL et al.; The urease enzyme of Campylobacter pylori was studied and compared with that of a related spiral-shaped bacterium, St1, isolated from the rodent ileum . Both bacteria possessed constitutive urease enzymes with activities up to 20-70 times that of Proteus vulgaris . This activity was retained on SDS-polyacrylamide gels . A major catalytic subunit of mol . wt 300,000 was located for all (six) strains of C . pylori subjected to SDS-PAGE whereas St1 had two active forms of mol . wts 140,000 and 150,000 . Western-blot analysis indicated the presence of anti-urease antibodies in the sera of patients with C . pylori-associated gastritis . The response to C . pylori urease was not strain-specific but no cross-reactivity was detected between the C . pylori enzyme and that of St1 . The very high urease activity of these bacteria is likely to be important in colonisation of the host . Possession of glutamate dehydrogenase activity by both organisms suggests that one role of the urease may be to assimilate the available urea nitrogen . Modification of the local environment to facilitate long-term colonisation is another possible function . Protection from acid is unlikely to be a primary role as the natural habitat of the organism St1 is the non-acid-secreting tissue of the small intestine.

Infect Dis Clin North Am, 1988 Sep, 2(3), 747 - 74
Diagnosis of infectious diarrheal diseases; Thorne GM; For many years, microbiologic examination of feces was focused on the isolation of two members of the family Enterobacteriaceae--Salmonellae and Shigellae . Over the past two decades, other enteric pathogens such as the various classes of diarrheagenic E . coli, Campylobacter, Vibrio spp., Yersinia enterocolitica, and Clostridium difficile have gained prominence . A newly recognized protozoan parasite, Cryptosporidium is now known to infect both immunocompetent and immunodeficient individuals . Added to these is the growing list of viruses incriminated in diarrheal diseases and gastritis . This article provides some of the basic information needed to allow for the isolation and identification of many of the currently recognized enteric pathogens . It also provides information on some of the currently available rapid test procedures that will speed up stool specimen testing and allow for more timely reporting to the physician.

Infect Dis Clin North Am, 1988 Sep, 2(3), 719 - 45
Treatment of diarrhea; Di John D et al.; Diarrheal diseases remain a leading cause of morbidity and mortality in the developing countries and represent at least a nuisance in the industrialized world . Fluid and electrolyte replacement, particularly via oral rehydration, is the mainstay of therapy for the prevention and treatment of dehydration associated with these illnesses . Antibiotics are not indicated for the majority of enteric infections, and their promiscuous use can contribute to the escalating prevalence of bacterial resistance worldwide . Used judiciously, however, antimicrobial agents can ameliorate illness or curtail pathogen excretion and spread of disease, or both, in some diarrheal infections . Antimicrobial agents are indicated for shigellosis, cholera, traveler's diarrhea, amebiasis, and giardiasis . They are indicated in some specific circumstances to treat infections caused by Campylobacter, some categories of diarrheagenic E . coli, C . difficile, nontyphoidal Salmonella, and certain Vibrionaceae . Few adjunctive treatments provide proven benefit without risk of adverse reactions; most offer no advantage over placebo, and their general use is not encouraged.

Infect Dis Clin North Am, 1988 Sep, 2(3), 643 - 54
Campylobacter; Cornick NA et al.; Campylobacter is now known to be a major cause of gastrointestinal illness throughout the world . There are seven species known to be associated with enteritis, and it is likely that more will be described . Campylobacter jejuni is responsible for more than 95 per cent of the cases of diarrhea due to Campylobacter . Contaminated food products are the major source of infection . The clinical illness usually involves diarrhea, abdominal pain, and other constitutional symptoms . An accurate diagnosis of Campylobacter enteritis is made when the organism is cultured from the patient's stool . Selective media are widely available, and the isolation of C . jejuni is not difficult . Although erythromycin and the quinolones have good in vitro activity against C . jejuni, antibiotic therapy generally is not indicated.

Scand J Gastroenterol, 1988 Sep, 23(7), 867 - 74
Campylobacter pylori infection and its relation to chronic gastritis . An endoscopic, bacteriologic, and histomorphologic study; Nedenskov-Sorensen P et al.; Campylobacter pylori was isolated from 27 of 61 gastric antral biopsy specimens and from 8 of 61 duodenal biopsy specimens . A significant correlation between the occurrence of C . pylori and chronic active gastritis was demonstrated . However, the presence of the bacterium on normal mucosa weakens the theory of C . pylori as a primary causal organism . There was a significant correlation between isolation of C . pylori and erosive lesions in the antral mucosa as diagnosed by endoscopy . No correlation was found between endoscopic findings and histologically verified chronic active gastritis . The microbiologic examinations in this study showed a high degree of homogeneity between the isolated strains of C . pylori . A 3-OH-octadecanoic acid of the bacterial cell wall seemed to be specific for this organism and was identified in all our isolates and in the type strain of C . pylori . We therefore conclude that all Campylobacter-like organisms isolated in this study belonged to one taxonomic unit.

Pathol Biol (Paris), 1988 Sep, 36(7), 888 - 90
{Chronic diarrhea caused by Campylobacter jejuni in a patient with AIDS}; Darbas H et al.; We report a case of C . jejuni chronic diarrhea in a homosexual man with AIDS . The antibiotic susceptibility of the bacteria was about normal for the species . Investigating specific immunity, we observed the presence of anti-C . jejuni IgG and the absence of anti-C . jejuni IgA . These findings concord with the hypothesis that specific IgA are necessary for C . jejuni clearance from the digestive tract.

Leber Magen Darm, 1988 Sep, 18(5), 259 - 62
{Bacteriologic and serologic diagnosis of enteral infections}; Ringelmann R; Infections of the gastrointestinal tract still are numerous, ranging on the second place after infections of the respiratory tract . Some of them show quite severe or prolonged course . In contrast to other infections, especially those of the urinary tract, laboratory diagnostic of enteritis is only scarcely ordered . During the last ten years new methods and knowledge of etiologic germs like Campylobacter, Yersinia, various types of E . coli, Clostridium difficile, Rotavirus, Adenovirus, Giardia, Blastomyces and Cryptosporidia have been accumulated . A better etiologic diagnosis of these infections should enable the clinician to start a more precise and therefore more effective therapy.

Eur J Epidemiol, 1988 Sep, 4(3), 277 - 83
Electrophoretic protein typing of Campylobacter jejuni subspecies "doylei" (nitrate-negative campylobacter-like organisms) from human faeces and gastric mucosa; Owen RJ et al.; Twenty-seven strains comprising 23 clinical isolates of nitrate negative campylobacters (NNC) from Australia, South Africa, the United Kingdom and the Federal Republic of Germany, a representative of the CNW (catalase negative/weak) group and reference strains of three other Campylobacter species, were characterized by one-dimensional SDS-polyacrylamide gel electrophoresis of cellular proteins . The protein patterns were highly reproducible, and were used as the basis for a numerical analysis which showed that the reference strain (NCTC 11951) of Campylobacter jejuni subspecies "doylei", and 20 NNC isolates formed a distinct group at the 74% similarity level . The protein patterns showed unexpectedly low similarity between subspecies "doylei" and the type strain of Campylobacter jejuni and revealed that some NNC strains were quite distinct from subspecies "doylei" . Four electrophoretic (EP) types (I-IV) were identified from phenons formed at the 81% similarity level . Three of these (I, III, IV) corresponded to geographical location of strain isolation but the type II strains were from diverse locations . The correlation observed between EP-type, catalase production and sensitivity to 2, 3, 5, triphenyltetrazolium chloride indicated these latter two tests might be useful for biotyping within the subspecies.

Afr J Med Med Sci, 1988 Sep, 17(3), 163 - 6
Study of plasmid screening amongst pathogenic bacteria isolated in Nigeria; Olukoya DK et al.; Clinical isolates of Neisseria gonorrhoeae, Campylobacter jejuni, Escherichia coli, Shigella dysenteriae, Shigella boydii, Yersinia spp . and Salmonella spp . were screened for the presence of plasmids . Approximately 80% of these strains harboured plasmids ranging in molecular weight from 1.0 to 45 x 10(6) daltons.

Vet Rec, 1988 Aug 6, 123(6), 152 - 4
Campylobacter infection in a closed dog breeding colony; Newton CM et al.; Most dogs in a closed breeding unit were shown to be asymptomatic excretors of campylobacter organisms by eight weeks old . Increasing serum antibody levels, which were correlated with the excretion of organisms, were demonstrated in the puppies and serum antibodies were also demonstrated in adult dogs . The significance of these findings with respect to the pathogenicity of campylobacter in dogs and their zoonotic implications are discussed.

Clin Pediatr (Phila), 1988 Aug, 27(8), 365 - 8
Acute gastroenteritis: clinical features according to etiologic agents; Khuffash FA et al.; The clinical manifestations in 595 children hospitalized with gastroenteritis during a 15-month time frame were studied . They were divided into eight groups according to etiologic agent: rotavirus (203 patients); Salmonellae (98); Escherichia coli (55); Campylobacter (36); Shigella (22); combined rotavirus and salmonellae (44); combined rotavirus and other bacteria (26); and no pathogen (111) . The mean duration of diarrhea was shortest in the rotavirus and "no pathogen" groups (4.8 and 5.6 days, respectively) and longest with pure and mixed salmonella infections (12.3 and 12.9 days, respectively) . Associated manifestations were most frequent with salmonellae and least frequent with rotavirus and E . coli infections . Malnutrition also was most common with salmonellae and lowest with rotavirus and E . coli . There were no differences in the frequency of hypernatremia . Hyponatremia was most frequently encountered with salmonella (25% compared to 9% in the rest of the patients) . Evidence of septicemia was found in 22 patients, 21 of whom were in the salmonella groups . The four deaths in this series (0.7%) also were in the salmonellae groups . The clinical severity of salmonella infection in developing countries, particularly in young and malnourished children, warrants attention to more intensive management . The selective use of antibiotics may help reduce the mortality and morbidity of gastroenteritis.

J Med Microbiol, 1988 Aug, 26(4), 265 - 8
Cross-protection of infant mice against intestinal colonisation by Campylobacter jejuni: importance of heat-labile serotyping (Lior) antigens; Abimiku AG et al.; An association of the heat-labile antigens detected by the Lior serotyping scheme with ability to protect infant mice against gastrointestinal colonisation with Campylobacter jejuni has been established . Overall, 39 (57%) of 68 infant mice challenged with a heterologous strain of the same Lior serotype as the vaccine strain were protected, compared with 40 (85%) of 47 infants protected against a homologous challenge . In contrast, none of the infant mice challenged with a strain carrying the same heat-stable antigens (i.e., of the same Penner serotype as the vaccine strain) were protected.

J Med Microbiol, 1988 Aug, 26(4), 257 - 63
Detection of Campylobacter pylori DNA by hybridisation with non-radioactive probes in comparison with a 32P-labelled probe; Wetherall BL et al.; A dot-blot hybridisation assay for the detection of Campylobacter pylori was used to compare a 32P-labelled probe with two biotinylated probes and a sulphonated probe . The minimum amount of pure C . pylori DNA that could be detected by the 32P-labelled probe was 100 pg, which corresponded to 5 x 10(4) bacteria . A biotin-labelled DNA (biotin-DNA) probe together with the BluGeneTM detection system produced by Bethesda Research Laboratories (BRL), and a sulphonated probe and ChemiprobeTM detection system (Orgenics) gave similar levels of sensitivity; nylon membranes could be used with both these non-radioactive detection systems . However, a photobiotin-labelled DNA (photobiotin-DNA) probe and detection system produced by Biotechnology Research Enterprises S.A . (BRESA) gave optimum results only with nitrocellulose membranes, and was quantitatively 100 times less sensitive than the other types of probe . The detection systems for the biotin-DNA and photobiotin-DNA probes produced non-specific reactions with crude bacterial blots of heterologous organisms; these non-specific reactions could be removed by treating the dot blots with proteinase K, but not by treatment with RNAase . The sulphonated probe and detection system did not give any reaction with heterologous organism blots.

Antimicrob Agents Chemother, 1988 Aug, 32(8), 1170 - 3
Detection of two different kanamycin resistance genes in naturally occurring isolates of Campylobacter jejuni and Campylobacter coli; Tenover FC et al.; A total of 225 isolates of Campylobacter jejuni and 54 isolates of Campylobacter coli were screened for resistance to kanamycin . Among these, five resistant isolates of C . jejuni and six resistant isolates of C . coli, all with different plasmid patterns, were identified . Each contained at least one plasmid greater than or equal to 41 kilobases in size . The MIC of kanamycin for all 11 strains was determined to be greater than or equal to 256 micrograms/ml by an agar dilution method . In addition, all of the strains exhibited resistance to tetracycline (greater than or equal to 16 micrograms/ml) . Eight of the 11 strains transferred the kanamycin resistance phenotype to other Campylobacter strains by conjugation . DNA from 9 of the 11 strains hybridized to a DNA probe specific for the 3'-O-aminoglycoside phosphotransferase type III gene . The remaining two strains also failed to show homology with DNA probes specific for the genes encoding 3'-O-aminoglycoside phosphotransferase types I, II, and III . The novel kanamycin resistance gene was cloned into the vector pBR322 and was expressed in Escherichia coli . Phosphocellulose paper binding assays on sonicates of the E . coli strain carrying the cloned kanamycin determinant demonstrated significant activity against kanamycin, neomycin, and amikacin but not against butirosin, gentamicin, tobramycin, or lividomycin, suggesting that the enzyme is the product of a 3'-O-aminoglycoside phosphotransferase type of aminoglycoside resistance gene.

Scand J Gastroenterol, 1988 Aug, 23(6), 760 - 4
Campylobacter pylori in peptic ulcer disease . II . Endoscopic findings and cultivation of C . pylori; Andersen LP et al.; Specimens from 153 consecutive patients were cultivated for C . pylori, and findings were correlated to the endoscopic findings . C . pylori was cultivated more frequently from males than from females . Culture-positive males had a high frequency of prepyloric abnormalities . No correlation between age or pH in gastric juice and cultivation of C . pylori was found . C . pylori was found significantly more often in patients with peptic ulcer and/or duodenitis than in patients with normal endoscopic findings . No differences could be detected between patients with gastritis or esophagitis and patients with normal endoscopic findings . C . pylori was found most frequently in the antral part of the stomach . It was cultivated significantly more often from patients with duodenal abnormalities than from patients with normal endoscopic findings . In less than half of the culture-positive patients with duodenal abnormalities we cultivated C . pylori from duodenal specimens . This study also showed C . pylori in esophageal specimens, which has not been previously described . Our results suggest that cultivation of C . pylori from duodenal specimens or gastric fluid samples gives no additional information beyond that obtained from the cultivation of antral biopsy specimens . It is our opinion that C . pylori, at least in some cases, may be a secondary infection.

Scand J Gastroenterol, 1988 Aug, 23(6), 701 - 4
Na+/H+ ion-exchange property of postmortem human gastric mucus; Thomsen L et al.; The Na+/H+ ion-exchange property of human gastric mucus and its relationship to age has been studied . Mucus was collected from 40 postmortem human stomachs (age range, 21-83 years) within 24 h of traumatic death . Twenty-one stomachs (age range, 21-76 years) were free of Campylobacter pylori infection and histologic gastritis . Mucus from these stomachs was consistently a cation exchanger at pH 6 in an in vitro system . The cation-exchange capacity of mucus from seven stomachs within the age range 55-70 years was 50% less than the cation-exchange capacity of mucus from eight stomachs within the age range 20-35 years . This study shows that human gastric mucus at pH 6 is a cation exchanger and that the ion-exchange capacity decreases with age.

Eur J Clin Microbiol Infect Dis, 1988 Aug, 7(4), 576 - 8
Demonstration of a cytotoxin from Campylobacter pylori; Hupertz V et al.; In order to determine if Campylobacter pylori produces a cytotoxin, a study was performed using bacterial lysates from three clinical isolates of the organism . The lysates were cytotoxic for Chinese hamster ovary cells, as determined by a microtiter assay . The lysates were also lethal for mice after intraperitoneal injection . Loss of toxicity and lethality followed trypsinization, heating and acidification of cell-free lysates . It is concluded that the toxic factor(s) in Campylobacter pylori may be a protein.

Eur J Clin Microbiol Infect Dis, 1988 Aug, 7(4), 570 - 5
Comparison of different antigen preparations in an evaluation of the immune response to Campylobacter pylori; Hirschl AM et al.; This study presents a novel approach to the analysis of protein antigens of Campylobacter pylori for use in serology . Protein fractions of this bacterium were resolved in polyacrylamide gel electrophoresis, eluted from gel strips in an electric field and used for coating of microtiter plates in an ELISA-type assay run with a small set of sera from both infected and non-infected patients . Reactivity and discriminative power of the different fractionated antigens (1-9) and crude antigen preparations (A-C) were compared . Better discrimination was achieved between positive and negative sera with high molecular weight fractionated preparations (antigens 8 and 9) than with low molecular weight fractions . Among the crude antigen preparations, antigens A (sonicated whole cells) and C (ultracentrifugated sonicate) seem to have a better discriminative power than antigen B (acid glycin extract).

Eur J Clin Microbiol Infect Dis, 1988 Aug, 7(4), 566 - 9
Susceptibility of clinical isolates of Campylobacter pylori to twenty-one antimicrobial agents; McNulty CA et al.; The MICs of 21 antimicrobial agents were determined for 97 clinical isolates of Campylobacter pylori . The beta-lactams (penicillin, ampicillin, cefoxitin and cephalexin), macrolides (erythromycin and azithromycin), quinolones (ciprofloxacin and ofloxacin), nitrofurans, gentamicin and tetracycline all had MIC90 values of less than or equal to 0.5 mg/l . Aztreonam, flucloxacillin, amifloxacin and rifampicin had moderate activity . All isolates were resistant to vancomycin, cefsulodin and amphotericin B . Five percent of the strains were inhibited by 8 mg/l of polymyxin . Of the oral agents tested, the nitrofurans and ampicillin are probably the most appropriate antimicrobial agents . Azithromycin and the oral form of cefuroxime are promising alternatives . Cefsulodin, vancomycin and amphotericin B would be suitable constituents of selective media for isolation of Campylobacter pylori.

