Infect Immun, 1989 Jun, 57(6), 1675 - 9 Human milk immunoglobulin A antibodies to Shigella virulence determinants; Cleary TG et al.; Because human milk is thought to protect infants from shigellosis, we evaluated milk for immunoglobulin A to Shigella virulence determinants . Milk was preincubated to remove antibodies unrelated to each locus of interest, using defined Shigella and E . coli hybrids containing known Shigella genetic segments prior to immunoblotting . The milk could not be shown to contain antibodies to chromosomally encoded virulence loci except for the expected antibodies to the products of the histidine locus . However, all the milk samples contained antibodies to antigens encoded by the large virulence plasmid . The finding of these antibodies suggests a possible mechanism by which human milk might protect infants. Mikrobiol Zh, 1989 May-Jun, 51(3), 52 - 6 {Features of the formation of antibodies to heterologous antigens in experimental Shigella infection in guinea pigs and mice}; Borisov VA; Experimental shigellous infection in guinea pigs and mice is accompanied by the phenomena of immunomodulation . Production of antibodies is stimulated with the primary and secondary immune response to ram erythrocytes or to Ni-antigen of typhoid bacteria . Simultaneously the suppression of the secondary immune response is observed . The immune-stimulating effect is demonstrated better on the models of shigellous keratoconjunctivitis and cystitis in guinea pigs and shigellous pneumonia in mice . Immunosuppression of the secondary response is displayed better with intraperitoneal infection of mice . The immunosuppressive action of virulent shigellas does not depend on the suppressive factor of the spleen. Microb Pathog, 1989 May, 6(5), 337 - 42 Loss of virulence in Shigella strains preserved in culture collections due to molecular alteration of the invasion plasmid; Chosa H et al.; Fifty-two Shigella strains long preserved by three Japanese culture collections were examined for virulence . All of them were avirulent when judged by the focus-plaque assay and the ability to bind Congo red . Fifteen strains had a plasmid comparable in size to that responsible for epithelial invasiveness and were positive in hybridization tests with a probe derived from a plasmid cistron, virG . Twenty-four strains had a similar plasmid but were negative in hybridization tests . The remaining 13 strains were negative in all the five criteria for virulence . Similar studies made on one hundred Shigella strains isolated from 1967 to 1985 clearly demonstrated loss of virulence with prolonged time of storage. J Clin Microbiol, 1989 May, 27(5), 998 - 1001 Clinical features, epidemiology, and treatment of Plesiomonas shigelloides diarrhea; Kain KC et al.; Recent studies have suggested that Plesiomonas shigelloides is a cause of diarrhea . The present study addresses the clinical features, epidemiology, and response to antimicrobial therapy of P . shigelloides diarrhea . Thirty cases of P . shigelloides infection were defined by isolation of the organism from stool specimens, and 30 age-matched control patients were identified by detection of other enteric pathogens . Clinical and epidemiological information was obtained by interviewing the referring physicians and the patients . Of the P . shigelloides-infected patients, 71% had a history of recent tropical travel, but 29% acquired their infections locally in association with the consumption of seafood or untreated water or both . Seventy-eight percent of the P . shigelloides-infected patients had findings suggestive of colitis, and P . shigelloides-infected patients had a history of tropical travel, acute illness, abdominal pain, and prolonged symptoms significantly more often than did the control patients . Antimicrobial therapy significantly reduced the duration of illness in patients with Plesiomonas diarrhea . These results suggest that P . shigelloides is a significant cause of both locally acquired and traveler's diarrhea that may respond to antimicrobial therapy. Indian J Med Res, 1989 May, 89, 132 - 7 Clinical & bacteriological profiles of shigellosis in Calcutta before & after an epidemic (1984-87); Dutta P et al.; Patients below 5 yr of age, hospitalised for shigellosis over a period of four years (1984-87), were studied . During the epidemic of bacillary dysentery (1984) isolation of different Shigella spp . as well as Shigella dysenteriae type 1 was high . Decreased isolation of Sh . dysenteriae type 1 and increased isolation of Sh . flexneri was observed during post-epidemic years (1985-87) . Isolation of different Shigella spp . was always above 25 per cent from patients with dysentery and greater than 7 per cent from those with watery diarrhoea during the post-epidemic years . Higher incidence of shigellosis was observed amongst older children (greater than 3 yr) . Most of the shigellosis patients complained of blood and mucus in stools . Vomiting was common among shigellosis patients presenting with watery diarrhoea whereas fever was commonly seen in patients with both dysentery and watery diarrhoea . Most patients of shigellosis presenting with blood and mucus in stools had no dehydration. Rev Infect Dis, 1989 May-Jun, 11 Suppl 3, S547 - 51 Shigella vaccines; Formal SB et al.; Shigellosis remains a major public health problem in developing countries . In these nations, the disease affects young children for the most part . The infecting organism causes illness by invading the colonic mucosa . It is closely related to nonpathogenic Escherichia coli, and genetic material can be transferred from one organism to the other, a process increasing the pathogenic potential of the E . coli or reducing the virulence of the strain of Shigella . Knowledge of the genetics of virulence of shigellae enables the construction of living, attenuated oral vaccines that may offer a practical means of controlling the disease. J Infect Dis, 1989 May, 159(5), 881 - 9 Pathogenesis of Shigella diarrhea . XIV . Analysis of Shiga toxin receptors on cloned HeLa cells; Jacewicz M et al.; Binding kinetics of Shiga toxin to HeLa CCL-2 cells and to cell lines cloned by limiting dilutions were determined . Lines with a wide range of sensitivity to Shiga toxin were obtained . Binding data, analyzed by a computer-based Scatchard model program, revealed two classes of binding sites, one of low affinity and high capacity and one of high affinity and low capacity . The number of high affinity, but not low affinity, sites present on the clones correlated with their sensitivity to toxin . Tunicamycin-treated CCL-2 cells became resistant to Shiga toxin in parallel with a reduction in the capacity of the high-affinity site . Cell content of Gb3, the glycolipid receptor for Shiga toxin, decreased as the sensitivity of the cells diminished . These data show that a minority of Shiga toxin binding sites of HeLa cells are involved in the cytotoxic response and suggest that Gb3 is the high-affinity functional cytotoxin receptor. J Bacteriol, 1989 May, 171(5), 2879 - 81 Identification of an Escherichia coli gene homologous to virR, a regulator of Shigella virulence; Hromockyj AE et al.; Virulence in Shigella spp., as well as in strains of enteroinvasive Escherichia coli, is regulated by growth temperature . Previously, virR had been identified as the gene controlling the temperature-regulated expression of Shigella virulence . Since Shigella spp . and E . coli are also known to share greater than 90% DNA sequence homology, we sought to determine if nonpathogenic E . coli K-12 C600 contains a gene homologous to the Shigella flexneri 2a gene virR . Through the use of transduction and molecular cloning of strain C600 chromosomal DNA we have shown that E . coli K-12 does indeed contain a gene functionally homologous to the virR of S . flexneri. Infect Immun, 1989 May, 57(5), 1391 - 8 Cloning of regions required for contact hemolysis and entry into LLC-MK2 cells from Shigella sonnei form I plasmid: virF is a positive regulator gene for these phenotypes; Kato J et al.; Two distinct regions required for both contact hemolysis and entry into LLC-MK2 cells were cloned into Escherichia coli from the Shigella sonnei form I plasmid, pSS120 . The first region was cloned into an E . coli HB101 strain containing noninvasive Tn1 insertion mutants of the form I plasmid, and expression of ipa (invasion plasmid antigen) gene products was restored . The plasmid carrying the first region was then transformed into E . coli lacking the form I plasmid, and additional DNA fragments from the form I plasmid were cloned into the same recipient on compatible vectors . Five of these double transformants were found to be positive for contact hemolysis activity . Restriction analysis of these five clones indicated that the previously reported ipa locus and the invA locus were present on the second plasmid region . Only the strains carrying both of these regions were active in contact hemolysis and cell invasion assays . Several proteins, including the a, b, c, and d proteins encoded by the ipa genes, were detected in the double transformants by Western blot (immunoblot) analysis with serum of a monkey convalescing from shigellosis . A positive regulator was suggested to exist in the first region, since the amounts of most of these proteins were simultaneously increased in the presence of this region . Subcloning and nucleotide sequencing indicated that this positive regulator gene was virF . Product analysis of the virF gene with minicells showed that two peptides (30 and 21 kilodaltons) were synthesized and that at least the 30-kilodalton protein was essential for regulation of the ipa genes. Proc Natl Acad Sci U S A, 1989 May, 86(10), 3867 - 71 Identification of icsA, a plasmid locus of Shigella flexneri that governs bacterial intra- and intercellular spread through interaction with F-actin; Bernardini ML et al.; The capacity of Shigella to spread within the cytosol of infected epithelial cells and to infect adjacent cells is critical for the development of infection foci, which lead to mucosal abscesses . Shigella is a nonmotile microorganism that appears to utilize host cell microfilaments to generate intra- as well as intercellular movements, since this movement was inhibited by cytochalasin D and involvement of F-actin was demonstrated by direct labeling of infected cells with the specific dye N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)phallacidin . Such movements led to the formation of extracellular protrusions, which may explain cell to cell spread . icsA, a locus necessary for intra- and intercellular spread, was identified on the Shigella flexneri virulence plasmid pWR100 . This locus was cloned and shown to express a 120-kDa outer membrane protein, which plays an important role in the interactions established between host cell microfilaments and the bacterial surface, thus leading to intracellular movement. J Clin Microbiol, 1989 May, 27(5), 829 - 31 Four new provisional serovars of Shigella; Gross RJ et al.; Four bacterial strains are described that possess the biochemical characteristics of Shigella species but do not belong to any of the established Shigella serovars or to any previously described provisional serovar . One strain fermented mannitol, and it is proposed that this be the type strain for a new provisional serovar of Shigella boydii . The remaining strains did not ferment mannitol and belonged to three different serovars . These strains are proposed as type strains for three new provisional serovars of Shigella dysenteriae . All four strains were invasive in a HEp-2 cell tissue culture test, but only one was invasive in the guinea pig eye test and might therefore be expected to cause dysenterylike illness in humans . It is important that the designation of such strains remain provisional until other reference laboratories have had the opportunity to search for additional isolates and the possible pathogenicity of these strains for humans can be further assessed. Mol Microbiol, 1989 May, 3(5), 627 - 35 A dual transcriptional activation system for the 230 kb plasmid genes coding for virulence-associated antigens of Shigella flexneri; Adler B et al.; The expression of plasmid-encoded, invasion-related antigens lpa b, c and d of Shigella flexneri was found to be positively regulated at transcriptional level by a 33kD protein produced by the previously defined, virulence-associated Region 1 on the SalI fragment B of the 230 kb invasion plasmid . The gene (designated virB) was identified and its nucleotide sequence determined . No Ipa b or c was produced in the absence of an intact virB gene although lower levels of d were produced . The previously reported regulatory activity of the virF gene some 30 kb distance away was shown to act exclusively through virB . In contrast, the activation of the virG gene necessary for intercellular spread occurred directly by virF without the requirement for virB . This study thus ascribes a critical function to a previously recognized, but functionally undefined, virulence locus on the large invasion plasmid of S . flexneri . The virF gene appears to have a central role in activation of the 230 kb plasmid-encoded virulence genes. Biochem Biophys Res Commun, 1989 Apr 14, 160(1), 126 - 32 Interaction of Shigella toxin with globotriaosyl ceramide receptor-containing membranes: a fluorescence study; Surewicz WK et al.; The interaction of the B-subunit of Shigella toxin with a globotriaosyl ceramide receptor incorporated into phosphatidylcholine vesicles was studied by fluorescence spectroscopy . From the position of the maximum in the emission spectrum and the accessibility to acrylamide quenching, it is concluded that a single tryptophan of a free B-chain is located in a highly polar environment, most likely on the surface of the folded polypeptide chain . Binding of B-subunits to the membrane-associated globotriaosyl ceramide results in a strong enhancement of fluorescence intensity and a small blue-shift of the emission maximum; these effects suggest a conformational change in the protein which provides a new environment to a tryptophan residue . However, the polarity of this new environment is still relatively high--as indicated by the position of the emission maximum at 344 nm--and suggests that the receptor-bound B-chain remains largely on the membrane surface, without penetrating the hydrophobic interior of a lipid bilayer . On the other hand, the A-chains are shown to interact directly with the receptor-free lipid bilayers; this nonspecific interaction may play a role in the mechanism by which A-subunit traverses the membrane of a target cell. Wis Med J, 1989 Apr, 88(4), 17 - 8 Shigellosis winter trends in Milwaukee; Gradus MS et al.; Shigellosis cases reported to the Milwaukee Health Department have been highest during the months November, December, and January for eight of the past 11 years (1978 to 1988) . Shigellosis in the United States has classically been described as a summer or late summer-early fall disease. Vaccine, 1989 Apr, 7(2), 111 - 6 Oral cholera vaccines containing B-subunit-killed whole cells and killed whole cells only . I . Cross-reacting antigens of members of family Vibrionaceae and the vaccines; Ciznar I et al.; Antigenic similarity between the oral cholera B subunit-whole cell (BS-WC) and whole-cell only (WC) vaccines and strains of the family Vibrionaceae was studied by crossed immunoelectrophoresis . A reference system consisting of Vibrio cholerae Inaba E1 Tor antigenic extract and homologous rabbit antiserum was applied in the study . The system was represented by 30 anodically migrating antigens forming distinct precipitation bands . Antigenic extracts of other members of the family Vibrionaceae showed the following numbers of cellular antigens shared in common with the reference system: Vibrio cholerae non-01-30, V . mimicus-23, V . fluvialis-15, V . parahaemolyticus-10, Aeromonas hydrophila-7, A . sobria-5, A . caviae-4 and Plesiomonas shigelloides-5 antigens . Homologous rabbit antiserum reacted with 11 antigens of BS-WC vaccine and 10 antigens of WC vaccine . The number of antigens which members of the family Vibrionaceae shared in common with those preserved in the WC component of the vaccines were as follows: Vibrio cholerae non-01, 7; V . mimicus, 5; V . fluvialis, 3; V . parahaemolyticus, 3; Aeromonas hydrophila, 2; A . sobria, 2; and A . caviae, 2; Plesiomonas shigelloides, 1 . None of the strains produced an antigen reacting with anti-cholera toxin antibodies . The presence of common antigens in the vaccine and among members of family Vibrionaceae indicates that the oral cholera vaccine could stimulate immunity effectively against other members of the family. Vaccine, 1989 Apr, 7(2), 117 - 20 Oral cholera vaccines containing B-subunit-killed whole cells and killed whole cells only . II . Field evaluation of cross-protection against other members of the Vibrionaceae family; Clemens JD et al.; Because of demonstrable cross-reactivity of cellular antigens contained in B subunit-killed whole-cell (BS-WC) and killed whole-cell-only (WC) oral cholera vaccines with antigens of various non-cholera species of the family Vibrionaceae (NCV), the protection conferred by the vaccines against diarrhoea associated with NCV was evaluated during a randomized, double-blind field trial in Bangladesh . Children aged 2-15 years and women aged greater than 15 years (62,285 in number) received three doses of BS-WC vaccine, WC-only vaccine, or a placebo consisting of Escherichia coli K12 strain (K12) . During 1 year of follow-up, the incidence of treated episodes of diarrhoea associated with non-cholera vibrios known to be enteric pathogens (non-01 Vibrio cholerae, V . fluvialis, V . parahaemolyticus, V . mimicus) in the placebo group was low (1.9 cases per 10,000 recipients) and identical to that for the two vaccine groups combined . The incidence (per 10,000 recipients) of treated diarrhoeal episodes associated with Aeromonas species was considerably higher, but nearly identical in the three groups (26.1 cases for BS-WC, 26.0 cases for WC; 25.9 cases for K12) . Pleisiomonas shigelloides was not isolated from any participant . It is concluded that NCV other than Aeromonas were rarely isolated from diarrhoeal patients in our study population and that killed oral vaccines which were effective against cholera exhibited no detectable cross-protection against diarrhoea associated with NCV organisms. Infect Control Hosp Epidemiol, 1989 Apr, 10(4), 147 - 9 Shigellosis occurring in newborn nursery staff; Beers LM et al.; Shigellosis is uncommon in the newborn nursery . We describe a case of Shigella sonnei gastroenteritis occurring in a newborn . Three of 32 health care providers caring for the infant acquired shigellosis . The neonate probably acquired the infection from its mother via vertical transmission . All six members of the infant's family had gastroenteritis and two siblings had stool cultures positive for Shigella . Transmission of Shigella in the newborn nursery is potentially great . Emphasis on handwashing and glove use, aggressive case finding, notification of contacts, and a liberal "forced paid sick time" policy may halt the spread. J Infect Dis, 1989 Apr, 159(4), 648 - 53 Dissemination of trimethoprim-resistant clones of Shigella sonnei in Bulgaria; Bratoeva MP et al.; Bacterial dysentery due to Shigella sonnei remains a serious public health problem in developed countries, including Bulgaria . At the National Shigella Reference Laboratory in Sofia, 17,126 strains of S . sonnei from epidemics and sporadic cases collected from 1973 to 1987 were studied . Antibiotic susceptibility testing, phage typing, colicin typing, and biotyping were performed for all strains to allow intraspecies differentiation and to track any clonal distribution . Of all strains, 84.3% were resistant to one or more antimicrobials, the most frequent being tetracycline (Tet), streptomycin (Str), sulfonamide (Sul), chloramphenicol (Chl), ampicillin (Amp), and trimethoprim (Tmp) . Resistance patterns most prevalent for successive 5-y periods included Tet, StrSulTet, and AmpChlStrSulTet, respectively . For the final 5 y, a new pattern (AmpKanStrSulTetTm {Kan = kanamycin}) was spread throughout the country by two trimethoprim-resistant clones . High-level resistance to trimethoprim (MIC greater than 1500 micrograms/mL) in both clones was determined by dihydrofolate reductase type I . The genes for trimethoprim resistance were located on a conjugative R-plasmid of approximately 145 kilobases which cotransferred all other antimicrobial resistances . A similar-sized R-plasmid had been found in earlier isolates of Bulgarian S . sonnei, suggesting that new antimicrobial resistance genes had been sequentially added to an ancestral R-plasmid . Controlling the expression of these new as well as older antimicrobial resistances, particularly for enteric pathogens, must involve reduction in usage of generic antimicrobial agents. J Cell Biol, 1989 Apr, 108(4), 1331 - 43 Endocytosis from coated pits of Shiga toxin: a glycolipid-binding protein from Shigella dysenteriae 1; Sandvig K et al.; Evidence is presented that endocytosis is involved in the transport to the cytosol of the cytotoxin from Shigella dysenteriae 1, Shiga toxin, which acts by removal of a single adenine residue in 28-S ribosomal RNA . Inhibition of endocytosis by ATP depletion of the cells prevented toxin uptake . Exposure of HeLa S3 and Vero cells to toxin at low extracellular pH, where translocation to the cytosol, but not endocytosis is inhibited, allowed the toxin to accumulate in a compartment where it was protected against antibodies to the toxin . Upon transfer of the cells to normal medium endocytosed toxin entered the cytosol . Electron microscopical studies of cells exposed at 0 degrees C to a toxin-horseradish peroxidase (HRP) conjugate, or to unconjugated toxin followed by horse antitoxin antibodies and then protein G-gold, revealed that the Shiga toxin binding sites were randomly distributed on the cell surface, without any preference to, for example, coated pits . In contrast, when cells were exposed to toxin at 37 degrees C, the binding sites were preferentially localized in coated pits . The Shiga-HRP conjugate was also seen in endosomes, lysosomes, and in the Golgi region . Endocytosis by the coated pit/coated vesicle pathway was selectively inhibited by acidification of the cytosol . Under these conditions, both the uptake of toxin-HRP conjugates and intoxication of the cells were inhibited . Evidence from the literature as well as our own results suggest that Shiga toxin binding sites are glycolipids . Thus, Shiga toxin appears to be the first example of a lipid-binding ligand that is endocytosed from coated pits. Zh Mikrobiol Epidemiol Immunobiol, 1989 Apr, (4), 14 - 7 {The effect of gram-negative bacteria lipopolysaccharides on the development of Rauscher leukosis in BALB/c mice}; Shevliagin VIa et al.; The dose-dependent action of Shigella sonnei lipopolysaccharide (LPS) on the development of acute erythroleukocytosis, as well as Rauscher chronic myeloid and lymphoid leukosis, in BALB/c mice sensitive to Rauscher virus was shown . Bordetella pertussis LPS in the doses used in this investigation stimulated the development of both acute erythroleukosis and chronic myeloid and lymphoid leukosis in BALB/c mice infected with Rauscher virus . Lipid A isolated from B . pertussis LPS was found to produce a stimulating effect on the development of Rauscher leukosis in mice . After the treatment of B . pertussis LPS with polymyxin B blocking lipid A no stimulating effect of B . pertussis LPS on the development of Rauscher leukosis was observed . A suggestion is made that lipid A is the active principle contributing to the stimulation of the development of Rauscher leukosis in BALB/c mice. Zh Mikrobiol Epidemiol Immunobiol, 1989 Mar, (3), 64 - 7 {The ratio of various lymphocyte populations in bacillary dysentery and nonspecific ulcerative colitis}; Burmistrova AL; The comparative study of the content of different lymphocyte populations of the peripheral blood in pathological states accompanied by lesions of the mucous membrane of the large intestine has been made . In shigellosis patients the accumulation of lymphocytes having the signs of young post-thymic forms (theophylline-dependent populations) and functionally active forms (Ea-rosette-forming cells) occurs in the circulating blood . In unspecific ulcerous colitis only an increase in the number of immature lymphocytes (theophylline-dependent lymphocytes and autorosette-forming cells) is observed . In both pathological states an increase in the number of O-lymphocytes with Fc gamma-receptors occurs in the circulation blood. Indian J Med Res, 1989 Mar, 89, 69 - 75 Relationship between multiple drug-resistance & enterotoxin production by Shigella species; Sharma A et al.; Culture filtrates prepared with strains of Shigella dysenteriae 1 and those of Sh . flexneri and Sh . sonnei, collected from different geographical locations in India caused accumulation of fluid in rabbit gut loops, indicating their capability to produce Shiga and Shiga-like toxins respectively . Sh . boydii strains were noted for the first time to produce Shiga-like toxins . The failure of production of fluid accumulation in rabbit gut by Shigella strains that lacked the R-markers of the antibiotics tested and the gradual enhancement in the secretory response by strains containing R-markers in the increasing order indicate a possible correlation between acquisition of higher number of R-markers and enterotoxic activity . The non-transferable and non-curable nature of most of the drug resistance markers, coupled with the failure of the two transconjugants to elicit a secretory response and the capacity of the single cured variant to retain this property suggest the involvement of certain chromosomal locii in mediating drug resistance and enterotoxicity in Shigella. Cesk Epidemiol Mikrobiol Imunol, 1989 Mar, 38(2), 65 - 73 {Results of a 30-year study of shigellae in a reference laboratory}; Aldova E et al.; In Czechoslovakia in addition to the most frequent species of the genus shigella, S . sonnei, and in addition to serovars of S . flexneri which during the years of investigation accounted for 4-40% of all Shigellae a small number of serovars of sub-groups A (S . dysenteriae) and C (S . boydii) were isolated . The European endemities of S . dysenteriae 2, S . boydii 1 and S . boydii 4 occur regularly and are mostly of local origin, while in Europe uncommon serovars 3, 4, 7, 12 of S . dysenteriae and serovars 2, 3, 5, 7, 9, 10, 14, 16 and provisional E 1655/79 of S . boydii were mostly of foreign origin . Of these uncommon serovars only S . boydii 13 was isolated in Kosice in 1986 and is the only one where a foreign origin was proved . In Czechoslovakia all serovars of subgroup B of S . flexneri were isolated, incl . the newly suggested sub-serovars and biochemically aberrant strains of sub-groups B, C and D . An epidemic in a nursery caused by serovar S . flexneri, 4b, where the source of infection was a monkey, was