Campylobacter

Int J Food Microbiol, 2001 Aug 15, 68(1-2), 53 - 9
Pre-harvest surveillance of Campylobacter and Salmonella in Danish broiler flocks: a 2-year study; Wedderkopp A et al.; In national surveillance programmes of broiler flocks carried out in Denmark during 1998 and 1999, 89,110 samples for Campylobacter representing 8911 broiler flocks were taken at 10 different abattoirs, and 44,550 samples for Salmonella were taken from the same flocks in the broiler houses at the farms . Of the swabs, 42.5% were Campylobacter positive . Most positive samples were found during July, August and September, while the lowest number of positive samples were found during January, February, March and April . Of the flocks, 5.5% were Salmonella positive, but no seasonal variation was observed . For each flock, the presence of Campylobacter and Salmonella was recorded in order to estimate the possible correlation between colonisation with the two pathogens . In conclusion, no significant effects on intensive cleaning and disinfection procedures on Campylobacter occurrence could be demonstrated, and no significant correlation between occurrence of Campylobacter and Salmonella infections in Danish broilers could be demonstrated which is in contrast to previous observations on concurrent colonisation of broilers with these two zoonotic pathogens.

Syst Appl Microbiol, 1987, 9, 231 - 8
Phylogenetic diversity and position of the genus Campylobacter; Lau PP et al.; RNA sequence analysis has been used to examine the phylogenetic position and structure of the genus Campylobacter . A complete 5S rRNA sequence was determined for two strains of Campylobacter jejuni and extensive partial sequences of the 16S rRNA were obtained for several strains of C . jejuni and Wolinella succinogenes . In addition limited partial sequence data were obtained from the 16S rRNAs of isolates of C . coli, C . laridis, C . fetus, C . fecalis, and C . pyloridis . It was found that W . succinogenes is specifically related to, but not included, in the genus Campylobacter as presently constituted . Within the genus significant diversity was noted . C . jejuni, C . coli and C . laridis are very closely related but the other species are distinctly different from one another . C . pyloridis is without question the most divergent of the Campylobacter isolates examined here and is sufficiently distinct to warrant inclusion in a separate genus . In terms of overall position in bacterial phylogeny, the Campylobacter/Wolinella cluster represents a deep branching most probably located within an expanded version of the Division containing the purple photosynthetic bacteria and their relatives . The Campylobacter/Wolinella cluster is not specifically includable in either the alpha, beta or gamma subdivisions of the purple bacteria.

Arch Pharm Res, 2001 Aug, 24(4), 316 - 22
Cloning, sequence analysis, and characterization of the astA gene encoding an arylsulfate sulfotransferase from Citrobacter freundii; Kang JW et al.; Arylsulfate sulfotransferase (ASST) transfers a sulfate group from a phenolic sulfate ester to a phenolic acceptor substrate . In the present study, the gene encoding ASST was cloned from a genomic library copy of Citrobacter freundii, subcloned into the vector pGEM3Zf(-) and sequenced . Sequencing revealed two contiguous open reading frames (ORF1 and ORF2) on the same strand and based on amino acid sequence homology, they were designated as astA and dsbA, respectively . The amino acid sequence of astA deduced from C . freundii was highly similar to that of the Salmonella typhimurium, Enterobacter amnigenus, Klebsiella, Pseudomonas putida, and Campylobacter jejuni, encoded by the astA genes . However, the ASST activity assay revealed different acceptor specificities . Using p-nitrophenyl sulfate (PNS) as a donor substrate, alpha-naphthol was found to be the best acceptor substrate, followed by phenol, resorcinol, p-acetaminophen, tyramine and tyrosine.

