J Clin Microbiol, 1988 Mar, 26(3), 605 - 6 Campylobacter jejuni antibodies in Nigerian children; Ani EA et al.; Titers of complement-fixing (CF) antibody to Campylobacter jejuni were demonstrated in 87 (36.7%) of 237 infants 6 to 15 months old in Jos, Nigeria . Of the total number of children examined, 81 had acute diarrhea and 27 of them (33.3%) were found to have CF antibodies in their serum . The remaining 156 children were asymptomatic, and 60 (38.4%) of them had CF antibodies . In the diarrheal group, 27 of 75 children 6 to 8 months old were CF antibody positive . There was no significant difference in the incidence of CF C . jejuni antibodies in the diarrheal and nondiarrheal infants (P greater than 0.05) . Also, infants 9 to 15 months old had a higher incidence of CF antibodies (46.5%) than those 6 to 8 months of age (25%) . The data suggest that the infants whose sera were CF antibody positive had had an exposure to C . jejuni . All 33 infants 6 to 8 months of age who had no diarrhea were CF antibody negative. J Clin Microbiol, 1988 Mar, 26(3), 518 - 23 Characterization of freshly isolated Campylobacter coli strains and suitability of selective media for their growth; Ng LK et al.; Typical and atypical Campylobacter strains were isolated from the colons of cattle and swine by techniques that enabled the selective pressures of antibiotics to be avoided . Some cephalothin-susceptible strains and a strain with an indeterminate hippurate reaction were classified as Campylobacter coli by DNA homology testing . Tetracycline-resistant isolates were obtained from animals with no recorded exposure to antibiotics . A selection of 12 C . coli and 6 C . jejuni strains was used to determine the ability of fresh isolates to grow on a range of selective media . C . coli isolates were inhibited more than C . jejuni on selective media containing antibiotics . The least inhibitory media were Skirrow medium (M . B . Skirrow, Br . Med . J . 2:9-11, 1977) and the charcoal-based media developed by Hutchinson and Bolton (D . N . Hutchinson and F . J . Bolton, J . Clin . Pathol . 37:956-957, 1984) and Karmali et al . (M . A . Karmali, A . E . Simon, M . Roscoe, P . C . Fleming, S . S . Smith, and J . Lane, J . Clin . Microbiol . 23:456-459, 1986) . The plasmid contents of the isolates did not appear to be related to their sensitivity to growth on selective (antibiotic-containing) media . The study indicates that selective media used to detect Campylobacter spp . could select against the isolation of C . coli. Gut, 1988 Mar, 29(3), 279 - 83 Effect of treatment on Campylobacter pylori in peptic disease: a randomised prospective trial; Humphreys H et al.; This study investigated the effect of colloidal bismuth subcitrate and cimetidine on Campylobacter pylori in peptic disease . In 74% of 135 patients with peptic disease diagnosed at endoscopy C pylori was detected before treatment . Compared with cimetidine, colloidal bismuth subcitrate significantly decreased the incidence of C pylori after six weeks of treatment (p less than 0.001) . In the colloidal bismuth subcitrate group, subsequent healing of the lesion was correlated with the clearance of C pylori, unlike in the cimetidine group . C pylori was strongly associated with the presence of histological gastritis, which was decreased by colloidal bismuth subcitrate (p less than 0.001). APMIS, 1988 Mar, 96(3), 273 - 9 Bacteria of the gastric antrum and their relation to chronic gastritis; Aase S et al.; Biopsy samples from the gastric antrum were taken from 61 patients . On bacteriological culture, Campylobacter pylori was isolated in 27 subjects . Thirty-four patients had chronic gastritis, as seen in routine-stained histological sections . By means of the May-Grunwald-Giemsa (MGG) staining technique, bacteria were demonstrated in sections from 26 subjects . Of these, 22 had gastritis histologically . In 13 subjects, structures similar to Campylobacter pylori were found in MGG-stained sections, 11 of these having chronic active gastritis histologically . Scanning electron microscopy demonstrated bacteria with the typical appearance of Campylobacter pylori, but other types of bacteria were also found, both on electron microscopy and on bacteriological culture . The study confirms that there is an increased frequency of histological gastritis when Campylobacter pylori is present in the samples (p = 0.009) . However, a causative role of the bacteria could not be demonstrated in this study, and bacterial penetration into the epithelium was not observed. Am J Gastroenterol, 1988 Mar, 83(3), 278 - 82 Histological gastritis in duodenal ulcer: relationship to Campylobacter pylori and effect of ulcer therapy; Dooley CP et al.; Antral gastritis has been described in up to 100% of patients with duodenal ulcer disease, and recently has been associated with Campylobacter pylori infection . The present study examines the effect of two ulcer therapies (cimetidine and colloidal bismuth subcitrate) on this lesion . Sixty-four consecutive patients with endoscopically diagnosed duodenal ulcer were randomized to treatment with either agent upon entry into the study . Antral biopsies were taken at both initial and final endoscopies for culture of C . pylori and assessment of degree of gastritis (as based on inflammatory cell infiltrate: grades 0 to 3) . The organism was detected in 90% of the patients at initial biopsy, and grades 2 and 3 gastritis were documented in 76% . The presence of the organism and the gastritis were significantly correlated (p less than 0.001), and the bacterium was not cultured from histologically normal antral mucosa . Active chronic gastritis (grade 3) was seen in 65% of those with C . pylori, and was not found in any patient without the bacterium . Cimetidine had no effect on either the organism or the gastritis, whereas the bismuth preparation significantly (p less than 0.002) reduced the prevalence of both . The present study documents that therapy directed against C . pylori has a significant effect on the gastritis of duodenal ulcer disease and possible mechanisms for the observed effects are discussed. Gut, 1988 Mar, 29(3), 385 - 9 Treatment of ulcerative reflux oesophagitis with colloidal bismuth subcitrate in combination with cimetidine; Borkent MV et al.; Twenty patients took part in a controlled double blind study comparing the efficacy of colloidal bismuth and cimetidine (800 mg at night) with cimetidine alone in the treatment of ulcerative reflux oesophagitis . Colloidal bismuth 120 mg was administered through an intraoesophageal tube four times a day . Cimetidine with colloidal bismuth gives significantly (p less than 0.001) better results than cimetidine alone . Of 10 patients treated with cimetidine and bismuth, seven had no endoscopic signs of oesophagitis after three weeks and three had grade I oesophagitis . Of 10 patients treated with cimetidine alone, one had grade I oesophagitis and three grade II oesophagitis after three weeks . The remaining six still had grade III oesophagitis . This study also shows that in nine of 10 patients reflux oesophagitis was accompanied by infection with campylobacter like organisms (CLO) . After treatment the bacteria disappeared promptly in five patients receiving combination therapy and in two of four treated with cimetidine alone . The possible role of CLO in reflux oesophagitis is uncertain. Arch Intern Med, 1988 Mar, 148(3), 739 - 41 Guillain-Barré syndrome following Campylobacter jejuni enteritis . Report of three cases and review of the literature; Sovilla JY et al.; We describe three cases of Guillain-Barre syndrome (GBS) associated with Campylobacter jejuni enteritis and review the data from eight other cases described in detail in the literature . The recent recognition of this association is probably due to improved stool culture technique . In comparison with GBS associated with respiratory infections, the delay between the first symptoms of infection and the development of GBS is somewhat longer, an observation in accordance with GBS associated with gastrointestinal symptoms of unidentified etiology . The clinical picture and the outcome do not seem to differ from those of GBS associated with other disorders . Campylobacter jejuni appears to be a pathogen capable of triggering GBS and will probably become increasingly recognized if appropriate culture and serologic tests are performed. Radiology, 1988 Mar, 166(3), 737 - 40 Campylobacter ileocolitis mimicking acute appendicitis: differentiation with graded-compression US; Puylaert JB et al.; In nine patients with clinical symptoms of acute appendicitis, graded-compression ultrasound (US) did not depict the appendix but instead demonstrated mural thickening of the terminal ileum and part of the colon, as well as moderately enlarged mesenteric lymph nodes . In one patient a normal appendix was removed; eight patients recovered without treatment . Infection with Campylobacter jejuni was proved in all nine patients . In four patients, an unnecessary appendectomy was avoided because of the US findings . Graded-compression US enables differentiation between acute appendicitis and Campylobacter ileocolitis, a vital differentiation, since surgery is almost certainly not indicated for the latter. Z Gastroenterol, 1988 Mar, 26(3), 155 - 9 {Ofloxacin in therapy of "resistant" duodenal ulcer . A pilot study}; Bayerdorffer E et al.; Since its description in 1983 Campylobacter pylori (C.p.) has been discussed as possible pathogenic factor at least in duodenal ulcer disease . The therapeutic combination of H2-receptor-antagonists (= H2-RA) and ofloxacin (Tarivid) has shown to heal resistant duodenal ulcers in some preliminary cases, which did not respond to a three month standard dosage treatment with H2-RA . This paper describes the results of twelve patients whose duodenal ulcers were resistant to H2-RA . C.p . was detected in all patients before therapy . The combined treatment with ofloxacin and H2-RA healed the duodenal ulcers within 2 weeks in 6 patients, within 4 weeks in 2, and within 6 weeks in 4 patients as proven by fortnightly performed endoscopic controls . At the end of therapy C.p . was not detected in 11 of 12 patients . The MIC's of ofloxacin for C.p . ranged from 0.5-1 microgram/ml in six investigated patients . The results suggest a possible pathogenic role of C.p . in duodenal ulcer disease. J Infect Dis, 1988 Mar, 157(3), 465 - 71 Restriction endonuclease analysis of the genome of Campylobacter pylori with a rapid extraction method: evidence for considerable genomic variation; Majewski SI et al.; We developed a rapid extraction method to analyze the chromosomal DNA of 84 isolates of Campylobacter pylori (formerly Campylobacter pyloridis) from 70 individuals . Only three of the nine endonucleases tested gave satisfactory digestions: HindIII, EcoRI, and SacI . The latter two produced mostly larger bands, whereas HindIII produced smaller bands, which allowed clearer comparisons between isolates . The isolates from 69 Australian subjects and one from England each had a unique profile . Isolates from a husband and wife were different, as were those from a brother and sister . In pairs of isolates from 11 individuals, the second isolate was markedly different in six subjects . The profile changes were not associated with changes in antibiotic susceptibility or with loss of catalase or urease activity, which can occur during storage of C . pylori . These restriction endonuclease profiles suggest considerable subspecies variation in C . pylori . Plasmid bands were found in undigested DNA from 40 of the 84 C . pylori isolates. Ann Trop Paediatr, 1988 Mar, 8(1), 26 - 30 Bacterial, parasitic and viral enteropathogens associated with diarrhoea in Saudi children; al-Bwardy MA et al.; In a 2-year study of stools from Saudi children with gastro-enteritis and from controls, rotavirus was the pathogen most frequently detected, either alone (44.3%) or in combination with other enteropathogens (7%) . There were two peaks for rotavirus isolates, one during the cold months and the other during the dry, hot season . Salmonella spp . and Campylobacter jejuni were the second and third most frequently isolated enteropathogens . Enteropathogenic Escherichia coli did not contribute significantly to diarrhoea . Detection of enterotoxigenic E . coli was not attempted and its role in diarrhoea remains obscure . Giardia lamblia was detected more frequently in controls than in cases of diarrhoea . Neither Entamoeba histolytica nor Schistosoma mansoni was detected in any of the children studied. Postgrad Med, 1988 Feb 15, 83(3), 98 - 100, 103-6 Gastritis . Bringing this enigma into sharper focus; Michaletz PA et al.; Type A and type B (probably Campylobacter pylori) gastritis are distinct clinical (but largely asymptomatic) and histologic entities that can be separated from other disease processes . While the association of C pylori gastritis with peptic ulcer disease is well documented, no causal relationship has been established . Acute inflammatory conditions of the stomach secondary to other disease processes, macroscopic abnormalities of the gastric mucosa, and sometimes poorly characterized epigastric pain all carry the name "gastritis." The fact that, as a disease, gastritis remains an enigma largely stems from the multiple implications of the term . An accurate classification system of the gastritides would be helpful but is not yet available . Until it is, the term "gastritis" will have more meaning if accompanied by a