remarkable . As to aberrant strains, the indole-positive variant of S . boydii 1, is remarkable being the first finding in the world. Zh Mikrobiol Epidemiol Immunobiol, 1989 Mar, (3), 36 - 9 {Biological properties of bacteria of the species Shigella flexneri}; Polikarpov NA et al.; Some biological properties of S . flexneri have been studied . The strains of this bacterial species have been shown to produce DNAase in 98.8 +/- 0.77% of cases and RNAase in 97.4 +/- 1.5% of cases . The capacity for the positive reaction with Congo red as early as after 24-hour incubation in the thermostat has proved to be characteristic of S . flexneri (91.1 +/- 3.6%) . If stored at 4 degrees C in semiliquid agar, S . flexneri cultures have been found to retain their capacity for producing the above-mentioned enzymes as long as 10-13 years . All S . flexneri serovars under study, with the exception of serovar 6, have shown high activity in the manifestation of their properties. Vojnosanit Pregl, 1989 Mar-Apr, 46(2), 94 - 6 {Isolation of Shigella boydii serotype 14 with altered biochemical characteristics in a water-borne epidemic of dysentery}; Sokolovski B et al.; Two water-borne epidemics of bacillary dysentery have been described in a garrison in which the leading causative agent has been shigella boydii, serotype of 14 altered biochemical characteristics isolated for the first time in Yugoslavia . All the isolated strains of this shigella were mannitol negative and they degradated gylocose to acidity and gas already after 24 hours, and arabinose and sorbitol to acidity and gas after 48 hours . The clinical picture of the diseased was characteristic of bacillary dysentery and did not differ from clinical picture of patients in whom other serotypes of shigella were isolated. Mol Gen Mikrobiol Virusol, 1989 Mar, (3), 16 - 20 {Localization of SsoII restriction endonuclease and methylase genes on the map of the P4 plasmid}; Kariagina AS et al.; The restrictional mapping of naturally occurring plasmid P4 from Shigella sonnei 47 strain coding for the SsoII restriction endonuclease and methylase genes has been made . Using the genetic engineering approach the locations of the SsoII host cell specificity system enzymes genes have been determined. J Clin Microbiol, 1989 Mar, 27(3), 561 - 3 Characterization of virulence marker antigen of Shigella spp . and enteroinvasive Escherichia coli; Pal T et al.; Antisera produced in rabbits immunized with an enteroinvasive O143 strain of Escherichia coli were absorbed with an avirulent derivative of the same strain . The resulting sera have been previously shown to recognize enteroinvasive pathogens when used in an enzyme-linked immunosorbent assay . In the current study, Western blots (immunoblots) showed that such an absorbed rabbit antiserum recognized two proteins (IpaB and IpaC) which are encoded by a large, virulence-associated plasmid . These proteins are the apparent constituents of the virulence marker antigen which is expressed by shigellae and enteroinvasive E . coli. Infect Immun, 1989 Mar, 57(3), 858 - 63 Role of M cells in initial antigen uptake and in ulcer formation in the rabbit intestinal loop model of shigellosis; Wassef JS et al.; Strains of Shigella flexneri with different invasive and pathogenic potentials were inoculated into the intestinal lumen of acutely ligated loops in nonimmune rabbits . After 90 min, tissues processed for ultrastructural as well as light microscopy showed that the bacilli were phagocytosed by M cells over lymphoid follicles of Peyer's patches and carried in vacuoles into the epithelium . Nonpathogenic as well as pathogenic strains were readily taken up regardless of the presence of the 140-megadalton virulence plasmid . More virulent than avirulent shigellae were found in M cells at 90 min, reflecting replication or preferential uptake of the virulent strains . Heat-killed shigellae of the virulent strain were taken up by M cells to the same degree as the avirulent strains . Incubation of the bacteria for 18 h resulted in surface ulceration which was limited to epithelium overlying lymphoid follicles (M cell areas) in acute loops exposed to the virulent shigellae . Villus epithelium adjacent to the ulcerated follicular domes was intact, although there was mucus depletion . In the present study, we found that pathogenic shigellae appear to replicate in the M cells, escape from the phagocytic vesicles, and thereby initiate the ulcerations in this experimental model of dysentery . While initial antigen processing in the gut for a mucosal immune response may require uptake of luminal microorganisms by M cells, this may pose a threat under some circumstances. Kansenshogaku Zasshi, 1989 Mar, 63(3), 228 - 33 {Enteroinvasive Escherichia coli O29:H--isolated from travellers' diarrheal cases}; Matsushita S et al.; Escherichia coli strains isolated in Tokyo from stool cultures of two sporadic diarrheal cases of travellers returning from South America and Thailand in 1985 and 1987 respectively, were found to be enteroinvasive strains with rare serotype O29:H-- . These E . coli O29:H-- strains showed typical biochemical reactions of enteroinvasive E . coli in that they were negative lysine decarboxylase and non-motile . They were positive for Sereny test with guinea pig eye, cell-invasion test with HeLa cells, 140 megadalton virulence plasmid, and the virulence-plasmid encoded outermembrane protein, indicating that these strains were pathogenic and may cause a Shigella-like disease . Although the same serotype strains have been isolated in other countries, this may be the first report of isolation in Japan. Med J Osaka Univ, 1989 Mar, 38(1-4), 39 - 49 Studies on shiga-like toxin produced by enterohemorrhagic Escherichia coli: purification and characterization of the toxin and development of methods for identifying the toxin; Kongmuang U; A simple purification method using DEAE cellulose column chromatography and immunoaffinity column chromatography was developed for purifying Shiga-like toxin produced by Escherichia coli O157:H7 . About 0.75 mg of purified toxin was obtained from 5 liters of culture (62% recovery) . The purified toxin was demonstrated to be immunologically, biologically and structurally indistinguishable from Shiga toxin . A sandwich enzyme-linked immunosorbent assay (ELISA) was developed for detection of Shiga-like toxin . In the ELISA assay, Shigella dysenteriae type 1, Escherichia coli O157:H7 and some strains of Escherichia coli isolated from traveller's diarrhea were positive . Shiga toxin-resistant Vero cells were isolated by treatment of the cells with nitrosoguanidine . Immunofluorescence studies showed that the mutant Vero cells had lost toxin binding capacity . Samples of S . dysenteriae type 1 and E . coli O157:H7 showed cytotoxicity to the parent cells, but not to the mutant cells . Samples of other organisms showed either no cytotoxicity or cytotoxicity to both cell lines . The results suggested that (1) the presence of a receptor for Shiga-like toxin on Vero cells is essential for expression of cytotoxicity of the toxin, (2) the mutant Vero cells could be used to identify Shiga-like toxin producing organisms. Mol Microbiol, 1989 Feb, 3(2), 207 - 13 Molecular cloning and characterization of chromosomal virulence region kcpA of Shigella flexneri; Yamada M et al.; In Shigella flexneri, in addition to several well-recognized plasmid-borne virulence loci, at least three genetic loci implicated in pathogenesis have been recognized on the chromosome . To understand more about the pathogenesis of bacillary dysentery at a molecular level, the genetically recognized but previously unidentified KcpA region (one of the chromosomal regions near purE) was cloned and sequenced . A single translatable open reading frame encoding a 12310 Dalton protein corresponding to the minicell product was found . Immunofluorescence microscopy, as well as optical and electron microscopic comparison of tissue-cultured cells and guinea-pigs' eyes infected with wild-type or kcpA mutant bacteria, revealed that the kcpA product is required by invading bacteria for spread into adjacent cells. Neth J Med, 1989 Feb, 34(1-2), 93 - 7 Shigellosis and AIDS . Report of a case and brief review of the literature; Boers M et al.; This report describes the fatal outcome of an infection with Shigella flexneri in a 39-yr-old man with the acquired immunodeficiency syndrome (AIDS) . The pertinent literature is reviewed. J Clin Microbiol, 1989 Feb, 27(2), 353 - 5 Chronic Shigella flexneri infection preceding development of acquired immunodeficiency syndrome; Simor AE et al.; Shigella sp . is known to be an important cause of diarrhea in homosexual men, although chronic infection is infrequently recognized . We describe recurrent and relapsing symptomatic infection due to Shigella flexneri in a human immunodeficiency virus-infected homosexual man subsequently developed acquired immunodeficiency syndrome . Patients with acquired immunodeficiency syndrome may be prone to developing chronic shigellosis because of impaired intestinal cell-mediated immunity. Infect Immun, 1989 Feb, 57(2), 477 - 86 Intracellular spread of Shigella flexneri associated with the kcpA locus and a 140-kilodalton protein; Pal T et al.; Escherichia coli K-12 hybrids carrying both the 220-kilobase plasmid and the purE-linked kcpA locus from Shigella flexneri expressed a 140-kilodalton (kDa) protein which was recognized by convalescent sera from monkeys infected with S . flexneri . These hybrids were tested for the ability to produce plaques in HeLa cell monolayers . Hybrid strains which carried both the 220-kilobase plasmid and the kcpA locus had a plaque-forming efficiency of at least 10(-4) PFU/CFU, whereas the plaque-forming efficiency of hybrids that carried only the shigella invasion plasmid ranged from undetectable to 10(-6) . Variants were purified from the rare plaques formed by E . coli hybrids that carried only the shigella invasion plasmid . These plaque-purified strains also expressed the 140-kDa protein, and they had a plaque-forming efficiency of at least 10(-4) . Transduction of the purE locus from a plaque-purified hybrid into a non-plaque-forming E . coli K-12 strain did not alter the phenotype of the recipient, but conjugation of the shigella invasion plasmid into this transductant reconstituted both expression of the 140-kDa protein and the plaque-forming phenotype . Invasive E . coli K-12 hybrids carrying only the shigella invasion plasmid remained localized within discrete areas of the HeLa cell cytoplasm, whereas hybrids that also carried the S . flexneri kcpA locus grew in a dispersed pattern throughout the host cell cytoplasm . The dispersal of these organisms was inhibited by cytochalasin D, which suggested that host cell microfilaments may play a role in the intracellular spread of enteroinvasive pathogens. J Clin Microbiol, 1989 Feb, 27(2), 331 - 4 Examination of colonies and stool blots for detection of enteropathogens by DNA hybridization with eight DNA probes; Echeverria P et al.; We compared three methods for detecting enteropathogens in 416 children with diarrhea: (i) examination of 10 lactose-fermenting and all non-lactose-fermenting Escherichia coli (colony blots); (ii) examination of 300 colonies (replicate blots); and (iii) determination of the total bacterial growth of stools (stool blots) . All specimens were spotted onto Whatman 541 filters and hybridized with specific radiolabeled DNA probes . Enterotoxigenic E . coli was detected in 38 patients by examining colony blots, in 52 patients by examining replicate blots, and in 45 patients by examining stool blots . Enteropathogenic E . coli adhesin factor was detected in 12 patients by colony blots, in 25 patients by replicate blots, and in 16 patients by stool blots . E . coli that hybridized with the enterohemorrhagic E . coli probe was detected in 2 patients by colony blots, in 11 patients by replicate blots, and in 0 patients by stool blots . Shiga-like toxin-producing E . coli was detected in 0 patients by colony blots, in 12 patients by replicate blots, and in 0 patients by stool blots . Shigella spp . were identified by standard bacteriological methods in 82 patients, and enteroinvasive E . coli was identified by colony blots in 11 patients (total, 93), by replicate blots in 56 patients, and by stool blots in 35 patients . Of 82 culture-confirmed Shigella infections, 45 were identified by examining replicate blots with the 17-kilobase-pair probe and 36 were identified by examination with the Ipa probe (P less than 0.05) . Examining replicate blots with specific probes identified more enterotoxigenic E.coli (P < 0.005), enteropathogenic E.coli adhesion factor-producing E.coli (P < 0.001), and Shiga-like toxin-producing E.coli (P < 0.005) infections than examining colony blots . More Shigella and enteroinvasive E.coli infections were identified by standard bacteriological methods and examining colony blots with a specific probe than by examining replicate and stool blots (P < 0.001). Zentralbl Bakteriol Mikrobiol Hyg {B}, 1989 Feb, 187(3), 261 - 5 Method for the detection of Shigella in foods; Beckers HJ et al.; A method for the detection of Shigella in foods was evaluated . The method consisted of selective enrichment at 37 degrees C in GN-broth supplemented with novobiocin (10 micrograms/ml) followed by subculture after 6 and 24 h incubation of 0.1 ml volumes to SS-agar with and without streptomycin (7.5 micrograms/ml) . Test samples were contaminated by adding shigellae to 1:10 suspensions of foods (minced meat, fresh cut vegetables and cooked peeled shrimp) in the GN-broth with novobiocin . Shigella could be detected at a contamination level of 1 per 25 g in the presence of shrimp (in all 20 samples) and at 25 per 25 g in the presence of nearly all samples of fresh cut vegetables (in 13 out of 18 samples) . Using this procedure Shigella could not be detected when the organism was present at a relatively high contamination level of 10(2) per 25 g in the presence of minced meat (with all 10 samples) . However, the procedure described is an improvement on methods currently available for the detection of Shigella in foods. Yonsei Med J, 1989, 30(1), 81 - 7 Guillain-Barre syndrome in Korean children; Coe CJ; Guillain-Barre syndrome is known as one of the autoimmune disease, but the etiology, pathophysiology relating immune reaction, as well as the treatment are not established . It still causes physical handicap although its rate is low . The causes, clinical symptoms and outcome of 132 cases of Guillain-Barre syndrome have been analyzed . The patients' ages ranged from 4 months to 15 years . The antecedent events for 56.1% of the patients were known . These were upper respiratory tract infection, unexplained fever, vomiting, diarrhea, vaccination, measles, german measles, shigellosis, mumps, hepatitis, pertussis and surgery in order of frequency . The CSF protein level reached a maximum at 12.3 +/- 9.5 days . Steroids did not influence the outcome of this disease . More studies are necessary to conquer the disease. Arch Inst Pasteur Madagascar, 1989, 56(1), 71 - 6 {Development of antibiotic resistance of type 1 Shigella dysenteriae strains (Shiga bacillus) isolated in Tananarive on the East coast of Madagascar}; Cassel-Beraud AM et al.; From November 1988 to March 1989, 804 Malagasy children stools were studied and 37 Shigella strains isolated . 