BMC Microbiol . 2001;1(1):13 . Epub 2001 Jul 30.
Phenotyping of Campylobacter jejuni and Campylobacter coli by a quantitative antibiogram {MIC} typing scheme using Euclidean distances {QATED}; Moore JE et al.; BACKGROUND: Enteropathogenic Campylobacter jejuni and C . coli are presently the most common cause of acute bacterial gastroenteritis in the developed world . An understanding of sources and means of transmission of Campylobacter is an essential factor in order to reduce the incidence of Campylobacter-related gastroenteritis in man . Consequently a reproducible, sensitive and well-standardised typing scheme is critical in the successful discrimination of strains and in the subsequent investigations of outbreaks . For this purpose, a phenotypic typing scheme based on quantitative antibiogram determination based on Euclidean distance (QATED), was developed . RESULTS AND CONCLUSION: The results obtained with this typing scheme demonstrated that individual livers of colonized pigs could be infected with multiple strains of Campylobacter spp . and subspecies types . In conclusion, phenotyping of Campylobacter jejuni and C . coli by QATED is a simple, inexpensive and discriminatory sub-species characterisation scheme, which may be useful in primary diagnostic clinical laboratories, where no specialist Campylobacter phenotyping or molecular genotyping schemes exist . It is especially suitable for food-borne outbreak investigations in the community, where a rapid and local response is required to aid with public health epidemiological investigations.

J Clin Microbiol, 2001 Sep, 39(9), 3346 - 9
Sequence typing confirms that Campylobacter jejuni strains associated with Guillain-Barré and Miller-Fisher syndromes are of diverse genetic lineage, serotype, and flagella type; Dingle KE et al.; Guillain-Barre syndrome (GBS) and Miller-Fisher syndrome (MFS) are correlated with prior infection by Campylobacter jejuni in up to 40% of cases . Nucleotide sequence-based typing of 25 C . jejuni isolates associated with neuropathy permitted robust comparisons with equivalent data from approximately 800 C . jejuni isolates not associated with neuropathy . A total of 13 genetic lineages and 20 flaA short variable region nucleotide sequences were present among the 25 isolates . A minority of isolates (4 of 25) had the flaA short variable region nucleotide sequences that were previously proposed as a marker for GBS-associated isolates . These 4 isolates probably represented the Penner serotype 19 lineage, which has been proposed to have an association with GBS.

Appl Environ Microbiol, 2001 Sep, 67(9), 4186 - 91
Survival of clinical and poultry-derived isolates of Campylobacter jejuni at a low temperature (4 degrees C); Chan KF et al.; Campylobacter jejuni is a leading cause of bacterial gastroenteritis in humans, and contamination of poultry has been implicated in illness . The bacteria are fastidious in terms of their temperature requirements, being unable to grow below ca . 31 degrees C, but have been found to be physiologically active at lower temperatures and to tolerate exposure to low temperatures in a strain-dependent manner . In this study, 19 field isolates of C . jejuni (10 of clinical and 9 of poultry origin) were studied for their ability to tolerate prolonged exposure to low temperature (4 degrees C) . Although substantial variability was found among different strains, clinical isolates tended to be significantly more likely to remain viable following cold exposure than poultry-derived strains . In contrast, the relative degree of tolerance of the bacteria to freezing at -20 degrees C and freeze-thawing was strain specific but independent of strain source (poultry versus clinical) and degree of cold (4 degrees C) tolerance.

Appl Environ Microbiol, 2001 Sep, 67(9), 3951 - 7
Prevalence, antigenic specificity, and bactericidal activity of poultry anti-Campylobacter maternal antibodies; Sahin O et al.; Poultry are considered the major reservoir for Campylobacter jejuni, a leading bacterial cause of human food-borne diarrhea . To understand the ecology of C . jejuni and develop strategies to control C . jejuni infection in the animal reservoir, we initiated studies to examine the potential role of anti-Campylobacter maternal antibodies in protecting young broiler chickens from infection by C . jejuni . Using an enzyme-linked immunosorbent assay (ELISA), the prevalence of anti-C . jejuni antibodies in breeder chickens, egg yolks, and broilers from multiple flocks of different farms were examined . High levels of antibodies to the organism were detected in serum samples of breeder chickens and in egg yolk contents . To determine the dynamics of anti-Campylobacter maternal antibody transferred from yolks to hatchlings, serum samples collected from five broiler flocks at weekly intervals from 1 to 28 or 42 days of age were also examined by ELISA . Sera from the 1-day and 7-day-old chicks showed high titers of antibodies to C . jejuni . Thereafter, antibody titers decreased substantially and were not detected during the third and fourth weeks of age . The disappearance of anti-Campylobacter maternal antibodies during 3 to 4 weeks of age coincides with the appearance of C . jejuni infections observed in many broiler chicken flocks . As shown by immunoblotting, the maternally derived antibodies recognized multiple membrane proteins of C . jejuni ranging from 19 to 107 kDa . Moreover, in vitro serum bactericidal assays showed that anti-Campylobacter maternal antibodies were active in antibody-dependent complement-mediated killing of C . jejuni . Together, these results highlight the widespread presence of functional anti-Campylobacter antibodies in the poultry production system and provide a strong rationale for further investigation of the potential role of anti-C . jejuni maternal antibodies in protecting young chickens from infection by C . jejuni.