Eur J Clin Microbiol Infect Dis, 1988 Aug, 7(4), 559 - 65
Enzyme-linked immunosorbent assay for detection of immunoglobulin A and G antibodies to Campylobacter pylori; von Wulffen H et al.; An enzyme-linked immunosorbent assay (ELISA) employing an acid-glycine extract was used to detect IgG and IgA antibodies to Campylobacter pylori in sera from 179 patients with upper gastrointestinal disease, 174 blood donors and 65 children . The incidence of positive ELISA results clearly increased with the severity of histopathologic findings in the antrum mucosa and was also high in patients with peptic ulcers and gastric cancer . The incidence in blood donors and children was much lower and increased with age . The results achieved with the ELISA were similar to those observed previously using the immunoblot method . Differences between whole cell preparation and acid-glycine extract with respect to their protein profiles and immunoblot reactivities were minor . IgM titres were very low and could not be related to histopathological findings, peptic lesions or culture findings . The ELISA may be particularly useful for monitoring the outcome of therapy aimed at eradication of Campylobacter pylori.

Eur J Clin Microbiol Infect Dis, 1988 Aug, 7(4), 555 - 8
Evaluation of a new selective medium for Campylobacter pylori; Dent JC et al.; Contaminating bacteria from the oropharynx and bacteria that colonise the stomachs of patients with a high gastric pH impede the isolation of Campylobacter pylori from gastric biopsy specimens . Commercially available selective supplements are inhibitory to this organism and therefore a specific selective medium is needed for isolation . Potential selective agents were evaluated for their activity against 97 strains of Campylobacter pylori . A modification of Skirrow's medium was developed; cefsulodin (5 mg/l) was substituted for polymyxin, and amphotericin B (5 mg/l) was added to inhibit Candida spp., a common contaminant of the stomach . No strains of Campylobacter pylori were inhibited by the Campylobacter pylori selective medium and it supported the growth of all strains compared with the biopsy urease test and Gram stained smear . Colonies were slightly larger and more easily recognised on the new medium compared with those grown on chocolate blood agar . This medium greatly improves the isolation of Campylobacter pylori and could be used alone, without a non-selective medium.

Drugs, 1988 Aug, 36(2), 132 - 57
Colloidal bismuth subcitrate . A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic use in peptic ulcer disease; Wagstaff AJ et al.; Colloidal bismuth subcitrate (CBS) possesses at least equal efficacy with histamine H2-receptor antagonist drugs in the treatment of peptic ulcer disease . However, CBS has the advantage of slower ulcer relapse rates than those seen after initial healing with the H2-antagonists . It has been postulated that this effect may be partly due to the antibacterial properties of CBS against Campylobacter pylori, a bacterium found in the gastric mucosa and gastric metaplasia within the duodenum of most patients with peptic ulcer and closely associated with gastritis . However, the role of C . pylori in the aetiology of peptic disease is far from clear . The mechanism by which CBS heals ulcers has not been fully elucidated, but several actions may be involved . CBS and mucus form a glycoprotein-bismuth complex in vitro . This provides a diffusion barrier to HCl and may, therefore, provide a protective coating in the ulcer crater which allows healing of the lesion to occur . Prostaglandin E2 production is also stimulated by CBS with subsequent secretion of alkali into the mucus layer . In addition, CBS has a direct inhibitory effect on C . pylori . Administration of CBS results in low levels of bismuth absorption . Most of the ingested bismuth is excreted as bismuth sulphide, causing blackening of the faeces, and the small amount absorbed is excreted in the urine . Bismuth intoxication (encephalopathy) has been reported with prolonged administration of bismuth salts, and there has been 1 report of similar intoxication in a patient receiving unusually high doses of CBS for a prolonged period . However, no such intoxication has been reported with CBS used at its recommended dosage in the acute treatment of peptic ulcer disease, and no other serious adverse effects have been associated with CBS . Tissue accumulation during prolonged therapy seems likely, and the safety of CBS during long term maintenance therapy has not been established . The lack of effect on gastric acid secretion is seen as an added advantage for CBS, since prolonged drug-induced hypochlorhydria has been postulated to have potentially detrimental effects . Thus, while the role of C . pylori in peptic ulceration requires further clarification, CBS would appear to have an important place in the treatment of peptic ulcer disease with the advantage of relatively slow relapse rates after initial healing and treatment discontinuation.

APMIS, 1988 Aug, 96(8), 681 - 7
Adherence of Campylobacter jejuni and Campylobacter coli to porcine intestinal brush border membranes; Naess V et al.; The adhesion of Campylobacter jejuni and C . coli to isolated porcine intestinal brush border membranes was studied by phase-contrast and electron microscopy . Approximately 45% of the cell population adhered to the brush borders, possibly in a specific manner . Pretreatment of the brush borders with trypsin or pronase, and competitive inhibition with L-rhamnose caused a slight reduction of the adhesion . Different forms of pretreatment of the bacterial cells reduced their ability to adhere, but also their motility.

Eur J Clin Microbiol Infect Dis, 1988 Aug, 7(4), 541 - 4
Comparative in vitro activity of the new oral macrolide azithromycin; Neu HC et al.; The in vitro activity of the new oral macrolide azithromycin was compared with that of erythromycin against gram-positive and gram-negative aerobic and anaerobic bacteria . Ninety percent of hemolytic streptococci groups A and B, and Streptococcus pneumoniae were inhibited by 0.5 microgram/ml . Activity of azithromycin was similar to that of erythromycin; erythromycin-resistant staphylococci and streptococci were not inhibited . Azithromycin was more active than erythromycin against Haemophilus influenzae (MIC90 1 microgram/ml) and Neisseria gonorrhoeae . It inhibited Campylobacter spp . and Pasteurella multocida, and had an MIC50 of 8 micrograms/ml for Escherichia coli, Salmonella spp., Shigella spp . and Yersinia enterocolitica compared to an erythromycin value of greater than 64 micrograms/ml.

J Bacteriol, 1988 Aug, 170(8), 3618 - 26
Nucleotide sequence analysis of tetracycline resistance gene tetO from Streptococcus mutans DL5; LeBlanc DJ et al.; Streptococcus mutans DL5, isolated from the dental plaque of a pig, was resistant to high levels of streptomycin (Sm, 20 mg/ml), erythromycin (Em, 1 mg/ml), and tetracycline (Tc, greater than 100 micrograms/ml), but contained no detectable plasmid DNA . The Smr and Emr determinants were cloned from cellular DNA on the self-replicating 5-kilobase-pair (kbp) EcoRI fragment of pAM beta 1 and the 4.2-kbp cryptic plasmid pVA380-1, respectively, by transformation of Streptococcus sanguis Challis . Helper plasmid cloning, with a Challis host containing pVA380-1, was required to clone the Tcr determinant of strain DL5 on this vector . A single-colony isolate of the original Tcr clone contained a hybrid plasmid, pDL421, composed of 2.6 kbp of vector DNA and 11.4 kbp of S . mutans DNA . Plasmid pDL421 did not hybridize to plasmids containing the streptococcal Tcr determinants tetL, tetM, and tetN . A shortened derivative of this hybrid plasmid, pDL422, missing a 4.9-kbp HincII fragment from the S . mutans DNA but still encoding Tcr, was obtained by subcloning in S . sanguis Challis . The Tcr gene was located in a 1,917-base-pair open reading frame (ORF) corresponding to a 72-kilodalton protein . The ORF exhibited 99.4% sequence identity with the 1,917-base-pair tetO gene from a strain of Campylobacter coli (W . Sougakoff, B . Papadopoulou, P . Nordmann, and P . Courvalin, FEMS Microbiol . Lett . 44:153-160, 1987) . A 1.67-kbp NdeI fragment, internal to the ORF from strain DL5, as well as pDL421 hybridized under stringent conditions to DNA from 10 of 10 Tcr strains of C . coli and Campylobacter jejuni from human and animal sources, but not to DNA from Tcs isolates of these two species.

J Neuroimmunol, 1988 Aug, 19(1-2), 133 - 9
Severe Guillain-Barré syndrome: an association with IgA anti-cardiolipin antibody in a series of 92 patients; Frampton G et al.; To determine whether anti-cardiolipin antibodies (ACA) are associated with acute Guillain-Barre syndrome (GBS), we studied sera from 92 patients with GBS, 82 age- and sex-matched hospital controls and 24 patients with uncomplicated cytomegalovirus or Campylobacter jejuni infection, using an isotype-specific ACA enzyme-linked immunosorbent assay (ELISA) . IgA ACA titres (but not IgG ACA or IgM ACA) were significantly elevated (P = 0.002) in GBS patients compared to controls, and associated with peak disease severity (P = 0.01), but not initial or residual disability, nor duration of neuropathy . Abnormal IgG ACA may cause or result from myelin damage in GBS.

J Wildl Dis, 1988 Jul, 24(3), 467 - 70
Occurrence of Campylobacter jejuni in free-living wild birds from Japan; Ito K et al.; Campylobacter jejuni was isolated from 44 of 313 free-living birds from Japan . The highest isolation rate was found in 30 of 87 (34%) crows (Corvus levaillanti and Corvus corone), followed by 2 of 10 (20%) blue magpies (Cyanopica cyanus), 5 of 35 (14%) gray starlings (Sturnus cineraceus), 2 of 16 (13%) domestic pigeons (Columbia livia domestica), 4 of 36 (11%) bulbuls (Hypsipetes amaurotis), and 1 of 62 (2%) eastern turtledoves (Streptopelia orientalis) . One-fourth of the contents of the crop and stomach of the crows was human refuse . One-third of the crop and stomach contents of gray starlings and blue magpies consisted of insects . More than one-half of the contents of bulbuls and eastern turtledoves were seeds and plant material . These differences in food habits may be a primary factor in the varying prevalence of C . jejuni in these respective avian species.

J Clin Microbiol, 1988 Jul, 26(7), 1421 - 4
Antibody response to Campylobacter coli in children during intestinal infection and carriage; Martin PM et al.; In the Central African Republic, etiological studies of diarrhea have shown that Campylobacter coli accounts for almost 40% of Campylobacter enteric isolations . This prompted us to investigate the antibody response to C . coli infection in children . As expected from the literature on Campylobacter jejuni infections, our results show that both infection and carriage elicited antibodies against glycine-extracted membrane antigens, flagella, and cholera toxin . The human antibody response to C . coli resembles the response to C . jejuni, and this similarity will allow comparative studies on larger numbers of infections, both symptomatic and asymptomatic . Anti-cholera toxin antibodies were directed against both the A and B subunits.

J Clin Microbiol, 1988 Jul, 26(7), 1393 - 4
Evaluation of a rapid urease test to detect Campylobacter pylori infection; Westblom TU et al.; Seventy-five consecutive patients referred for upper gastrointestinal tract endoscopy were evaluated for Campylobacter pylori infection by pathology, culture, and a biochemical test to detect bacterial urease . Forty-eight patients (64%) had C . pylori present based on pathology or culture or both . Thirty-two urease tests were positive after 1 h, all in patients with C . pylori detected by the two other methods (specificity, 100%; sensitivity, 67%) . After 24 h, 47 urease tests were positive, but only 40 had C . pylori present (specificity, 74%; sensitivity, 83%) . When read after 1 h, the urease test was highly specific and led to rapid presumptive diagnosis.

Gut, 1988 Jul, 29(7), 909 - 15
Campylobacter pylori in a sample of Finnish population: relations to morphology and functions of the gastric mucosa; Siurala M et al.; The occurrence of Campylobacter pylori (CP) was examined in 179 subjects representing a sample collected from the population of South Finland . In a normal antral and body mucosa CP was present in 5% and 11% and in superficial gastritis (SG) in 71% and 91% of subjects, respectively . In atrophic gastritis (AG) of antrum and body the prevalence of CP decreased significantly with an increasing degree of atrophy, so that CP was not found in severe body AG . Different combinations of antral and body gastritis revealed a characteristic pattern . Campylobacter pylori was lacking when antral and body mucosa were normal, but was present in 41% when normal mucosa was associated with gastritis in the opposite area . In SG affecting diffusely antrum and body, the bacterium was present in every case, but when SG was associated with AG in the opposite area it was lacking in 29% of the subjects . When SG affecting both areas was compared with SG accompanied by different degrees of AG in the body, there was a highly significant decrease of the prevalence of CP in antrum and body along with an increasing degree of AG in the body . This decrease showed a highly significant positive correlation with the acid output . On the whole, acid output correlated well with the occurrence of CP in both antrum and body . Thus the prevalence of CP was 10% in achlorhydria and rose up to 100% in cases with acid output above 30 mmol/h . The presence of CP did not correlate with signs of acute inflammation, but correlated significantly with those of chronic inflammation . No correlation was found in the antrum and a significant negative one in the body, between CP infestation and the extension of intestinal metaplasia . It is concluded that increased pH of gastric contents and mucus secreted by intestinalised glands may create unfavourable conditions for survival of the bacteria and might explain the decrease in the prevalence of CP in the more severe degrees of AG . The present results, however, give no definite answer to the question of the pathogenic significance of CP in the development of chronic gastritis.

Am J Gastroenterol, 1988 Jul, 83(7), 737 - 40
Are dyspeptic symptoms in patients with Campylobacter pylori-associated type B gastritis linked to delayed gastric emptying?
Wegener M, Borsch G, Schaffstein J, Schulz-Flake C, Mai U, Leverkus F.
In this paper, the association of gastric Campylobacter pylori (CP) colonization with histologic findings and gastric emptying of a mixed solid-liquid meal was prospectively investigated in 43 consecutive patients with essential non-ulcer dyspepsia (ENUD) . Gastric emptying was also measured in 30 symptom-free control subjects . The frequency of CP infection in patients with ENUD was 44.2% . We found a strong association between gastric CP colonization and chronic antral type B gastritis . Although gastric emptying was significantly prolonged in patients with ENUD, compared with the control group (p less than 0.05), we could not detect significant differences of gastric emptying between CP-negative and CP-positive ENUD patients, both groups disclosing a similar proportion of patients with significantly delayed gastric emptying (29.2% vs 31.6%) . We therefore conclude that delayed gastric emptying of a mixed solid-liquid meal is not correlated with CP-positive chronic antral type B gastritis, and does not help to explain dyspeptic symptoms, which may possibly arise in relation to gastric CP colonization.

Gastroenterology, 1988 Jul, 95(1), 216 - 8
Gastric and esophageal Campylobacter pylori in patients with Barrett's esophagus; Paull G et al.; Campylobacter pylori organisms were found with similar frequency in the stomachs of patients with Barrett's esophagus and in age- and sex-matched controls (10 of 26 vs . 11 of 26) . Campylobacter pylori was also observed in esophageal Barrett's mucosa in some patients with gastric C . pylori, but not when gastric infection was absent (4 of 10 vs . 0 of 16) . Campylobacter pylori was not detected in esophageal squamous mucosa from patients with Barrett's esophagus or in 25 non-Barrett's patients with gastric C . pylori and histologic changes of esophageal reflux . Overall frequency of ulceration in Barrett's esophagus was 35% (9 of 26), and frequency of ulceration was similar whether or not C . pylori was noted in gastric or Barrett's mucosa.

Gastroenterology, 1988 Jul, 95(1), 209 - 12
Campylobacter pylori gastritis in the acquired immunodeficiency syndrome; Meiselman MS et al.; Campylobacter pylori has been associated with gastritis, duodenitis, and duodenal ulceration in the immunocompetent individual . It has been described within the superficial mucus layer, in interepithelial junctions, and occasionally in the microcanaliculi of epithelial cells, but never in the lamina propria . We describe a case of invasive C . pylori in a patient with the acquired immunodeficiency syndrome and discuss its clinical presentation and histopathological findings.

South Med J, 1988 Jul, 81(7), 859 - 62
Campylobacter gastritis and associated disorders; Hendrix TR et al.; Our review of evidence that Campylobacter pylori is an important factor in gastritis, peptic ulcer disease, and "nonulcer dyspepsia" suggests that C pylori is the most common cause of chronic active gastritis . The association between C pylori gastritis and duodenal ulcer, which approaches 100%, leads to the suggestion that this infection plays an important role in the pathogenesis of duodenal ulcer . Evidence supporting a central role in the pathogenesis of gastric ulcer and nonulcer dyspepsia is less compelling.

Ann Intern Med, 1988 Jul 1, 109(1), 11 - 7
Campylobacter pylori antibodies in humans; Perez-Perez GI et al.; STUDY OBJECTIVE: To determine the diagnostic value of assays to measure serum antibodies to Campylobacter pylori, and to use these assays to determine the prevalence of C . pylori infection in a healthy population . DESIGN: A survey of patients having endoscopies for upper gastrointestinal symptoms, patients with other gastrointestinal illnesses, and healthy controls . SETTING: Outpatients attending endoscopy suites in two university-affiliated medical centers . PATIENTS: One hundred and twenty patients who had gastroduodenoscopies, 61 patients with lower intestinal illnesses, and 166 healthy controls . INTERVENTION: Assay to detect serum IgA, IgG, and IgM antibodies specific for C . pylori . MEASUREMENTS AND MAIN RESULTS: Absorption with other gram-negative pathogens showed that IgG and IgA assays, but not IgM assays, were specific for C . pylori . In patients in whom C . pylori had been isolated and who had gastritis diagnosed by histologic methods, significantly higher mean IgA and IgG levels were seen compared with patients without demonstrable C . pylori or gastritis . The sensitivity and specificity of a positive value in both IgA and IgG assays were more than 93% . Among healthy persons, IgG and IgA antibodies were rarely seen in patients less than 20 years old, but antibody prevalence progressed with age, reaching 50% in patients more than 60 years old . High IgA and IgG levels to C . pylori in five persons tested remained stable for more than 1 year, suggesting the organism persists for at least that period . In 61 patients with acute bacterial enteritis, acute pancreatitis, Crohn disease, or ulcerative colitis, prevalence of antibodies to C . pylori was consistent with age and unrelated to current disease . CONCLUSIONS: Campylobacter pylori infection, which is highly associated with active gastritis, may be diagnosed by serologic assay . Acquisition of infection begins in adult life, and prevalence increases with age.