description of the type of gastritis or of the responsible etiologic factor, secondary disease, or toxic insult (eg, gastric mucosal injury associated with use of nonsteroidal antiinflammatory drugs) . Deletion of the term "gastritis" from the clinical vocabulary and substitution of better terms (eg, "nonulcer dyspepsia," "irritable bowel syndrome") will also serve to clarify the issue. J Appl Bacteriol, 1988 Feb, 64(2), 135 - 40 Serovars and biovars of Campylobacter strains isolated from humans and slaughterhouse animals in northern Germany; Wokatsch R et al.; A total of 318 Campylobacter strains from sporadic cases of human enteritis (109 strains) and healthy slaughterhouse animals in northern Germany (209 strains) were bio- and serotyped according to the Lior typing schemes . Three hundred strains were typable (94.3%) and 38 serovars were identified . Among human strains 28 serovars were identified with 30% of them belonging to serovar 4 . Strains from pigs were associated with 25 serovars, the most frequent being serovar 20 (21.2%) . Fourteen serovars were identified in the ovine strains of which 31.1% were of serovar 49, and 22.2% of serovar 4 . All of the strains from one chicken farm were of serovar 11, whereas in those from another serovar 1 was predominant (85.4%) . Twenty-five of the 38 serovars identified were associated with at least two different biovars . Campylobacter jejuni biovar I was predominant in humans, sheep and chickens and Campylobacter coli biovar I in pigs . The results suggest that the combined use of bio- and serotyping according to the Lior typing schemes would be of use in studies on the epidemiology of human campylobacteriosis in Germany. J Clin Gastroenterol, 1988 Feb, 10(1), 10 - 2 Campylobacter pylori-associated gastritis . Is antibiotic therapy now justified? Talley NJ. Campylobacter pylori clearly is a common inhabitant of the human stomach and is associated with nonautoimmune antral gastritis, chronic peptic ulceration, and non-ulcer dyspepsia . This editorial reviews whether therapy is now justified for patients with this infection . The criteria that must be fulfilled before an association can be considered to be of etiologic significance are discussed in relation to C . pylori infection and clinical disease . An overview of therapeutic approaches to eradicate C . pylori is presented, emphasizing their limitations and hazards . It is concluded that prescribing treatment for C . pylori infection outside the setting of a controlled trial is currently not appropriate. Leber Magen Darm, 1988 Feb, 18(1), 17 - 28 {Campylobacter pylori--status of knowledge from the morphologic viewpoint}; Ruhl GH et al.; The morphological alterations of the gastric mucosa due to Campylobacter pylori (C.p.) were examined with high resolution light microscopy, scanning electron microscopy, and transmission electron microscopy . On the ultrastructural level the number and distribution of bacteria were correlated to the extent of the inflammatory resp . degenerative epithelial alterations . Intestinal metaplasia was always free of bacteria, even with strong colonization of the residual mucosa . In comparison to the gastric mucosa in the IM the cellular disintegration was less strongly developed . The topographical distribution of C.p . was studied on two ulcer resection specimens and documented by means of "campylobacter-mapping" . Contrary to the subjective impression made by stomach biopsies, the bacterial colonization examined was not patchy, but rather it was evenly distributed . The association between C.p . and duodenal ulcer, made in most literature, relies primary on cultural, or morphological studies of the antrum mucosa, thereby actually representing the correlation of C.p . to the accompanying gastric inflammation . An analysis of the detection methods--morphological, cultural, and the urease-test--confirms the significance of morphological methods in the diagnosis of C.p.-infection. Epidemiol Infect, 1988 Feb, 100(1), 27 - 34 Experimental colonization of broiler chicks with Campylobacter jejuni; Shanker S et al.; Minimal colonization inocula for two broiler strains of Campylobacter jejuni were determined in broiler chicks aged 2-3 days and 2 weeks . Individually housed chicks were exposed to a single oral or cloacal challenge . Diarrhoeal symptoms were absent in all 380 chicks included in the study . Chick susceptibility to the two C . jejuni strains varied . Colonization was effected by less than 10(2)-10(4) colony forming units (c.f.u.) via cloacal challenge and 10(4)-10(6) c.f.u . via the oral route . Colonization inocula for 2- to 3-day and 2-week-old chicks were similar . Treatment of 1-day-old chicks with fresh adult caecal flora or an anaerobic broth culture of adult caecal flora did not inhibit colonization after challenge with low-dose C . jejuni . Susceptible chicks were colonized rapidly . C . jejuni was detected in 167 of 189 (88%) colonized chicks within 3 days of challenge and persisted during the 2-week monitoring period . Our data suggest that colonization of broiler chicks with C . jejuni is effected more easily by the cloacal than the oral route and is independent of age. Epidemiol Infect, 1988 Feb, 100(1), 17 - 25 The extent of surface contamination of retailed chickens with Campylobacter jejuni serogroups; Hood AM et al.; Eighty-two chickens purchased at 11 retailers (supplied by 12 wholesalers) in the south of England were cultured for Campylobacter jejuni by a method involving total immersion . The organism was isolated from 22 (48%) of 46 fresh birds, 12 of 12 uneviscerated (New York dressed) birds, but only 1 of 24 frozen birds . Viable counts of up to 1.5 x 10(6)/chicken were obtained from fresh birds and 2.4 x 10(7)/chicken from uneviscerated birds . Surface swabbing of breasts, thighs, wings and vents of fresh chickens showed that contamination was generally distributed over the carcasses . Salmonellas were found in only 2 of 69 of the fresh chickens . The prevalence of several Lior and Penner C . jejuni serogroups was similar in chickens and sporadic human cases of enteritis . Penner serogroup 4 (mostly of Lior serogroup 1) was found in 26% of human isolates and 14% of chicken isolates . The rising incidence of campylobacter enteritis during the last 6 years could well be a reflection of the increasing proportion of fresh chickens consumed over that period (32% higher in 1986 than in 1981). Lab Anim Sci, 1988 Feb, 38(1), 34 - 6 Campylobacter-like omega intracellular antigen in proliferative colitis of ferrets; Fox JG et al.; Proliferative colitis in the ferret consistently displays, along with marked proliferation of mucosal cells, intracytoplasmic campylobacter-like organisms within the apical portion of the epithelial cells . Fluorescent antibody to "omega" campylobacter antigen present in porcine intestinal adenomatosis and hamster proliferative ileitis was demonstrated at the site of bacterial colonization within hyperplastic epithelial cells of six colons from ferrets affected with proliferative colitis. Leber Magen Darm, 1988 Feb, 18(1), 9 - 16 {Campylobacter pylori-associated chronic gastritis: a new entity in gastroduodenal diseases?}; Borsch G et al.; Clinical, morphological and immunological data in addition to animal studies clearly support the conclusion, that Campylobacter pylori infection is a direct cause (sufficient condition) for chronic type B gastritic in man . C . pylori gastritis is primarily a histologic entity defined by the presence of a gastric mucosal cellular infiltrate and the histologic demonstration of typical curved bacilli . Preliminary findings indicate, that this infection is not associated with a specific combination of symptoms . Also, it is not exclusively confined to human beings, since this or similar infections appear to represent a rather common phenomenon of mammalian stomachs . The emergence of C . pylori gastritis as a distinct entity may give rise to a new classification of dyspeptic disorders based on etiologic considerations . However, the clinical impact of C . pylori will in all likelihood depend primarily on the as yet unestablished therapeutic potential to effectively eradicate the organisms. Leber Magen Darm, 1988 Feb, 18(1), 38 - 45 {Therapy of Campylobacter pylori infection}; Borsch G; A simple and efficient therapy eradicating C . pylori with high reliability from gastroduodenal mucosae is presently unknown . In regard to such a "puristic" approach, antibiotics given as monotherapy are presently as ineffective as bismuth salts, which may temporarily reduce the bacterial density, but yield a low complete bacterial eradication rate of not more than 10% to 30% of all patients . Pilot studies are being performed in many centers to identify more efficacious drugs or combinations . Alternative modalities, such as manipulation of mucus, active vaccination, or clearing of bacterial sources in the environment, presently represent nothing but hypothetical models . Bismuth salts might play an important future role in a more "pragmatic" approach, which investigates any potential clinical benefit derived from a mere suppression of bacterial growth, possibly resulting in a temporary restoration of the mucosal integrity . However, this approach will probably fail to modify the long-term natural history of C . pylori-associated chronic gastritis and its sequelae. Leber Magen Darm, 1988 Feb, 18(1), 31 - 7 {Microbiology of Campylobacter pylori}; Mai U et al.; Campylobacter pylori is a hitherto unknown spiral bacterium . It is implicated in the pathogenesis of chronic antral type B gastritis and also of duodenal and gastric ulcer disease . However, its causal role has not yet been unequivocally established . Taxonomically, C.pylori appears to belong to a genus different from genuine campylobacters, but a precise classification is likewise lacking . The in vitro sensitivity analyses of various antibiotics are complicated by a number of technical difficulties . This is one of the reasons, that results of in vivo eradication trials have to be interpreted with considerable caution. J Clin Pathol, 1988 Feb, 41(2), 207 - 10 Prevention of nitroimidazole resistance in Campylobacter pylori by coadministration of colloidal bismuth subcitrate: clinical and in vitro studies; Goodwin CS et al.; One hundred patients with duodenal ulceration and Campylobacter pylori in their stomach were entered into a double blind placebo controlled prospective study . Treatment schedules were cimetidine and placebo, or cimetidine and tinidazole, or colloidal bismuth subcitrate (CBS) and placebo, or CBS and tinidazole . Seventeen per cent of isolates of C pylori obtained at the first endoscopy were resistant to tinidazole and 70% of the second isolates from patients given cimetidine and tinidazole became tinidazole resistant . Suspensions of nitroimidazole sensitive cultures of C pylori showed that three of 22 isolates had a nitroimidazole resistant subpopulation . In patients who healed and remained free of C pylori after treatment ulcers recurred less often than in patients who healed but retained C pylori (23% v 73% over 12 months, p less than 0.001). Pathol Biol (Paris), 1988 Feb, 36(2), 163 - 6 {In vitro bacteriostatic and bactericidal effect of ciprofloxacin and others quinolone derivatives on Campylobacter jejuni}; Vanhoof R et al.; The in vitro bacteriostatic (MIC) and bactericidal (MBC) activities of ciprofloxacin and seven other quinolone derivatives on Campylobacter jejuni from human origin were determined . Ciprofloxacin, pefloxacin and rosoxacin exhibited the best bacteriostatic and bactericidal activities . For the three compounds the MIC90 was less than or equal to 0.33 microgram/ml while the MBC90 was resp . 