Neurology, 2001 Aug 28, 57(4), 686 - 91
Miller Fisher syndrome and Haemophilus influenzae infection; Koga M et al.; OBJECTIVE: To examine the association between Miller Fisher syndrome (MFS) and antecedent Haemophilus influenzae infection . BACKGROUND: Little is known about agents in prior respiratory tract infection of MFS, whereas antecedent upper respiratory symptoms are frequent . H . influenzae is a major pathogen that can cause human respiratory tract infection . METHODS: The authors used ELISA to detect serum antibody against the bacterium in 70 consecutive patients with MFS and 110 with Guillain-Barre syndrome (GBS) . RESULTS: Serum anti-H . influenzae IgG and IgM antibody activities were significantly higher in the MFS group than in age- and sex-matched patients with other neurologic diseases (n = 62) and normal control subjects (n = 82) . The GBS group showed no significant increase in any class of antibody activities compared with control groups . Serologic evidence of recent infection was found in five (7%) of the patients with MFS and two (2%) of 110 patients with GBS, all of whom had a history of antecedent respiratory tract infection . They frequently showed ophthalmoplegia, but other neurologic features were not remarkable . Serum anti-GQ1b IgG antibody that had cross-reactivity with GT1a ganglioside was detected in six of these seven patients . Thin-layer chromatography with immunostaining showed that serum IgG from H . influenzae-seropositive patients with high anti-GQ1b and anti-GT1a IgG antibody titers bound to the lipopolysaccharide fraction extracted from the type b H . influenzae serostrain . These bands were also stained by anti-GT1a monoclonal antibody (GMR11), indicating that the lipopolysaccharide bears the GT1a epitope . CONCLUSIONS: These findings point to H . influenzae being an agent associated with MFS . Epitopic overlap between H . influenzae and human nerve tissue may be involved in the development of MFS much as GBS is associated with Campylobacter jejuni enteritis.

Pathology, 2001 Aug, 33(3), 353 - 8
Diagnosis of enteric pathogens in children with gastroenteritis; McIver CJ et al.; The aim of this study was to determine the isolation trends of common and emerging pathogens in children over a 12-month period . The study group included 412 children under 6 years with diarrhoea who were either hospitalised, or seen in the outpatients department of The Sydney Children's Hospital . Pathogens were detected in 137 (33%) samples, with rotavirus most common (40%), followed by adenovirus (26%), astrovirus (12%), Campylobacter jejuni (12%), Salmonella spp . (10%) and Giardia lamblia (< 1 %) . Giardia-specific antigen (GSA) was detected in 11 of 382 (3%) using an enzyme immunoassay (EIA), and this included four samples in which cysts of G . lamblia were detected by microscopy . Using electron microscopy (EM), viruses were detected in 29 of 120 (24%) samples from hospitalised children and 53 of 171 (31%) outpatients (P = 0.23) . Amongst this subset, Norwalk-like viruses (NLVs) were detected by RT-PCR in 10 samples including six of 14 with small round viruses, one of seven with small viral-like particles (SVLPs), and three of 126 EM-negative samples . Lactoferrin, detected by EIA, was 59% more likely to be positive in samples infected with salmonella/campylobacter than in samples in which bacterial pathogens were not isolated . As an indicator for infection with these bacterial agents, the assay showed a sensitivity and specificity of 95 and 40.3%, respectively . A routine microbiological analysis of stools from children of this age group should include a screen for foodborne bacterial agents and rotavirus . Tests for adenovirus, astrovirus and NLVs should be secondary . The cost-effectiveness of including the EIAs for lactoferrin and G . lamblia in the routine testing protocol needs to be evaluated.