Microb Pathog, 1988 Jul, 5(1), 71 - 6
Effect of mucin on Campylobacter jejuni association and invasion on HEp-2 cells; de Melo MA et al.; We report the development of an in vitro assay using HEp-2 cell monolayers in which cell association of five C . jejuni strains and E . coli K12 C600 were tested under different experimental conditions . Both total cell associated colony forming units (CFU) and the CFU protected from gentamicin killing (i.e . internalized bacteria) were determined . Pretreatment of HEp-2 cells with mucin (100 micrograms/ml) enhanced internalization of four fresh isolates of C . jejuni by 3.2 to 20.7-fold, depending on the strain, but not internalization of C . jejuni K105 (a stock culture) or E . coli C600 . Mucin also increased the total number of cell associated C . jejuni fresh isolates by 2 to 3.4-fold, the four strains yielding similar results . We conclude from these studies that mucin, which has been shown to be a prerequisite of intestinal colonization by C . jejuni, also promotes infectivity.

Jpn J Antibiot, 1988 Jul, 41(7), 875 - 84
{Laboratory and clinical studies of rokitamycin dry syrup in the field of pediatrics}; Kuno K et al.; Laboratory and clinical studies on rokitamycin (RKM) dry syrup, a new macrolide antibiotic, were carried out in the field of pediatrics . The results are summarized as follows . 1 . Plasma concentrations and urinary recovery rates after oral administration on fasting of RKM dry syrup at doses of 10 mg/kg and 20 mg/kg to 2 and 1 cases, respectively, were determined . Peak plasma levels were obtained in 30 minutes after administration of both dosages with half-lives of 1.5 to 2.2 hours . A clear-cut dose response was observed . Urinary recovery rates in the first 6 hours after administration ranged from 1.75 to 2.26% . 2 . The MICs of RKM against 80 clinical isolates (Streptococcus pyogenes 9, Streptococcus pneumoniae 14, Branhamella catarrhalis 4, Haemophilus influenzae 27, Haemophilus parainfluenzae 9, Haemophilus haemolyticus 2, Haemophilus parahaemolyticus 14 and Campylobacter jejuni 1) were compared with MICs of midecamycin acetate (MOM), josamycin (JM) and erythromycin (EM) . The antibacterial activity of RKM was superior to those of MOM and JM and slightly inferior to that of EM . 3 . Twenty-eight pediatric patients with acute infectious diseases (acute tonsillitis 4, streptococcal infection 4, acute bronchitis 9, pneumonia 4, mycoplasmal pneumonia 2 and Campylobacter enteritis 5) were treated with RKM dry syrup at a daily dose of 12-42.9 mg/kg t.i.d . as a rule . Efficacy rates were 92.9% clinically and 58.6% bacteriologically . 4 . No adverse reactions were observed . Abnormal laboratory findings were mild; thrombocytosis in 2 and eosinophilia in 1 . 5 . The taste and the odor of RKM dry syrup preparation were sufficiently tolerable for the pediatric patients to accept it.

Jpn J Antibiot, 1988 Jul, 41(7), 863 - 70
{Clinical study of rokitamycin dry syrup in pediatrics}; Minamitani M et al.; A total of 22 patients with acute pediatric infections was treated with rokitamycin (TMS-19-Q, RKM) dry syrup, a new macrolide antibiotic developed by Toyo Jozo Co., Ltd., Ohhito, Japan, to investigate its clinical efficacy . 1 . A girl of an age 4 years 2 months (weighing 16.5 kg) was administered orally 10 mg/kg of RKM, and a boy of an age 8 years 7 months (weighing 24.5 kg), 15 mg/kg, and blood concentrations of RKM in these subjects were measured to investigate its absorption and excretion . Blood concentrations of the drug reached a peak of 0.84 microgram/ml in an hour after the administration in the girl, 0.72 microgram/ml in 30 minutes in the boy, with T1/2 of 0.86 and 1.82 hours, respectively . Their 6-hour cumulative urinary recovery rates were 2.79 and 2.13%, respectively . 2 . A total of 20 patients was treated with RKM dry syrup . These patients included 3 with acute pharyngitis, one with acute tonsillitis, 4 with hemolytic streptococcal infections, 7 with acute bronchitis, 2 with pneumonia, another 2 with pertussis, and one with Campylobacter enteritis . The treatment was effective in 18 of them with a clinical efficacy of 90.0% . 3 . Bacteriological responses to RKM dry syrup were as follows: eradication of pathogens in 5, pathogens decreased in 3, and no changes were observed in 3 of 12 patients from whom pathogens had been isolated prior to the treatment, thus the eradication rate was 45.5% with the exception of 1 patient whose bacteriological response was unknown.(ABSTRACT TRUNCATED AT 250 WORDS)

Jpn J Antibiot, 1988 Jul, 41(7), 920 - 59
{Microbiological, pharmacokinetic and clinical studies of rokitamycin dry syrup in the pediatric field}; Motohiro T et al.; Rokitamycin (RKM), a newly developed macrolide antibiotic with a 16-membered ring, dissolves well under acidic conditions . It has been improved over other macrolides to minimize individual variations in its absorbability . We measured, using the GA-test, variations in gastric acidities of 43 children with ages between 1 to 14 years, and investigated the relationship between gastric acidities and pharmacokinetic values . Also activities (expressed in MICs) of antimicrobial agents were studied against clinically isolated 229 bacterial strains using an inoculum size of 10(6) cells/ml . Tested organisms included Streptococcus pyogenes (77 strains), Streptococcus agalactiae (29), Streptococcus pneumoniae (2), as Gram-positive cocci, and Haemophilus influenzae (1), Haemophilus parainfluenzae (1), Bordetella pertussis (12), Salmonella sp . (4) and Campylobacter jejuni (103) as Gram-negative bacilli . Against stock strains of bacteria, MICs of 10 drugs (RKM, erythromycin (EM), josamycin (JM), midecamycin (MDM), midecamycin acetate (MOM), clindamycin (CLDM), amoxicillin (AMPC), cefaclor (CCL), minocycline, ofloxacin (OFLX} were determined . Against isolates from patients who underwent treatment with RKM, MICs of only 4 drugs (RKM, EM, JM, MOM) were determined . Measurements were made on plasma and urinary concentrations of RKM and its urinary recovery rates after patients including 6 boys with ages between 5 years 1 month and 11 years 6 months were administered with RKM (dry syrup) . Two groups of 6 boys were administered between meals with RKM at dose levels of 5 and 10 mg/kg, respectively . Clinical and bacteriological effects of RKM were evaluated for 175 patients including 5 cases of pharyngitis, 3 tonsillitis, 32 pneumonia, 17 mycoplasmal pneumonia, 34 atypical pneumonia, 28 streptococcal infections, 29 Campylobacter enteritis, 4 Salmonella gastroenteritis, and 23 enteritis due to unknown organisms . Five drop-out cases were excluded from the evaluations . In the evaluable cases, an average dose level used was 31.8 mg/kg/day, with a daily dose divided into 3 to 4 administrations and with an average treatment duration of 9 days . Adverse reactions of RKM and its effects on laboratory test values were investigated in these patients including the drop out cases . Obtained results of these studies are summarized below . 1 . The GA-test produced pH values indicating that amounts of gastric acid were mostly either normal or high in 42 of the 43 subjects tested (97.7%), and only one low acid case (2.3%) was observed.(ABSTRACT TRUNCATED AT 400 WORDS)

Jpn J Antibiot, 1988 Jul, 41(7), 901 - 13
{Laboratory and clinical studies of rokitamycin in pediatric fields}; Nishimura T et al.; We have carried out laboratory and clinical studies on rokitamycin (RKM, TMS-19-Q) . The results are summarized as follows . Serum and urinary concentrations of RKM were determined in 6 children with ages between 6 and 12 years given single oral doses of 5, 10 and 15 mg/kg . Mean serum concentrations peaked at 30 minutes after administration of 5, 10 and 15 mg/kg, and respective peak values were 0.30 microgram/ml, 0.79 microgram/ml and 1.32 micrograms/ml . Biological half-lives for 5, 10 and 15 mg/kg were 2.0 hours, 1.65 hours and 1.36 hours . The 6-hour urinary recovery ranged from 1.11% to 2.58% after administration of 5 mg/kg, and the mean 6-hour urinary recoveries were 1.35% after administration of 10 mg/kg and 2.28% after administration of 15 mg/kg . Therapeutic responses were recorded as excellent or good in 22 (73.3%) of the children, comprising 6 with tonsillitis, 2 with pharyngitis, 4 with bronchitis, 1 with bronchopneumonia, 1 with Mycoplasma pneumonia, 2 with whooping cough, 5 with streptococcal infections, 5 with Campylobacter enteritis, 3 with impetigo and 1 with SSSS . The microbiological effectiveness of RKM on identified pathogens comprising 4 strains of Staphylococcus aureus, 1 strain of Streptococcus pneumoniae, 6 strains of Streptococcus pyogenes, 4 strains of Haemophilus influenzae and 5 strains of Campylobacter spp . was not so satisfactory as evidenced by a eradication rate of 50.0% . No significant side effect due to the drug was observed in any cases . In conclusion, RKM was found to be efficacious and safe for the treatment of bacterial infections in children.

Jpn J Antibiot, 1988 Jul, 41(7), 841 - 53
{Studies on susceptibility of isolated organisms from pediatric infections against various antimicrobial agents}; Fujii R et al.; Twelve oral antimicrobial agents were tested for their antimicrobial activities against causative organisms isolated from pediatric infections . Activities of these antimicrobial agents against Streptococcus pyogenes were also examined in relation to T-antigen typing of the species . The results of the investigation are summarized as follows . 1 . Against Staphylococcus aureus, rokitamycin (RKM), josamycin, ofloxacin, minocycline exhibited strong antimicrobial activities, and few strains of S . aureus showed resistance to these antimicrobial agents . More strains exhibited resistance to erythromycin (EM) than to other macrolide antibiotics (MLs) examined . Amoxicillin (AMPC)-resistance was often observed also . 2 . Against S . pyogenes, beta-lactam antibiotics (beta-lactams) and RKM had MIC80 of 0.20 microgram/ml or below, and no resistant strains of this organism were observed against these antibiotics . Only 2 resistant strains (2.0%) of S . pyogenes to MLs were detected, but resistance to tetracyclines (TCs) was observed at a high frequency, with 71.4% or more strains among T-4, T-6, T-12 and T-28 antigen types exhibited resistance to TCs . Among the 21 strains of T-12 antigen type examined, only one strain (4.8%) was found resistant to MLs . These observations suggested that the reduction in the frequency of ML-resistant strains was not due to the reduction in the number of T-12 antigen type strains but due to losses of resistance factors against MLs of plasmids . 3 . Antibacterial activities of beta-lactams and MLs against Streptococcus pneumoniae strains were good, similarly to activities against S . pyogenes . But many strains of S . pneumoniae were resistant to TCs . 4 . New quinolone antimicrobial agents (quinolones) showed excellent activities against Branhamella catarrhalis strains with EM and RKM showing the next best activities . The number of resistant strains against quinolones, however, seemed to be on an increase . 5 . Quinolones had strong antimicrobial activities against Haemophilus influenzae, few strains of which showed resistance to quinolones . AMPC had the next best activity, but approximately 10% of H . influenzae exhibited resistance to this antibiotic . 6 . Against Campylobacter spp., quinolones and MLs showed the best activities with MIC80 values at or below 0.25 microgram/ml, and no resistant strains of the species against these antimicrobial agents were observed . Fosfomycin and TCs showed somewhat inferior activities to quinolones and MLs, with beta-lactams showing still lower activities . 7 . Only few strains of Mycoplasma pneumoniae and Chlamydia trachomatis were examined, but MLs and TCs appeared to be effective against these organisms.(ABSTRACT TRUNCATED AT 400 WORDS)

Br J Hosp Med, 1988 Jul, 40(1), 27, 30 - 6
A review of Campylobacter pylori in upper gastrointestinal disease; Walker SJ et al.; The organism Campylobacter pylori is frequently found in association with gastritis and peptic ulcer disease . Whether it is the cause, a contributory factor or a simple commensal is not known but there is evidence to support a pathological role . Current research may alter our understanding of the causes of upper gastrointestinal disease and have important implications for treatment.

Baillieres Clin Gastroenterol, 1988 Jul, 2(3), 573 - 91
Bacteria in ulcer pathogenesis; Yeomans ND; A great deal of information about the spiral bacteria of the stomach has accumulated in the past 5 years . These bacteria, currently named Campylobacter pylori but likely to be renamed as a new genus, have adapted to living beneath the mucus layer and above the gastric surface mucous cells . When metaplastic gastric mucous cells are also present in the duodenal bulb, C . pylori may also get a foothold in this latter location . Observations of the high prevalence of C . pylori in patients with gastritis and with duodenal ulcers, and the slightly lower prevalence in patients with gastric ulcer, have led to the hypothesis that the bacteria play an aetiological role in these three conditions . There is now fairly convincing evidence that the organisms can cause active chronic gastritis . The most persuasive of this comes from reports of the rapid development of gastritis and symptoms in two volunteers who swallowed the organism, plus two other series of accidental challenges . Other evidence is provided by the waning and waxing of gastritis, which has been correlated in several studies with clearance followed by recrudescence of the organisms . The role of the bacterium in peptic ulcer is less certain . The present data do not provide strong evidence for a causal role in gastric ulcer, although we cannot rule out that it may be important in some . The very high prevalence in patients with duodenal ulcer, including one series in children (who rarely harbour the organism), raises the distinct possibility that the bacteria play an aetiological role in this form of ulcer . Reports of ulcer healing with antibiotics and of lower recurrence rates in those cleared of the organism, increase the possibility, However, methodological flaws in some studies, plus the usual need for confirmation of key studies, indicate that we should await more definitive evidence before accepting that duodenal ulcer can be an infectious disease.

Am J Trop Med Hyg, 1988 Jul, 39(1), 97 - 102
Foods as a source of enteropathogens causing childhood diarrhea in Thailand; Rasrinaul L et al.; Foods obtained in markets in Bangkok were cultured for bacterial enteric pathogens and examined for their similarity to strains isolated from children under 5 years of age in Bangkok in 1986 . Salmonella was isolated from 17%, Campylobacter from 12%, and enterotoxigenic Escherichia coli (ETEC) from 3% of 510 foods examined . Campylobacter was isolated from 13.5%, ETEC from 13%, and Salmonella from 12% of 1,230 children under 5 years of age with diarrhea . Eighty-eight percent of children infected with Salmonella were infected with serotypes isolated from foods of animal origin . Six percent of children with Salmonella were infected with the same serotype containing plasmids with identical endonuclease restriction patterns as isolates from food . Eighty-seven percent of children with Campylobacter were infected with the same serotypes and biotypes found in food of animal origin . Thirty-one percent of heat-labile enterotoxin (LT) producing ETEC from foods containing genes coding for LT II, but LT II ETEC was not isolated from children . Twenty-one percent of ETEC isolated from foods vs . 53% isolated from children were resistant to 2 or more antibiotics (P less than 0.01) . Salmonella and Campylobacter, but not ETEC, isolated from foods were similar to strains isolated from children . Foods of animal origin are an important source of Salmonella and Campylobacter in Thailand.

Acta Gastroenterol Belg, 1988 Jul-Oct, 51(4-5), 329 - 37
Campylobacter pylori-associated gastritis: attempts to eradicate the bacteria by various antibiotics and anti-ulcer regimens; Glupczynski Y et al.; The efficacy of various antimicrobial and anti-ulcer agents on the eradication of Campylobacter pylori in patients with antral gastritis or duodenal ulcers was investigated by several open studies or double-blind, placebo-controlled protocols . Among the anti-ulcer agents, ranitidine, cimetidine or sucraflate had no effect on C . pylori . Colloidal bismuth subcitrate achieved clearance of C . pylori in 40% of treated patients at the end of therapy but a high relapse rate (14/16 patients) was observed after a 6-month follow-up period . The antibacterial agents doxycycline, minocycline, ofloxacin, clindamycin, paromomycin and nifuroxazide failed to eradicate C . pylori in most patients . By contrast, short term elimination of C . pylori could be achieved in more than 90% of patients treated with amoxycillin . However, relapse occurred as a rule in all amoxycillin-treated patients within one month after therapy . Overall, we observed no correlation between the in-vitro activity of the different antibacterial agents and their in vivo efficacy . Development of resistance during therapy does not seem to account for this discrepancy since it occurred only with ofloxacin . On the basis of these results, we conclude that long term eradication of C . pylori from the gastric antrum cannot be achieved after monotherapy either with antibiotics or with bismuth salts.

J Clin Microbiol, 1988 Jul, 26(7), 1411 - 3
Identification of an antigen common to different species of the genus Campylobacter; Mills SD et al.; Affinity-purified antibody specific for a determinant on flagellin from Campylobacter jejuni was used to screen by immunoblotting strains of C . coli, C . laridis, C . fetus, "C . upsaliensis," C . pylori, and C . sputorum biovar fecalis . The antigen was detected in each of these species, but the molecular weights of the proteins bearing the common antigen varied considerably.

JAMA, 1988 Jun 24, 259(24), 3567 - 70
Escherichia coli O157:H7, an emerging gastrointestinal pathogen . Results of a one-year, prospective, population-based study; MacDonald KL et al.; To examine the incidence of Escherichia coli O157:H7 enteric infections in the United States and to evaluate the vehicles of transmission for sporadic cases, we conducted a one-year, population-based study at a large health maintenance organization (HMO) in the Puget Sound area of Washington State . All stool specimens submitted for culture to the HMO laboratory were screened for E coli O157:H7; the organism was identified in 25 (0.4%) of 6485 stool specimens . All patients with E coli O157:H7 identified had diarrhea; 24 patients (96%) had bloody diarrhea . Exposure histories demonstrated that rare ground beef was consumed more often by patients (21%) than by age-matched control subjects (4%) in the week before onset of illness . Raw milk also was consumed by two patients but by none of the control subjects . Incidence rates for laboratory-confirmed enteric infections in the HMO population were as follows: Campylobacter, 50/100,000 person-years; Salmonella, 21/100,000 person-years; E coli O157:H7, 8/100,000 person-years; and Shigella, 7/100,000 person-years . The organism is a more common pathogen in the United States than is generally recognized, and the diagnosis should be considered for patients with suspected enteric infection.