5 Shigella dysenteriae type 1 from Malagasy East coast (Mananjary), presented a multiply resistance to ampicillin, carbenicillin, streptomycin, chloramphenicol, tetracycline, sulphonamides and trimethoprim . This last resistance has recently appeared in this area. Ter Arkh, 1989, 61(11), 39 - 41 {Prostaglandins and cyclic nucleotides in the gastrointestinal form of yersiniosis}; Proskurina LN et al.; In spite of the resemblance of the clinical picture of gastrointestinal yersiniosis and acute dysentery, material differences underlie the pathogenesis of these diseases . Yersiniosis is marked by the predominance of an increase in the content of PGF2 alpha, whereas acute dysentery by an increase in the content of PGE, which may be accounted for by greater intensity of the allergic manifestations in yersiniosis patients as compared with dysentery . Shigellosis runs its course in the presence of the prevailing influence of the guanylate cyclase system, whereas yersiniosis in that of the adenylate cyclase . This is likely to be related to graver destructive lesions in the colonic mucosa in acute dysentery. Scand J Gastroenterol Suppl, 1989, 169, 47 - 53 A randomized, controlled, single-blind study comparing furazolidone with trimethoprim-sulfamethoxazole in the empirical treatment of acute invasive diarrhea; Rodriguez RS et al.; An outpatient study of 125 children with acute invasive diarrhea was conducted at the Hospital Infantil de Mexico Federico Gomez . Through a single-blind randomization, we compared the efficacy of furazolidone, 7.5 mg/kg/day (49 patients), with trimethoprim-sulfamethoxazole (TMP-SMX), 8 mg/40 mg/kg/day (52 patients), each given for 5 days . A control group of 24 patients received no antimicrobials . Stool samples were collected from all patients at the time of admission, and active drugs were administered before the stool culture results were available . At baseline, 48 of 125 patients (38.5%) had negative stool cultures . In the other patients, the most frequently isolated pathogens were Shigella sp and enteropathogenic Escherichia coli . Of the total population who completed the study 43 of 49 (87.8%) of the patients in the furazolidone group and 43 of 52 (82.7%) of the patients in the TMP-SMX group achieved clinical cure by day 3, compared with 10 of 22 (45.5%) of the patients in the control group . Day 3 cure rates were similar between groups, independent of baseline stool culture results . Of those patients who had positive stool cultures on day 1, 20 of 34 (58.8%) in the furazolidone group and 19 of 29 (65.5%) in the TMP-SMX group had negative culture results on day 6, compared with 4 of 12 (33.3%) in the control group . Overall, clinical and bacteriologic success was achieved in 31 of 49 (63%) patients treated with furazolidone and in 36 of 52 (69%) patients treated with TMP-SMX, compared with 5 of 22 (23%) patients in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) Acta Paediatr Scand Suppl, 1989, 351, 131 - 6 The protective effect of human milk against diarrhea . A review of studies from Bangladesh; Glass RI et al.; PIP: Field studies conducted in Bangladesh in collaboration with laboratory studies in Goteborg, Bethesda and Atlanta were directed toward identifying specific enteric infections in infants influenced by breastfeeding . The international Centre for Diarrheal Disease Research set up at the Dhaka Hospital examined 4000 children under 5 with diarrhea between March 1980 and February 1982 . Breast feeding is the preferred feeding method in this population, and is extended into the 2nd and 3rd years in the majority . Infants 6-11 months old were more likely to be breast fed than younger infants (88 vs . 77%), suggesting that breast feeding confers some protection against diarrhea in the 1st 6 months . The most frequently found enteric pathogens were rotavirus (35%), enterotoxigenic E . coli (ETEC) (14%), C . jejuni (14%), shigella (11%), G . lamblia (6%), V . cholerae (6%), and E . histolytica (2%) . Children with shigellosis were significantly less likely to be breast-fed than those with other infections . Those already weaned were more likely to have shigellosis (15 vs . 9/%) or cholera (6 vs . 3%) . In contrast, breast feeding was more common in children with rotavirus . Rates of breastfeeding did not differ among children positive for ETEC or C . jejuni . Among children with shigellosis, breast feeding was associated with a milder disease . In mother-child pairs who were contacts of index cases, breast milk with higher IgA titers was protective against clinical cholera, but not against colonization with V . cholerae 01 . Acute and convalescent phase sera from women showed consistently high anti-cholera titers, but breast milk did not in the 3- week period of the study . Shedding of G . lamblia appeared to be enhanced in breast feeding women . Microbiol Immunol, 1989, 33(11), 897 - 906 Monoclonal antibodies against the surface antigens of Shigella flexneri serotype 1b and Shigella dysenteriae serotype 1; Suzuki K et al.; Monoclonal antibodies against the surface antigens of Shigella flexneri 1b and S . dysenteriae 1 were prepared . The specificities of the antibodies were evaluated by enzyme-linked immunosorbent assay (ELISA), and quantitative agglutination using microtiter plate . Monoclonal antibodies against S . flexneri 1b, designated Sf2B2 and Sf2G4, belonged to IgG2a and IgG1 subclass, respectively . The former was specific for S . flexneri 1b, whereas the latter was reactive not only to S . flexneri 1b, but also weakly to 3a and 4b . Monoclonal antibody against S . dysenteriae 1, Sd5E1 (IgM), reacted with S . dysenteriae 1, 3, 6, 7, and S . boydii 2. J Hyg Epidemiol Microbiol Immunol, 1989, 33(3), 261 - 7 Epidemiology of the enteroinvasive Escherichia coli . Observations in Hungary; Ketyi I; The Hungarian experiences on the epidemiology of enteroinvasive Escherichia coli (EIEC) concerning the dominant serogroup 0124 are summarized . One of the basic differences between Shigella and EIEC infections may be attributed to the higher environmental resistance of EIEC, therefore first of all water-borne outbreaks may be frequent . The other essential difference is in te age incidence: the infection rate of infants is low, the rise of incidence rate begins at the 3rd year and its peak is in the school-children age . EIEC, like to other nosological units of E . coli is not a zoonosis . Symptomless carriership is frequent and may be long lasting with the excretion of the virulent agent for over 1 year. Curr Top Microbiol Immunol, 1989, 146, 213 - 23 The enteric immune response to shigella antigens; Keren DF et al.; Mucosal immunity to some enteropathogens occurs naturally following infection . By learning how to optimize initiation of the mucosal immune response it will be possible to develop vaccines against a wide variety of enteropathogens and their toxic products . In the past few years, we have examined stimulation of the mucosal response to Shigella antigens . We have found that the mucosal memory response to Shigella LPS can be stimulated by oral immunization with live, but not with killed Shigella . This primes specific B lymphocytes which, following rechallenge, quickly migrate from the Peyer's patches to mesenteric lymph nodes, the spleen, and back to the Peyer's patches . We have found that the uptake of S . flexneri is the initial step in developing a mucosal immune response to Shigella . Whereas there is little difference between the initial uptake of virulent and avirulent bacteria by M cells, pathogenic strains of Shigella are able to replicate following their uptake by the specialized M cells located in the follicle-associated epithelium of the gut . This likely serves as the source of the ulcerative lesions found in dysentery . Lastly, we have detected a vigorous secretory IgA response to Shiga toxin . The titer of IgA activity to Shiga toxin from these loop secretions correlated well with the ability to prevent Shiga toxin cytotoxin effects in vitro . The extremely vigorous mucosal immune response to Shiga toxin makes this an attractive alternative to cholera toxin to potentiate the secretory IgA immune response. An Esp Pediatr, 1989 Jan, 30(1), 15 - 8 {Childhood shigellosis: clinical and microbiological characteristics}; Reina Prieto J et al.; Authors present a retrospective study on 89 cases of pediatric shigellosis detected between 1983-1987 . Most frequent isolated strain was S . sonnei with 67.4% and S . flexneri with 31.4% cases . 73.9% of all isolements were marked between the months october-december . Mean age of patients was 4.4 years and 44.9% of them need not to be hospitalized . Only 3.3% of patients presented a clinical syndrome of bacillar disentery with blood and mucus . Strains were resistent to ampicilin in 84.2% and to thrimetoprim-sulphimethosaxol in 80.9% of cases. Am J Trop Med Hyg, 1989 Jan, 40(1), 77 - 85 Introduction and spread of multi-resistant Shigella dysenteriae I in Thailand; Taylor DN et al.; Outbreaks of Shigella dysenteriae I occurred in northeastern Thailand in the fall of 1986 and again in the spring and fall of 1987 for the first time in over 20 years . The epidemic strain of S . dysenteriae I was resistant to tetracycline, streptomycin, chloramphenicol, and trimethoprim-sulfamethoxazole, but susceptible to ampicillin . Trimethoprim resistance was chromosomally encoded by type I dihydrofolate reductase . In Ubon Province, where 10,000 cases of dysentery were reported, there were 3-5 cases of dysentery per 1,000 residents during the peak months, with 2-5 hospitalizations per 100 cases of reported dysentery . There were 2 deaths among 101 hospitalized, culture-confirmed cases . The overall case-fatality rate among reported cases of dysentery in this province was 0.9% . In contrast to S . flexneri infections, which occurred predominantly among children less than 5 years old, S . dysenteriae I infections occurred in all age groups . The large number of susceptibles appeared to be important in allowing rapid spread of S . dysenteriae I . In 1 village, 46% of 434 villagers reported dysentery; S . dysenteriae I was isolated from 24 out of 81 (30%) individuals cultured . Based on the prevalence of IgG antibody to S . dysenteriae I lipopolysaccharide, it was estimated that 76% of the villagers had been infected. J Bacteriol, 1989 Jan, 171(1), 353 - 9 virG, a plasmid-coded virulence gene of Shigella flexneri: identification of the virG protein and determination of the complete coding sequence; Lett MC et al.; On the 230-kilobase-pair (kb) virulence plasmid of Shigella flexneri 2a strain YSH6000, at least seven separate genetic determinants have been identified . One of them, an approximately 4-kb region, virG, that is required for the Sereny reaction, was extensively studied to examine the role of the virG region . The phenotype of a VirG- mutant (M94) of YSH6000 in the cytoplasm of cultured MK cells was characterized by a kinetic study of the invading shigellae . The observed phenotype of M94 in the cytoplasm indicated that the virG locus is not required for multiplication of the invading shigellae, but is essential for their spread to adjacent cells . The DNA region necessary for the VirG function was localized to a 3.6-kb DNA sequence on the 230-kb plasmid . A 130-kilodalton polypeptide was confirmed to be the virG product . External labeling of bacteria with 125I indicated that the 130-kilodalton virG protein is exposed on the bacterial surface . The nucleotide sequence of 4,472 bp, which contains the functional virG gene and its own regulatory sequence, was determined, and a large open reading frame encoding 1,102 amino acid residues was identified. Scand J Gastroenterol Suppl, 1989, 169, 34 - 8 In vitro susceptibility of Shigella strains isolated from stool cultures of dysenteric patients; Burstein S et al.; A reprospective analysis was conducted on the susceptibility by diffusion of 100 Shigella strains to 8 antimicrobial agents . These strains were isolated from 852 stool cultures obtained from dysenteric patients seen between January 1986 and April 1987 . Seventy-one per cent of the samples from which Shigella sp were isolated were obtained from children under age 6 years; 86% of these samples revealed pus, with or without blood . The Shigella serotypes isolated most often were S . flexneri (57%) and S . sonnei (38%) . The highest susceptibility rates were observed with furazolidone (98%), nalidixic acid (97%), and gentamicin (90%) . The same strains were significantly less susceptible to other antimicrobial agents used to treat shigellosis; among them, ampicillin and trimethoprim-sulfamethoxazole, for which susceptibility rates of 40% and 64%, respectively, were observed . Thus, it is important 1) to evaluate regularly the in vitro susceptibility of Shigella sp strains to antimicrobials commonly used to treat shigellosis, and 2) to conduct controlled clinical trials on the efficacy of alternative drugs in treating this disease. Scand J Infect Dis, 1989, 21(4), 415 - 9 The role of shigella spp . in childhood diarrhoea in Iran and their antibiotic resistance; Katouli M et al.; The incidence of shigellae was measured in 445 children with diarrhoea in Sanandaj, Kordestan, and 715 in Tehran during a 1-year study . 