0.36, 0.56 and 0.56 microgram/ml . The MBC values were always significantly higher than the MIC values (P less than 0.001) . An attempt was made to select strains with an induced resistance against the quinolone derivatives. Proc Natl Acad Sci U S A, 1988 Feb, 85(3), 856 - 60 High-voltage electroporation of bacteria: genetic transformation of Campylobacter jejuni with plasmid DNA; Miller JF et al.; Electroporation permits the uptake of DNA by mammalian cells and plant protoplasts because it induces transient permeability of the cell membrane . We investigated the utility of high-voltage electroporation as a method for genetic transformation of intact bacterial cells by using the enteric pathogen Campylobacter jejuni as a model system . This report demonstrates that the application of high-voltage discharges to bacterial cells permits genetic transformation . Our method involves exposure of a Campylobacter cell suspension to a high-voltage exponential decay discharge (5-13 kV/cm) for a brief period of time (resistance-capacitance time constant = 2.4-26 msec) in the presence of plasmid DNA . Electrical transformation of C . jejuni results in frequencies as high as 1.2 x 10(6) transformants per microgram of DNA . We have investigated the effects of pulse amplitude and duration, cell growth conditions, divalent cations, and DNA concentration on the efficiency of transformation . Transformants of C . jejuni obtained by electroporation contained structurally intact plasmid molecules . In addition, evidence is presented that indicates that C . jejuni possesses DNA restriction and modification systems . The use of electroporation as a method for transforming other bacterial species and guidelines for its implementation are also discussed. J Rheumatol, 1988 Feb, 15(2), 315 - 20 Absence of Antienterobacteriaceae and anti-HLA-B27 antibodies in mitogen stimulated cultures of lymphocytes from patients with Reiter's syndrome and ankylosing spondylitis; Cavender DE et al.; Lymphocytes from HLA-B27 positive patients with ankylosing spondylitis or Reiter's syndrome and from matched controls were cultured with pokeweed mitogen and heat-killed S . aureus bacteria under conditions designed to maximize immunoglobulin production . Despite the secretion of microgram quantities of immunoglobulin, which were not significantly different in patients and controls, only negligible amounts of IgM, IgG and IgA antibodies to Campylobacter, Shigella and Yersinia were detectable . In addition, no anti-HLA-B27 antibodies were produced by any patient . Our results are not consistent with the hypothesis that HLA-B27 crossreactive antibodies to Enterobacteriaceae antigens have a role in the pathogenesis of ankylosing spondylitis or Reiter's syndrome. J Pathol, 1988 Feb, 154(2), 125 - 32 Lymphocytic gastritis--relationship to Campylobacter pylori infection; Dixon MF et al.; The existence of a distinctive form of chronic gastritis characterized by marked infiltration of the surface and pitlining epithelium by mature T lymphocytes has been confirmed . Seventeen cases were identified amongst 382 patients with active chronic gastritis (4.5 per cent) . The cases with lymphocytic gastritis had significantly higher counts of intraepithelial lymphocytes than sex and age-matched controls drawn from a series of patients with the usual form of active Type B chronic gastritis . Furthermore, the lymphocytic gastritis group exhibited unusual endoscopic findings, namely erosions and 'raised lesions', in the body of the stomach . Such appearances have been previously described as 'varioliform' gastritis . Only seven of the patients (41 per cent) had C . pylori-positive biopsies, compared with over 90 per cent in the generality of active chronic gastritis, but all but two of the eleven cases tested had serological evidence of C . pylori infection . While the pathogenesis of this condition is unclear, the histological resemblance to coeliac disease suggests that lymphocytic gastritis might also represent an abnormal response to a local antigen to which the patient has become sensitized . It is possible that this antigen is C . pylori. Microb Pathog, 1988 Feb, 4(2), 115 - 26 A new heat-labile cytolethal distending toxin (CLDT) produced by Campylobacter spp; Johnson WM et al.; A new heat-labile toxin cytolethal to CHO, Vero, HeLa, and HEp-2 cells and negative in Y-1 cells has been demonstrated in culture filtrates of many strains of Campylobacter spp . This new toxin was termed a cytolethal distending toxin (CLDT) to reflect the progressive cell distention and eventual cytotoxicity observed in all sensitive tissue cells . CLDT was distinct from previously reported cytotoxins and cholera-like enterotoxin produced by some Campylobacter spp . Since CHO elongation induced by either the Campylobacter enterotoxin or CLDT could not be differentiated after 24 h incubation, continuation of the assay for 96 h was essential for observation of CLDT-associated progressive morphological changes and cytolethal events . Specific assay conditions were required for demonstration of CLDT in Vero, HeLa, and HEp-2 cells . A 31-fold increase in cyclic AMP levels was observed in CHO cells exposed for 24 h to CLDT of catalase negative or weak positive Campylobacter . CLDT was detected in culture filtrates from strains of Campylobacter jejuni, C . coli, C . fetus subsp . fetus, C . laridis and catalase negative or weak positive Campylobacter . Of 718 strains investigated from both human and animal isolations, 295 (41%) were found to produce this toxin . Campylobacter CLDT was negative in adult rabbit ligated ileal loops, suckling mouse and rabbit skin tests . Hemorrhagic responses were observed in rat ligated ileal loop tests of CLDT-positive cultures . The new CLDT toxin could only be neutralized by homologous rabbit antitoxin, was trypsin-sensitive, nondialyzable and over 30,000 in molecular weight . CLDT-producing strains were observed in many serogroups and biotypes of Campylobacter spp . The strains tested originated from many countries and no clear association of toxigenicity with serotype or biotype could be established. J Clin Microbiol, 1988 Feb, 26(2), 261 - 6 Development and testing of invasion-associated DNA probes for detection of Shigella spp . and enteroinvasive Escherichia coli; Venkatesan M et al.; Genetic determinants of the invasive phenotype of Shigella spp . and enteroinvasive Escherichia coli (EIEC), two common agents of bacillary dysentery, are encoded on large (180- to 210 kilobase), nonconjugative plasmids . Several plasmid-encoded antigens have been implicated as important bacterial ligands that mediate the attachment and invasion of colonic epithelial cells by the bacteria . Selected invasion plasmid antigen (ipa) genes have recently been cloned from Shigella flexneri serotype 5 into the lambda gt11 expression vector . Portions of three ipa genes (ipaB, ipaC, and ipaD) were tested as DNA probes for diagnostic detection of bacillary dysentery . Under stringent DNA hybridization conditions, all three DNA sequences hybridized to a single 4.6-kilobase HindIII fragment of the invasion plasmids of representative virulent Shigella spp . and EIEC strains . No hybridization was detected in isogenic, noninvasive Shigella mutants which had lost the invasion plasmid or had deleted the ipa gene region . Furthermore, these probes did not react with over 300 other enteric and nonenteric gram-negative bacteria tested, including Salmonella, Yersinia, Edwardsiella, Campylobacter, Vibrio, Klebsiella, Aeromonas, Enterobacter, Rickettsia, and Citrobacter spp . and various pathogenic E . coli strains . The use of unique invasion-essential gene segments as probes for the specific detection of invasive dysentery organisms should benefit both epidemiologic and diagnostic analyses of Shigella spp . and EIEC. Z Gastroenterol, 1988 Feb, 26(2), 137 - 44 {Rheumatologic syndrome in gastrointestinal diseases . Clinical and pathogenetic aspects}; Hermann E et al.; Patients with reactive arthritis, sacroiliitis, spondylitis or Reiter's syndrome following intestinal infection from Yersinia, Salmonella, Shigella or Campylobacter organisms have been reported from endemic areas and after epidemic dysenteries . Possession of the antigen HLA B27 affects severity and prognosis of the arthritis and is more often associated with spondylitis and Reiter's syndrome . Articular manifestations are also quite common systemic complications of chronic inflammatory bowel disease . The clinical picture, pathogenetical aspects and treatment of arthritis associated with Crohn's disease, ulcerative colitis and Whipple's disease are reviewed . In only few cases, coeliac disease can be complicated by arthritis . In patients undergoing intestinal bypass surgery systemically absorption of intestinal bacterial antigens and immune complex formation may contribute to the development of bypass-arthropathy and dermatologic manifestations. APMIS, 1988 Feb, 96(2), 128 - 32 Campylobacter pylori in Swedish patients referred for gastroscopy; Gnarpe H et al.; Campylobacter pylori was isolated more often from patient with peptic ulcers and in an age-related manner in a material of 395 consecutive patients referred for gastroscopy . Direct microscopy was done with Gram and Acridine Orange stain and found too insensitive for practical use . All patients were investigated serologically with an enzyme immunoassay which showed excellent correlation with positive cultures for C . pylori . The findings were discussed, and the enzyme immunoassay, with a negative predictive value of 0.99, was found to be a valuable tool for primary screening of patients suspected of being carriers of C . pylori. S Afr Med J, 1988 Jan 23, 73(2), 83 - 7 Enteropathogens associated with acute infantile diarrhoea in Cape Town; Househam KC et al.; The results of a year-long controlled study on the causation of acute infectious diarrhoea in infants are reported . Campylobacter fetus subspecies jejuni, rotavirus and certain enteropathogenic Escherichia coli (EPEC) types were identified as the most common enteropathogens . Shigella, Salmonella group B and Yersinia enterocolitica were significant but less common pathogens . Campylobacter, rotavirus, the significant EPEC types and Shigella infections were more frequent in the warm summer and autumn months . This only partially accounts for the marked summer peak of diarrhoea, since at this time the percentage of cases of undetermined causation is highest (61%) . Over the year an identifiable cause of the diarrhoea was found in 49% of the patients studied . A specific EPEC type, 0126:K71(B16), appeared to vary in pathogenicity on a seasonal basis . Multiple enteropathogens occurred relatively frequently. Scand J Infect Dis, 1988, 20(3), 353 - 4 Mannose-resistant haemagglutination by Campylobacter pylori; Emody L et al.; 10 Campylobacter pylori strains were screened for the presence of presumptive colonization factors by measuring cell surface hydrophobicity and haemagglutination . All 8 clinical isolates and 2 reference strains caused haemagglutination of rabbit, human and/or sheep erythrocytes in the presence of mannose . None of the strains expressed a hydrophobic cell surface . In preliminary experiments the haemagglutination could be inhibited with monosialogangliosides suggesting that these strains express sialic acid specific haemagglutinin(s) which could be involved in colonization of mucosal surfaces. Scand J Infect Dis, 1988, 20(3), 349 - 50 Antibody response to Campylobacter pylori in diverse ethnic groups; Dwyer B et al.; Antibody response to Campylobacter pylori was measured in ethnic groups of Vietnamese, El Salvadorean and Ethiopian origin . The results were compared with the previously reported antibody titres found in sera of culture positive and culture negative patients, patients suffering from duodenal ulcer, white Australian blood donors and Australian Aboriginals . While in Vietnamese the prevalence of serologically positive sera was found to be similar to the white Australian population, numbers of serologically positive sera in El Salvadorean and Ethiopian ethnic groups was found to be very high . The high incidence of serologically positive sera in the Ethiopians correlated with the reported high incidence of duodenal ulcer in this population. Scand J Infect Dis, 1988, 20(3), 303 - 14 Acute diarrhoea in adults: aetiology, clinical appearance and therapeutic aspects; Svanteson B et al.; A prospective study of acute diarrhoea was performed during 15 months 1981/1982 and included 731 patients and 240 controls . 43% had been infected abroad . A cluster of travellers with bacterial pathogens was diagnosed in July-August . The following pathogens were found: Campylobacter (18%), enterotoxigenic E . coli (6%), Salmonella spp . (5%), rotavirus (4%), Yersinia enterocolitica (3%), Giardia lamblia (3%), Shigella spp . (2%), Clostridium difficile (2%), enteroviruses (2%) and Entamoeba histolytica (less than 1%) . More than 90% of the bacterial or parasitic enteropathogens were detected in the first stool sample . Only 10% of the patients needed hospital treatment and for 97% oral fluids were sufficient . The median duration of diarrhoea was 9 days . No fatal cases occurred and only 2 cases of chronic bowel disease were detected. Microbiol Immunol, 1988, 32(4), 327 - 37 Purification and antigenic analysis of flagella of Campylobacter jejuni; Ueki Y et al.; The flagella of Campylobacter jejuni strain FUM158432 were purified and a flagellin preparation consisting of only a single peptide of 63,000 daltons was obtained . The peptide of 92,000 daltons usually associated with a flagellar preparation was shown to be a peptide derived from the hook region . Antiserum was prepared by immunizing a rabbit with the flagellin preparation . The reaction of the antiserum was found to be highly specific for the flagellar filament by immunoelectron microscopy and for flagellin peptide by the immunoblotting method . Seventeen of 23 clinically isolated strains of C . jejuni reacted with this antiserum but the other six strains did not, indicating the existence of antigenic variation of the flagella of C . jejuni . The flagella of a few strains of C . coli also reacted with this antiserum. Eur Neurol, 1988, 28(3), 150 - 1 Fisher's syndrome associated with Campylobacter jejuni infection; Kohler A et al.; A patient developed typical features of Fisher's syndrome after an infection with Campylobacter jejuni as ascertained by positive serology both in the blood and spinal fluid . This may be the first case of this association described. Can J Microbiol, 1988 Jan, 34(1), 80 - 2 Migratory birds of central Washington as reservoirs of Campylobacter jejuni; Pacha RE et al.; Migratory ducks, Canada geese, and sandhill crane from the Pacific North American Flyway have been screened for Campylobacter spp . Samples (298) from these birds were examined and the incidence of Campylobacter spp . in the samples were as follows: sandhill crane (Grus canadensis tabida), 81%; ducks (Aythya collaris, Anas carolinensis, Aythya americana, and Anas platyrhynchos), 73%; and Canada geese (Branta canadensis), 5% . All isolates were identified as Campylobacter jejuni . To our knowledge this is the first report of the isolation of C . jejuni from sandhill crane . The high frequency of isolation in both the sandhill crane and migratory ducks indicated that these bird populations may play a significant role in the dissemination of the bacterium . Because of their migratory habits, these birds may be particularly important in spreading C . jejuni to remote areas. Arkh Patol, 1988, 50(2), 13 - 8 {Campylobacter pyloridis in peptic ulcer}; Aruin LI et al.; To study the role of Campylobacter pyloridis (CP) in the etiology of peptic ulcer and chronic gastritis, biopsies were obtained from gastric and duodenal mucosa of 54 ulcer patients and 8 healthy controls . In normal histological appearance and moderate gastritis without signs of exacerbation CP were not registered contrary to atrophic antral gastritis demonstrating CP irrespective of ulcer location . CP resided on the epithelium under the mucous layer between epitheliocytes . Contamination proved mild in 13%, moderate in 50% and profound in 80% of cases . CP were associated with peptic ulcer in 78% of relevant patients, with duodenal ulcer in 80% of those . The duodenal presentation was observed only in the regions of gastric metaplasia . CP did not occur in fundal mucosa, ulcer boundaries and intestinal metaplasia . There was no significant difference in CP amount at various ulcer sites . It is suggested that CP may play a role in the etiology and pathogenesis of peptic ulcer. Microbiol Immunol, 1988, 32(2), 141 - 50 Small-scale DNA preparation for rapid genetic identification of Campylobacter species without radioisotope; Ezaki T et al.; A simplified and rapid genetic identification method for Campylobacter species without radioisotope was established . Three different amounts of DNA (200, 50, and 12.5 ng) extracted from each type strain of Campylobacter species with standard Marmur's procedure were spotted on a nitrocellulose filter . DNA obtained from one ml bacterial suspension at a concentration of McFarland standard turbidity No . 