Redox Rep, 2001, 6(3), 179 - 81
Intracellular redox status and antibiotic resistance in enterogastric micro-aerophilic bacteria: evidence for the 'scavenging of oxygen' hypothesis; Mendz GL et al.; Metronidazole and glutathione reduction activities were measured in situ in the micro-aerophilic bacteria Campylobacter coli and Helicobacter pylori employing 14N- and 1H-nuclear magnetic resonance spectroscopy . The properties of these enzyme activities were investigated in matched pairs of strains with sensitive and resistant phenotypes to the antimicrobial metronidazole . The results indicated that the ability of each type of strain to reduce metronidazole corresponded to its sensitive or resistance phenotype . Higher levels of glutathione reduction and a significantly lower Ki for metronidazole were observed in sensitive strains compared to resistant strains . These findings suggested a relationship between the cellular machinery regulating intracellular redox status in C . coli and H . pylori, and the effects of metronidazole on these bacteria, which supported the 'scavenging of oxygen' hypothesis.

J Endotoxin Res, 2000, 6(5), 341 - 59
Lipopolysaccharides in the development of the Guillain-Barré syndrome and Miller Fisher syndrome forms of acute inflammatory peripheral neuropathies; Prendergast MM et al.; Guillain-Barre syndrome (GBS), an acute inflammatory polyneuropathy, is preceded in most cases by an infectious illness, and Campylobacter jejuni, a leading cause of acute gastroenteritis, is the most common antecedent to GBS and its ocular variant, Miller Fisher syndrome (MFS) . O (Penner) serotyping is considered to distinguish between C . jejuni strains based on differences in lipopolysaccharide (LPS) structure . Serotypes of C . jejuni uncommon in enteritis, such as serotype O:19 and O:41, have been associated with GBS . Chemical studies on the core oligosaccharide (OS) of C . jejuni LPSs from serotypes including O:1, O:2, O:4, O:10, O:19, O:23, O:36 and O:41 have revealed structures that mimic human gangliosides including GM1, GD1a, GD2, GD3, and GM2 . Research has focused on the view that molecular mimicry may be a factor in the pathogenesis of GBS . Serum antibodies against gangliosides, particularly GM1 ganglioside, are present in 30% of GBS patients, and are highly associated with MFS, but are generally absent in enteritis cases uncomplicated by neuropathy . Collective data from human and animal studies with anti-ganglioside antibodies suggest a pathogenic role for the antibodies . Many aspects of the pathogenesis of GBS are unclear, in particular how LPS is presented to T cells or the role of host factors in disease development.

J Immunol Methods, 2001 Oct 1, 256(1-2), 11 - 8
Immunomagnetic separation methods for the isolation of Campylobacter jejuni from ground poultry meats; Yu LS et al.; Campylobacter jejuni is now recognized as a leading foodborne pathogen, for which poultry products constitute the main transmission route . Two alternative immunomagnetic beads (IMB) were tested for direct detection of C . jejuni ATCC 35918 in artificially inoculated ground poultry meats and culture suspension . Polyclonal anti-Campylobacter antibodies were used to coat tosylactivated Dynabeads . The same antibodies conjugated with biotin were used to label streptavidin-coated beads . After these beads were incubated with inoculated poultry slurry or culture suspension, Campylobacter-bead complexes were separated from other components with a magnet . The capture efficiency was tested by plating bead-captured cells and unbound cells in the supernatant onto Karmali agar . The effects of different coating procedures, incubation time (60, 90, 120 min), numbers of immunomagnetic beads (10(6) to 10(7)/ml) and innoculum levels (10(3) to 10(7) CFU/g or ml) were determined . Without pre-enrichment, this approach could detect 10(4) CFU/g of ground poultry meats . These methods represent a new approach to extracting, concentrating and isolating Campylobacter spp . directly from foods.