18 (4%) patients in Sanandaj and 41 (5.7%) patients in Tehran were positive for various shigella species . Sh . boydii (7 strains) and Sh . sonnei (25 strains) were the commonest species in Sanandaj and Tehran respectively . Among the isolates from Sanandaj the highest resistance was to tetracycline (55.5%), whereas in Tehran it was to sulfamethoxazole/trimethoprim (68.3%). J Egypt Public Health Assoc, 1989, 64(5-6), 381 - 9 Shigellae and Vibrionaceae species as a cause of diarrhoea among children in Aden; al-Sallami S; In Aden, the incidence of diarrhoea among infants and children is still high . The present work aimed at investigation of Shigelleae and Vibrionaceae as etiologic agents of enteric infections . Stool specimens obtained from 1056 children complaining of diarrhoea were cultured on plating media and on enrichment media . Suspected colonies were then serotyped and antibiotic sensitivity tests performed . Seven percent of the specimens were found positive for Shigella strains . Shigella boydii was the commonest, particularly serotypes 14 and 1 . Two percent of specimens were positive for Vibrionaceae, Plesiomonas shigelloides had the highest frequency . Several Shigella strains revealed multiple resistance to antibiotics, this was explained as due to a plasmid role. J Med Liban, 1989, 38(1), 25 - 8 Pediatric mortality: an avoidable tragedy; Mounla NA et al.; PIP: To focus attention on the problem of infant mortality in Lebanon, data were compiled on infant mortality from 1978 to 1986 at the American University of Beirut Medical Center . Causes of death are analyzed for 602 males and 398 females . 54.9% deaths occurred at 1 month of age and 77.4% died within the 1st year . Autopsies were performed on .7% . 37.7% of all neonatal deaths were due to neonatal diseases such as hyaline membrane disease, asphyxia neonatorum, immaturity, necrotizing enterocolitis, hemorrhage, hemolysis, meconium aspiration, and kernicterus . Better prenatal care would reduce this group, or the administration of corticosteroids to the mother 24-48 hours prior to delivery, as well as rapid resuscitation at birth and prevention of the 5 curses: hypoxemia, hypoglycemia, hypothermia, hypotension, and acidosis . Although unavailable in Lebanon, administration of surfactants through an endotracheal tube would also help . Infections constitute 25.1% of deaths; many are preventable through adequate public health measures and strict personal hygiene, i.e., diseases such as sepsis, pneumonia, meningitis, gastroenteritis, hepatitis, encephalitis, and 1-2 cases of the following: diphtheria, measles, peritonitis, tetanus, tuberculosis, cytomegalis inclusion, herpes, parathyphoid, pertussis, poliomyelitis, and shigellosis . Congenital diseases were 21.6% . In utero diagnosis could prevent some diseases and in utero treatment is possible for hydrocephalus and hydronephrosis . Screening programs postnatally could lead to treatment . 5.9% were malignancies such as leukemia, lymphoma, brain tumors, histocytosis, Wilm's tumor, Ewing sarcoma, and Hodgkin's disease . Early diagnosis is critical if mortality is to be reduced in this group, but medical advances are still needed . 2.9% are miscellaneous diseases such as poisoning, rheumatic diseases, marasmus, Reye's syndrome, nephrosis, rickets, and epilepsy . Most of these diseases are preventable, except for rheumatic inflammation of the heart . Recommended necessary steps to reduce infant mortality are: prenatal care, diagnosis and screening, intrauterine surgery; resuscitation and intensive care centers with modern equipment and trained personnel; national vaccination and screening programs; adequate public health measures and hygiene; parental education; and well-equipped hospitals to serve all regardless of income level . Kansenshogaku Zasshi, 1989 Jan, 63(1), 15 - 26 {Drug-resistance and its transferability of Shigella strains isolated in 1986 in Japan}; Tanaka T et al.; Two hundred and fifty Shigella strains isolated in Japan were examined for their drug-resistances and their conjugal transferability . Drugs used and the isolation frequency of resistant strains were: sulfanilamide (SA) 96%, streptomycin (SM) 85%, tetracycline (TC) 82%, fosfomycin (FOM) 76%, chloramphenicol (CP) 51%, trimethoprim (TMP) 46%, ampicillin (ABPC) 45%, nalidixic acid (NA) 6%, kanamycin (KM) 5%, cephaloridine (CER) 4%, gentamicin (GM) 0%, amikacin (AMK) 0%, colistin (CL) 0%, norfloxacin (NFLX) 0% . All of the KM-resistances and none of the FOM-resistances were transferable . Each 20 to 30% of CP, TC, SM, SA or ABPC-resistant isolates transferred each drug-resistance . Two thirds of the isolates were brought to Japan by travellers mostly from South-East Asia . The isolation frequency of resistant strains was not different between domestic and foreign strains except that NA-resistance was not found in foreign strains . The frequency of isolates carrying transferable R plasmids were higher in domestic strains than foreign strains . Most of the isolated had multiple drug-resistance . Major resistance types were: (CP, TC, SM, SA, ABPC) 22%; (TC, SM, SA, TMP) 20%; (CP, TC, SM, SA, ABPC, TMP) 16%; (TC, SM, SA) 8% . Strains showing different resistance types were different among each other in their serum type, conjugal transferability, and derived country . Stepwise evolution of multiple resistance in one country was not demonstrated . The resistance types of Shigella isolates in Japan have been influenced by yearly change of imported strains. Arch Immunol Ther Exp (Warsz), 1989, 37(5-6), 693 - 701 Mechanism of antigenic variation in Shigella flexneri bacilli . I . Selective lethal effect of normal sera on mixed population of S . flexneri 1b serotype and its antigenic 3b mutant; Doroszkiewicz W et al.; Normal non-immune calf, human and mice sera kill-preferentially the Shigella flexneri 1b serotype cells with antigenic formula I; 3, 4, 6 leaving the antigenic mutant cells of the serotype 3b with antigenic formula III; 3, 4, 6 . The strongest lethal action was observed in normal calf serum . This serum makes possible to obtain the 3b serotypes mutant from pure population of 1b serotype cells . Thermal inactivation of the complement deprives the serum of its selective activity. Yi Chuan Xue Bao, 1989, 16(4), 305 - 11 {Cloning of the gene relative to invasive ability of Shigella flexneri 5}; Su GF et al.; A genomic library of S . flexneri 5 large plasmid (140 Md) was constructed using the cosmid pJB8 as vector . There were more than 4,000 transformants in the library . 66 clones were picked out from the library by hybridization with 17kb gene probe relative to invasive ability . A few clones were analyzed . The results indicated that all these clones tested contained recombinant plasmids, they could hybridize with 17 kb gene probe . When these recombinant plasmids were digested with EcoR1, 17 kb fragments which hybridized with 17 kb gene probe always existed in these recombinant plasmids . It showed that all these recombinant plasmids contained the DNA fragments relative to invasive ability . It provides the possibility to construct an oral living vaccine against S . flexneri. Lab Delo, 1989, (9), 66 - 70 {An immunoenzyme method for determining the O-antigen of Sonne's shigella with the use of affinity isolated antibodies}; Voronov AV et al.; The sensitivities of ELISA systems for assays of Shigella sonnei O-antigen, developed on the basis of specific rabbit antibodies isolated from antisera by different chromatography techniques have been compared . The highest specificity and sensitivity of O-antigen determination (0.5-1 ng/ml) is achieved when using affinity-isolated antibodies to O-antigen . Clinical trials of this ELISA system have been carried out. Lab Delo, 1989, (5), 67 - 8 {A comparison of the sorption capability and standardization of plates of different shapes for immunoenzyme analysis}; Salamatova SA et al.; The sorption characteristics of ELISA plates manufactured by the Moscow and Leningrad plants and by some foreign firms are compared . Sorption activities and standard specifications of the plates for chemically heterogeneous antigens like ovalbumin or Shigella sonnei lipopolysaccharides and for complex antigens like Mycobacterium tuberculosis or S . sonnei ribosomal fractions have been examined . Sorption activities of the plates varied in tests with different antigens . The sorption activity and the standard specifications of the plates manufactured in Leningrad have been found in fact the same as of the foreign plates with all the antigens examined, whereas the Moscow plates have been inferior to both. Zh Mikrobiol Epidemiol Immunobiol, 1989 Jan, (1), 57 - 61 {Comparative diagnostic value of methods for detecting dysentery antigens in substrates of the patient's body}; Li VH et al.; The comparative evaluation of different immunological methods, such as the enzyme immunoassay, the aggregate hemagglutination test and the complement fixation test, used for the detection of specific Shigella antigens in biological body substrates obtained from 287 patients with acute dysentery caused by S . sonnei, S . flexneri and S . newcastle has been carried out . The enzyme immunoassay and the aggregate hemagglutination test most effective (97.5 +/- 0.5 and 92.4 +/- 0.9, respectively), the object of study being the patients' blood taken at the early stages of the disease . The diagnostic specificity of these methods has proved to be 98.7 +/- 6.7 and 95.2 +/- 1.4, respectively. J Clin Microbiol, 1989 Jan, 27(1), 162 - 7 Immunoglobulin M, A, and G antibody response to lipopolysaccharide O antigen in symptomatic and asymptomatic Shigella infections; Cohen D et al.; The antilipopolysaccharide antibody response in sera obtained from subjects involved in 10 outbreaks of shigellosis occurring in Israeli military field units was determined by an enzyme-linked immunosorbent assay and a passive hemagglutination test . Both tests were found to be sensitive and specific for the diagnosis of shigellosis . A significant antibody response was detected in 73 to 82% of the symptomatic and 48 to 60% of the asymptomatic subjects during the Shigella sonnei and Shigella flexneri outbreaks . Fifty percent of the symptomatic and none of the asymptomatic subjects showed a significant antibody response in the Shigella boydii outbreaks . An examination of the kinetics of the antibody levels over a 10-week period after the onset of disease revealed that immunoglobulin A (IgA) levels were highest 2 weeks after infection and had declined to initial levels within 2.5 months . In contrast, IgG levels at the late convalescent stage were half those measured at early convalescence, still being about twice as high as the initial titers . Although the IgM levels showed a pattern similar to that of IgA, their elevation at the early convalescent stage was less pronounced . We conclude that the detection of an increase in the level of the IgA fraction appeared to be the best indicator for recent symptomatic, as well as symptomatic, infections due to Shigella organisms. Am J Med, 1988 Dec 23, 85(6A), 56 - 8 Bacterial epitopes involved in the induction of reactive arthritis; Stieglitz H et al.; A panel of documented arthritogenic Shigella flexneri strains as well as an epidemic-associated non-arthritogenic Shigella sonnei control was used to identify a 2-megadalton plasmid specific to the arthritogenic strains . The plasmid, pHS-2, contains a DNA sequence that encodes a 22-amino acid polypeptide encompassing a pentapeptide homologous to part of the polymorphic region of the alpha-1 domain of HLA-B27 . These results suggest that molecular mimicry between arthritogenic bacterial-encoded epitopes and the HLA-B27 molecule may play a role in the development of reactive arthritis. J Clin Microbiol, 1988 Dec, 26(12), 2675 - 7 Pseudoappendicitis caused by Plesiomonas shigelloides; Fischer K et al.; A 20-year-old patient was hospitalized with clinical signs of acute appendicitis . After surgery, the histological findings in the appendix and a lymphatic node suggested the diagnosis of