1 of Campylobacter fetus, C . jejuni, C . coli, and C . pylori isolates were sufficiently labeled with photo-biotin within 15 min and clearly hybridized with the type strain of the corresponding species within four to six hours . Hybridized spots were visualized with alkaline-phosphatase-conjugated streptavidin color-detection method . The reaction was usually stopped within 30 min . Atypical clinical isolates such as a nitrate-negative C . jejuni, two nalidixic acid-resistant C . jejuni, and two strains of C . fetus able to grow at 42 C, which were tentatively identified as such, were definitely identified by the simplified DNA hybridization method presented here . This method will be applicable routinely for the definite identification of atypical strains of Campylobacter species and other gram-negative bacteria difficult to identify biochemically. Microbiol Immunol, 1988, 32(1), 75 - 82 The immune system response to Campylobacter infection; Melamed A et al.; Campylobacter may be one of the most common causes of bacterial gastroenteritis (GE) in children . It has recently been suggested that it is one of the bacterial pathogens most likely to infect immune-compromised children, and it may facilitate colonization of enteric pathogens . The immune system response was studied in 12 children with Campylobacter fetus subspecies jejuni (CBJ) infections . Serum concentrations of IgA, IgM, and IgG were analyzed using a Beckman auto-analyzer . Sera specific Ab to CBJ were tested with CBJ specific enzyme-linked immunosorbent assay (ELISA) . Mitogen stimulation of lymphocytes was performed to three lectins: Con A, PWM, and PHA . The lymphocyte blast transformation to Campylobacter was studied using the Campylobacter antigen . T-cell subsets were studied using the monoclonal antibodies Leu 2, 3, and 4 (Becton Dickinson) . Chemotaxis was measured in modified Boyden chambers; chemotactic stimulants were the Formyl Met Leu Phe, Campylobacter antigen virion, and E . coli 0111 B . Immunoglobulins were normal in nine cases and abnormal in two children previously diagnosed as agammaglobulinemic and one diagnosed as hypoagammaglobulinemic . Specific serum Ab level was significantly higher in the CBJ group, except in the agammaglobulinemic group . Stimulation indices to mitogens and monoclonal subset were in the normal range . The blastogenic transformation to CBJ Ag was decreased compared to normal lectins, and positive and high compared to controls . The chemotactic activity to campylobacter Ag was decreased in comparison to other stimulants . Most CBJ infections are self-limiting due to a normal immune response and collaboration of all cellular limbs . When, however, the immune response is disturbed, we may find a prolonged and complicated course of CBJ. J Submicrosc Cytol Pathol, 1988 Jan, 20(1), 237 - 42 Epithelial morphology of duodenal bulb and Campylobacter-like organisms; Caselli M et al.; We have carried out ultramicroscopical investigations on 30 patients with endoscopical aspects of congestive or erosive duodenitis associated or not with bulbar ulcer in relation to the presence of Campylobacter-like organisms (CLO), considered as a possible etiologic agent of peptic disease . Bacteria were found in all of the 14 patients with duodenal ulcer and in only five patients without ulcer . The ultrastructural studies provided elements for the evaluation of epithelial colonization of the duodenal bulb by CLO and which may lead to a new interpretation of gastric metaplasia. J Infect, 1988 Jan, 16(1), 77 - 9 Campylobacter pylori infection in children; Eastham EJ et al.; Two children with antral nodular hyperplasia and active chronic gastritis associated with Campylobacter pylori are reported . The organism was observed by scanning electron microscopy and cultured from antral biopsies obtained at endoscopy from each patient . Anti-C . pylori IgG was detected in high titre in both patients together with serum IgM in one patient . Treatment with ampicillin and a bismuth preparation resulted in total resolution of symptoms . Repeated endoscopy with antral biopsy and culture, as well as the absence of acute inflammatory changes, confirmed the eradication of the organism . Correlation of positive bacteriological cultures and serological tests with the clinical improvement related to therapy supports a causative role for C . pylori in antral lymphoid hyperplasia and antral gastritis in children. Zh Mikrobiol Epidemiol Immunobiol, 1988 Jan, (1), 15 - 8 {Effect of the composition of the nutrient media and culture conditions on the growth of strains of Campylobacter jejuni and C . coli}; Gericke B et al.; The influence of the composition of culture media and cultivation conditions on the growth of Campylobacter strains has been studied . Blood-containing media have been found to ensure the most favorable growth conditions . No differences between the use of RCT supplement (rifampicin, cephalothin and trimethoprim in amounts of 10, 15 and 5 mg/l respectively) and DC supplement (0.1% of sodium deoxycholate and 15 mg/l of cephalothin), as well as between different methods used for the creation of microaerophilic conditions, have been established. Scand J Infect Dis, 1988, 20(1), 63 - 8 Antibody response to Campylobacter pylori in an ethnic group lacking peptic ulceration; Dwyer B et al.; The association between duodenal ulcer, gastritis and gastroduodenal colonization with Campylobacter pylori suggests a causal role for this newly described bacterium . In an attempt to challenge the verity of this association we studied a group of people in whom duodenal ulcer is apparently absent . Serological evidence of infection was sought with a sensitive, specific ELISA assay for C . pylori specific IgG and was compared with results from control sera from teenagers referred for respiratory viral serology, volunteer blood bank donors, patients with duodenal ulcers and patients in whom the presence or absence of C . pylori had been determined by histological and microbiological examination of gastric tissue . A relatively isolated group of Australian Aborigines in whom peptic ulceration is virtually unknown, was observed to possess age-specific mean C . pylori antibody levels comparable those found in a group of white Australian dyspeptic patients without microbiological evidence of infection with this organism . The antibody levels of Aborigines were lower than those found in an aged-matched group of 'healthy' white Australians, both of these groups having levels which were significantly lower than the levels found in culture positive white Australian dyspeptic patients . It was found that 21/144 'healthy' white Australians (14.6%) had antibody levels greater than or equal to the lower 99% confidence interval of the mean level found in culture positive patients, while only 2/274 Aborigines (0.7%) had such elevated levels . By contrast, 89/142 (62.7%) patients with endoscopically proven duodenal ulcer had similarly elevated specific antibody levels . These differences were highly significant . We consider these findings to be consistent with the hypothesis that C . pylori is important in the pathogenesis of duodenal ulcer. Antimicrob Agents Chemother, 1988 Jan, 32(1), 27 - 32 A-61827 (A-60969), a new fluoronaphthyridine with activity against both aerobic and anaerobic bacteria; Fernandes PB et al.; A-61827 (A-60969 is the hydrochloric salt of A-61827) is a new aryl-fluoronaphthyridine which is active against aerobic and anaerobic bacteria . The MICs of A-61827 for 90% of strains (MIC90) of staphylococci and streptococci were less than or equal to 1 microgram/ml and were generally 1 to 4 twofold dilutions less than those of ciprofloxacin for these bacteria . The MIC90S of A-61827 for members of the family Enterobacteriaceae and Pseudomonas aeruginosa were also less than or equal to 1 microgram/ml . Ciprofloxacin was 1 to 3 twofold dilutions more active than A-61827 against these gram-negative bacteria . Neisseria gonorrhoeae, Campylobacter jejuni, and Haemophilus influenzae were susceptible to less than 0.06 microgram of A-61827 per ml . The MIC90 of A-61827 for Legionella pneumophila was 0.25 microgram/ml . A-61827 was as potent or 1 to 2 twofold dilutions more potent than ciprofloxacin against these organisms . The MIC90 of A-61827 for all anaerobic bacteria was less than or equal to 4 micrograms/ml compared with less than or equal to 32 micrograms/ml for ciprofloxacin . In mouse protection tests, A-61827 was as active as ciprofloxacin against Escherichia coli, P . aeruginosa, and Salmonella typhimurium and 5 to 10 times more active than ciprofloxacin against Staphylococcus aureus and Streptococcus pyogenes . A-61827 was as active as ciprofloxacin against P . aeruginosa in a mouse pyelonephritis model and more active than ciprofloxacin and metronidazole in a mouse Bacteroides fragilis abscess model . After oral administration of 100 mg/kg to mice, the peak concentrations of A-61827 and ciprofloxacin in serum were 2.3 and 2.4 micrograms/ml and the half-lives in serum were 3.9 and 1.2 h, respectively. APMIS, 1988 Jan, 96(1), 84 - 8 Campylobacter pylori is associated with chronic gastritis but not with active peptic ulcer disease; Sipponen P et al.; Campylobacter pylori is supposed to be involved in the pathogenesis of gastroduodenal peptic ulcer diseases and chronic gastritis . In order to study whether the Campylobacter pylori in the stomach of peptic ulcer patients is related to ulcer itself or to a co-existing chronic gastritis, we examined the frequency of the bacteria in Giemsa stained histological sections of biopsy specimens from a series of patients with active peptic ulcer and from series of non-ulcer control subjects . We found no difference in the frequency of Campylobacter- positive cases between ulcer patients and non-ulcer controls when the comparison was done within the same category of chronic gastritis; e.g., within the category of chronic superficial gastritis 74% and 78% of cases showed the bacteria in antral biopsies from ulcer patients and from non-ulcer controls, respectively . In both ulcer patients and control subjects, in similar way in both antral and body mucosa, the Campylobacter pylori was strongly associated with chronic superficial gastritis but was more weakly associated with chronic atrophic gastritis, and the bacteria were only occasionally seen in normal mucosa . We conclude that Campylobacter pylori is associated with chronic gastritis in peptic ulcer patients but is not related to active ulcer. J Clin Pathol, 1988 Jan, 41(1), 85 - 8 Campylobacter associated gastritis in patients with non-ulcer dyspepsia; Loffeld RJ et al.; Gastric biopsy specimens from 109 patients with non-ulcer dyspepsia were retrospectively examined . Sixty one patients had gastritis and there was a strong correlation with the presence of Campylobacter pyloridis . Ninety eight per cent were positive in large numbers for C pyloridis by histological examination or by culture, or both . Of 48 patients with normal histological results, 21 had evidence of C pyloridis by histological examination or culture, or both, but in small numbers . It is concluded that there is a quantitative rather than a qualitative association between C pyloridis and gastritis. J Clin Microbiol, 1988 Jan, 26(1), 47 - 9 Evaluation of the campyslide agglutination test for confirmatory identification of selected Campylobacter species; Hodinka RL et al.; The utility of a rapid latex slide agglutination test (Campyslide; BBL Microbiology Systems, Cockeysville, Md.) in detecting selected Campylobacter spp . was evaluated