Dtsch Med Wochenschr, 1988 Jun 10, 113(23), 923 - 9
{Bismuth subsalicylate treatment in chronic Campylobacter pylori-associated erosive gastritis}; Malfertheiner P et al.; In a prospective open study 21 patients with upper abdominal complaints and chronic active gastritis as well as endoscopically proven erosions were treated with bismuth subsalicylate (4 X 30 ml/day, corresponding to 4 X 314 mg Bi3+) for three weeks . In 20 patients (95%) Campylobacter pylori (CP) was found in at least two of three examinations (culture, CLO quick-test, special histology) . After the treatment 17 of 21 patients (81%) were CP negative, and the clinical symptoms had gradually disappeared . The histologically demonstrated degree of activity had regressed significantly after the three-week treatment; in 90% of patients the inflammatory process had completely abated . These results demonstrate that bismuth subsalicylate is highly effective in the acute treatment of CP-associated chronic erosive gastritis.

Vet Rec, 1988 Jun 4, 122(23), 554 - 7
Serological diagnosis of the porcine proliferative enteropathies: implications for aetiology and epidemiology; Lawson GH et al.; Campylobacter mucosalis and C hyointestinalis have been associated with the proliferative enteropathies of pigs . An examination of the antibody response to these organisms and to the intracellular campylobacter-like organism was undertaken . Antibody to the campylobacter-like organism was predominantly IgM, short lived, and could be detected by an immunofluorescence test using bacteria released from lesions as antigen . The majority (75 per cent) of pigs with proliferative enteropathy at necropsy were antibody positive and a small number (4 per cent) of pigs in which lesions were not observed were found to have antibody . Antibody appeared to be correlated with the presence of lesions rather than with exposure to infection and was independent of the presence of antibody to C mucosalis or C hyointestinalis . In natural outbreaks of the disease antibody to the campylobacter-like organism was more prevalent than clinical signs in the affected animals.

Lab Anim Sci, 1988 Jun, 38(3), 262 - 5
Campylobacter jejuni/coli in commercially reared beagles: prevalence and serotypes; Fox JG et al.; A 5 year longitudinal study involving 187 commercially reared beagles from three suppliers was undertaken to determine prevalence and serotypes of Campylobacter jejuni and C . coli . Campylobacter jejuni or C . coli was isolated from the feces in 62 of 177 asymptomatic beagles and 8 of 10 dogs with diarrhea for an overall prevalence of 37% . A total of 36 isolates were serotyped on the basis of thermostable antigens with 20 antisera prepared against frequently occurring serotypes isolated from humans with campylobacter associated enteritis (15 C . jejuni, 5 C . coli serotypes) . Of these isolates, 17 (47%) serotyped with antisera to 7 C . jejuni serotypes frequently isolated in human cases of enteric campylobacteriosis (serotypes 1, 4, 10, 16, 18, 19, 37) . One C . coli reacted to antisera 24, 34, 37, one strain of C . coli to antisera type 37, and another C . coli to antisera type 34 . All three C . coli belonged to serotypes frequently encountered in diarrheic human patients.

Eur J Epidemiol, 1988 Jun, 4(2), 154 - 7
Susceptibility of clinical isolates of Campylobacter pylori to 24 antimicrobial and anti-ulcer agents; Glupczynski Y et al.; Forty-nine isolates of Campylobacter pylori were tested for their susceptibility to twenty antibiotics and four anti-ulcer agents by an agar dilution technique . Penicillin and amoxycillin were the most active drugs (MIC90, 0.06 microgram/ml); erythromycin, cefazolin, minocycline, ciprofloxacin, ofloxacin and gentamicin were slightly less active (MIC90, less than or equal to 1 microgram/ml) . Moderate activity was found for doxycyclin, rifampin, nitrofurantoin, norfloxacin, pefloxacin, enoxacin, paromomycin, metronidazole and tinidazole . All strains were resistant to trimethoprim (MIC greater than 512 micrograms/ml) . Nalidixic acid (MIC90, greater than 256 micrograms/ml) and colistin (MIC90, greater than 64 micrograms/ml) had little to no activity . Of four anti-ulcer drugs, only bismuth subcitrate showed activity (MIC90, 64 micrograms/ml) . Strains resistant to all 4-quinolones were found in patients who had previously received ofloxacin as part of a clinical trial aimed at eradication of C . pylori . These isolates remained susceptible to amoxycillin, tetracyclines and to other classes of antibiotics.

Scand J Gastroenterol, 1988 Jun, 23(5), 585 - 90
Evidence for weakening of gastric mucus integrity by Campylobacter pylori; Sarosiek J et al.; The role of Campylobacter pylori in weakening the mucus component of the gastric mucosal barrier was investigated . The extracellular material elaborated by C . pylori, cultured from antral mucosal biopsy specimens of patients undergoing gastroscopy, caused a rapid degradation of mucus glycoprotein polymer to glycopeptides comparable in size to those produced by the action of pepsin . Viscosity measurements showed that incubation of C . pylori filtrate with gastric mucus led to a gradual loss in mucus viscosity, which at the end of 48 h decreased by 36% . The C . pylori filtrate also had a detrimental effect on the ability of mucus to retard the diffusion of H+ . After 12 h of incubation the permeability of mucus to H+ increased by 10%, whereas a 32% increase in permeability was observed after 48 h . The results suggest that the degenerative changes produced in gastric mucus gel by C . pylori may be a contributing factor in the pathogenesis of gastritis and peptic ulcer.

Onderstepoort J Vet Res, 1988 Jun, 55(2), 85 - 7
The isolation of Campylobacter hyointestinalis from a pig in South Africa; van der Walt ML et al.; The isolation of a strain of Campylobacter hyointestinalis from a piglet is described . The animal originated from a farm where another animal showed signs of intestinal adenomatosis . The animal from which the isolation was made had diarrhoea, and an enteropathogenic Escherichia coli was also isolated . No pathological changes indicative of intestinal adenomatosis were detected in this animal.

Arch Dis Child, 1988 Jun, 63(6), 654 - 5
Campylobacter pylori gastritis; Mahony MJ et al.; Campylobacter pylori colonisation of the stomach is strongly associated with type B non-autoimmune gastritis in adults . In a retrospective study of 38 gastric biopsy specimens taken during upper gastrointestinal endoscopy in children attending this hospital we found C pylori in nine (24%) . Ten biopsy specimens showed histological evidence of gastritis and C pylori was found in eight.

J Med Microbiol, 1988 Jun, 26(2), 93 - 9
Cytotoxic activity in broth-culture filtrates of Campylobacter pylori; Leunk RD et al.; Broth-culture filtrates of Campylobacter pylori induced non-lethal cytopathic effects in vitro in 7 of 9 mammalian cell lines tested . Transmission electronmicroscopy revealed that the response consisted of intracellular vacuolisation . Intestine 407 cells were among the most responsive and were used for routine assay . About 55% of isolates of C . pylori tested, originating from four geographic regions worldwide, produced cytotoxic activity . The activity was neutralisable by specific antisera to broth-culture filtrates or to sonicated bacteria but not by antisera to other bacterial preparations . Cytotoxic activity was heat-labile (70 degrees C for 30 min), was protease-sensitive and ammonium-sulphate precipitable . It did not pass through an ultrafiltration membrane with a nominal mol.-wt limit of 100 X 10(3) . It was concluded that C . pylori can produce a factor that alters cultured cells in vitro . The relevance of this factor to the pathogenesis of gastritis associated with C . pylori remains to be determined.

J Med Microbiol, 1988 Jun, 26(2), 87 - 91
Enterotoxigenicity of chicken isolates of Campylobacter jejuni in ligated ileal loops of rats; Saha SK et al.; Ligated ileal loops in rats of the Charles-Foster strain, weighing 200-250 g and aged 7-8 months, provided a sensitive and reproducible means of testing the enterotoxigenicity of Campylobacter jejuni . All of 16 chicken isolates caused fluid accumulation comparable to that produced by toxigenic Vibrio cholerae O1, strain 569B . However, 11 of the isolates required one to three consecutive passages through the rat gut before doing so . The amount of fluid produced increased after each passage . Of three culture media tested, brucella broth of pH 6.7 supported the highest degree of enterotoxigenesis . Filtrates of cultures of all 16 chicken isolates in this medium were as effective as viable C . jejuni in producing fluid in ileal loops . The enterotoxin was neutralised completely by cholera antitoxin diluted 1 in 160, indicating its close immunobiological relationship to cholera toxin.

J Clin Pathol, 1988 Jun, 41(6), 653 - 9
Immunoblot analysis of immune response to Campylobacter pylori and its clinical associations; von Wulffen H et al.; Systemic immune response to Campylobacter pylori was detected by the immunoblot technique in serum samples from 200 patients, 129 blood donors, and 96 children . The results of the IgG immunoblot test showed excellent correlation with the detection of C pylori by culture and also with histopathological examination of the antrum, as well as with peptic ulcer disease . An IgA response also occurred and gave results comparable with those of the IgG immunoblot test, although on a quantitatively lower scale . The IgM immunoblots were of no help in the serodiagnosis of C pylori infection . The protein bands that seemed to be the most specific for C pylori and which were consistently observed in patients positive for C pylori were a 110 kilodalton and a 63 kilodalton band on the IgG immunoblot and an 89 kilodalton band on the IgA immunoblot . A 94 kilodalton and a 28 kilodalton band were also included in the evaluation . While immunoblot analysis may be used effectively for the serodiagnosis of C pylori infection and can distinguish between patients with normal antrum mucosa and those with gastritis, the test does not help to distinguish between those patients with antrum gastritis who subsequently develop peptic ulcers and those who do not.

Infect Immun, 1988 Jun, 56(6), 1560 - 6
Chemotactic behavior of Campylobacter jejuni; Hugdahl MB et al.; The chemotactic behavior of Campylobacter jejuni was determined in the presence of different amino acids, carbohydrates, organic acids, and preparations and constituents of mucin and bile . L-Fucose was the only carbohydrate and L-aspartate, L-cysteine, L-glutamate, and L-serine were the only amino acids producing a chemotactic (positive) response . Several salts of organic acids, including pyruvate, succinate, fumarate, citrate, malate, and alpha-ketoglutarate, were also chemoattractants, as were bile (beef, chicken, and oxgall) and mucin (bovine gallbladder and hog gastric) . Most constituents of bile tested individually were chemorepellents, but the mucin component was chemoattractant . The chemotactic behavior of C . jejuni toward L-fucose, a constituent of both bile and mucin, may be an important factor in the affinity of the organism for the gallbladder and intestinal tract.

Dig Dis Sci, 1988 Jun, 33(6), 649 - 53
Prevalence of Campylobacter pylori and association with antral mucosal histology in subjects with and without upper gastrointestinal symptoms; Pettross CW et al.; To determine the incidence and significance of Campylobacter pylori in patients undergoing routine endoscopic evaluation at this hospital, biopsies of the antrum were obtained from 132 patients and from 15 asymptomatic volunteers . Specimens were cultured and silver stained for the presence of C . pylori and were examined histologically . C . pylori was detected in 67 (51%) patients and two (13%) volunteers (P = 0.006) . In patients, C . pylori was found significantly more often when the mucosa was inflamed (67%) than when the mucosa was normal (13%), and both volunteers with C . pylori had chronic gastritis on histological examination . When compared to the volunteers, patients with upper gastrointestinal symptoms had a significantly increased prevalence of antral inflammation, even if the endoscopic examination was normal . C . pylori is infrequently found in young asymptomatic adults but is found in both asymptomatic volunteers and patients in association with all forms of histological antral gastritis which is prevalent in patients with both normal endoscopic findings and peptic ulcer disease.

Arch Neurol, 1988 Jun, 45(6), 655 - 6
Campylobacter diarrhea and Guillain-Barré syndrome; Ropper AH; Four of 106 consecutive patients with acute Guillain-Barre syndrome had preceding bacterial enteritis caused by Campylobacter jejuni . One had a severe illness with axonal damage and poor outcome; three had typical courses with good recovery . Preceding illnesses in the other 102 patients were the following: diarrhea in nine (with negative stool cultures in five), upper respiratory tract infections in 46, hepatitis in six, other infectious illnesses in eight, and none in 33 . Eight patients previously reported with Campylobacter associated with Guillain-Barre syndrome, and the serologic and clinical diagnosis of Campylobacter enteritis in this context, are reviewed.

South Med J, 1988 Jun, 81(6), 802 - 3
Campylobacter fetus endocarditis on a prosthetic heart valve; Caramelli B et al.; Campylobacter fetus infection in man is rare . Few cases of Campylobacter endocarditis have been described, and none have been associated with a prosthetic heart valve . We have reported a case of Campylobacter fetus ssp fetus on a prosthetic mitral valve in a 48-year-old woman who was treated successfully with penicillin and streptomycin (and later with gentamicin) . Replacement of the prosthetic valve was done because of stenosis and vegetations . Pathologic examination showed vegetations on a calcified prosthesis, but no bacteria were seen.

Ann Intern Med, 1988 Jun, 108(6), 865 - 79
Non-ulcer dyspepsia: potential causes and pathophysiology; Talley NJ et al.; Dyspepsia, defined as chronic or recurrent upper abdominal pain or nausea, is a common occurrence . Dyspepsia without an ulcer (non-ulcer dyspepsia) is diagnosed in patients at least twice as often as peptic ulceration . Diseases that may present with similar symptoms include gastroesophageal reflux, biliary tract disease, chronic pancreatitis, and irritable bowel syndrome . A careful history and physical examination, supplemented by selected tests, usually lead to a correct diagnosis . The pathogenesis of non-ulcer dyspepsia remains unknown . Gastric acid secretion, duodenogastric reflux, psychological factors, environmental exposures, and heredity probably do not play a major role . Some patients may have motility disturbances, but whether these disturbances cause dyspepsia is unknown . Campylobacter pylori infection and associated gastritis are common in non-ulcer dyspepsia, but their etiologic role is controversial, as is the importance of chronic duodenitis . By recognizing the heterogeneity of patients who present with non-ulcer dyspepsia, more rational management may be possible . Although an empiric trial of antacids or H2 blockers has been recommended to treat dyspepsia, most controlled trials show that although these substances reduce severity of symptoms, they are no more effective than placebos in non-ulcer dyspepsia.

Jpn J Antibiot, 1988 Jun, 41(6), 720 - 38
{Bacteriological, pharmacokinetic and clinical studies on a rokitamycin dry syrup in the pediatric field}; Toyonaga Y et al.; Bacteriological, pharmacokinetic and clinical studies were done on the effect of rokitamycin (RKM, TMS-19-Q) in the field of pediatrics . The results are summarized below . 1 . Antibacterial activities Antibacterial activities of RKM against Staphylococcus aureus (including 50 methicillin-sensitive and 50 methicillin-resistant strains), 18 strains of Haemophilus influenzae and 50 strains of Campylobacter jejuni were studied comparatively with activities of josamycin (JM), midecamycin (MDM), erythromycin (EM) and cefaclor (CCL) or ampicillin . Minimum inhibitory concentrations (MICs) of the 5 antibiotics against methicillin-sensitive S . aureus showed a wide variation but RKM was somewhat superior among them . MIC80 of those antibiotics tested against methicillin-sensitive S . aureus were as follows; RKM 1.56, JM 12.5, MDM 12.5, EM 6.25, and CCL 3.13 micrograms/ml . Among methicillin-resistant S . aureus (MRSA), ratios of strains highly resistant to these antibiotics (MIC greater than or equal to 100 micrograms/ml) to total number of strains tested were: 18% to RKM, and 26%, 34% and 48% to JM, MDM and EM, respectively, again showing the superiority of RKM and the proliferation of resistant organisms to EM . MICs of RKM against H . influenzae were distributed in a range between 0.78 and 12.5 micrograms/ml, which were similar to MIC range of CCL, and approximately twice as high as that of EM, but 4 folds lower than those of JM and MDM . Against C . jejuni, the MIC range of RKM was quite broad, 0.10-12.5 micrograms/ml, with a peak value of 0.20 micrograms/ml . The cumulative number of strains vs . MIC curve was similar to that of EM, and RKM was approximately 4 to 8 folds more effective than the other 3 antibiotics . 2 . Absorption and excretion The absorption and the excretion of RKM were studied with its dry syrup preparations . Dose levels examined were 5 mg/kg in 2 cases, 10 mg/kg in 7 cases, 15 mg/kg in 2 cases and 20 mg/kg in 1 case . Peak concentrations of RKM in blood were not dose-dependent and were 0.16-0.23, 0.29-0.91, 0.35-0.46 microgram/ml and 0.53 microgram/ml, respectively, for the 4 dose levels . Most of drug levels dropped below the detection limit in 4 hours after the administration when dose levels up to 10 mg/kg were used, and when dose levels were at or above 15 mg/kg, 0.07-0.09 microgram/ml of RKM was detected in blood at 6 hours after the administration . Urinary recovery rates in 6 hours were between 0.19 and 3.31%.(ABSTRACT TRUNCATED AT 400 WORDS)

Jpn J Antibiot, 1988 Jun, 41(6), 745 - 54
{A clinical study of rokitamycin in pediatrics}; Sunakawa K et al.; A total of 29 patients with pediatric infections was treated orally with 21.4-44.4 mg/kg/day of rokitamycin (RKM) dry syrup . The obtained results are summarized as follows . 1 . Clinical responses to RKM in 24 evaluable patients were excellent in 2 and good in 3 of 5 patients with tonsillitis and laryngitis; excellent in 3 and good in 5 of 8 patients with bronchitis; excellent in 3, good in 2 and fair in one of 6 patients with bronchopneumonia; excellent in 2 and good in the other of 3 patients with psittacosis; and excellent in 2 of 2 patients with Campylobacter colitis . The overall efficacy rate was 95.8% . 2 . Bacteriological responses to the drug were: reduction in 1 and no change in the other of 2 strains of Streptococcus pyogenes; eradication of a strain of Streptococcus pneumoniae and 2 strains of Staphylococcus aureus; eradication of 2 and no change in 3 of 5 strains of Haemophilus influenzae; and eradication of 2 out of 2 strains of Campylobacter spp . 3 . Diarrhea was complained of as an adverse reaction to the RKM medication by 1 patient, abdominal pain was reported by another, and anorexia by another of the 27 patients treated . Laboratory examination was performed on some patients, but not abnormal test values were found except in 1 case showing an increase in platelet count from 27.6 to 78.2 X 10(4)/mm8 . The results suggested that RKM dry syrup might be a very useful and safe drug for the treatment of pediatric infections.