pseudoappendicitis caused by Plesiomonas shigelloides, which was isolated in pure culture from the lymphatic node . The strain of P . shigelloides was found to elaborate a heat-stable toxin and harbored two plasmids of 280 and 4 kilobases . A large plasmid has previously been implicated as a virulence marker in P . shigelloides infections. Zh Mikrobiol Epidemiol Immunobiol, 1988 Dec, (12), 18 - 21 {Effect of the conditions for dynamic homogeneous batch stab cultivation on the reproductive process in Shigella sonnei bacteriophages}; Kazakova TB et al.; The use of the bacterial population, exponentially multiplying in the newly developed cultivation process, ensures the optimum conditions for the dynamic batch cultivation of S . sonnei bacteriophages . The yield of bacteriophage biomass has been found to depend on the concentration of bacterial cells, the oxygen saturation of the medium and the concentration of glucose and amino acids in the medium. J Med Microbiol, 1988 Dec, 27(4), 285 - 9 Transferable or mobilisable antibiotic resistance in Shigella dysenteriae types 1, 2, 3, 4, 6 and 7 isolated in Ethiopia during 1974-85; Gebre-Yohannes A et al.; A total of 199 Shigella dysenteriae isolates resistant to one or more antibiotics and belonging to types 1, 2, 3, 4, 6 and 7 was examined by one-step broth mating with Escherichia coli K12 and, if non-conjugative, additionally by triparental crosses with the conjugative plasmids X and delta . Of the S . dysenteriae type 1 (Shiga's bacillus) strains, 96% harboured conjugative plasmids . During 1974-79, isolates of Shiga's bacillus carried conjugative plasmids coding for ACSSuT (ampicillin, chloramphenicol, streptomycin, sulphonamide, tetracycline) resistance that transferred at low frequencies (less than 10(-4) . After 1980, however, about 50% of isolates of Shiga's bacillus with this resistance (R)-type carried conjugative plasmids that transferred at high frequencies (10 degrees-10(-2)) and that expressed the ACT determinant only . The introduction of a new clone of Shiga's bacillus into Ethiopia in 1980 is suspected . Conjugative plasmids coding for SSuT resistance were detected in S . dysenteriae types 2, 3, and 4 . Non-conjugative SSu determinants in S . dysenteriae type 3 were mobilised by conjugative plasmids X and delta . R-type CSSuT in strains of types 2 and 7, and R-type ACST in type-3 strains were neither transferable nor mobilisable and are probably determined chromosomally. Am J Epidemiol, 1988 Dec, 128(6), 1312 - 21 A shigellosis outbreak traced to commercially distributed shredded lettuce; Davis H et al.; In the period August 30-October 7, 1986, 347 persons in adjacent west Texas counties (Ector and Midland) contracted culture-confirmed Shigella sonnei gastroenteritis . A case-control study showed an increased risk of acquiring shigellosis in Ector County with eating at outlets of fast-food Restaurant A, and in Midland County with eating at Restaurant B or C . A second case-control study, of persons who had eaten at Ector County outlets of Restaurant A, showed an increased risk of acquiring shigellosis with eating foods containing shredded lettuce and tomatoes, which were served together (odds ratio = 68.8; 95% confidence interval 8.5-293.1) . All implicated restaurants received shredded lettuce produced at one lettuce-shredding plant; two implicated restaurants did not receive tomatoes from the lot delivered to other implicated restaurants . The lettuce-shredding plant distributed shredded lettuce and intact lettuce; restaurants that received only intact lettuce were not involved in the outbreak . Investigation at the lettuce-shredding plant suggested that a food handler might have been the source of contamination and that the method of processing might have allowed cross-contamination to occur . In the laboratory, the outbreak strain of S . sonnei multiplied rapidly on shredded lettuce at 22 C and survived on refrigerated shredded lettuce for at least seven days . This outbreak, one of the largest outbreaks of Shigella infections in the United States in the last decade, indicates that a large, geographically widespread shigellosis outbreak can result from contaminated shredded lettuce that is distributed commercially. Proc Natl Acad Sci U S A, 1988 Dec, 85(23), 9317 - 21 Characterization of invasion plasmid antigen genes (ipaBCD) from Shigella flexneri; Venkatesan MM et al.; The large invasion plasmid of Shigella flexneri M9OT-W was used to generate recombinant plasmids carrying the ipaA, -B, -C, and -D genes, whose products are associated with the entry of the bacteria into colonic epithelial cells . Complete DNA sequences of ipaB, -C, and -D were determined . The proteins predicted (62, 42, and 37 kDa, respectively) from the nucleotide sequences lack a signal-peptide sequence . Hydrophilic segments of the IpaB and IpaC proteins were found to overlap known epitopic domains of these membrane antigens . Analysis of total RNA demonstrated that temperature control of ipa gene expression occurs at the level of transcription . Multiple mRNA bands were detected by using ipa gene fragments as hybridization probes, and a putative transcript map for the ipa genes was constructed . Comparison of this map with the DNA sequence reveals a complex system of ipa gene regulation. J Pediatr, 1988 Dec, 113(6), 1008 - 14 Anticytotoxin-neutralizing antibodies in immune globulin preparations: potential use in hemolytic-uremic syndrome; Ashkenazi S et al.; The pathogenesis of primary (classic) hemolytic-uremic syndrome (HUS) is thought to be related to cytotoxin-producing enteric pathogens such as Shigella dysenteriae serotype 1 and Escherichia coli serotypes O157:H7 and 026:H11 . The relevant cytotoxins include Shiga toxin and the closely related Shiga-like toxins (SLTs) produced by some E . coli strains . Intravenously administered immune globulin (IVIG) therapy has been reported to be beneficial in a few children with HUS . We therefore examined commercially available immune globulin preparations for the presence of anticytotoxin-neutralizing antibodies . Cytotoxicity and neutralization of the HUS-associated cytotoxins were quantitatively determined by means of a (3H)thymidine-labeled HeLa cell assay . The immune globulin preparations tested almost completely neutralized Shiga toxin (produced by S . dysenteriae 1) and SLT-I (produced by E . coli serotype 026:H11) . Twofold dilutions of the preparations showed significant (p less than 0.01) neutralizing titers of 1:64 to 1:128 . No significant neutralization (greater than 20%) of SLT-II (produced by E . coli strain C600 (933W} was noted . The IVIG preparation lost its inhibitory activity when passed through a protein A-Sepharose column, which bound immune globulin, indicating that its neutralizing effect is related to the antibody content . We also examined sera from 30 children without diarrhea or HUS; only one child had neutralizing titers against Shiga toxin (1:64) and SLT-I (1:128) . Immune globulin preparations contain anticytotoxin-neutralizing antibodies, a finding that warrants further investigation of the therapeutic role of these preparations in early treatment of children with HUS related to Shiga toxin and SLT-I. Infect Immun, 1988 Dec, 56(12), 3099 - 109 Role of Shiga toxin in the pathogenesis of bacillary dysentery, studied by using a Tox- mutant of Shigella dysenteriae 1; Fontaine A et al.; A Tox- mutant of Shigella dysenteriae 1, SC501, was genetically engineered by cloning the Shiga toxin operon, inserting a cassette into the A subunit gene, and exchanging this in vitro-mutagenized sequence with the wild-type gene . SC501 produced a low amount of residual cytotoxicity which was not neutralized by a rabbit immune serum directed against Shiga toxin . Invasion of cultured cells demonstrated that Shiga toxin had no effect on the rate of intracellular growth of bacteria or on the rapid killing of invaded host cells . On the other hand, several significant differences were observed in macaque monkeys infected intragastrically with either the wild-type strain or its mutant . The production of Shiga toxin by the invading strain was correlated with the presence of blood within stools, a sharp drop in blood polymorphonuclear cells, and histopathological alterations, such as the destruction of capillary vessels within the connective tissue of the colonic mucosa, severe inflammatory vasculitis of the peritoneal mesothelium, and major efflux of inflammatory cells to the intestinal lumen . It is proposed that Shiga toxin influences the severity of bacillary dysentery by inducing colonic vascular damage, which accounts for bloody stools, intestinal ischemia, and inflation of a polymorphonuclear intestinal compartment during the infectious process. Zh Mikrobiol Epidemiol Immunobiol, 1988 Dec, (12), 76 - 8 {The results of a seroepidemiologic study of Newcastle dysentery}; Naumovich LS et al.; Differences in the monthly distribution in the number of seropositive individuals among children and adults in years with different intensity of the epidemic process have been revealed . Immunity in cases of dysentery caused by S . newcastle reflects the yearly and seasonal activation of the epidemic process in this Shigella infection both in children and adults, the seroconversion characteristics observed in the year of a high morbidity level being a more objective criterion indicating the beginning of the activation of the epidemic process in dysentery caused by S . newcastle in comparison with the commonly registered morbidity level. Zh Mikrobiol Epidemiol Immunobiol, 1988 Dec, (12), 72 - 6 {The possibility of using the demonstration of Shigella antigens in the study of the epidemic process in dysentery}; Karal'nik BV et al.; The detection of Shigella antigens in feces in accordance with the results of the passive hemagglutination test is more effective than the bacteriological method for finding out persons infected with Shigella, especially in the absence of pronounced clinical manifestations of dysentery, and can be used in the study of the mechanism of the epidemic process . The examination of two groups, each consisting of permanent and temporary members, has revealed that the use of this method for detection of the antigen makes it possible to perform the epidemiological analysis of morbidity and, in particular, to determine the source(s) of infection. J Bacteriol, 1988 Dec, 170(12), 5579 - 87 Genetics and regulation of enterobactin genes in Shigella flexneri; Schmitt MP et al.; Although Shigella flexneri possesses the genes for two siderophore systems, enterobactin and aerobactin, the enterobactin system is only rarely utilized . To investigate the regulation of enterobactin expression in S . flexneri, all of the genes specifically required for synthesis and transport of enterobactin were cloned from both an expressing (Ent+) and a nonexpressing (Ent-) strain . Notable differences between the cloned genes included endonuclease restriction site changes and the presence of an IS1 element in the Ent- DNA . Southern hybridization revealed that this IS1 element, present at the 3' end of the entF gene, is conserved at this location in different strains and serotypes of Ent- S . flexneri . The Ent- cloned genes were tested for their ability to complement the defect in 11 different Escherichia coli enterobactin mutants . The Ent- genes fully complemented nine mutants but failed to complement the entF mutant AN117 and only partially complemented the entE mutant AN93 . Whole-cell RNA isolated from E . coli and the Shigella strains was hybridized to 32P-labeled DNA containing the entB gene or a fragment carrying a portion of the entF gene . E . coli and the Ent+ Shigella strains exhibited derepression of transcription of these genes in low-iron media . Transcription in the Ent- strain remained repressed regardless of iron concentration . Expression of the entB and entF genes was also examined in an Ent- Shigella fur mutant . Expression of entF was only partially derepressed and entB remained fully repressed at all iron concentrations, suggesting that factors other than Fur are responsible for the repression of these enterobactin genes in the Ent- Shigella strains. Zh Mikrobiol Epidemiol Immunobiol, 1988 Nov, (11), 56 - 61 {The world-wide pandemic and drug resistance of the causative agent of Grigor'ev-Shiga dysentery}; Solodovnikov IuP et al.; One of the factors facilitating the global pandemic of Grigor'ev-Shiga dysentery is considered in detail . All Shigella dysenteriae 1 strains, irrespective of the geographical zone of their spread, showed medicinal resistance . As pandemic developed, the spectrum of medicinal resistance constantly increased in all hyperendemic foci . The presence of pronounced relationships between the strains circulating in each of three hyperendemic foci and the strains circulating in different hyperendemic foci could be observed . The necessity of paying greater attention to this dangerous infectious disease, and especially to the problems related to the medicinal resistance of its causative agents, is emphasized. J Pediatr, 1988 Nov, 113(5), 901 - 7 Therapy for shigellosis . I . Randomized, double-blind trial of nalidixic acid in childhood shigellosis; Salam MA et al.; We compared nalidixic acid, 55 mg/kg/day, with ampicillin, 100 mg/kg/day, both given orally for 5 days, in the treatment of children with dysentery caused by shigellosis . All patients entered into the study had illness of less than 72 hours' duration and no prior allopathic drug therapy . Treatment was randomized and administered in double-blind fashion . Patients initially treated with ampicillin who were infected with a Shigella strain resistant to ampicillin were considered as a separate group (ampicillin-R) . All isolates were susceptible to nalidixic acid . Similar percentages of patients treated with nalidixic acid (26/32, 81%) and with ampicillin (17/22, 77%) were clinically cured by the end of therapy; the rate in ampicillin-R (3/14, 21%) patients was significantly lower (p less than 0.001) . Stool frequency in patients treated with nalidixic acid was significantly less than for ampicillin-treated or ampicillin-R patients during the final 3 study days . All patients treated with nalidixic acid and ampicillin had Shigella eradicated from their stool by day 3, compared with 77% (10/13) of ampicillin-R patients (p less than 0.05, ampicillin-R vs nalidixic acid or ampicillin) . We conclude that nalidixic acid is an effective alternative to ampicillin in the treatment of shigellosis caused by nalidixic acid-susceptible strains. Am J Public Health, 1988 Nov, 78(11), 1432 - 5 The persistence of Shigella flexneri in the United States: increasing role of adult males; Tauxe RV et al.; The annual reported isolation rate of Shigella flexneri decreased from 1964 to 1973, but has remained constant since then at 1 per 100,000 . Between 1975 and 1985, the median age of males from whom S . flexneri was isolated rose from 5 to 26 years . During this time, the isolation rate of S . flexneri rose more than five-fold among men, did not change in adult women, and decreased in children . By 1985, 23 per cent of reported S . flexneri isolates came from men aged 20-49 . Increased male homosexual transmission of S . flexneri is a possible explanation for these findings. J Virol, 1988 Nov, 62(11), 4369 - 71 A single-base change in gene 10 of bacteriophage T7 permits growth on Shigella sonnei; Pierce JC et al.; Bacteriophage T7 can extend its host range to include Shigella sonnei D2 371-48 by a mutation called ss found in the T7 major capsid protein, the gene 10 product . We show that a single A-to-C transversion at position 23150 in the T7 genome is responsible for the T7 ss mutant phenotype that allows the phage to avoid DNA degradation and undergo productive infection . The ss mutation causes an amino acid substitution of proline for glutamine at position 61 of the 344-amino-acid T7 major capsid protein. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Nov, 270(1-2), 41 - 51 Purification and characterization of a phage-encoded cytotoxin from an Escherichia coli O111 strain associated with hemolytic-uremic syndrome; Karch H et al.; Cytotoxin production by Escherichia coli O111:H-strain HUS-2 (Hamburg) is associated with a temperate toxin-converting bacteriophage (Tcp-111) . E . coli laboratory strain C600 transduced and subsequently lysed by the phage produced and liberated large amounts of cytotoxin (CT111) which was purified by sequential chromatography . When compared with published procedures for toxin release from viable cells, lysis of the C600 culture by the phage was most effective . By SDS-PAGE CT111 as Shiga toxin from Shigella dysenteriae 1 were shown to consist of two polypeptides of MW 31 kd and 4-5 kd . Both toxins share common antigenic epitopes as revealed by immunoblotting and neutralization studies . With rabbit anti-CT111 toxic activity of only 5 out of 8 clinical E . coli O111 isolates was neutralized suggesting the presence of different cytotoxins in E . coli serogroup O111 . Taken together, our data established CT111 as a potent cytotoxin with significant enterotoxic and neurotoxic properties similar or identical to Shiga toxin and to Shiga-like toxin I from E . coli O26:H11 and O157:H7 strains. Antibiot Khimioter, 1988 Oct, 33(10), 757 - 60 {Increase in the sensitivity of Shigella to antibiotics}; Zemskov AM et al.; Passages of 10 Shigella strains for 10 times in meat-peptone broth supplemented with sodium nucleinate provided an increase in sensitivity of the cultures to levomycetin for a period of 264 hours . In three strains of S . sonnei, S . flexneri and S . newcastle the authors observed an increase in sensitivity to tetracycline, benzylpenicillin and streptomycin . Some nitrous bases included in sodium nucleinate were also able to increase antibiotic sensitivity in Shigella. Microbiol Sci, 1988 Oct, 5(10), 307 - 10 Genetics of virulence of Shigella species; Watanabe H; The virulent phenotype of Shigella is genetically controlled in the diverse form . Both chromosomal and extrachromosomal genetic loci that are required for the expression of the virulent phenotype have been identified . Advances in the genetics and the molecular biology of Shigella virulence are discussed. Ann Trop Med Parasitol, 1988 Oct, 82(5), 481 - 3 Antibiotic resistance among Shigella species isolated in Tehran, Iran; Nikkah J et al.; A study of adult patients with gastroenteritis was carried out over an 18-month period from March 1984 until August 1985, with the aim of detecting Shigella species and studying their antibiotic resistance pattern . Two thousand four hundred and eighteen stool specimens were examined and 230 isolations of Shigella were made, a detection rate of 9.5% . Of the 230 isolates, 61.2% were found to be Sh . flexneri, and resistance to ampicillin, chloramphenicol, co-trimoxazole and tetracycline was extremely high, varying from 47% of isolates for chloramphenicol to 77% for tetracycline . Resistance to nalidixic acid was not encountered . In view of the fact that this disorder tends to be a self-limiting condition in Iran, it is advisable to be selective and cautious in the use of antibiotics for treatment. Microb Pathog, 1988 Oct, 5(4), 267 - 74 Genetic relatedness of the basic replicon of the virulence plasmid in shigellae and enteroinvasive Escherichia coli; Makino S et al.; The regions required for replication (Rep) and for stable maintenance (Stb) of the 230 kilobase virulence plasmid, pMYSH6000, in Shigella flexneri 2a YSH6000 were identified on the restriction enzyme Sa/l fragments, C and O, respectively . The stable plasmid, pMYSH6610, consisting of adjacent fragments C and O was found to belong to the incompatibility group Fl . In all strains of shigellae and enteroinvasive Escherichia coli (EIEC) tested, virulence plasmids were found to be highly homologous with the Rep region of pMYSH6000 . The restriction map of this probe was very similar to that of the inc region of RepFIIA replicon . The virulence plasmid of S . flexneri 6, S . boydii, S . dysenteriae and EIEC all coexisted stably with pMYSH6610, whereas that of S . flexneri other than serotype 6 and S . sonnei did not . These findings indicate that all the virulence plasmids of shigellae and EIEC are highly related but can be divided into at least 2 groups. Mol Gen Mikrobiol Virusol, 1988 Oct, (10), 26 - 30 {Modifying methylase SsoI from Shigella sonnei 47 cells}; Nikol'skaia II et al.; A simple and fast method for isolation and purification of SsoI methylase from the bacterial strain Shigella sonnei 47 has been proposed . The enzyme is a modifying component of host cell specificity system and protects the acceptor DNA from hydrolysis by restriction endonucleases SsoI and EcoRI . The method is based on the hydrophobic chromatography of ammonium sulphate fraction on the phenylsepharose . The enzyme preparation obtained is devoid of specific and nonspecific endonucleases traces and is stable at storage in 30% glycerol during a year . The conditions of manifestation of "stroke" activity by the enzyme were studied. Zh Mikrobiol Epidemiol Immunobiol, 1988 Oct, (10), 8 - 11 {Electron microscopic study of the interaction of virulent and avirulent Shigella flexneri strains with the macrophages of murine peritoneal exudate}; Kirillova FM et al.; The electron microscopic dynamic study of the interaction of S . flexneri virulent strain 2a and S . flexneri avirulent strain, genetically related to strain 2a and having the same antigenic structure, with peritoneal macrophages of CBA mice at an early period showed differences in the cytotoxic action of these strains . Even at the early period of the interaction between macrophages and virulent shigellae structural changes were observed in macrophages: ruptures in the membranes of parasitophore phagosomes, the vacuolization of the cytoplasm, the destruction of mitochondria . These changes were indicative of the early cytotoxic action of shigellae belonging to the virulent strain . In macrophages infected with avirulent shigellae the manifestations of this cytotoxicity were less pronounced and appeared later than in macrophages infected with S . flexneri virulent strain. Antimicrob Agents Chemother, 1988 Oct, 32(10), 1598 - 9 High-level resistance to trimethoprim in Shigella sonnei associated with plasmid-encoded dihydrofolate reductase type I; Delgado R et al.; By DNA hybridization, the gene encoding dihydrofolate reductase type I was found in 58 of 59 highly trimethoprim-resistant clinical isolates of Shigella sonnei obtained from 1981 through 1987 in Madrid, Spain . No strain harbored the type II gene . In selected strains, the type I gene was demonstrated to be in a plasmid. J Clin Microbiol, 1988 Oct, 26(10), 2083 - 6 Plasmid analysis of Shigella dysenteriae type 1 isolates obtained from widely scattered geographical locations; Haider K et al.; Plasmid profiles and antimicrobial susceptibility patterns of 343 strains of Shigella dysenteriae type 1, obtained from 18 different geographical locations, were analyzed . Three plasmids, with molecular sizes of 140, 6, and 2 megadaltons (MDa), were present in 94, 98, and 96%, respectively, of the 343 strains isolated during either epidemic or nonepidemic periods from 1965 to 1987 . In addition to these plasmids, 83% of the strains harbored a 4-MDa plasmid and 25% harbored a 20-MDa plasmid . Various plasmid profiles were observed in which the 140-, 6-, and 2-MDa plasmids occurred commonly, irrespective of the place of isolation and drug resistance pattern of the strains . Certain profiles showed significant association with drug resistance patterns . These findings suggest that three plasmids, of molecular sizes 140, 6, and 2 MDa, are unique to S . dysenteriae type 1 strains and may indicate the global spread of a pathogenic bacterial clone . Additionally, these core plasmids, plus plasmids of various other sizes, could be used to identify emerging subclones which are causing both epidemic and sporadic disease . Thus, plasmid profiles of S . dysenteriae type 1 strains can be used to monitor possible pandemic strains as well as individual epidemic strains. J Infect Dis, 1988 Oct, 158(4), 737 - 41 Deletion of the Shiga toxin gene in a chlorate-resistant derivative of Shigella dysenteriae type 1 that retains virulence; Neill RJ et al.; We used a probe specific for detecting the structural-gene sequences of Shiga toxin to analyze the genetic nature of toxin synthesis in mutant derivatives of Shigella dysenteriae type 1 . A chlorate-resistant (chl) mutant (725-78) of S . dysenteriae type 1 strain 3818T, which had retained virulence but had lost production of high levels of cytotoxic activity associated with Shiga toxin synthesis, contained a complete deletion of the Shiga toxin structural-gene sequences . These structural-gene sequences were also absent in a derivative of S . dysenteriae type 1 that contained a substitution of Escherichia coli DNA in the trp region of the chromosome . Isolates of Shigella flexneri and Shigella sonnei also did not react with the probe . The low-level cytotoxic activities associated with the mutant S . dysenteriae type 1 strains or with the virulent S . flexneri and S . sonnei strains are neutralizable with antiserum to Shiga toxin; however, these cytotoxic activities are not determined by the genes encoding classic Shiga toxin. Am J Epidemiol, 1988 Oct, 128(4), 878 - 81 Is passive surveillance always insensitive? An evaluation of shigellosis surveillance in Oklahoma; Harkess JR et al.; The authors studied the reporting of shigellosis in Oklahoma to evaluate the sensitivity of the state-based passive surveillance system for shigellosis . They found that passive surveillance for shigellosis can be more sensitive than has been previously observed . Laboratory-based reporting was found to be far superior to reporting by physicians. Eur J Biochem, 1988 Sep 15, 176(2), 471 - 6 Structural and immunochemical studies of the lipopolysaccharide from a new provisional serotype of Shigella flexneri; Wehler T et al.; The chemical structure of the O-antigen of a proposed new provisional serotype of Shigella flexneri has been determined . Methylation analysis, GLC-MS, 1H-NMR and 13C-NMR showed that the linear O-antigenic polysaccharide is the same as for all S . flexneri {Kenne, L., Lindberg, B., Petersson, K . & Romanowska, E . (1977) Carbohydr . Res . 56, 363-370} . A novel structural feature is that the disaccharide alpha-D-Glcp-(1----2)-alpha-D-Glcp is linked to O4 of the N-acetyl-glucosamine residue . (Formula: see text) Western blotting of the lipopolysaccharide with an E . coli R3 core-specific monoclonal antibody, suggested the presence of an E . coli R3 core. Lancet, 1988 Sep 3, 2(8610), 552 - 5 Diagnosis and management of dysentery by community health workers; Ronsmans C et al.; To develop guidelines for community health workers in the treatment of patients with diarrhoea, diarrhoea prevalence was actively surveyed for a year in a remote rural community of 915,000 persons, and the enteric pathogens and clinical features associated with diarrhoeal illness were determined in a sample of 300 patients . Bloody diarrhoea accounted for 39% of all diarrhoea episodes and 62% of diarrhoea-associated deaths . 