and compared with that of conventional identification methods . Isolated colonies suggestive of Campylobacter spp . were tested directly from primary selective media after incubation at 42 degrees C under microaerophilic conditions . Stock cultures of Campylobacter jejuni (n = 27) and C . coli (n = 3) were correctly confirmed to the genus level by latex agglutination when tested in pure cultures or isolated from seeded human feces . A total of 50 fresh clinical isolates of Campylobacter spp . (45 C . jejuni and 5 C . coli) were examined, with complete agreement observed between the latex test and conventional methods . Of 173 non-Campylobacter isolates tested from primary plates, only 1 rough strain of Pseudomonas aeruginosa produced a false-positive result . Although the manufacturer recommends a 30-min antigen extraction, 1 or 5 min was found to be sufficient . Also, confirmation could be achieved within 24 h of inoculation of clinical specimens, 2 days earlier than with conventional methods. J Clin Microbiol, 1988 Jan, 26(1), 142 - 3 Case report of an unclassified microaerophilic bacterium associated with gastroenteritis; Romero S et al.; An unusual microaerophilic gram-negative bacterium was isolated from the stools of two individuals presenting with chronic diarrhea . This bacterium resembled Campylobacter species by colonial morphology and biochemical reactions . However, microscopic examination revealed a fusiform rod with a corrugated surface, rather than a spiral rod . This is the first reported isolation of this bacterium from humans. J Clin Microbiol, 1988 Jan, 26(1), 101 - 5 Characterization of an unclassified microaerophilic bacterium associated with gastroenteritis; Archer JR et al.; Four isolates of an unclassified microaerophilic bacterium resembling Campylobacter species were characterized by growth requirements, microscopic examination, biochemical characteristics, antimicrobial susceptibility tests, and protein profile analysis . The unclassified isolates were differentiated from Campylobacter jejuni, Campylobacter coli, Campylobacter fetus subsp . fetus, Campylobacter laridis, Campylobacter pylori, and an ovine isolate . The bacterium was fusiform shaped with a corrugated surface due to the presence of periplasmic fibers and had multiple bipolar flagella . Biochemically, the bacterium was separated from the Campylobacter controls by its negative catalase reaction, negative nitrate reduction, and no growth in 1% glycine . It was also resistant to ampicillin . Protein profile analysis demonstrated nine major protein bands present in the unclassified isolates that were absent in the Campylobacter controls . The bacterium also differed from the ovine isolate by its negative catalase reaction, rapid urea hydrolysis, and susceptibility to clindamycin, erythromycin, and tetracycline . Our results showed that the unclassified bacterium was distinct from the recognized Campylobacter species. Pediatr Infect Dis J, 1988 Jan, 7(1), 53 - 7 Aeromonas-associated gastroenteritis in children; San Joaquin VH et al.; During a 20-month period 55 strains of Aeromonas species were isolated from 53 children with diarrhea . The isolation rate of 2.5% for Aeromonas compared with the rates of 4.5% for Shigella, 3.3% for Salmonella, 2.7% for Campylobacter and 0.05% for Yersinia . In 45 children Aeromonas was the sole bacterial enteropathogen identified . Aeromonas was also isolated from 2 (0.5%) of 380 asymptomatic children . Despite its known lack of identifiable virulence properties, Aeromonas caviae was the most prevalent species, accounting for 69% of the isolates . None of the A . caviae strains produced cytotoxin by the 51Cr release assay and 12.5% were weakly enterotoxigenic by the infant mouse assay . All of the Aeromonas sobria and 71% of Aeromonas hydrophila were positive for both toxins . Ninety-two percent of the children with Aeromonas-associated diarrhea were younger than 3 years; 84% of the cases were seen between May and October . The majority of the children had an acute onset of watery diarrhea . Fever and vomiting were most commonly associated with the isolation of A . sobria . Eight children had chronic or intermittent diarrhea lasting for weeks to months before consultation; A . caviae was the isolate in all these cases . Several complications possibly related to Aeromonas intestinal infection were observed . These included Gram-negative bacteremia, intussusception, internal hernia strangulation, hemolytic uremic syndrome and failure to thrive in patients with chronic diarrhea. J Nucl Med, 1988 Jan, 29(1), 11 - 6 Carbon-14 urea breath test for the diagnosis of Campylobacter pylori associated gastritis; Marshall BJ et al.; Urease in the human gastric mucosa is a marker for infection with Campylobacter pylori (CP), an organism suspected of causing chronic gastritis and peptic ulceration . To detect gastric urease, we examined 32 patients who were being evaluated for possible peptic ulcer disease . Fasting patients were given 10 microCi (370 kBq) of 14C-labeled urea . Breath samples were collected in hyamine at intervals between 1 and 30 min . The amount of 14C collected at these times was expressed as: body weight X (% of administered dose of 14C in sample)/(mmol of CO2 collected) . The presence of C . pylori colonization was also determined by examination of multiple endoscopic gastric biopsy specimens . On average, patients who were proven to have C . pylori infection exhaled 20 times more labeled CO2 than patients who were not infected . The difference between infected patients and C . pylori negative "control" patients was highly significant at all time points between 2 and 30 min after ingestion of the radionuclide (p less than 0.0001) . The noninvasive urea breath is less expensive than endoscopic biopsy of the stomach and more accurate than serology as a means of detecting Campylobacter pylori infection . Because the test detects actual viable CP organisms, it can be used to confirm eradication of the bacterium after antibacterial therapy. Infect Immun, 1988 Jan, 56(1), 99 - 105 Mucosal and systemic immunity to Campylobacter jejuni in rabbits after gastric inoculation; Burr DH et al.; The mucosal and systemic immune responses to Campylobacter jejuni were studied in rabbits receiving gastric inoculation with live organisms . A lavage procedure was used to facilitate repeated monitoring of the intestinal immune response to C . jejuni . Immunity to C . jejuni was determined by secondary challenge by using the removable intestinal tie adult rabbit diarrhea (RITARD) model and monitoring for resistance to colonization and bacteremia . Oral-gastric inoculation of normal rabbits produced a transient intestinal colonization without diarrhea . C . jejuni serotypes differed in their ability to colonize the intestines of rabbits and to stimulate primary intestinal and serum antibody responses . Animals previously colonized were resistant to recolonization and the development of bacteremia after homologous challenge by the RITARD procedure but were not resistant to heterologous challenges . Anticampylobacter intestinal and serum IgA titers before this secondary infection were the most reliable predictors of resistance to colonization and bacteremia. Gastroenterology, 1988 Jan, 94(1), 33 - 40 Campylobacter pyloridis-associated chronic active antral gastritis . A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment; Rauws EA et al.; To determine the clinical importance of Campylobacter pyloridis infection, its association with gastric inflammation, and the response to drug therapy, patients with a duodenal or gastric ulcer (n = 63), patients with nonulcer dyspepsia (n = 240), and asymptomatic volunteers (n = 34) were studied . In a prospective longitudinal study, the type, intensity, and distribution of inflammation in antral biopsy specimens were correlated with the presence of C . pyloridis . Campylobacter pyloridis was cultured from antral biopsy specimens in 98% of the ulcer patients, 70% of the nonulcer dyspepsia patients, and 20% of the asymptomatic volunteers . The dependency of chronic active gastritis on the presence of C . pyloridis was shown by an association of gastritis with positive culture and healing of gastritis with negative culture after various therapeutic regimens . Spontaneous disappearance of C . pyloridis never occurred . Colloidal bismuth subcitrate, amoxicillin, and the combination of colloidal bismuth subcitrate and amoxicillin were effective therapies in eradicating C . pyloridis . Recolonization with the same bacterial subtype and recurrence of gastritis frequently occurred within 1 mo after initial eradication . In this study we demonstrate ultimate normalization of gastric mucosa after successful eradication of C . pyloridis . Especially complete normalization of gastric mucosa after amoxicillin monotherapy provides additional strong evidence for a true cause-effect relationship between C . pyloridis colonization and gastritis. Pediatr Med Chir, 1988 Jan-Feb, 10(1), 19 - 23 {Campylobacter pylori and gastroduodenal pathology in children}; Oderda G et al.; Since Warren and Marshall rediscovered in 1983 the presence of a spiral microorganism on the gastric mucosa, and named it Campylobacter Pylori (CP), its significance and characteristics have been largely studied . CP has fulfilled Koch's postulates, which need to proven before a microorganism can be said to cause a disease . The natural source of infection is unknown, but in human volunteer studies, ingestion of a suspension of CP was followed by the development of severe dyspepsia associated with colonization of gastric antrum and histologically proven gastritis B . CP is found overying the gastric epithelium, in the gastric crypts and in the mucus gel layer that protects it from gastric acid . There it causes infiltration of the mucosa by polymorphonuclear leucocytes and mononuclear cells, and mucin depletion . It is found in 60-70% of children with chronic active antral gastritis and can cause various lesions of upper intestinal tract, like esophagitis, duodenitis and gastric or duodenal ulcers . Several tests have been proposed to detect serum antibody against CP, but they are not yet commercially available . Breath test with C 13 or C 14-urea are promising, but up to now the diagnosis can be made only by upper G.I . endoscopy and antral biopsy . A pseudopolypoid antral gastritis seems to be the peculiar lesion caused by CP, but in children it is present only in 40% of cases . CP is easily seen in antral biopsies by Giemsa or Hematoxylin-Eosin staining, or can be cultured in Skirrow's agar under microaerophilic conditions.(ABSTRACT TRUNCATED AT 250 WORDS) Zentralbl Mikrobiol, 1988, 143(1), 47 - 54 {Detection of Campylobacter jejuni and C . coli in waste water}; Stelzer W; For the detection of C . jejuni and C . coli in waste water the content of rifampicin in selective media was reduced from 10 micrograms/ml (Bolton and Robertson 1982) to 5 micrograms/ml and the content of polymymyxin B was increased from 0,25 microliter/ml (Skirrow 1977) to 2.5 micrograms/ml . On the Basis of this modification the isolation of C . jejuni and C . coli from waste water samples by membrane filter technique as well as by enrichment procedure was possible . Before inoculation of waste water samples the enrichment broth was preincubated at least 1 d at 37 degrees C under microaerophilic conditions . The Campylobacter test strains showed significant differences of growth between preincubated and non preincubated enrichment broth in the first hours of incubation. Am J Surg Pathol, 1988, 12 Suppl 1, 89 - 99 Campylobacter pylori: a newly recognized infectious agent in the gastrointestinal tract; Yardley JH et al.; Recent experience with the gastritis-associated organism Campylobacter pylori is reviewed, placing special emphasis on pathologic aspects . C . pylori is a spiral, gram-negative, urease-producing bacillus that has been found to infect the stomach in many people . C . pylori organisms are readily seen overlying the gastric epithelium, often in large numbers . Demonstration in gastric biopsies with silver stains is most vivid, but other faster, simpler stains such as Giemsa, acridine orange, and, at times, hematoxylin-eosin are satisfactory for routine purposes . The frequent occurrence of C . pylori in persons with chronic active gastritis has been confirmed in medical centers around the world . In addition, epidemiological, serological, pathological, and clinical observations suggest that C . pylori infection occurs in stomachs of duodenal ulcer patients with a frequency approaching 100%, and the infection may be relevant to pathogenesis or therapeutic response in duodenal ulcer disease . C . pylori probably also causes an acute infectious gastritis associated with hypochlorhydria . C . pylori still requires extensive investigation to establish its pathogenic role in upper gastrointestinal disorders, but evidence continues to accumulate that such a role exists and that it may be important. Ann Intern Med, 1988 Jan, 108(1), 70 - 9 The clinical significance of Campylobacter pylori; Dooley CP et al.; Campylobacter pylori has recently been isolated from gastric mucosal biopsy specimens . Campylobacter pylori has many attributes in common with other campylobacters but it may represent a new genus . It produces abundant quantities of urease, and this property has been used to develop a rapid diagnostic test . The organism is found predominantly beneath the gastric mucus layer that