Jpn J Antibiot, 1988 Jun, 41(6), 712 - 9
{Studies on efficacy, safety and dosage of rokitamycin in the treatment of pediatric infections}; Hirosawa H et al.; The usefulness of a new macrolide antibiotic rokitamycin (RKM, TMS-19-Q) was evaluated in the field of pediatrics . 1 . Twenty seven patients were enrolled in the study . One patient was excluded from the study because the illness was due to a viral infection . They included 14 boys and 13 girls with ages 7 months to 9 years 11 months . 2 . The patients were treated with RKM at daily doses ranging 19.2-41.1 mg/kg, divided into 3 equal portions . The administration was done orally at fasting, lasting 2-15 days, with total doses of 22.2-500.0 mg/kg . 3 . The patients were diagnostically classified into the following categories: 9 with acute pharyngitis, 15 with acute bronchitis, and one each with pneumonia, purulent lymphadenitis and Campylobacter enteritis . 4 . The clinical response to the treatment was good or excellent in 22 of the patients with an overall efficacy rate of 81.5% . An efficacy rate of 88.9% was achieved for the patients with acute pharyngitis, 80.0% for those with acute bronchitis, and 100% for the patient with purulent lymphadenitis and the patient with Campylobacter enteritis . From the patient with pneumonia whose response was evaluated "fair" was Haemophilus influenzae isolated by culturing pharyngeal material . This organism was found resistant to RKM by the disk method . 5 . Bacteriological responses were as follows; of 26 isolates presumed to be pathogens, 9 were eradicated, 5 decreased, 7 unchanged and 5 unknown, with an eradication rate of 42.9% . 6 . Neither adverse reactions nor abnormal changes in laboratory findings were observed with the medication in any patients during and after the end of the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Jpn J Antibiot, 1988 Jun, 41(6), 696 - 711
{Bacteriological, pharmacokinetic and clinical studies of a rokitamycin syrup in pediatrics}; Sato H et al.; Rokitamycin (RKM) dry syrup was administered to a group of pediatric patients . The results obtained are summarized as follows . 1 . Of the recent isolates of Streptococcus pyogenes, fewer strains were highly resistant to RKM than to josamycin (JM), midecamycin (MDM), erythromycin and lincomycin . Also, macrolides (MLs)-resistant strains proved to be susceptible to RKM . 2 . Recent isolates of Staphylococcus aureus, Streptococcus agalactiae, group G Streptococci, S . pyogenes, Streptococcus pneumoniae and Haemophilus influenzae were more susceptible to RKM than to midecamycin acetate and JM . Oral administrations of 10-15 mg/kg of the drug were followed by its peak concentrations of 0.07-0.77 micrograms/ml in the blood at 30 minutes in many patients, and by an undetectable level at 6 hours also in many of them . T1/2 values were 1.2-2.6 hours, and first 6-hour urinary excretion rates were 1.26-1.74% . 3 . Fifty-two patients with acute upper and lower respiratory tract infections, Campylobacter enteritis, etc . were treated with RKM at about 20-40 mg/kg daily for 4-14 days, with an overall efficacy rate of 88.5% . 4 . An eradication rate of 81.4% was achieved for 43 strains of 7 species isolated from the patients . 5 . No abnormal laboratory test values were observed after treatment with drug 4 approximately 14 days . A side effect, stomach discomfort, was observed in 1 patient.

Jpn J Antibiot, 1988 Jun, 41(6), 686 - 95
{Clinical and pharmacokinetic studies of rokitamycin in children}; Meguro H et al.; Rokitamycin dry syrup (RKM), a new macrolide antibiotic preparation, was evaluated for its safety, efficacy and pharmacokinetics in 19 children . RKM was effective in mycoplasmal pneumonia, Chlamydia trachomatis pneumonitis and Campylobacter gastroenteritis . Efficacies of RKM in streptococcal pharyngitis and Haemophilus influenzae pneumonia, however, were insufficient . Pharmacokinetic observations seemed to indicate that RKM achieved higher blood concentrations than older macrolides, but a large individual variation was observed . Diarrhea which was the only type of side effect observed in our cases, was encountered in 2 of 17 evaluable cases . From these data, RKM seems to have a place in the treatment of pediatric infectious diseases.

Jpn J Antibiot, 1988 Jun, 41(6), 646 - 62
{Appraisal of rokitamycin in the pediatric field}; Fujii R et al.; In a study of rokitamycin (RKM) dry syrup for its usefulness in pediatric infections, the following results were obtained: 1 . Frequencies of RKM-resistant strains among fresh isolates from sick children were very low, and 4.4% of 68 isolates of Staphylococcus aureus, 4.2% of 48 isolates of Streptococcus pneumoniae, and none of 96 isolates of Streptococcus pyogenes were found to be RKM-resistant . 2 . Hypo- to achlorhydria was found in 2 (3.77%) of 53 children . 3 . When children were administered once orally with 5, 10 and 15 mg/kg of RKM dry syrup at fasting, mean peak values of plasma concentration were 0.25, 0.55 and 0.74 micrograms/ml with a T1/2 (beta) of 2.18, 1.97 and 2.00 hours, respectively . Urinary recovery rates during the first 0-6 hours were quite low, and values were 1.21, 1.38 and 2.23%, respectively . 4 . The clinical efficacy of RKM dry syrup was studied on children chiefly with acute pneumonia, mycoplasmal pneumonia and tonsillitis . Among 379 children from whom pathogens had been determined, responses to the treatment were excellent in 186, good in 144, fair in 24, poor in 20 and unknown in 5 patients, the overall efficacy rate being 88.2% . Among all 598 treated patients, including those with undetermined pathogens, responses were excellent in 247, good in 269, fair in 42, poor in 35 and unknown in 5 patients, the efficacy rate being 87.0% . 5 . The clinical efficacy of the drug in treating Chlamydia infection in 12 patients including a Chlamydia carrier and the clinical efficacy in treating Campylobacter enteritis in 36 patients were studied . All the cases showed "good" responses . Among 66 patients with mycoplasmal pneumonia, responses were excellent in 33 and good in 27 patients, with an efficacy rate of 90.9% . 6 . The optimal dose of RKM dry syrup seemed to be in the range between 20 and 40 mg/kg . It appeared, however, that a dose of about 40 mg/kg would be required to eradicate the pathogen from the pharynx in S . pyogenes infection . 7 . Adverse reactions to RKM dry syrup were found in 9 (1.45%) of 622 patients . The reactions were gastrointestinal symptoms except eruption occurred in 1 patient, but they were all mild . Laboratory examinations revealed eosinophilia in 19 and abnormal hepatic enzyme activities in 8 of 455 patients studied, but such abnormalities were all transient and mild.

Microb Pathog, 1988 Jun, 4(6), 455 - 62
Production of a Shiga-like cytotoxin by Campylobacter; Moore MA et al.; Cell lysates and culture supernatants of 36 Campylobacter isolates from patients with enteritis were tested for cytotoxic activity on HeLa cells . Cytotoxic activity was considered Shiga-like if neutralized by monoclonal antibody to the B subunit of Shiga-like toxin I of Escherichia coli and rabbit anti-Shiga toxin . Fifteen of the Campylobacter isolates produced no detectable cytotoxin, 10 produced a non-neutralizable cytotoxin, and 11 produced low levels of a cell-associated SLT . However, under low stringency conditions no hybridization was observed between a DNA fragment containing cloned SLT-I genes and restriction enzyme-digested total DNA from a Campylobacter strain that produced low levels of a Shiga-like toxin I . The Shiga-like toxin neutralizing titers in sera from 15 patients with C . jejuni infections, 5 patients infected with S . sonnei, and 20 healthy persons were then determined . No rise in neutralizing titer between acute and convalescent sera of patients with C . jejuni infection or S . sonnei infection was observed, although 27% of C . jejuni-infected patients, 40% of S . sonnei-infected patients, and 30% of the healthy controls had neutralizing activity in their sera . These data indicate that low levels of Shiga-like toxin are produced by some Campylobacter isolates but that SLT is genetically distinct from the SLT-I toxin produced at high levels by certain E . coli . The findings also suggest that exposure to SLTs is common in the adult population but not as a consequence of infection with C . jejuni or S . sonnei.

Dan Med Bull, 1988 Jun, 35(3), 282 - 5
Distribution of Campylobacter pylori in dyspeptic and non-dyspeptic gastroenterologic patients; Hansen IM et al.; The presence of Campylobacter pylori (Cp) in antral biopsies from patients undergoing routine gastroscopy or ERCP was determined by microbiological and histological methods and correlated to the histopathology . 322 endoscopies were performed . Of 125 Cp positives only one did not present with histopathological evidence of gastritis . In patients with gastritis the percentage positive for Cp was highest (88.6) in severe gastritis . We also found a highly significant correlation of Cp to all types of ulcers . There was good agreement between microbiologically and histologically demonstrated Cp . Our findings were in agreement with previously published reports.

Vet Microbiol, 1988 Jun, 17(2), 179 - 91
Infection of established cell lines with Campylobacter mucosalis; Rajasekhar M et al.; Campylobacter mucosalis (CM) and other Campylobacter spp . mainly from cases of the porcine proliferative enteropathies were used to infect cell line cultures . CM attached to and persisted intracellularly in PK (15), MDBK, BHK, HeLa, INT-407 and other cells; in PK (15) this infection resulted in a marked cytopathic effect and total destruction of the cell culture in 10 days . MDBK, INT-407, BHK and HeLa cultures were more resistant to the effects of infection . CM did not adhere to Vero, LLCMK2 or CEF cells and no cytopathic changes took place . The other Campylobacter spp tested did not attach to cell cultures and cell death occurred within 4 days . Attempts to passage CM were unsuccessful due to a decrease in the number of bacteria at each passage.

Eur J Clin Microbiol Infect Dis, 1988 Jun, 7(3), 388 - 93
Human serum antibody response in Campylobacter jejuni enteritis as measured by enzyme-linked immunosorbent assay; Herbrink P et al.; An ELISA for detection of IgG, IgA, and IgM antibody using an acid-glycine extract from Campylobacter jejuni as antigen was developed . To determine the value of this assay for the diagnosis of acute Campylobacter jejuni infections, the IgG, IgA, and IgM immune response against Campylobacter jejuni was investigated at various timepoints after infection in patients with culture-proven infection . A total of 112 sera from 46 patients and 78 sera from a control group were tested . All but one of the 46 patients with culture-proven Campylobacter jejuni enteritis developed IgG antibodies against Campylobacter jejuni . IgA and IgM ELISA both showed 97% specificity, and sensitivity of 63% and 30% respectively . IgG antibody titers generally remained at a constant level for more than 50 days, whereas IgA and IgM antibody titers declined more rapidly to normal values within 30 to 50 days after onset of clinical symptoms . Detection of Campylobacter jejuni specific IgA antibodies in a single serum sample provided the most useful assay for serological diagnosis of Campylobacter jejuni enteritis . The presence of Campylobacter jejuni specific IgM antibodies was the sole diagnostic criterion in three cases . Serological diagnosis of Campylobacter jejuni enteritis should therefore include both IgA and IgM antibody determination.

Infect Dis Clin North Am, 1988 Jun, 2(2), 475 - 84
Infections due to encapsulated bacteria, Salmonella, Shigella, and Campylobacter; Chaisson RE; Bacterial infections occur often in HIV-infected patients . Defects in both cell-mediated and humoral immunity are associated with an increased frequency of infections due to encapsulated and enteric bacteria . Pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and other pathogens may occur early in the course of AIDS and have typical clinical presentations . Bacteremia is extremely common, and patients frequently fail to develop protective elevations in specific antibodies following infection . Recurrences are noted in up to one third of patients, and suppressive antimicrobial therapy may be required . The frequency of salmonellosis is increased as much as 20-fold in AIDS patients and is associated with bacteremia in more than 40 per cent of cases . Salmonella, Shigella, and Campylobacter infections in HIV-infected individuals may precede an AIDS diagnosis, may fail to respond to appropriate therapy, or may recur after completion of treatment . Prevention of bacterial infections with antibiotics or immunotherapy, or both, is recommended for children with AIDS or ARC.

Pathol Biol (Paris), 1988 Jun, 36(5 Pt 2), 675 - 7
{Sensitivity of Campylobacter to 2 new groups of beta-lactams}; Belbouri A et al.; One hundred strains of Campylobacter (44 C . jejuni, 34 C . coli, and 22 C . fetus ssp . fetus) were tested with two new groups of beta-lactams:monobactams (azthreonam and carumonam) and carbapenem (imipenem) . MICs were determined by using an agar dilution technique . The monobactams were not effective against Campylobacter species . In contrast, imipenem showed a high activity (MIC 90, 0.25 mg/l) . Clinical trials will indicate if this compound can be used in the therapy of severe Campylobacter infections.

Antimicrob Agents Chemother, 1988 Jun, 32(6), 945 - 8
Dispersal in Campylobacter spp . of aphA-3, a kanamycin resistance determinant from gram-positive cocci; Papadopoulou B et al.; DNA annealing studies indicated that kanamycin resistance in Campylobacter strains from various geographical areas is encoded by a gene structurally related to aphA-3 of gram-positive cocci . This finding confirms the transfer of genetic material between gram-positive and gram-negative bacteria under natural conditions.

J Clin Gastroenterol, 1988 Jun, 10(3), 247 - 8
Problems with clinical trials on Campylobacter pylori; Carrick J; Clinical trials investigating Campylobacter pylori infection have proven difficult to conduct and to interpret . Those trials examining the relapse rates of duodenal ulcer disease among subjects in whom C . pylori infection has been eradicated have shown a significant reduction in recurrence rates . However, since the Bismuthate compounds used in these trials have cytoprotective ulcer-healing properties, reduced relapse rates cannot be attributed to antibiotic activity alone . Those trials examining infective gastritis and "nonulcer dyspepsia" are hampered by the ill-defined nature of this entity, "dyspepsia," and by the subjective end-points of these trials.

J Med Microbiol, 1988 Jun, 26(2), 101 - 5
The effect of campylobacter lipopolysaccharide on fetal development in the mouse; O'Sullivan AM et al.; Purified lipopolysaccharide (LPS) obtained from isolates of Campylobacter fetus ss . fetus and Campylobacter jejuni impaired fetal development when administered to mice on day 13 of pregnancy . Strikingly more fetal resorption was produced by C . jejuni LPS than by similar amounts of C . fetus ss . fetus LPS . Three of the four Campylobacter strains examined produced LPS that had no effect on maternal health, but LPS from one C . jejuni strain killed all of the mice to which it was administered.

APMIS, 1988 Jun, 96(6), 568 - 70
In vitro susceptibility of diarrhoea producing gram negative enteric bacteria to sulfasalazine, 5-aminosalicylic acid, sulfapyridine and four quinolones . Brief report; Andreasen JJ et al.; The in vitro susceptibility of diarrhoea producing Gram negative enteric bacteria to sulfasalazine, 5-aminosalicylic acid, sulfapyridine and four quinolones was investigated using an agar dilution method . All strains were resistant to 1600 micrograms/ml of sulfasalazine and 5-aminosalicylic acid . MIC range of sulfapyridine for Y . enterocolitica was 3.1-25 micrograms/ml (median:6.2) and for Salmonella 25-100 micrograms/ml (median: 100) Campylobacter jejuni/coli were less susceptible to sulfapyridine with MIC values ranging from 200 to 800 micrograms/ml . Shigella and three of five E . coli strains were resistant to 1600 micrograms/ml of sulfapyridine . Two strains of E . coli were inhibited by 25 micrograms/ml . All strains were fairly susceptible to enoxacin, ciprofloxacin, pefloxacin and ofloxacin . Cirpofloxacin was the most active drug on weight basis.

APMIS, 1988 Jun, 96(6), 559 - 64
Campylobacter pylori detected by indirect immunohistochemical technique; Andersen LP et al.; An immunohistochemical assay for staining C . pylori is described . The method is compared with cultivation of C . pylori and observation of campylobacter-like organisms (CLOs) in hematoxyline-eosine (HE) stained sections . Eighteen biopsies from which C . pylori was cultivated but not seen in HE stained sections and three culture negative biopsies with CLOs seen in HE stained sections were selected from 331 biopsies including 113 culture positive biopsies . There were agreements between cultivation of C . pylori and CLOs seen in HE stained sections in the remaining 310 biopsies . Fourteen of the 18 and one of the three biopsies were found positive by the immunohistochemical assay . In addition 21 culture-positive control biopsies and one of 18 culture-negative control biopsies were also found positive . When the immunohistochemical assay was compared with cultivation the predictive value of positive result is 93% and of negative result 89% . By this method we were able to detect single organisms and no cross-reactions to other curved bacteria on the gastric epithelium were observed.

J Biol Chem, 1988 May 5, 263(13), 6416 - 20
Purification and characterization of a family of high molecular weight surface-array proteins from Campylobacter fetus; Pei Z et al.; A variety of Gram-negative and Gram-positive bacteria possess crystalline surface layers, although little is known of their function . We previously have shown that the high molecular weight surface-array proteins of Campylobacter fetus are important in both the pathogenicity and antigenicity of this organism . For biochemical and immunological characterization, we purified high molecular weight (100,000, 127,000, 149,000) surface-array proteins from three C . fetus strains using sequential gel filtration and ion exchange high performance liquid chromatography . These proteins are acidic with pI values between 4.12 and 4.25 and contain large proportions of acidic amino acids (19.7%-22.0%) in addition to hydrophobic amino acids (37.3%-38.5%) . They share a novel amino-terminal sequence through at least 19 residues . Carbohydrate analysis using periodic acid-Schiff staining and treatment with trifluoromethanesulfonic acid shows no evidence of glycosylation . Antiserum to a purified Mr = 100,000 protein from C . fetus 82-40 LP cross-reacts with three other purified C . fetus surface-array proteins by enzyme-linked immunosorbent assay with titers greater than 12,800 . We conclude that: 1) there is a family of surface-array proteins of C . fetus with common structural and antigenic characteristics; 2) that these molecules have similar biochemical characteristics to surface-array proteins described for other bacteria; but however, 3) by amino-terminal sequence analysis these are unique.