51 (50%) of 101 patients with a history of bloody diarrhoea had Shigella infection, compared with 31 (16%) of 199 patients with other types of diarrhoea . A history of bloody diarrhoea was as predictive of the presence of shigella infection (positive predictive value 50%, negative predictive value 86%) as more complex prediction schemes incorporating other clinical features or stool microscopic examination . In the area of Bangladesh where the study was done reduction of diarrhoea-related morbidity and mortality will depend on control and treatment of shigellosis, and community health workers have been instructed to provide antibiotics for patients with a history of bloody dysentery. J Diarrhoeal Dis Res, 1988 Sep-Dec, 6(3-4), 221 - 7 Enteropathogenicity of plesiomonas shigelloides by oral inoculation in adult conditioned rabbits; Chowdhury K et al.; To study presumptive diarrhoeagenic and invasive properties of Plesiomonas shigelloides, adult conditioned rabbits (n = 75) were fed 10(10) CFU of 3 isolates (2 from diarrhoea patients and one from river water) of the organism, and one isolate of Shigella sonnei (from a dysentery patient as positive control) or brain-heart infusion broth (as negative control) . Each rabbit received in succession i.v . cimetidine (50 mg/kg body weight), two 15 ml oral doses of 5% NaHCO3 at 15 and 30 minutes respectively, prompt bacterial or sham inoculum followed 30 minutes by 2 ml of i.p . tincture of opium . Rabbits fed with P . shigelloides did not die or develop diarrhoea, but in a majority of them, histopathological examinations of the intestine revealed mild acute inflammation of the mucosa, mainly in the ileum . There was no serum antibody response by indirect haemagglutination against the lipopolysaccharide of the homologous strains of P . shigelloides . The culture filtrates of the organism also did not show any cytotoxic morphological changes on CHO and Y1 adrenal cell cultures . By contrast, rabbits fed with S . sonnei developed clinical diarrhoea, small to widespread severe acute inflammation of the gut mucosa, and all died on day 7 . It may be concluded that P . shigelloides are able to provoke a mild inflammatory lesions of the gut mucosa in this rabbit model; but there is little prospect of using this model to assess easily the virulence of the organism. J Diarrhoeal Dis Res, 1988 Sep-Dec, 6(3-4), 215 - 20 A steep decline of death in a shigellosis epidemic in Bangladesh by a community--participated intervention; Islam Q et al.; The outcome of an intervention of a shigellosis epidemic during April-July 1985 at Dimla, northern Bangladesh is reported . People of the epidemic-affected community operated a makeshift hospital to provide early indoor treatment for 1,708 patients of blood dysentery, based on empirically selected antibiotic(s), oral rehydration of the patients and giving them high-protein diets . They raised funds and received technical and logistic assistance from the physicians and officials of the local government health centre and of the International Centre for Diarrhoeal Disease Research, Bangladesh . In comparison with the number of deaths recorded before intervention, there was a 187-fold reduction of case-fatality ratio from 11.2 to 0.06% (p less than 0.0001) . Probable causes for this precipitious decline of mortality are discussed . It is concluded that such a community action in the intervention of a rural shigellosis epidemic in a developing country may avert death almost totally. Microb Pathog, 1988 Sep, 5(3), 207 - 13 Production of a heat stable enterotoxin by Plesiomonas shigelloides; Matthews BG et al.; Eight strains of Plesiomonas shigelloides were assayed for enterotoxin production in the rabbit ileal loop assay . Seven strains required serial in vivo passage in the rabbit's intestine before enterotoxin activity was detected in the cells' filtrate . Enterotoxin production was readily lost with subculture of these toxinogenic cells . Heat treatment of the cells' filtrate from three strains that had never been passed in vivo led to detectable enterotoxin activity in three of six separate assays . Using LT, CT, STIa, STIb and STII as probes, no homology to the whole cell DNA of the eight strains was detected on Southern hybridization under low stringency conditions . The enterotoxin of P . shigelloides appears to be novel since production is induced by in vivo passage, activity is seen with heat treatment of cells' filtrate and there is no DNA homology to the cloned enterotoxin genes of Escherichia coli and Vibrio cholerae. Curr Eye Res, 1988 Sep, 7(9), 877 - 92 The role of inflammation in the development of epiretinal membranes; Hiscott PS et al.; Single or multiple (3) injections of "Shigella" endotoxin were administered into the rabbit vitreous body to investigate the development of epiretinal membranes following intraocular inflammation . The evaluation included clinical assessment of the resulting traction retinal detachments, together with histological, autoradiographic, immunohistochemical and ultrastructural studies . Traction retinal detachments were found beneath fibroglial epiretinal membranes (being more extensive in eyes which had received 3 endotoxin injections) in the vicinity of the medullary rays, while purely glial membranes occurred over attached peripheral retina . The primary change at the vitreoretinal interface was an elevation of the inner limiting lamina of the retina followed by the extension of glial cells onto the retinal surface . It is postulated that glial cells breach the inner limiting lamina as a sequel to inflammation involving the vitreoretinal interface and form a scaffold upon which fibroblast-like cells migrate. Mol Microbiol, 1988 Sep, 2(5), 589 - 97 Expression of four virulence antigens of Shigella flexneri is positively regulated at the transcriptional level by the 30 kiloDalton virF protein; Sakai T et al.; On the virulence plasmid of Shigella flexneri the virG region required for cell-to-cell spread of the bacterium encodes a 130 kiloDalton (kD) antigen and Region-2 essential for the bacterial invasion of epithelial cells encodes 57, 43 and 39 kD antigens . The expression of these four antigens is positively regulated by the 30 kD protein encoded by virF, whose nucleotide sequence had been determined and which was previously found to be essential for virulence . An approximately 3.8 kilobase (kb) RNA transcript is found to be transcribed by the virG region and is positively regulated by the virF protein resulting in increased production of the 130 kD antigen . The virF sequence is conserved among all shigellae and enteroinvasive Escherichia coli. J Diarrhoeal Dis Res, 1988 Sep-Dec, 6(3-4), 208 - 14 Plasmid profile as a useful marker of a Shigella dysenteriae type 1 strain causing an epidemic of shigellosis; Al-Wortman KH et al.; Plasmid profiles of 60 Shigella dysenteriae type 1 isolates obtained during an epidemic period (April - October 1983) were compared with that of 74 other Shigella species isolated during the same period of time and also with that of 20 S . dysenteriae type 1 isolates obtained before the epidemic period (1969 - 1982) . All samples were collected during an epidemic of shigellosis from diarrhoeal patients being treated at the Dhaka Treatment Centre of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) between April and October 1983 . Approximately 4% of the patients were sampled . The isolated showed varied patterns of resistance to several antimicrobial agents . Ninety-two per cent of the 60 S . dysenteriae type 1 strains showed a typical profile of four plasmids with masses of 140, 6, 4 and 2 megadaltons (Mdal) . The finding is in contrast with that of a previous study at the ICDDR,B, in which 14 different plasmid profiles were observed in 23 strains of S . dysenteriae type 1 isolated during a 10 - month period in 1982 . The profile typical for this study was different from those found in other species of Shigella isolated at the same time . There was a strong association between the possession of this plasmid profile and resistance to chloramphenicol, streptomycin, tetracycline and trimethoprim - sulphamethoxazole . Twenty S . dysenterae type 1 strains isolated from the faeces of patients at the ICDDR,B during 1969 - 1982 were also analysed for their plasmid profiles . The finding is in contrast with that of the epidemic strains . The typical epidemic plasmid pattern, i.e . the 140, 6, 4 and 2 Mdal, was absent in isolates obtained before 1983 epidemic.(ABSTRACT TRUNCATED AT 250 WORDS) Infect Dis Clin North Am, 1988 Sep, 2(3), 599 - 605 Shigella; DuPont HL; Shigella strains capable of producing illness possess a 140 megadalton plasmid that determines its property of epithelial cell penetration . In the classic presentation, there is a descending intestinal tract infection beginning with the passage of small numbers of large-volume stools and progressing to the passage of many small-volume stools that contain blood and mucus . Shigellae are efficiently transmitted to contacts in person-to-person spread and only 200 viable cells are sufficient to produce illness in susceptible persons . Shigellosis should be suspected in persons with severe diarrhea, in those with fever, when bloody stools are passed, or when stool smears contain many leukocytes . The current treatment of choice is TMP-SMX or, in adults, a quinolone (norfloxacin or ciprofloxacin). Zh Mikrobiol Epidemiol Immunobiol, 1988 Sep, (9), 59 - 63 {Etiologic structure of bacterial dysentery in the USSR in 1983-1985}; Solodovnikov IuP; The etiological structure of dysentery in the USSR in 1983-1985 is characterized . Sonne dysentery was found to prevail in the territories with adequate water supply, while dysentery caused by Shigella flexneri prevailed at the territories with unsatisfactory water supply . S . dysenteriae and S . boydii were found to play a limited role in the etiology of dysentery . In the presence of global pandemic, an increase in the isolation rate of S . dysenteriae I in the USSR is observed . The data on the biochemical structure of S . sonnei are presented. Gut, 1988 Sep, 29(9), 1277 - 8 Persistent shigellosis; Clements D et al.; Shigella usually causes a self-limited infection which untreated lasts on average seven days (range one to 30 days) . We report a patient who had persistent symptoms for 10 months caused by Shigella flexneri which was finally identified on cultures from a rectal swab. Arthritis Rheum, 1988 Sep, 31(9), 1190 - 3 Reactive arthritis associated with Shigella sonnei infection; Lauhio A et al.; Several studies have failed to show an association between Shigella sonnei dysentery and reactive arthritis . We describe 3 patients who had reactive arthritis and a recent or concurrent S sonnei infection . To our knowledge, this is only the second study to suggest this association . We propose that S sonnei should be considered as a triggering agent for reactive arthritis. J Bacteriol, 1988 Sep, 170(9), 4223 - 30 Cloning and sequencing of a Shiga-like toxin type II variant from Escherichia coli strain responsible for edema disease of swine; Weinstein DL et al.; A Shiga-like toxin type II variant (SLT-IIv) is produced by strains of Escherichia coli responsible for edema disease of swine and is antigenically related to Shiga-like toxin type II (SLT-II) of enterohemorrhagic E . coli . However, SLT-IIv is only active against Vero cells, whereas SLT-II is active against both Vero and HeLa cells . The structural genes for SLT-IIv were cloned from E . coli S1191, and the nucleotide sequence was determined and compared with those of other members of the Shiga toxin family . The A subunit genes for SLT-IIv and SLT-II were highly homologous (94%), whereas the B subunit genes were less homologous (79%) . The SLT-IIv genes were more distantly related (55 to 60% overall homology) to the genes for Shiga toxin of Shigella dysenteriae type 1 and the nearly identical Shiga-like toxin type I (SLT-I) of enterohemorrhagic E . coli . (These toxins are referred to together as Shiga toxin/SLT-I.) The A subunit of SLT-IIv, like those of other members of this toxin family, had regions of homology with the plant lectin ricin . SLT-IIv did not bind to galactose-alpha 1-4-galactose conjugated to bovine serum albumin, which is an analog of the eucaryotic cell receptor for Shiga toxin/SLT-I and SLT-II . These findings support the hypothesis that SLT-IIv binds to a different cellular receptor than do other members of the Shiga toxin family but has a similar mode of intracellular action . The organization of the SLT-IIv operon was similar to that of other members of the Shiga toxin family . Iron did not suppress SLT-IIv or SLT-II production, in contrast with its effect on Shiga toxin/SLT-I . Therefore, the regulation of synthesis of SLT-IIv and SLT-II differs from that of Shiga toxin/SLT-I. Infect Immun, 1988 Sep, 56(9), 2373 - 8 Direct cytotoxic action of Shiga toxin on human vascular endothelial cells; Obrig TG et al.; To help explain a role of the Shiga toxin family in hemorrhagic colitis and hemolytic-uremic syndrome in humans, it has been hypothesized that these toxins cause direct damage to the vascular endothelium . We now report that Shiga toxin purified from Shigella dysenteriae 1 does indeed have a direct cytotoxic effect on vascular endothelial cells in cultures . Human umbilical vein endothelial cells (HUVEC) in confluent monolayers were reduced 50% by 10(-8) M Shiga toxin after a lag period of 48 to 96 h . In c