lines the surface epithelium of the stomach . Infection with C . pylori causes an acute histologic gastritis which may become chronic . The bacterium is the etiologic agent in type-B gastritis . Prevalence of the organism in asymptomatic persons appears to be age related . Campylobacter pylori is found commonly in patients with peptic ulcer disease, always in association with chronic gastritis . Eradication of the organism is associated with healing of the gastritis and a lower relapse rate in duodenal ulcer disease . A role for the organism in other upper gastrointestinal diseases is unproven. Arkh Patol, 1988, 50(12), 51 - 4 {Effect of Campylobacter pyloridis and other parietal microflora on gastric epitheliocytes in peptic ulcer and following vagotomy}; Baibekov IM et al.; Using light and transmission electron microscopy, the authors studied the effect of vagotomy on the interaction between the parietal microflora (Campylobacter pyloridis, in particular) and gastric epitheliocytes in peptide ulcer patients (n = 80) . Campylobacter pyloridis abundant in pyloric and antral portions of the stomach following vagotomy was found in still increasing quantities . Ultrastructurally, there were alterative changes in parietal microflora-contacting epitheliocytes both in peptic ulcer and following vagotomy. Scand J Gastroenterol Suppl, 1988, 155, 53 - 60 Gastritis--a misused term in clinical gastroenterology; Varis K; Gastritis is an inflammation in the gastric mucosa . The definition, classification and diagnosis of gastritis is based on morphological changes . The term 'gastritis' is widely used as a catchbag for upper abdominal complaints . Although acute or specific forms of gastritis may present upper abdominal symptoms, chronic gastritis is asymptomatic, and is not the cause of long standing upper abdominal complaints . Chronic gastritis is a very common condition in the general population . Hence the probability of finding chronic gastritis in endoscopic biopsies of patients with upper abdominal complaints is high for statistical reasons, and this does not prove any causal relation between chronic gastritis and subjective complaints . Campylobacter pylori is associated with chronic gastritis . It may activate the inflammatory process in the gastric mucosa, or it may just be an innocent bystander, which subsists within a diseased mucosa . The role of campylobacter pylory in the etiology of non-ulcer dyspepsia or peptic ulcer is questionable. Drugs Exp Clin Res, 1988, 14(7), 445 - 51 Comparative in vitro potencies of nine new macrolides; Fernandes PB et al.; The in vitro activities of the 14-membered macrolides (14M) clarithromycin (CL), roxithromycin (RO), dirithromycin (DI) and flurithromycin (FL), a 15-membered macrolide (15M) azithromycin (AZ), and the 16-membered macrolides (16M) josamycin (JM), spiramycin (SP), miocamycin (MI) and rokitamycin (RK) were compared with erythromycin (ER) . CL was two- to four-fold more potent than ER against all organisms except Haemophilus and Campylobacter jejuni against which it was two-fold less active . RO and DI were generally two- to four-fold less active than ER . FL was two-fold less active than ER . AZ was equal to or two-fold less active than ER against Gram-positive bacteria and two- to four-fold more active than ER against Gram-negative bacteria, such as Haemophilus, Neisseria gonorrhoeae and Branhamella . The 16M were generally four- to eight-fold less active than ER against most aerobic bacteria and two-fold less active than ER against anaerobic bacteria . RK was generally two-fold more active than the other 16M . Bacteria carrying a constitutive-type of MLS resistance were resistant to the 14M, 15M and 16M, whereas bacteria with an inducible-type of resistance were susceptible to the 16M but resistant to the 14M and 15M . Addition of serum to the medium increased the activity of ER, CL, DI, FL, AZ and SP . The activity of RO was reduced four- to six-fold and the activity of MI was reduced by two-fold by adding serum to the medium . The activity of JO was unaffected by serum . All the macrolides were one- to four-fold more active at pH 8.0 than at pH 6.5 . All the macrolides were bacteriostatic against Staphylococcus aureus 553, except RO and MI which were slowly bactericidal . All the macrolides were slowly bactericidal against Haemophilus influenzae 1435. Arq Gastroenterol, 1988 Jan-Mar, 25(1), 23 - 8 {Occurrence of Campylobacter pylori in patients with gastritis and peptic ulcer}; Carneiro Leao G et al.; Endoscopic biopsies from the gastric antrum and margin of peptic ulcers (gastric and duodenal) were obtained from 56 patients for histologic and microbiologic studies in order to establish the occurrence of Campylobacter pylori . Thirty nine of them had antral gastritis and in 37 (94.8%) the bacteria was detected . In 17 cases with normal mucosa the culture was positive in only 2 of them (p less than 0.01) . Patients with duodenal and gastric ulcer had a 100% and 88.8%, respectively, of positivity to C . pylori at samples from the margin of the lesions . Bacteriologic findings were similar to those described in the literature . At the electronic microscopy bacilli were found near or adhering to the cellular surface without signs of intraepithelial penetration . This study confirms the association between C . pylori and gastritis and peptic gastroduodenal ulcer. Scand J Infect Dis, 1988, 20(5), 553 - 7 Microabscesses in gastric biopsies shown by acridine orange staining; Sodervik HJ et al.; Acridine orange staining of endoscopic biopsies of gastric mucosa was used in 70 patients with various upper gastrointestinal symptoms to identify Campylobacter pylori abscess formations with polymorphonuclear leucocyte infiltration . In comparison with cultures, the staining test proved to be a rapid and reliable test particularly in outpatient clinics as results are available in 6-8 min, thus enabling any necessary treatment to start immediately. Chemotherapy, 1988, 34(4), 326 - 31 Antimicrobial sensitivity and plasmid-mediated tetracycline resistance in Campylobacter jejuni isolated in Bangladesh; Akhtar SQ; The antimicrobial sensitivity of Campylobacter jejuni isolated in Bangladesh from patients with diarrhoea, asymptomatic carriers and domestic animals was performed . All isolates were sensitive to erythromycin, gentamicin, furazolidone and kanamycin . Seven percent isolates were resistant to tetracycline, 8% to nalidixic acid, 37% to ampicillin and 100% to sulfamethoxazole-trimethoprim and cephalothin . Tetracycline resistance was observed to be plasmid mediated . No plasmid band(s) coding for ampicillin, sulfamethoxazole-trimethoprim or cephalothin resistance were observed, possibly indicating chromosomally located resistance . No significant differences in the susceptibility patterns of C . jejuni isolated from the different sources was observed . However, 10 patients' isolates showed low molecular weight (2-3, 7 Mdaltons) plasmid band(s) which were completely absent in isolates from asymptomatic carriers and animals. Am J Pediatr Hematol Oncol, 1988 Spring, 10(1), 35 - 8 Methemoglobinemia and hemolytic anemia associated with Campylobacter jejuni enteritis; Smith MA et al.; A 7-week-old infant with methemoglobinemia, hemolytic anemia, and inadequate weight gain was found to have a Campylobacter jejuni gastrointestinal tract infection . Known etiologies of methemoglobinemia such as oxidative drug exposure, deficiency of NADH-methemoglobin reductase, and hemoglobin M disorder were excluded . The patient had a twin brother (probably identical) who had neither methemoglobinemia nor stool cultures positive for C . jejuni . The twin essentially served as an experimental control, making other environmental or genetic causes of methemoglobinemia unlikely in the patient . Both the methemoglobinemia and the C . jejuni infection responded to adequate treatment with erythromycin . The association of a C . jejuni infection with methemoglobinemia is discussed in light of previous associations of enteritis and methemoglobinemia in infants. Scand J Infect Dis Suppl, 1988, 53, 70 - 3 Pharmacokinetic, bacteriological and clinical aspects on the use of doxycycline in patients with active duodenal ulcer associated with Campylobacter pylori; Unge P et al.; Seven patients with active duodenal ulcer and positive cultures for Campylobacter pylori were given anti-ulcer treatment for 28 days with the addition of doxycycline for the last nine days . Repeated endoscopy with biopsy for culture and doxycycline concentration determinations from the mucosa at the end of doxycycline therapy showed that five of seven patients remained positive in culture . The concentrations of doxycycline in biopsy material were 0.1 to 0.3 mg/kg in four patients; in three patients the level of antibiotic was not measurable . The serum concentrations of doxycycline in six patients varied between 0.5 and 2.7 mg/l . One patient had less than 0.5 mg/l . The two patients with C . pylori negative cultures at the end of therapy had serum concentrations of doxycycline of 2.4 and 1.0 mg/l . These patients were positive in biopsy culture for C . pylori 12 weeks after therapy . In conclusion, doxycycline does not eradicate C . pylori when given in recommended dosage for 9 days. Scand J Gastroenterol Suppl, 1988, 142, 9 - 13 Epidemiology of Campylobacter pylori infection: ethnic considerations; Graham DY et al.; A proper perspective of the association of Campylobacter pylori with various diseases can be achieved only when the incidence of C . pylori infection in the normal population is known . We used the 13C urea breath test (a simple, specific, noninvasive, safe, and reproducible method to assess the presence of active C . pylori infection) to compare the frequency of C . pylori infection in healthy young adults from three areas of the world . We studied 26 women and 32 men (ages 20 to 29): 29 from the United States, 10 from China, 6 from Mexico, and 13 from India . All foreign nationals had been in the United States 5 years or less . The frequency of C . pylori infection was 21%, 67%, 33% and 46%, for those from the U.S., China, Mexico and India, respectively . Although, we found no difference in the frequency of C . pylori infection among ethnic groups from North America (U.S . citizens compared with citizens of Mexico), all individuals studied were of middle to upper class socioeconomic status . Subsequent studies will investigate whether the prevalence of C . pylori infection is different in economically disadvantaged populations . Our results suggest that there may be major differences in the age-related frequency of C . pylori infection in individuals from different parts of the world. Scand J Gastroenterol Suppl, 1988, 142, 87 - 92 Chronic erosive gastritis--a therapeutic approach with bismuth; Malfertheiner P et al.; 37 patients with epigastric pain and chronic erosive gastritis underwent an open controlled therapeutic trial with bismuthsubsalicylate (BS) . Group A (21 patients) was treated with BS, liquid, 4 X 314 mg for three weeks, group B (16 patients) with BS tablets, 3 X 300 mg for two weeks . A significant reduction of symptoms (p less than 0.001) and endoscopically assessed chronic erosions (p less than 0.001) was achieved in both groups . Campylobacter pylori was detected in 89% of the patients before treatment, but was absent in 78% of the patients after treatment . The histological grading of antral mucosa showed a significant reduction (p less than 0.001) of polymorphonuclear cell (PML) infiltration after two and three weeks treatment respectively . While in group A PML cells had disappeared from gastric mucosa in all but two patients, in group B 50% of the patients had some degree of PML cell infiltration left in the antral mucosa . This study confirms the beneficial effect of BS in the treatment of C . pylori associated active chronic gastritis and reemphasizes the pathogenetic role of C . pylori in this disease. Scand J Gastroenterol Suppl, 1988, 142, 76 - 81 The efficacy of antimicrobial treatment in Campylobacter pylori-associated gastritis and duodenal ulcer; Hirschl AM et al.; The efficacy of various antimicrobial and anti-ulcer agents on the elimination of Campylobacter pylori in duodenal ulcer patients was investigated . Ranitidine, cimetidine, pirenzepine, aluminium phosphate gel as well as combinations of H2-receptor antagonists or pirenzepine + penicillin V, ciprofloxacin, ofloxacin, phenyl-mercuryborate or rifampicin had no influence on C . pylori in vivo . Short term elimination of C . pylori was achieved in 3/15 patients treated with ranitidine + bacampicillin and in 1/5 treated with cimetidine + metronidazole . This elimination was accompanied by a significant reduction of polymorphonuclear infiltration of the antral mucosa . Development of bacterial resistance was observed in patients with additional quinolones, metronidazole and rifampicin but not in patients treated with betalactam antibiotics. Scand J Gastroenterol Suppl, 1988, 142, 69 - 75 Prevalence of Campylobacter pylori in duodenal and gastric mucosa--relationship to inflammation; Johnston BJ et al.; Endoscopic biopsies from 310 patients were studied for the presence of Campylobacter pylori (Cp) . In the first group of 150 patients duodenal and antral biopsies were obtained and in the second (160 patients) biopsies were taken from various sites in the stomach including the antrum, incisura, body and fundus . In the duodenum there was a strong association with active inflammation