Trends Microbiol, 2001 Aug, 9(8), 389 - 96
Campylobacter jejuni--microtubule-dependent invasion; Kopecko DJ et al.; Campylobacter jejuni is the leading bacterial cause of food-borne illness worldwide and a major cause of Guillain-Barre paralysis . Recent molecular and cellular studies of one well-characterized C . jejuni strain have begun to unravel the details of an unusual microtubule-dependent (actin-filament-independent) gut-invasion mechanism, through which at least some C . jejuni initiate disease . Although responsible for causing a human dysenteric syndrome remarkably similar to that triggered by Shigella spp., current evidence suggests that C . jejuni use some markedly different molecular mechanisms of pathogenesis compared with shigellae.

Rev Environ Health, 2001 Apr-Jun, 16(2), 117 - 31
Direct exposure to animal enteric pathogens; Enriquez C et al.; Humans have very close interactions with working, food-producing, and companion animals . According to the American Veterinary Medical Association, there are more than one hundred million cat and dog pets in the United States . Furthermore, non-traditional pets like reptiles and exotic birds are not unusual companion animals in households . In addition to sharing with animals our living and/or working space and time, we also share, unfortunately, many disease causing microorganisms . In the past few years, we have become aware that several enteric pathogens that were thought to be mostly restricted to animals are a major cause of human disease . Examples of such pathogens include the protozoan parasite Cryptosporidium parvum and bacteria such as Campylobacter spp . This review will examine the characteristics of zoonotic enteric pathogens including bacterial (Helicobacter spp., Campylobacter spp., Salmonella spp., and verotoxin-producing Escherichia coli); parasitic (Toxoplasma gondii, Giardia spp., Cryptosporidium spp.); and viral (rotavirus, norwalk-like virus, hepatitis E virus), and the status of our knowledge with regard to the impact of such pathogens on human health.

Clin Infect Dis, 2001 Sep 15, 33(6), 901 - 5 Epub 2001 Aug 21.
Campylobacter jejuni enteritis; Baqar S et al.; We report the development of Campylobacter jejuni enteritis in a patient with preexisting humoral and cellular immune recognition of C . jejuni antigens . This is one of few studies in which the immunologic status of a person with regard to C . jejuni before and after C . jejuni infection is directly compared, and it is the only study of which we are aware that includes measurements of cellular immunity . The findings may be important to Campylobacter vaccine development efforts.

Rheumatology (Oxford), 2001 Aug, 40(8), 920 - 7
Bacterial DNA in synovial fluid cells of patients with juvenile onset spondyloarthropathies; Pacheco-Tena C et al.; OBJECTIVE: To identify bacterial DNA in synovial fluid cells of patients with active juvenile onset spondyloarthropathy (SpA) . METHODS: The main group of study constituted 22 patients with juvenile onset SpA . In addition, five patients with adult onset SpA and nine with rheumatoid arthritis (RA) were studied . Polymerase chain reaction (PCR) with either genus- or species-specific primers was performed on synovial fluid cells to detect DNA sequences of Chlamydia trachomatis, Yersinia enterocolitica, Salmonella sp., Shigella sp., Campylobacter sp . and Mycobacterium tuberculosis . The presence of antibacterial antibodies in sera and synovial fluid was also determined by enzyme-linked immunoassay . RESULTS: The synovial fluid of nine patients with juvenile onset SpA, three with adult onset SpA and one with RA contained bacterial DNA . Five juvenile onset SpA samples had DNA of one single bacterium; two juvenile onset SpA and three adult onset SpA had DNA of two bacteria and two juvenile onset SpA had DNA of three bacteria . Overall, Salmonella sp . DNA was detected in seven synovial fluid samples, Shigella sp., Campylobacter sp . and M . tuberculosis were found in four samples each, and C . trachomatis was found in two . The bacterial DNA findings correlated with neither diagnosis nor disease duration . One RA synovial fluid had DNA of Campylobacter sp . Neither serum nor synovial fluid antibacterial antibodies correlated with DNA findings or clinical diagnosis . CONCLUSION: In this study, single and several combinations of bacterial DNA were identified in the synovial fluid of patients with long-term undifferentiated and definite juvenile onset SpA and adult onset SpA . Of relevance is that bacterial DNA corresponds to bacteria producing endemic disease in our population.