J Neurol Neurosurg Psychiatry, 1988 May, 51(5), 613 - 8
A prospective study of acute idiopathic neuropathy . II . Antecedent events; Winer JB et al.; The incidence of antecedent events and serological evidence of preceding infection were studied in 100 patients with acute idiopathic neuropathy and age and sex matched control subjects in South-East England . Symptoms of respiratory infections occurred within one month before onset of neuropathic symptoms in 38% of patients and 12% of controls (p less than 0.001) and symptoms of gastrointestinal infections in 17% of patients and 3% of controls (p less than 0.005) . Immunisations, insect bites and animal contact were equally common in the patient and control subjects . Eight per cent of patients had undergone an operation within the preceding 3 months . Six per cent of patients had co-existing "autoimmune" diseases . Serological evidence of recent infection was identified in 31% of patients . Campylobacter jejuni (14%) and cytomegalovirus (11%) were both significantly more frequently demonstrated in patients than controls . Serological evidence of recent infection with mycoplasma (1%), Epstein Barr virus (1-2%) and parvovirus B19 (4%) was also identified in the patients but not more frequently than in the controls . Possible explanations for the association of these agents with acute idiopathic neuropathy include possession of antigens shared with myelin and inhibition of suppressor mechanisms.

Aust Vet J, 1988 May, 65(5), 153 - 6
Prevalence of bovine venereal disease in the Victoria River District of the Northern Territory: likely economic effects and practicable control measures; McCool CJ et al.; Area prevalences of bovine Campylobacteriosis and Trichomoniasis in the Victoria River District (VRD) of the Northern Territory were determined by a survey of bulls . Eighty-seven percent of herds were infected with Campylobacteriosis and 65.6 percent were infected with Trichomoniasis . The levels of infection recorded are likely to be causing significant reductions in reproductive rates . Control of Campylobacteriosis is unlikely to be practicable on a district basis, but in some herds it may be possible to implement control measures in select groups subject to good stock control . Trichomoniasis control measures are generally not implementable in the VRD management situation . Computer modelling suggests that control measures are unlikely to be profitable in commercial herds . There is a need for field investigations to confirm this.

J Clin Microbiol, 1988 May, 26(5), 948 - 9
Simple microbiologic detection of Campylobacter pylori; Parsonnet J et al.; A study of 84 gastric biopsies taken from 42 adult patients revealed simple techniques for Gram stain and culture for Campylobacter pylori . In an initial study of 18 biopsies, Gram stains prepared from ground, diluted tissue were all negative for curved, gram-negative rods, whereas 13 of these specimens were positive for C . pylori by culture . The Gram stains for the remaining 66 biopsies were prepared by a rinse-imprint technique . In this group, there were 30 Gram stains positive for organisms resembling C . pylori and 32 positive cultures . By Gram-staining two sites, fundus and antrum, the sensitivity of the Gram stain for identifying a positive specimen increased from 91 to 100% . Gram stain may be the preferred technique for rapid diagnosis . When cultured, C . pylori was recovered most often on modified Thayer-Martin medium incubated microaerophilically at 35 degrees C . The presence of antibiotics in modified Thayer-Martin medium limited upper respiratory flora overgrowth, which was often present on nonselective media.

J Clin Microbiol, 1988 May, 26(5), 863 - 8
Influence of strain characteristics and immunity on the epidemiology of Campylobacter infections in Thailand; Taylor DN et al.; To determine how strain differences and immunity affect the clinical expression of Campylobacter infections, we conducted a study of acute diarrheal disease in Thailand in which specimens from children with Campylobacter infections were cultured weekly for up to 12 weeks to determine the serotype-specific length of time of convalescent-phase excretion and rate of reinfection . Levels of immunoglobulin G to cell-surface antigens of C . jejuni were determined in another population of healthy children who were closely related by age and location to the children in the diarrheal disease study . Campylobacter species were initially isolated from 18% of 586 children under 5 years old with diarrhea; most isolates in Thailand belonged to serotypes commonly found in developed countries . C . coli was significantly less often associated with symptomatic infections and with bloody diarrhea than C . jejuni (P less than 0.001 and P = 0.045, respectively) . The peak age of isolation and the peak level of immunoglobulin G to Campylobacter species occurred before 2 years of age . The mean duration of convalescent-phase excretion was 14 +/- 2 (standard error of the mean) days for children less than 1 year old and 8 +/- 2 days for children 1 to 5 years old (P = 0.02, t test) . Infection with another Campylobacter serotype was found in 34% of 105 children during the 12-week follow-up period . The rate of reinfection in these children was 15% (range, 8 to 22%) each week . Hyperendemic exposure to Campylobacter species in Thailand confers immunity to infection that is associated with an early peak in specific serum antibodies and an age-related decrease in the case-to-infection ratio and duration of convalescent-phase excretion but does not prevent asymptomatic infections.

J Clin Microbiol, 1988 May, 26(5), 831 - 6
Characterization of urease from Campylobacter pylori; Mobley HL et al.; Campylobacter pylori, a suspected agent of gastritis and peptic ulceration, rapidly hydrolyzes urea . Because urease serves as the basis of detection of the organism in gastric biopsies and may represent an important virulence factor, biochemical characteristics of the enzyme were determined . C . pylori was isolated from antral biopsies from 10 patients with complaints of abdominal pain or history of peptic ulcer disease . All isolates were urease positive, with an average rate of hydrolysis by cell lysates being 36 +/- 28 mumol of NH3 per min per mg of protein, more than twice that of Proteus mirabilis and 10 times that of other urinary tract isolates . The enzyme had an apparent molecular weight of 625,000 +/- 15,000 by column chromatography, an isoelectric point of 5.9, a Km of 0.8 +/- 0.1 mM urea, an optimal temperature of 45 degrees C, and an optimal pH of 8.2 . Ten isolates tested produced ureases with identical electrophoretic mobilities on nondenaturing 5% polyacrylamide activity gels . Acetohydroxamic acid (100 micrograms/ml), hydroxyurea (85 micrograms/ml), flurofamide (0.05 micrograms/ml), and EDTA (8 mM) inhibited enzyme activity by 50% . Cell lysates retained 50% of initial urease activity after 6 days and 40% activity after 18 days when stored at 4 degrees C in 20 mM sodium phosphate, pH 6.8 . At -70 degrees C for 18 days, 1 mM EDTA or 15% glycerol preserved 40 or 34%, respectively, of initial activity . The urease of C . pylori appears to be biochemically unique from the enzymes of other common urease-producing species.

J Clin Microbiol, 1988 May, 26(5), 1029 - 30
Failure of Campylobacter pylori to grow in commercial blood culture systems; Westblom TU et al.; Of 50 blood culture sets, 20 Bacto (Difco Laboratories, Detroit, Mich.), 20 Septi-Chek (Hoffmann-La Roche, Inc., Nutley, N.J.), and 10 BACTEC 6B and 7D (Johnston Laboratories, Inc., Towson, Md.) sets were inoculated with Campylobacter pylori and fresh human blood . None of the 50 blood cultures produced any detectable growth . Current commercial blood culture systems may be inadequate for the detection of C . pylori bacteremia.

J Clin Invest, 1988 May, 81(5), 1434 - 44
Pathogenesis of Campylobacter fetus infections . Failure of encapsulated Campylobacter fetus to bind C3b explains serum and phagocytosis resistance; Blaser MJ et al.; Campylobacter fetus ssp . fetus strains causing systemic infections in humans are highly resistant to normal and immune serum, which is due to the presence of high molecular weight (100,000, 127,000, or 149,000) surface (S-layer) proteins . Using serum-resistant parental strains (82-40 LP and 23D) containing the 100,000-mol wt protein and serum-sensitive mutants (82-40 HP and 23B) differing only in that they lack the 100,000-mol wt protein capsule, we examined complement binding and activation, and opsono-phagocytosis by polymorphonuclear leukocytes . C3 consumption was similar for all four strains but C3 was not efficiently bound to 82-40 LP or 23D even in the presence of immune serum, and the small amount of C3 bound was predominently the hemolytically inactive iC3b fragment . Consumption and binding of C5 and C9 was significantly greater for the unencapsulated than the encapsulated strains . Opsonization of 82-40 HP with heat-inactivated normal human serum caused greater than 99% killing by human PMN . Similar opsonization of 82-40 LP showed no kill, but use of immune serum restored killing . Findings in a PMN chemiluminescence assay showed parallel results . Association of 32P-labeled 82-40 HP with PMN in the presence of HINHS was 19-fold that for the 82-40 LP, and electron microscopy illustrated that the difference was in uptake rather than in binding . These results indicate that presence of the 100,000-mol wt protein capsule on the surface of C . fetus leads to impaired C3b binding, thus explaining serum resistance and defective opsonization in NHS, mechanisms that explain the capacity of this enteric organism to cause systemic infections.

Arch Intern Med, 1988 May, 148(5), 1149 - 51
Gastritis and Campylobacter pylori in healthy, asymptomatic volunteers; Barthel JS et al.; A high prevalence of histologic gastritis in asymptomatic individuals has been reported in the literature . The studies have been poorly controlled for gastritis risk factors . We evaluated 20 healthy, asymptomatic volunteers free of known risk factors for gastritis with endoscopy, mucosal biopsy, culture, and gastric pH determination . The prevalence of gastritis on histologic examination was found to be 20% . There was no relationship between the presence of macroscopic findings at endoscopy and the presence of histologic gastritis . In all instances where histologic gastritis was documented, Campylobacter pylori was observed in the gastric mucus . Mucosal tissue invasion by C pylori was not observed . The presence of gastritis and C pylori was associated with fasting hypochlorhydria . Follow-up evaluation was performed eight to 13 months after the initial endoscopic evaluation in three of the volunteers with positive test results . Persistence of C pylori and gastritis was observed . These findings suggest that histologic gastritis is common in healthy, asymptomatic individuals and is strongly associated with the presence of C pylori.

Am Fam Physician, 1988 May, 37(5), 195 - 207
Diarrheal infections; Mitchell JE et al.; Infectious agents usually cause diarrhea by invading and damaging the intestinal mucosa or by producing enterotoxins that alter the secretory and absorptive capacities of the intestinal mucosa . Some infectious agents may do both . Physical malabsorption produced by proliferative outgrowth of bacteria or protozoa may also occur . Rotavirus is the most common cause of pediatric infectious diarrhea in the United States . Escherichia coli and Campylobacter species are the most common bacterial agents.

Arch Pathol Lab Med, 1988 May, 112(5), 523 - 5
Immunocytochemical identification of Campylobacter pylori in gastritis and correlation with culture; Barbosa AJ et al.; Endoscopic biopsy specimens of antral mucosa from 25 patients presenting with gastric complaints were obtained for culture and histologic and immunocytochemical studies . The histopathologic study revealed chronic gastritis in 22 patients and borderline chronic gastritis in three patients . The unlabeled-antibody peroxidase-antiperoxidase (PAP) method was applied for the detection of Campylobacter pylori, and its results were compared with those obtained with the culture technique . Strongly positive immunoperoxidase staining was localized in spiral, curved bacteria that were present in the mucus layer adjacent to the gastric epithelial cell surface . The microorganisms were frequently congregated in clumps and were sectioned in several directions . The PAP stains were positive in 19 specimens (76%), and the cultures were positive in 20 (80%) . All results negative by culture were also negative by PAP method . Compared with the cultures, the sensitivity and positive predictive value of the PAP method for identification of C pylori in antral mucosa obtained from endoscopic biopsy specimens were 95% and 100%, respectively.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 May, 268(3), 341 - 6
In search of an animal model for experimental Campylobacter pylori infection: administration of Campylobacter pylori to rodents; Ehlers S et al.; Various mouse strains and Lewis rats were either orally or intravenously infected with high inocula of Campylobacter pylori and bacterial counts in the liver, spleen, heart, kidneys, and the stomach were followed over time . The intravenously infected animals displayed transient bacteremia and colonization of their livers and spleens . A loglinear decrease led to complete bacterial clearance after 72 hours . Oral administration of Campylobacter pylori neither resulted in colonization nor tissue invasion in any of the infected mice, even if infection had occurred under complete drug-induced achlorohydria . We conclude that under the conditions chosen, mice and rats are not suited for an animal model for experimental Campylobacter pylori infection.

J Gen Microbiol, 1988 May, 134 ( Pt 5), 1185 - 95
The relationship between the base composition of bacterial DNA and its intracellular melting temperature as determined by differential scanning calorimetry; Mackey BM et al.; The correlation between the melting temperature of intracellular DNA, determined by differential scanning calorimetry (DSC) of whole bacteria, and its guanine + cytosine (G + C) content, was examined for 58 species of bacteria . Samples of vegetative cells were heated in a Perkin-Elmer DSC-2C at 10 degrees C min-1 from 5 to 130 degrees C, cooled to 5 degrees C and then re-heated as before . Literature values for the mole fraction of G + C, XGC, were linearly related to the temperature, Tmax, at which the reversible peak, pr, observed on the second heating run was at a maximum, via the equation XGC = (Tmax -73.8)/41.0 . This equation accounted for 91.9% of the variance in XGC with 95% confidence limits of +/- 7.3%, approximately 1.6 times the corresponding uncertainty (+/- 4.5%) quoted by De Ley (Journal of Bacteriology 101, 738-754, 1970) for estimates based on the spectroscopically determined melting temperature of purified DNA . Random errors of measurement of Tmax did not greatly limit the precision of the prediction and it was concluded that factors additional to base composition affected the temperature of DNA melting within the bacterial cell . Displacement of Tmax values from the fitted line was particularly noticeable in Campylobacter, Corynebacterium and Bacterionema species and part of the residual variation appeared to be species specific, possibly caused by differences in intracellular solute concentration.

Aust Vet J, 1988 May, 65(5), 133 - 5
Comparison of direct electron microscopy and enzyme immunoassay for the detection of rotaviruses in calves, lambs, piglets and foals; Ellis GR et al.; Direct electron microscopy (EM) and enzyme-immunoassay (rotazyme) results for the detection of rotaviruses in 346 enteric specimens from calves, lambs, piglets and foals were compared . The rotazyme test was at least 3 times more sensitive than direct EM in diagnosing infection . Rotavirus antigen was demonstrated by rotazyme in 22% of 280 scour samples and in 27% of 66 samples from non-scouring animals . There was an association between diarrhoea and higher amounts of rotavirus antigen . This prevalence of rotaviruses detected in animals with diarrhoea highlights the significant involvement of other pathogens identified in the study including Eimeria, Cryptosporidia, Escherichia coli, Campylobacter, and other viruses.

Can J Microbiol, 1988 May, 34(5), 594 - 604
The ultrastructure and ATPase nature of polar membrane in Campylobacter jejuni; Brock FM et al.; Polar membrane in Campylobacter jejuni has been visualized on membrane vesicles . It was composed of doughnut-shaped particles 5-6 nm in diameter, with stalks, arranged in a hexagonal array . This structure was stabilized on the membrane by a high ionic strength buffer in the presence of 2-mercaptoethanol . Histochemical staining indicated localized ATPase activity at the poles of the cells . An ATPase with distinctive properties has been isolated and purified from this organism; it gives a specific activity of approximately 0.3 units/mg of protein . Electron microscopy showed doughnut-shaped particles 5-6 nm in diameter . Nondissociating and sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified enzyme revealed, respectively, a single band with ATPase activity and a molecular weight of ca . 75,000 Da . The enzyme was cold labile and activity was abolished by trypsin . Dicyclohexylcarbodiimide inhibited the membrane-bound form of the enzyme, but did not inhibit the soluble form . Oligomycin had no inhibitory activity on either form of the enzyme . The enzyme specifically hydrolysed ATP, but other nucleotide substrates were not degraded . The enzyme was activated by Mg2+ and inhibited by Ca2+, whereas other ions had no effect on activity . Antibodies prepared to this enzyme bound to the polar regions of whole cells as shown by protein A - colloidal gold immunoelectron microscopy . The antibodies to this ATPase cross reacted (shown by Western blotting) with four proteins from a whole-cell extract of this organism, two proteins in Aquaspirillum serpens MW5, and three proteins from Escherichia coli K12 . They did not cross-react with any proteins from Spirillum volutans, Methanococcus voltae, Vibrio cholerae, or rat liver mitochondria . Antibodies raised against the F1-ATPase of E . coli K12 cross reacted with six proteins in a whole-cell extract of this organism, and one protein species in each of the whole-cell extracts of V . cholera, A . serpens MW5, S . volutans, and rat liver mitochondria . These antibodies did not recognize any whole cell proteins from either C . jejuni or M . voltae . These results along with the ATPase activity localized by histochemical staining suggest that polar membrane is an assembly of ATPase molecules at the poles of the cell and that the ATPase isolated from C . jejuni is serologically and structurally unusual.

J Med Microbiol, 1988 May, 26(1), 55 - 9
Role of murine macrophages and complement in experimental Campylobacter infection; Bar W; The roles of macrophages and the complement system as potential host defence mechanisms in mice against campylobacter infection were studied in vivo, by depleting the murine serum-complement or the phagocytic cells . Macrophage-depletion was performed by intraperitoneal (i.p.) injection of silica dust, Liquoid or dextran sulphate . During 5 days after infection, such mice showed a significant increase in mortality, compared with controls . In contrast, mice that were previously decomplemented by i.p . injection of Cobra Venom Factor showed no significant increase in mortality . The results with combined macrophage depletion and decomplementation did not differ from those with macrophage depletion alone . These experiments suggest that macrophages seem to be more important than complement in the defence of mice against experimental campylobacter infection.