and the presence of gastric metaplasia . Cp were never seen in the normal duodenum . In the stomach Cp presence was associated with gastritis irrespective of severity and site, but was absent in areas showing intestinal metaplasia . Cp were seen in histologically normal biopsies from all areas of the stomach but were significantly more common in normal fundal than normal antral mucosa. Scand J Gastroenterol Suppl, 1988, 142, 53 - 7 An enzyme-linked immunosorbent assay for the serodiagnosis of Campylobacter pylori-associated gastritis; Newell DG et al.; An ELISA system, using an acid extractable cell surface C . pylori antigen, has been used to detect anti-C . pylori antibodies in 176 endoscoped patients . The antibody concentration was related to histological diagnosis and colonisation with Campylobacter-like organisms . The criteria for sero-positivity was determined from the median antibody concentration in a group of 368 non-endoscoped control patients . The specificity and sensitivity of the sero-diagnostic assay for histological gastritis in antral biopsies was 83.0% and 95.6% respectively . The positive (79.3%) and negative predictive values (94.3%) indicate that such a sero-diagnostic assay could be used to screen patients prior to endoscopy. Scand J Gastroenterol Suppl, 1988, 142, 44 - 9 Immune response of the gastric mucosa to Campylobacter pylori; Wyatt JI et al.; The histological features of non-autoimmune chronic gastritis are consistent with those of a local immune response by the gastric mucosa . If Campylobacter pylori is causative in this condition, then the immune response will be in part specific for this organism . Antibodies to C . pylori are present in the gastric juice of infected patients . Coating of mucosal C . pylori by antibody in vivo can be demonstrated by immunohistochemistry, and a neutrophil infiltrate (active gastritis) is associated with coating by opsonising antibodies . Gastric mucosa from patients with C . pylori produces specific immunoglobulin in vitro, and this antibody production correlates with the plasma cell infiltrate seen in these patients . Lymphoid follicles in gastric mucosa, implying local antigenic stimulation, are a specific feature of campylobacter-associated gastritis . The inflammation gradually abates following eradication of the bacteria . We conclude that the morphological features of campylobacter-associated gastritis represent the immune response of the mucosa to C . pylori. Scand J Gastroenterol Suppl, 1988, 142, 40 - 3 Possible pathogenetic pathways of Campylobacter pylori in gastro-duodenal disease; Rathbone BJ et al.; The exact pathogenic mechanisms involved in Campylobacter pylori associated gastro-duodenal inflammation are unclear . C . pylori adheres to gastric type epithelium and colonisation is associated with a number of ultrastructural abnormalities . Other factors thought important include the marked bacterial urease activity, enzymatic degradation of the mucous layer and possible toxins . The induced inflammatory reaction will also contribute to tissue damage and a breakdown of normal defense mechanisms. Scand J Gastroenterol Suppl, 1988, 142, 25 - 39 Pathogenetic implications of ultrastructural findings in Campylobacter pylori related gastroduodenal disease; Bode G et al.; There is now substantial evidence that Campylobacter pylori (Cp) is able to colonize the gastroduodenal mucosa and is responsible for active chronic gastritis, its role in duodenitis, gastric ulceration and duodenal ulceration is still under debate . Cp has a lot of characteristics which are prerequisites for a pathogen: the typical S-shape, the corkscrew-like movement and the powerful urease and protease enzymes . These features allow a rapid movement through the mucous layer to permit access to the apical membranes of the surface mucous cells . There they adhere directly to the membranes and induce several ultrastructural alterations: degeneration of microvilli, depletion of mucous granules and an increase in sialic-acid rich glycoproteins in the apical part of the cytoplasma . Cp weakens the tight-junction complex and is found between the cells and sometimes intracellularly . Cp is phagocytized by invading polymorphonuclear leukocytes and causes an intense inflammatory response . These observations clearly demonstrate pathological alterations which in the cellular level induced by Cp with the result of a disrupted mucosal barrier of the stomach and the duodenum. Scand J Gastroenterol Suppl, 1988, 142, 21 - 4 Histological aspects of Campylobacter pylori colonisation and infection of gastric and duodenal mucosa; Price AB; The main features of the histopathology of Campylobacter pylori-associated gastritis are reviewed . The organism is strongly associated with the Type B pattern of chronic gastritis . It colonizes the abnormal antrum and is not usually seen on the normal mucosa . However it fails to colonize the abnormal antrum in the Type A gastritis of pernicious anaemia . When present in the duodenum it is in conjunction with severe duodenitis and gastric metaplasia . Although the organisms are present in over 70% of patients with peptic ulcer disease care must still be taken with identification, as other gastric spiral organisms can be present that are not Campylobacters. Scand J Gastroenterol Suppl, 1988, 142, 101 - 6 Monotherapy or polychemotherapy in the treatment of Campylobacter pylori-related gastroduodenal disease; Borsch G et al.; Three pilot studies were performed to evaluate the efficacy of bismuth subsalicylate (BSS) and nitrofurantoin to eradicate Campylobacter pylori colonization in man . Nitrofurantoin 3 x 100 mg capsules for 10 days did not clear C . pylori in any of 13 patients, and neither did the combination of BSS and nitrofurantoin suspension (0/6 patients) . Immediately after high dose BSS therapy 3 x 900 mg for 28 days, 8/17 patients (47%) had negative cultures and rapid urease tests . There was recrudescence in 5 out of 6 patients so far submitted to follow-up investigations, giving a best possible outcome estimate of 18% and a worst possible eradication rate of 6% in this study . Preliminary data indicate that triple therapy may be a more effective option, but doubts remain as to whether the puristic therapeutic goal of complete bacterial eradication can be safely and effectively achieved with presently available drugs. Boll Ist Sieroter Milan, 1988, 67(5-6), 363 - 8 {Campylobacter jejuni infections in slaughterhouse workers}; Mancinelli S et al.; Complement fixing (C.F.) antibodies to Campylobacter jejuni were detected in 83 slaughterhouse workers and 83 blood donors . Workers were aged 18-65 years (mean, 41.7 +/- 12.3) and had worked in the slaughterhouse for 2-40 years (mean, 17.5 +/- 5.1) . C.F . antibodies were detected according to Mosimann's method and by including five antigens: Campylobacter jejuni, Yersinia enterocolitica types 03 and 09, Yersinia pseudotuberculosis and Brucella . Positive titers were found in 12.1% of workers and in 2.4% of control subjects (p less than 0.01); values ranged from 1:10 to 1:40 . Frequent and close contact with animals or their products was significantly associated with seropositivity . No association was found with the time of employment . Sixty per cent of seropositive workers referred rheumatological symptoms . These findings confirm that slaughterhouse workers exposed to potential sources of C . jejuni have elevated titers of antibodies . Attention has, therefore, to be focused on breaking the chain of transmission as a means of control. Geogr Med Suppl, 1988, 1, 19 - 31 Further serological investigations in humans and domestic animals on the Cape Verde Islands (Q-fever, brucellosis, listeriosis, shigellosis, campylobacteriosis, yersiniosis, toxoplasmosis and chlamydia of PLT-group); Miorini T et al.; 439 sera of domestic animals and various number (150-500) of human sera of the Cape Verde Islands were examined for antibodies against Coxiella burnetti, Brucella abortus, B.melitensis, Listeria monocytogenes, Shigella dysenteriae, S.flexneri, S . boydii, S.sonnei, Campylobacter jejuni, C.fetus ssp . intestinalis, Yersinia enterocolitica, Toxoplasma gondii and Chlamydia of the PLT-group . It could be shown, that on the Cape Verde Islands there is to be counted with numerous zoonoses due to various microorganisms in man as well as in domestic animals . Q-Fever examination showed exceedingly high positivity of human sera (81.6%) and those of domestic animals (84.7%) . One of the main reasons for the wide distribution of infectious diseases, especially diarrhoeal diseases such as Shigellosis, Yersiniosis and Campylobacter infections as well as Salmonellosis and Amebiasis on the Islands is the bad hygienic situation, an improvement of which as well as an intensification of research work, health education and a better medical care would be essential for the control of communicable diseases on the Cape Verde Islands. Trans R Soc Trop Med Hyg, 1988, 82(4), 637 - 41 A two-year study of enteric infections associated with diarrhoeal diseases in children in urban Somalia; Casalino M et al.; A hospital-based systematic sample of 1667 children with severe diarrhoeal disease was studied in Mogadishu, Somalia, throughout 1983 and 1984 . One or more enteric pathogens were found in 61% of the patients . Rotavirus (25%), enterotoxigenic Escherichia coli (11%), Shigella spp . (9%), Aeromonas hydrophila (9%), Giardia lamblia trophozoites (8%), Campylobacter jejuni (8%), and Vibrio cholerae non-O1 (6%) were the most frequently identified pathogens . Age-specific detection rates of enteric pathogens and helminths, seasonal patterns, and relationship of some specific infections with feeding status and main clinical features have been defined for all the sample examined. Scand J Gastroenterol Suppl, 1988, 155, 68 - 81 Campylobacter pylori; Tytgat GN et al.; Worldwide Campylobacter pylori is a major cause of active chronic gastritis in man . This curved spiraled microorganism can readily be detected within the mucusgel especially in the antrum, in particular in patients suffering from peptic ulcer disease or non-ulcer dyspepsia, rarely in individuals with normal gastroduodenal mucosa . Increasingly arguments are being presented in support of a pathogenetic role of C . pylori in non-ulcer dyspepsia and in peptic ulcer disease . There is a striking discordance between in vitro antibiotic sensitivity, and in vivo efficacy with respect to suppression or eradication of the organism . At present the combination of colloidal bismuth subcitrate and amoxicilline or tinidazole appears to be encouraging with respect to longterm eradication of this peculiar microorganism . Eradication by antibacterial treatment ultimately may result in histologic normalization of the gastric mucosa . To what extent peptic ulcer disease . There is a striking discordance between in vitro antibiotic sensitivity, and in. Scand J Gastroenterol Suppl, 1988, 155, 141 - 51 Does the choice of acute treatment influence future ulcer relapse? Bodemar G. Despite the fact that the direct effect of drugs used for healing of ulcers does not last longer than hours, or at most a few days, some clinical studies have indicated that the rate of new ulcers after short courses of treatment depends on the drug used for healing . Several studies have now shown that the development of new ulcers in the same, regardless whether active ulcers have been healed with antacids or histamine H2-receptor antagonists . This lack of difference in clinical outcome is very likely true also for sucralfate and omeprazole in comparison with histamine H2-antagonists . A bismuth compound can perhaps prolong the period of clinical remission in a subgroup of patients in whom campylobacter pylori do not recur after finalized ulcer healing treatment . Other factors, i.e . smoking, and not the choice of ulcer healing drug, are of importance to recurrencies of new ulcers. Drugs, 1988, 36 Suppl 4, 6 - 17 Bacterial-induced diarrhoea; Velasquez Jones L et al.; In diverse parts of the world, many bacterial strains have been recognised as the causative agents of diarrhoea . Great achievements have been made in perceiving the varied mechanisms which explain their intestinal pathogenicity . These achievements include the elucidation of the 5 mechanisms of disease production by Escherichia coli, the mechanisms of action of Shigella, Salmonella, Campylobacter and Yersinia, new information about antimicrobial-associated colitis caused by Clostridium difficile and the recognition of microbes such as Aeromonas hydrophila and Pleisomonas shigelloides . Information is available on the use and indications of antimicrobial treatment in children with diarrhoea of bacterial aetiology which is proven or suspected by clinical symptomatology or simple laboratory procedures . Finally, the usefulness of oral rehydrating solutions has been appreciated in the prevention as well as in the correction of diarrhoeal dehydration. Drugs, 1988, 36 Suppl 4, 48 - 60 Oral rehydration in infantile diarrhoea in the developed world; Mackenzie A et al.; Acute diarrhoea is an important health problem in developed countries, particularly in young children . The attack rates for viral diarrhoea are similar in developed and developing countries . Rotavirus is the most common pathogen, followed by adenovirus . Bacterial diarrhoea is less common in developed than developing countries . The 2 most common bacterial pathogens are Campylobacter jejuni and Salmonella . The most serious consequence of diarrhoea is dehydration, and the treatment for this is the same whatever the pathogen . Recently, there have been major changes in the management of diarrhoea with emphasis on oral rehydration and early feeding . Two controversial areas are the sodium content of solutions designed for developed countries and the best route of administration of fluids to children with moderately severe dehydration . There have been 4 randomised controlled trials in developed countries comparing oral and intravenous rehydration . The findings have confirmed the experience in developing countries that most children without shock can be rehydrated orally, thus substantially reducing the need for intravenous fluids . It is important to give physiologically balanced solutions which contain 2% glucose and 50 to 90 mmol/L of sodium . Many of the commercially available oral solutions are appropriate for rehydration and maintenance of hydration in infants with diarrhoea of all types . They are recommended particularly for the prevention of dehydration in children of all ages with severe diarrhoea and for the treatment of dehydration . Children with mild diarrhoea and no dehydration can be given commercial clear fluids diluted with water, or homemade solutions made with table sugar and water . Salt must not be used . Babies should continue on breast milk or formula with extra water . Education is the key to successful oral rehydration, and the ultimate aim should be the prevention of dehydration. Scand J Gastroenterol Suppl, 1988, 146, 58 - 66 The Campylobacter pylori story; Marshall BJ; The Campylobacter pylori story began before the turn of the century, with early works describing 'spirochaetes' in the gastric mucosa of animals . Culture of the organism in 1982 enabled investigators to make sense of the many previous works concerning the microbiology, biochemistry, and histology of the gastric mucosa . Whereas some physicians remain skeptical of C . pylori's pathogenic role, those who have studied the new organism believe it is a major gastrointestinal pathogen and see the possibility of curative therapy for what is now called 'acid peptic disease'. Scand J Gastroenterol Suppl, 1988, 146, 34 - 9 The protective role of gastric acid; Hunt RH; This paper reviews the relationship between gastric acid secretion and infection and the protective role of gastric acid as a primary bactericidal barrier and modulator of gastrin section . Gastric acid is bactericidal at pH 3 or less, but reduction of acidity predisposes to infection with a wide variety of bacteria . Bacterial infections or hyperpyrexia may be associated with a marked reduction in gastric acid secretion, and Campylobacter pylori has been suggested as one cause of epidemic hypochlorhydria . Achlorhydria is also associated with hypergastrinaemia with levels 20-fold higher in pernicious anaemia patients than normal subjects . Treatment with antisecretory drugs is associated with hypergastrinaemia with gastrin levels 2- to 5-fold higher than with placebo, and the gastrin levels correlate with the degree of acid suppression . The possible relationship among infection, acid suppression, hypergastrinaemia, and the development of enterochromaffin cell hyperplasia and possible carcinogenesis is reviewed. J Gen Microbiol, 1988 Jan, 134 ( Pt 1), 53 - 9 Motility of Campylobacter jejuni in a viscous environment: comparison with conventional rod-shaped bacteria; Ferrero RL et al.; The motility of four strains of Campylobacter jejuni in solutions of varying viscosity was measured and compared to that of a number of conventional rod-shaped bacteria (CRSB) . All the bacteria tested showed an initial increase in velocity in the low viscosity solutions--between 1 and 3 centipoise (1 P = 0.1 Pa s) . However, only the campylobacters were actively motile in highly viscous solutions with velocities ranging from 60 to 100 micron s-1 . All strains of C . jejuni tested showed three separate peaks of motility as the viscosity of the solution was increased . A higher proportion of C . jejuni cells exhibited longer path lengths when the viscosity of the surrounding medium was increased from 1.4 to 57 cP . The findings of the study suggest that C . jejuni has a motility suited to movement in a viscous environment, and that this ability might provide the organism with an ecological advantage when in intestinal mucus . It is proposed that the mechanism of motility changes depending on the viscosity of the supporting environment. Scand J Gastroenterol Suppl, 1988, 142, 93 - 100 The role of antibiotics in Campylobacter pylori associated peptic ulcer disease; Bayerdorffer E et al.; Since the recognition and first culture of Campylobacter pylori (Cp) the hypothesis of a pathogenic role has been strengthened by numerous investigations . Its close association with active chronic gastritis and even active duodenitis, and the disappearance of these pathologic conditions with antimicrobial treatment suggest a pathogenic role for Cp in active chronic gastritis . The close association of antral gastritis with duodenal ulcer (DU) suggests that Cp associated active chronic gastritis may be an important precondition for the development of DU . Therapy studies so far using either bismuth, antibiotics, or a combination of both could demonstrate that the healing of DU ulcer was closely related to the clearance of Cp and healing of gastritis . Relapse of DU was closely associated with reappearance of Cp and active chronic gastritis . At the present state the combination of bismuth salts and antibiotics has achieved the highest eradication rates of Cp and thus lowest relapse rates of DU . Antibiotics therefore seem to be an indispensable factor in the antimicrobial treatment of Cp associated diseases. Scand J Gastroenterol Suppl, 1988, 142, 82 - 6 Bismuth: effects on gastritis and peptic ulcer; Rokkas T et al.; The healing properties of colloidal bismuth subcitrate (CBS) on peptic ulcer are well established and several studies have shown that healing with CBS is associated with a lower relapse rate than that produced by H2-receptor antagonists . The recent observation that CBS is effective against Campylobacter pylori has shed light on this because recent studies have shown that eradication of C . pylori by CBS leads to resolution of the associated gastritis and this may explain the low relapse rates . CBS is also effective in C . pylori positive patients with non ulcer dyspepsia (NUD) in whom clearance of these organisms from the stomach is associated with significant improvement of the associated gastritis and symptoms. Scand J Gastroenterol Suppl, 1988, 142, 58 - 63 Heterogeneity of Campylobacter pylori as demonstrated by co-agglutination testing with rabbit antibodies; Danielsson D et al.; The indirect immunofluorescence (IFL) and the co-agglutination (CoA) methods were used to study the serology of Campylobacter pylori strains isolated from patients in different countries (Sweden, Finland, Canada and Australia) . Antisera were obtained from rabbits immunized with whole cell antigens . With IFL tests the highest serum titers were obtained with C . pylori strains and their homologous antisera . These tests also showed that all the tested strains contained cross-reactive antigens . With the use of the CoA technique strain or type specific heat labile and heat stable antigens were demonstrated, and a provisional "seropattern" of a particular strain could be defined with selected CoA reagents . With the use of such reagents we were able to show that a patient may be infected with multiple C . pylori strains with different sets of surface antigens . The clinical and epidemiological implications of this serological heterogeneity of C . pylori are discussed. J Med Microbiol, 1988 Jan, 25(1), 7 - 12 Campylobacters and impaired fetal development in mice; O'Sullivan AM et al.; Intravenous injection of eight human strains of Campylobacter fetus ss fetus and Campylobacter jejuni into mice at various stages of pregnancy demonstrated significant strain differences in ability to affect implantation of the fertilised ovum and to cause resorption of the mouse fetus . Implantation was significantly impaired when C . fetus ss fetus was injected intravenously on day 2 of pregnancy, but no effect was observed in mice receiving C . jejuni . On day 6 of pregnancy, before the development of placental circulation, both C . fetus ss fetus and C . jejuni impaired fetal growth; one strain of C . jejuni had a greater effect than others of the same species . In animals inoculated on day 13 of pregnancy, after the development of placental circulation, six of the eight campylobacter strains caused resorption of the mouse embryos . A similar effect on the embryos was observed after injection of heat-killed organisms, and endotoxin-like substances may have been responsible . It is also suggested that factors other than endotoxin-like substances have a deleterious effect on embryonic growth. Scand J Gastroenterol Suppl, 1988, 155, 159 - 65 Comparison between medical and elective surgical treatment of peptic ulcers; Strom M; During the last decades we have learnt how to treat chronic peptic ulcer disease both with surgery (mainly vagotomy) and with long term medical treatment (mainly H2-receptor antagonists) with great success and safety . Although much attention has lately been given to 'cytoprotective' agents, it is still too early to regard them as alternatives to acid reducing treatment in the long term management of severe peptic ulcer disease . The importance of campylobacter pylori for long term outcome is today only speculative . Only a few randomized studies have been performed comparing surgical and medical treatment . The hitherto published studies involve small numbers of patients or do not use an optimal dosage of the drug given . Nevertheless for most patients with severe peptic ulcer disease one can conclude that we have both medical and surgical alternatives of comparable efficacy and safety to choose among . The final decision if an elective operation or not should be performed must be based on the preference of the individual patient. Scand J Gastroenterol Suppl, 1988, 146, 175 - 84 Future trends in the management of peptic ulcer disease; Misiewicz JJ; Future trends in the short- and long-term management of peptic ulcer disease are considered . The present state of development of pharmacologic agents for the short-term healing of duodenal and gastric ulcer is impressive, and high rates of healing with rapid symptom relief can be safely achieved with several agents . The problem of ulcer recurrence has not been solved, although new work concerning the role of Campylobacter pylori holds promise . The mortality of acute gastrointestinal haemorrhage remains unacceptably high, especially in the elderly . Therapeutic endoscopy may be effective in decreasing the death rate from bleeding. Toxicol Pathol, 1988, 16(2), 260 - 6 The pathophysiological and pharmacological basis of peptic ulcer therapy; Freston JW; Both genetic and nongenetic factors predispose to ulcer diathesis . At the mucosal level ulcers result from an imbalance between aggressive factors and mucosal defense . Ulcer therapy reduces aggressive forces, bolsters defense, or both . Gastric acid, the major aggressive factor, may have its secretion inhibited or it may be partially neutralized by antacids . H2 receptor antagonists competitively block histamine occupancy of H2 receptors on parietal cells, thereby preventing stimulation of adenylate cyclase, cAMP rises, and activation of protein kinase and H+/K+ATPase . Prostaglandins inhibit acid secretion largely by preventing histamine-induced cAMP rises . Proton pump inhibitors bind H+/K+ATPase . Antimuscarinics inhibit acetylcholine receptors on the parietal cell, thereby blocking Ca2+ entry and subsequent activation of protein kinase and the proton pump . Mucosal defense is enhanced by certain prostaglandins, colloidal bismuth subcitrate and sucralfate . Prostaglandins stimulate secretion of bicarbonate and mucus, among other effects . Colloidal bismuth and sucralfate bind to proteins in the ulcer base and stimulate bicarbonate and mucus secretion, partially, in the case of sucralfate, by increasing endogenous prostanoid synthesis . Sucralfate also binds pepsin and bile acids . Colloidal bismuth temporarily eradicates mucosal colonization by Campylobacter pylori, another putative agent in ulcer diathesis. Comp Biochem Physiol A, 1988, 90(4), 611 - 7 The antisecretory factors: inducible proteins which modulate secretion in the small intestine; Lonnroth I et al.; 1 . Cholera toxin and glucose induce the synthesis of antisecretory factors (ASF) of isoelectric points 5.0 and 4.3, respectively, and of a molecular mass of ca 60,000 . 2 . ASF, in nanogram amounts, inhibit intestinal secretion induced by cholera toxin, Campylobacter toxin, E . coli heat-stable toxin, C . difficile toxin A, and Dinophysis toxin . 3 . Intraspinal injection of cholera toxin and glucose induces the synthesis of pituitary ASF much more effectively than does either peroral or intranasal administration . 4 . Cholera toxin and glucose seem to act synergistically while inducing ASF . 5 . Vagotomy abolishes both the intestinal effects of ASF and the peroral, but not the intraspinal induction of pituitary ASF . 6 . ASF has no effect on ion transport across isolated intestinal mucosa from either pig or hen . 7 . The results suggest that both the induction and the intestinal effects of ASF are mediated via the