Vet Rec, 1988 Apr 30, 122(18), 438 - 9
Rarity of tylosin resistance in human pathogenic bacteria; Lacey RW; Of 3812 human cultures of Staphylococcus aureus, Streptococcus pyogenes and Campylobacter species only 1.0 per cent were resistant to tylosin, an antibiotic used extensively in animals but not in man . There was no evidence for a significant animal source of these resistant cultures, a result which provides further evidence for the rarity of the flow of resistant organisms (or their genes) from animal sources to human beings.

Schweiz Med Wochenschr, 1988 Apr 23, 118(16), 577 - 83
{Campylobacter pylori: cause of gastritis and ulcer disease?}; Gebbers JO et al.; Several studies have shown a striking association between the presence of Campylobacter pylori (C.p) in the gastric mucosa and histologically confirmed gastritis and ulcer disease . The microorganism has been found in up to 90% of patients with active chronic antral (type B) gastric ulcer, and in up to 70% of patients with duodenal ulcer . Voluntary ingestion of C.p . by two persons and two epidemic occurrences after apparent C.p . contamination of stomach probes, with demonstration of the bacterium in the mucosa, have shown that C.p . can induce acute gastritis; in one volunteer the acute gastritis progressed to the active chronic form . Eradication of C.p . by antibacterial treatment is associated with resolution of gastritis . Relapse of peptic ulcer is closely related to infection by C.p . The microorganism has important virulence factors allowing it to select an ecological niche below the mucus layer on the gastric mucosa . C.p . exhibits strong mucolytic activity through proteases which could damage the mucus barrier and therefore increase susceptibility to development of gastritis and peptic ulcers; however, the pathogenic impact of C.p . remains unknown . C.p . is diagnosed by histological or microbiological examination of gastric biopsy specimens or by serological techniques . Bismuth salts alone or in combination with antibiotics are effective against C.p., but the efficacy of antimicrobial treatment of gastritis and ulcer disease associated with C.p . has still to be proven by large double-blind placebo-controlled trials . The hitherto published findings do not allow definite evaluation of the pathogenetic significance of C.p . in gastritis and ulcer disease.(ABSTRACT TRUNCATED AT 250 WORDS)

J Am Vet Med Assoc, 1988 Apr 15, 192(8), 1083 - 6
Losses related to the ingestion of lincomycin-medicated feed in a range sheep flock; Bulgin MS; Because of an episode of abortion caused by a tetracycline-resistant Campylobacter jejuni, lincomycin was mixed into a barley pellet and fed to 3,000 range ewes at a dosage of 225 mg/ewe/day . After the second feeding, a number of ewes were anorectic and diarrheic, and 6 were dead . Necropsies revealed congestion and hemorrhage of the entire gastrointestinal tract . The feeding of the medicated pellets was discontinued immediately . Sick ewes were treated with antihistamines and corticosteroids, but they did not recover, and many died during the next several weeks . Lambs born within the first 7 days after the incident were alert and vigorous . Dams did not produce milk and many died during or after parturition . Later, however, lambs were born dead or weak, and abortions of autolyzed lambs began . Affected ewes examined 3 weeks later had salmonellosis and/or toxic tubular nephrosis associated with an oxalate-like crystal . The flock had been grazed on range infested with Halogeton glomeratus just before treatment with lincomycin, and it also had a history of Salmonella-related abortions . The deaths finally ceased after a month . Approximately 2,000 ewes and 3,200 lambs were lost, resulting in an economic loss of $550,000.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Apr, 268(2), 271 - 6
Antibody response of patients against a 120 kDa surface protein of Campylobacter pylori; Apel I et al.; Campylobacter pylori strains were isolated and serum samples were obtained from 63 patients . Immunoblots of 52 patients sera using their own isolates as antigen showed a 120 kDa band, which was missing in the other 11 isolates and the respective sera . This band was not detected in other Campylobacter species . Effects of trypsin treatment of bacteria and absorption of sera by live organisms suggest a C . pylori-specific surface protein.

Scand J Gastroenterol, 1988 Apr, 23(3), 358 - 62
Prevalence of Campylobacter pylori in an unselected Swedish population of patients referred for gastroscopy; Blomberg B et al.; A survey of the prevalence of Campylobacter pylori in an unselected series of 117 patients referred for gastroscopy showed that 49.6% of the patients were infected . In 87% of infected patients both the antrum and the body of the stomach were involved . Duodenal infection occurred in only 9% of 102 studied patients . C . pylori could usually be demonstrated in mucosa showing signs of active chronic inflammation, whereas it was rarely found in histologically normal mucosa . The acridine orange staining method for demonstration of bacilli correlated well with bacteriology; identical results were obtained in 92.8% of the samples.

Scand J Gastroenterol, 1988 Apr, 23(3), 347 - 50
Campylobacter pylori in peptic ulcer disease . III . Symptoms and paraclinical and epidemiologic findings; Andersen LP et al.; Only a few publications have dealt with the subjective symptoms, the paraclinical findings, or the epidemiology in relation to cultivation of C . pylori . Seventy-two patients answered a questionnaire containing questions about symptoms, dietary habits, smoking, and animal contact . C . pylori was cultivated from the biopsy specimens of 41 of these patients, and 31 were culture-negative . In addition, leukocyte count, differential count, and blood immunoglobulins were measured . In many culture-positive patients a variation in symptoms during the year was found, and symptoms had lasted more than 5 years . This was statistically significant for non-ulcer patients . In addition, we found initial abdominal pain and present vomiting to be significant features, but they did not seem to have any clinical significance . Unlike Marshall & Warren, we did not find ructus to be related to infections with C . pylori . In all other respects we found no differences between culture-negative and culture-positive patients . It was not possible to detect any descriptive variables in patients with C . pylori infections.

Scand J Gastroenterol, 1988 Apr, 23(3), 257 - 64
Distribution of Campylobacter pylori in the human stomach obtained at postmortem; Morris A et al.; The distribution of Campylobacter pylori, its prevalence, and its relationship to gastritis and urease activity have been studied in 54 postmortem stomachs . Infection was confirmed by finding C . pylori in a Gram-stained smear of gastric mucus harvested from the entire stomach . Eight tissue specimens were obtained from predetermined sites from each stomach and examined for histologic gastritis and urease activity . Thirty-seven per cent of stomachs were infected, and of these 80% had widespread histologic gastritis . The detection of urease activity provided information on the distribution of the organism and had a high correlation with histologic gastritis . The organism is capable of infecting any area of the stomach . Infection is common and is more prevalent in Polynesian subjects (60%) than in Caucasians (19%).

Am J Vet Res, 1988 Apr, 49(4), 456 - 8
Campylobacter jejuni infections in gnotobiotic pigs; Boosinger TR et al.; At 3 days of age, 12 gnotobiotic pigs were inoculated orally with broth cultures of Campylobacter jejuni . One pig was euthanatized and evaluated each day for 12 days . In the cecum and colon, there was diffuse edema, neutrophilic infiltration, and sloughing of epithelial cells from the mucosa on postinoculation days (PID) 2 through 5 . Dysplastic colonic crypt epithelial cells were observed in the submucosa of the colon on PID 5 through 12 . Curved, rod-shaped bacteria were detected on the surface of ileal, cecal, and colic absorptive and glandular epithelial cells . Bacteria also were found around small submucosal vessels on PID 3 and 4 and were associated with numerous perivascular neutrophils . The gnotobiotic pig appears to provide a simple, well-controlled in vivo model for the study of the pathogenesis of C jejuni infections in human beings, pigs, and other mammals.

Am J Vet Res, 1988 Apr, 49(4), 449 - 55
Vaccination of pregnant guinea pigs with Campylobacter fetus: effects of antigen dose, Campylobacter strain, and adjuvant type; Bryner JH et al.; For the purpose of developing and improving vaccines to protect cattle against bovine genital campylobacteriosis, the interaction of vaccine dose, strain(s) of Campylobacter fetus, and type of adjuvant was studied in the pregnant guinea pig model . Five strains of C fetus were used in the preparation of 20 monovalent vaccines containing various doses of bacteria (0.1 mg to 20 mg, dry weight) in Freund incomplete adjuvant, Freund complete adjuvant, or aluminum hydroxide gel adjuvant . Vaccinal protection against homologous or heterologous challenge exposure with viable C fetus strains was measured in terms of infection, abortion, and serum antibody titers . Major emphasis in the study was placed on vaccines containing highly virulent C fetus subsp venerealis strains (1289 and 17761) that possess most of the heat-labile K antigens that have been identified . Vaccines incorporating strain 1289 provided greater protection against abortion than did strain 17761 vaccines (difference, 29%; P less than 0.05) . A positive (P = 0.61) correlation was seen between protection from abortion and strain 1289 serum antibody titer . When the titer was greater than or equal to 4, protection was greater than 80%, whereas abortion was associated with a serum antibody titer less than or equal to 2 . In an experiment comparing 2-mg vs 20-mg doses of strain 17761 prepared in aluminum hydroxide gel adjuvant, protection against challenge exposure with the heterologous strain 23 was significantly (P less than 0.05) lower than that against challenge exposure with the homologous strain at the 2-mg dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Gut, 1988 Apr, 29(4), 465 - 72
Naturally occurring chronic gastritis and C pylori infection in the rhesus monkey: a potential model for gastritis in man; Baskerville A et al.; Histological examination of the stomachs of Rhesus monkeys at autopsy showed chronic gastritis in a high proportion of all ages . Lesions consisted of mild to heavy infiltration of the lamina propria by lymphocytes, plasma cells, and histiocytes . The antrum was most consistently affected, but lesions were also present in the fundus and pylorus . Gastric Campylobacter-like organisms (GCLO) apparently identical to human C pylori were cultured and/or detected immunohistologically in several animals . Electron microscopy showed the spiral bacteria on the epithelial surface and in gastric pits . They did not penetrate the cells but were intimately attached to the apical plasma membrane and caused loss of microvilli . Antibodies to C pylori were detected in serum of the monkeys by ELISA . The immunospecificity of this antibody response was confirmed by Western blotting techniques . A small number of cynomolgus monkeys examined had gastritis, which may also be associated with the presence of C pylori . Baboons did not have gastritis, nor was C pylori cultured from their stomachs . The study indicates that the Rhesus monkey has a naturally occurring gastritis associated with C pylori infection and may therefore be a suitable experimental animal for the human disease.

Cryobiology, 1988 Apr, 25(2), 148 - 52
Cryopreservation studies of Campylobacter; Mills CK et al.; Seven strains of Campylobacter fetus ss . fetus, one of Campylobacter fetus ss . venerealis, and one of Campylobacter jejuni were preserved using a variety of cryopreservation methods . Organisms were frozen to -150 degrees C in a liquid nitrogen refrigerator, in the freezer compartment of a refrigerator (-20 degrees C), and in a mechanical freezer (-65 degrees C) . In the latter two cases, viabilities of the organisms were compared after being frozen in Brucella Albimi broth and 10% glycerol . Viabilities were also examined after Campylobacter species were freeze-dried using rapid or slow cooling, using sucrose or skim milk as cryoprotective agents and in bulb-type vials on a manifold or batch vials . Preservation in liquid nitrogen resulted in no loss in viability after 4 years storage . When Campylobacter species were frozen at -20 degrees C, no cells were recovered after 1 month storage in Brucella Albimi broth or seven months in glycerol . A 6.5 log decrease in viability resulted after organisms were frozen at -65 degrees and subsequently stored at the same temperature for 2 years . In this case, glycerol had no protective advantage over Brucella Albimi broth . Postpreservation viability of organisms cooled slowly was two logs higher than those cooled rapidly prior to freeze-drying . When skim milk or sucrose were employed as cryoprotective agents during freeze-drying, equal viabilities resulted . Equivalent viabilities were also demonstrated when the bulb type or "batch" vials were utilized for freeze-drying . No significant differences were observed between the viabilities of the three species when a given cryopreservation method was employed.

Br J Rheumatol, 1988 Apr, 27(2), 113 - 6
Campylobacter pylori associated gastritis in patients with rheumatoid arthritis taking nonsteroidal anti-inflammatory drugs; Upadhyay R et al.; Fifty-two patients with rheumatoid arthritis taking nonsteroidal anti-inflammatory drugs were studied in order to assess the carriage rate of Campylobacter pylori (C . pylori) with reference to dyspeptic symptoms, endoscopic appearance and antral histology . All patients were interviewed using a standard gastrointestinal symptom scoring questionnaire and underwent endoscopy at which two antral biopsies were obtained . Sections were examined for the presence and severity of gastritis and of C . pylori . Forty-four of 52 patients (85%) had histological evidence of gastritis . Twenty-six of 44 (59%) patients with gastritis were positive for C . pylori . Twenty-six of 28 patients with 'active' (polymorph infiltration) chronic gastritis were positive for C . pylori (p less than 0.002) . Sixteen of 26 bacteria-positive patients had gastrointestinal symptoms compared with eight of 26 bacteria-negative patients (p less than 0.05) and this may have therapeutic implications . There was no correlation between the presence of organisms and the appearances at endoscopy.

Br J Rheumatol, 1988 Apr, 27(2), 110 - 2
Nonsteroidal anti-inflammatory drug-induced dyspepsia--is Campylobacter pyloridis implicated?
Doube A, Morris A.
An endoscopic study of 34 patients with rheumatic diseases taking nonsteroidal anti-inflammatory drugs (NSAIDs) was undertaken to evaluate whether dyspepsia was associated with Campylobacter pyloridis . Twenty-two patients had an indication for upper gastrointestinal endoscopy and 12 patients were asymptomatic volunteers . Dyspepsia did not correlate with the macroscopic findings at endoscopy, the presence of histological gastritis or the presence of C . pyloridis . However, this study did demonstrate that macroscopic mucosal changes, histological gastritis and the presence of C . pyloridis have an equal prevalence in asymptomatic volunteers and symptomatic patients.

Am J Pathol, 1988 Apr, 131(1), 125 - 31
Ultrastructure of Campylobacter jejuni in gamma-irradiated mouse jejunum; Sosula L et al.; This paper describes the ultrastructure of intracellular elongated, transitional and coccoid forms of Campylobacter jejuni, in irradiated mouse jejunum infected both in vitro and in vivo and in cultured human skin fibroblasts . Jejunum of irradiated mouse incubated for 1 hour under conditions favorable to the organisms showed minimal tissue degeneration . The intracellular organisms in this material were free cytoplasmic forms showing inner membrane degeneration, loss of cytoplasmic granules, and absence of flagella . The diameter of the coccoids was up to four times that of the elongated forms, as in plate cultures . Intracellular organisms were not found in challenged unirradiated controls, indicating that irradiation of mouse cells may be required for intracellular infection with human strains of C jejuni . In contrast, challenged human fibroblasts contained typical elongated organisms in cytoplasmic vacuoles . These findings are discussed with reference to Campylobacter strain, host resistance, and "natural" animal and human Campylobacter infections.

Ann Intern Med, 1988 Apr, 108(4), 540 - 6
Persistent Campylobacter jejuni infections in patients infected with the human immunodeficiency virus (HIV); Perlman DM et al.; We identified Campylobacter jejuni infections in four patients infected with the human immunodeficiency virus (HIV); three had persistent and severe C . jejuni infections . Multiple isolates obtained from each patient had the same biochemical and serotypic characteristics, indicating recurrent infection rather than reinfection with unrelated strains . Serum antibody responses to C . jejuni group antigens by enzyme-linked immunosorbent assay were markedly impaired in the three patients with persistent infection compared with forty-two immunocompetent C . jejuni-infected controls and with the HIV-infected patient who readily cleared the organism . One patient was bacteremic; his blood isolate was killed by normal serum but was resistant to his own serum, whereas a simultaneous stool isolate of a different serotype was sensitive . Failure of two patients to eradicate the organism and long-term administration of erythromycin therapy led to the in-vivo development of resistance to this antibiotic, which is most frequently used to treat C . jejuni infections.

J Infect Dis, 1988 Apr, 157(4), 777 - 80
Effect of age on the frequency of active Campylobacter pylori infection diagnosed by the {13C}urea breath test in normal subjects and patients with peptic ulcer disease; Graham DY et al.; We studied the frequency of active Campylobacter pylori infection in persons from North America (n = 53) or the People's Republic of China (n = 15) who had no gastrointestinal symptoms or a history of ulcer disease and in patients with active or recently active duodenal or gastric ulcers diagnosed by endoscopy (n = 105) . C . pylori infection was significantly (P less than .001) more frequent in patients with peptic ulcers (88%) than in the normal group (45%) . An age-related increase in the frequency of C . pylori infection in subjects with no gastrointestinal symptoms paralleled the known age-related increase in prevalence of gastritis . The frequency of C . pylori infection in patients with duodenal ulcers was greater than 80%, irrespective of age . C . pylori infection was more common in the Chinese group (age, 20-39 y) than in the North American group of the same age (60% vs . 24%) . Association of C . pylori with specific diseases should not be inferred without knowing the prevalence of C . pylori infection in reference populations of the same age and ethnic background.

Gastroenterology, 1988 Apr, 94(4), 923 - 7
Acid secretion and serum gastrin levels in individuals with Campylobacter pylori; Brady CE 3rd et al.; Campylobacter pylori may cause gastritis and has been proposed as an etiologic factor in the development of peptic ulcer . However, it may be an acid-sensitive microbe and before it can be implicated in the pathogenesis of peptic ulcer, it should be consistently found in ulcer patients with normal acid secretion . Thirty-six patients with C . pylori by Warthin-Starry stain underwent gastric analysis; 25 were normochlorhydric and 11 hypochlorhydric . Ulcers were present in 19 normochlorhydric patients (10, gastric; 9, duodenal) and 2 hypochlorhydric patients (gastric) . Median basal acid output was higher for those with duodenal ulcer (38 mmol/h) than gastric ulcer (28 mmol/h) or miscellaneous endoscopic features (33 mmol/h) . The hypergastrinemia seen in 12 patients with negative secretin provocation tests was believed to be due to various nongastrinoma conditions . Campylobacter pylori was found in 6 normogastrinemic patients with elevated acid output and in 1 gastrinoma patient with marked acid hypersecretion . Histologic chronic gastritis was present in all subjects and 29 had active chronic gastritis . Twenty-three patients were taking H2-receptor antagonists at the time of diagnosis which did not seem to interfere with culture results . Using standard acid secretory tests, we conclude that C . pylori can survive in a wide range of acid conditions.

Immun Infekt, 1988 Apr, 16(2), 49 - 55
{Campylobacter pylori: significance, diagnosis and treatment}; von Wulffen H; The association between colonization of the antrum mucosa by Campylobacter pylori and antrum gastritis as well as peptic ulcers has been documented in a number of studies . The ability of these bacteria to produce a cytotoxin and a protease that hydrolyzes the mucosa-protecting mucin assigns pathogenetic properties to this species that suggest an etiological role for C . pylori in the pathogenesis of peptic ulcers and gastritis . This concept is supported by some preliminary results of therapeutic trials which have shown that successful eradication of the organism leads to histologic improvement of the gastritis and markedly reduced relapse rates regarding peptic lesions . Best results were achieved using combinations of a bismuth salt with an antibiotic such as amoxicillin . Diagnosis of C . pylori infection is based on culturing the organism from antral biopsies . Detecting the urease activity directly in the biopsy has also been shown to be an effective and reliable method . As a noninvasive method serologic testing for C . pylori may also be employed . An IgG-ELISA used by us showed a good correlation with cultural and histological results.

Am J Gastroenterol, 1988 Apr, 83(4), 365 - 72
Campylobacter pylori-associated gastritis: a double-blind placebo-controlled trial with amoxycillin; Glupczynski Y et al.; We randomly assigned 45 adult patients with Campylobacter pylori-confirmed antral gastritis to 8 days of treatment with 1 g amoxycillin suspension twice a day, or placebo, according to a double-blind study design . At the end of therapy, 91% of patients treated with amoxycillin demonstrated clearance of the organism from the antrum, compared with 16% in the placebo group (p less than 0.001) . Active antral gastritis resolved in 68% of patients in the amoxycillin group versus only 9% in the placebo group (p less than 0.001) . No significant difference was observed when looking at the evolution of chronic only gastritis . No significant improvement was observed in the assessment of clinical symptoms and endoscopic appearance . Reappearance of C . pylori and significant worsening of the histological score of active gastritis was observed after 2 wk in all patients . In a second study phase, 18 patients initially not cleared of their bacteria received amoxycillin single blind for 14 days . Clearance of bacteria associated with improvement or resolution of active gastritis was observed in 72% of the cases . In this subgroup, all patients investigated after 1 month were recolonized with C . pylori and, again, had histological active gastritis . We conclude that amoxycillin is effective in treating active antral gastritis associated with C . pylori, but not in preventing relapses, which occur in all cases within 1 month after therapy.

Z Gastroenterol, 1988 Apr, 26(4), 204 - 8
Prospective study on the distribution of Campylobacter pylori in unselected patients of an endoscopy unit in West Germany; Raedsch R et al.; In recent years a series of publications predominantly from English speaking countries have reported on the colonization of the gastric epithelium with Campylobacter pylori in association with gastritis and ulcer disease . In this prospective study we investigated the distribution of Campylobacter pylori in unselected patients undergoing routine endoscopy at the Department of Gastroenterology of the University of Heidelberg . A total of 175 patients were included in the study . Campylobacter pylori could be demonstrated by microbiological and histological methods in 17% of patients with normal gastric mucosa, in 44% with chronic active gastritis and in 48% with stomach ulcer . In our series only 6/23 patients with duodenal ulcer were Campylobacter pylori positive . Additionally intragastric acidity and concentrations of total bile acids were correlated to the colonization of Campylobacter pylori . Bile acid concentrations were found significantly (p less than 0.001) lower in patients with gastritis when Campylobacter pylori was present . These data suggest an association of Campylobacter pylori with diseases of the stomach also in West Germany and a negative correlation of these organisms to enterogastric bile reflux.

Rev Argent Microbiol, 1988 Apr-Jun, 20(2), 53 - 68
Identification of campylobacters from bovine and ovine faeces; Terzolo HR; Campylobacters isolated in Scotland and the north of England from bovine (497 isolates) and ovine (51 isolates) faeces were studied in order to determine which simple methods would be useful for identification of groups and species . By means of the catalase test, growth and microscopic characteristics, coccal transformation and nalidixic acid (Nal) and cephalothin sensitivity, isolates were separated into 3 groups: C . jejuni - C . coli, C . hyointestinalis - C . fetus and C . fecalis - C . sputorum subsp . bubulus . Hippurate hydrolisis was used to differentiate C . jejuni (positive) from all the other Campylobacter spp (negative) . The production of hydrogen sulphide in Triple Sugar Iron was used to separate C . hyointestinalis and the C . fecalis - C . sputorum subsp . bubulus group (positive) from C . fetus (negative) . The production of hydrogen sulphide in iron-bisulphite-pyruvate (FBP) medium was used to separate the C . fecalis - C . sputorum subsp . bubulus group (positive) from most C . hyointestinalis isolates (96.4% were negative) . Additional characteristics useful for identification of the C . fecalis - C . sputorum subsp . bubulus group were: adherent sticky growth; inhibition of growth by FBP or ferrous sulphate and sodium metabisulphite; and inversion of Nal resistance on FBP agar . Catalase test was used to separate C . fecalis (positive) from C . sputorum subsp . bubulus (negative), although these two species should be regarded as a single species with a variable catalase test . Bovine C . hyointestinalis isolates were serologically classified as type 1 (related to the porcine C . hyointestinalis standard strain NCTC 11562) and type 2 (unrelated) . Based on the above criteria, isolates in cattle were classified as: 229 C . jejuni, 66 C . coli, 112 C . hyointestinalis type 1, 53 C . hyointestinalis type 2 and 37 C . fetus . In sheep they were: 25 C . jejuni, 11 C . coli, 12 C . fecalis and 3 C . sputorum subsp . bubulus.

J Appl Bacteriol, 1988 Apr, 64(4), 337 - 43
Peroxide sensitivity and catalase activity in Campylobacter jejuni after injury and during recovery; Humphrey TJ; Cells of Campylobacter jejuni damaged by freezing or mild heat showed increased sensitivity to hydrogen peroxide and also required the addition of catalase for growth on nutrient agar . These phenomena, which could have important practical consequences, were not associated, however, with changes in total catalase activity and may be due to alterations in outer membrane permeability.

Eur J Clin Invest, 1988 Apr, 18(2), 133 - 8
Campylobacter pylori: prospective analysis of clinical and histological factors associated with colonization of the upper gastrointestinal tract; Borsch G et al.; The association of Campylobacter pylori (C.p.) colonization of the upper gastrointestinal tract with five predefined anamnestic variables, seven symptoms of dyspepsia, and various blindly evaluated histological criteria, was prospectively investigated in a consecutive series of 149 patients submitted to upper gastrointestinal tract endoscopy . Colonization was determined by biopsy urease tests and histological searches . Significant differences (P less than 0.05) between C.p.-positive and C.p.-negative patients were found for smoker status and the frequency of therapy with ulcer-healing drugs (positive association with C.p.) and antibiotics (negative association), but not for any other of the anamnestic data or symptoms . These data were further submitted to stepwise multiple logistic regression analyses . Concerning histological findings, C.p . colonization was significantly associated with the degree of antrum and body gastritis (P less than 0.01), and also with lymphocellular infiltration in antrum and body biopsies and neutrophil cellular grading in gastric antra . We conclude that C.p . colonization of the upper gastrointestinal tract is associated with gastritic change of the antrum and, albeit to a lesser extent, of the body mucosa . However, a specific pattern of symptoms to predict C.p . colonization could not be established.

J Bacteriol, 1988 Apr, 170(4), 1704 - 8
Gene disruption and replacement as a feasible approach for mutagenesis of Campylobacter jejuni; Labigne-Roussel A et al.; Campylobacter jejuni and Campylobacter coli are important causes of human enteric infections . Several determinants of pathogenicity have been proposed based on the clinical features of diarrheal disease and on the phenotypic properties of Campylobacter strains . To facilitate an understanding of the genetic determinants of Campylobacter virulence, we have developed a method for constructing C . jejuni mutants by shuttle mutagenesis . In the example described here, a kanamycin resistance gene was inserted into Campylobacter DNA fragments encoding 16S rRNA cloned in Escherichia coli . These disrupted, modified sequences were returned to C . jejuni via conjugation . Through the apparent process of homologous recombination, the kanamycin resistance-encoding sequences were rescued by chromosomal integration, resulting in the simultaneous gene replacement of one of the 16S sequences of C . jejuni and the loss of the vector . We propose that Campylobacter isogenic mutants could be developed by using this system of shuttle mutagenesis.

Gastroenterology, 1988 Apr, 94(4), 984 - 93
Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome; Laughon BE et al.; We studied 388 homosexual or bisexual men from the Baltimore-Washington area to define the spectrum of enteric pathogen carriage in a population at high risk for "gay bowel syndrome" in association with human immunodeficiency virus infection . Seventy-seven patients with acquired immunodeficiency syndrome, 68 gay men with symptoms of acute diarrhea or proctitis, and 243 gay men without gastrointestinal symptoms and participating in a natural history study of human immunodeficiency virus infection were selected for study . Approximately 12% of the asymptomatic men harbored at least one enteric pathogen; the most frequently recovered were Chlamydia trachomatis, herpes simplex virus, and Giardia lamblia . Men carrying a pathogen were more likely to be human immunodeficiency virus seropositive (48%) than men without a pathogen (25%) (p = 0.018), more likely to have fewer T helper cells (p = 0.015), and more likely to have a mucopurulent exudate (p = 0.014) . We recovered an agent of enteric disease from 68% of gay men presenting with diarrhea or proctitis . Campylobacter species, herpes simplex virus, Neisseria gonorrhoeae, C . trachomatis, G . lamblia, and Shigella species were identified most frequently . The most common pathogen associated with diarrhea in acquired immunodeficiency syndrome was Cryptosporidium (16% of 49 cases) . Other agents identified were Clostridium difficile, Vibrio parahemolyticus, Campylobacter species, G . lamblia, Isospora, and cytomegalovirus . Approximately half of the identifiable etiologic agents of diarrhea in acquired immunodeficiency syndrome patients were treatable with antibiotics, but these agents required special culture procedures for detection.

Biochim Biophys Acta, 1988 Mar 30, 933(1), 114 - 23
The microaerophilic respiration of Campylobacter mucosalis; Goodhew CF et al.; A model is proposed for the respiratory adaptation to falling oxygen concentration during growth of the microaerophilic bacterium Campylobacter mucosalis . During the early stages of growth, the oxidation of formate is a two-stage branched process involving the production of H2O2 followed by its peroxidatic removal . In later stages of growth, at lower oxygen concentrations, the predominant electron flow is linear to a membrane-bound cytochrome-c oxidase which reduces O2 directly to H2O . Several components of this model have been investigated . H2O2 was produced during formate oxidation and accumulated when electron transfer to the cytochrome-c peroxidase was inhibited . A cytochrome c-553, of the Class 1 types, was purified and shown to be the specific electron donor to both the peroxidase and the membrane-bound oxidase . The levels of this cytochrome c and of the peroxidase were higher in cells harvested early in growth . In later stages of growth, the activity of the membrane-bound oxidase increased . Proton pumping across the membrane was detected with either H2O2 or oxygen as terminal electron acceptor . The novel energy-conserving role of H2O2 in this catalase-negative bacterium is discussed in relation to its microaerophilic nature.

N Z Med J, 1988 Mar 23, 101(842), 140 - 1
Campylobacter pylori infection in patients undergoing endoscopy in Fiji; Beg F et al.; Forty two patients (20 Fijian and 22 Indian) presenting for endoscopy at the Colonial War Memorial Hospital, Suva, Fiji, were biopsied to detect Campylobacter pylori infection . Detection of the organism's urease activity in biopsy material or seeing the organism in Warthin-Starry silver stained histology sections were used to diagnose infection . Thirty-nine patients (93%) were infected; 19 of 20 Fijians (95%) and 20 of 22 Indians (91%) . Of the 39 infected patients, 37 (95%) had chronic active gastritis and 24 (62%) had active peptic ulcer disease . The implications of these findings in relation to the management of endoscopy patients in Fiji are discussed.

Vet Rec, 1988 Mar 12, 122(11), 245 - 9
Experimental infection of dogs with Campylobacter jejuni; Macartney L et al.; Three groups of conventional puppies were inoculated orally with Campylobacter jejuni biotype 2 which had been isolated from the small intestine of a dog with enteritis . Mild enteric disease was observed in one group . There was superficial intestinal colonization by the organism but penetration of intestinal epithelial cells was not apparent . C jejuni was isolated from the blood and viscera of inoculated dogs which showed no histological evidence of disease.

Schweiz Med Wochenschr, 1988 Mar 5, 118(9), 302 - 4
{Campylobacter jejuni: sepsis and meningitis in an adult without risk factors}; Ruef C et al.; A case of Campylobacter jejuni meningitis with associated septicemia and positive stool culture in a normal host is presented . Clinical findings, course of the illness and serologic data are compared with data from the literature . The possibility of infection due to a serum-resistant strain of Campylobacter jejuni is raised . Retrospective analysis of immunity revealed normal humoral and cellular immunity in a healthy patient one year later.

Schweiz Med Wochenschr, 1988 Mar 5, 118(9), 293 - 301
{Campylobacter pylori, gastritis and ulcer disease . Microbiological, histological and serological studies}; Schaub N et al.; In a prospective study of 70 patients with epigastric pain, gastroduodenoscopy revealed gastric and/or duodenal ulcers in a total of 41 and no ulceration in the remainder . Biopsies were taken to assess the severity of gastritis and the presence of Campylobacter pylori (CP) by histology and culture . Gastritis was found in 54 patients . CP was detected in 78% of the ulcer patients and 52% of the patients without ulcer (p less than 0.05) . CP was demonstrated in 83% of the histologically diagnosed cases of gastritis (all grades) but no CP was detectable in patients with normal gastric mucosa . Among the ulcer patients, CP was more frequent in those with no history of medication with nonsteroidal antiinflammatory drugs (p less than 0.01) . Sera from CP-positive ulcer and gastritis patients have significantly higher levels of IgG antibodies to CP than sera from those found to be free of ulcer or gastritis . In 200 blood donors an increasing percentage of elevated CP-antibody titres were found with advancing age (50% over 60 years of age) . Quantification of circulating CP antibodies, would thus seem a valuable adjunct in the diagnosis of gastritis and probably also of peptic ulcer . The data presented furnish further evidence of the high rate of association of CP and the gastritis-peptic ulcer complex.

Lancet, 1988 Mar 5, 1(8584), 503 - 6
Cohort study of intestinal infection with campylobacter in Mexican children; Calva JJ et al.; A cohort of 179 children under 5 years of age from a low-income urban community was followed up for a year to determine the incidence of symptom-producing and of diarrhoea-free campylobacter intestinal infections, and thus their illness-to-infection ratio . 66% of all children had at least one campylobacter infection, one-third of these being associated with diarrhoea . The annual incidence of all campylobacter infections was 2.1 episodes per child . The incidence was inversely related to age (r = -0.78 p less than 0.02) . The illness-to-infection ratio, which in infants younger than 6 months was 1:2, was negatively associated with age (r = -0.7, p less than 0.02) . Only symptom-producing infections occurring early in life seemed to protect against subsequent infections.

Arch Fr Pediatr, 1988 Mar, 45(3), 207 - 11
{Etiological study of acute gastroenteritis in children in Tunisia}; Gueddana N et al.; This study was aimed at identifying the relative importance of the various agents responsible for gastroenteritis and to contribute to the etiopathogeny of this condition . Four hundred and two samples of stools of patients and 209 of control subjects, all under 3 years of age, were submitted to bacteriological, parasitologic and virologic examinations . An enteral etiology of gastroenteritis was found in 50% of the children . It consisted of enteropathogenic bacteria in 11%, rotaviruses in 29% and both associated in 19% of cases . There was a significant difference between patients and controls for bacterial (p less than 0.0001) and viral (p less than 0.00001) infestation . The most frequently isolated bacteria consisted overall of Escherichia coli . Eighty-seven isolated strains of E . Coli were tested for their enterotoxinogenic capacities . Four strains were bearing the attachment factor (EAF) and 14 were toxinogenic . Shiga-like toxin (or vero toxin) was detected in 4 strains . Campylobacter was isolated as frequently in patients as in controls and was often associated with other bacteria or rotaviruses . The presence of parasites and candidas was not significantly different in patients and in controls . Giardia intestinalis was the most frequently isolated parasite.

J Appl Bacteriol, 1988 Mar, 64(3), 247 - 55
Response of Campylobacter jejuni to combinations of ferrous sulphate and cadmium chloride; Stern NJ et al.; On Mueller Hinton (MH) agar, Campylobacter jejuni showed 20.0 and 30.9 mm zones of inhibition surrounding discs impregnated with 2.5 and 20 micrograms CdCl2 respectively . The minimal inhibitory concentration (MIC) ranged from 0.64 to 3.2 micrograms CdCl2/ml of MH agar for four C . jejuni strains . In the presence of 23 micrograms FeSO4/ml of MH the MIC increased to a range of 1.5-5.4 micrograms CdCl2/ml of MH . Moreover, the numbers of colonies present on MH supplemented with FeSO4 were greater than on MH without iron . The growth response of C . jejuni in the presence of 0.025% (w/v) FeSO4 in MH broth was increased about 10,000 fold in three of four strains when compared with the growth in unsupplemented MH broth . Zones of inhibition surrounding 20 micrograms discs of CdCl, were 50.6 and 24.4 mm on MH and Campy-BAP media respectively, with cells grown on MH . These results suggest that the blood-containing medium 'neutralized' the biocidal influence of the CdCl2 . In comparison, C . jejuni inoculum from fluid thioglycollate (FT) medium showed smaller zones of inhibition . These decreased from 34.9 mm on MH agar to 19.6 mm on Campy-BAP agar, suggesting that components in the FT growth medium ameliorated the toxic influence of CdCl2 . Atomic absorption spectroscopy analysis indicated mean values (mg/100 g dry weight) of selected metals bound by C . jejuni as: Cu, 10.4; Mg, 146; Na, 2385; Fe, 45.1; Zn, 13.0; and K, 172.

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