Res Microbiol, 2001 Jul-Aug, 152(6), 577 - 82
Direct detection of thermotolerant campylobacters in chicken products by PCR and in situ hybridization; Moreno Y et al.; We have evaluated the use of PCR and fluorescent in situ hybridization (FISH) techniques for the detection of thermotolerant campylobacters in naturally contaminated chicken products . 16S rRNA sequence data was used to design two specific primers and an oligonucleotide probe for PCR and FISH analyses, respectively . The PCR protocol amplified a 439-bp fragment corresponding to a portion of specific 16S RNA gene from thermotolerant campylobacters . The detection range of the PCR assay varied between 10 cells (after enrichment) to 10(2) cells per mL (without enrichment) . FISH probes were able to identify thermotolerant Campylobacter species in 'spiked' and 'unspiked' naturally contaminated samples . PCR and FISH were performed on naturally contaminated samples and compared with the isolation of cells on selective media . The in situ hybridization technique was less sensitive than PCR, although its sensitivity of detection was increased considerably after 22 h of enrichment . These results confirm the usefulness of 16S rRNA-based techniques for the direct detection of campylobacters in food samples.

Infect Immun, 2001 Sep, 69(9), 5921 - 4
Demonstration of polysaccharide capsule in Campylobacter jejuni using electron microscopy; Karlyshev AV et al.; Recently, we reported that Campylobacter jejuni, an important gastrointestinal pathogen, has the genetic determinants to produce a capsular polysaccharide (Karlyshev et al., Mol . Microbiol . 35:529-541, 2000) . Despite these data, the presence of a capsule in these bacteria has remained controversial . In this study we stain C . jejuni cells with the cationic dye Alcian blue and demonstrate for the first time by electron microscopy that C . jejuni cells produce a polysaccharide capsule that is retained in the coccoid form but is absent in a kpsM mutant.

J Periodontol, 2001 Jul, 72(7), 945 - 52
Clinical periodontal findings and microflora profiles in children with chronic neutropenia under supervised oral hygiene; Okada M et al.; BACKGROUND: This is the first known case report that used a polymerase chain reaction (PCR)-based method to help identify the oral microflora in patients with chronic neutropenia . In this study, we report clinical periodontal findings and microflora profiles of 2 children, 1 with severe congenital neutropenia (SCN, Kostmann type) and 1 with cyclic neutropenia (CN) . METHODS: The SCN patient had severe gingivitis, whereas the patient with CN had mild gingivitis in the gingival margins . Monthly oral cleaning instruction and review were performed without subsequent periodontal therapy . Oral hygiene conditions remained satisfactory and visible plaque was scarce, despite the persistence of mild gingivitis . Under supervised oral hygiene, we examined the presence of periodontal pathogens from patient plaque samples . RESULTS: By a PCR-based method, Prevotella nigrescens, Bacteroides forsythus, Campylobacter rectus, and Capnocytophaga gingivalis were detected in the SCN patient and P . intermedia, C . rectus, C . gingivalis, and C . sputigena in the CN patient, suggesting the existence of periodontal pathogens . Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and C . ochracea were not found in either patient . CONCLUSIONS: Use of 1% povidone iodine solution and local antibiotic application under supervised oral hygiene were helpful to improve gingival conditions in patients with chronic neutropenia.

Mol Microbiol, 2001 Jul, 41(2), 477 - 87
Identification of the Helicobacter pylori anti-sigma28 factor; Colland F et al.; Flagellar motility is essential for colonization of the human gastric mucosa by Helicobacter pylori . The flagellar filament is composed of two subunits, FlaA and FlaB . Transcription of the genes encoding these proteins is controlled by the sigma28 and sigma54 factors of RNA polymerase respectively . The expression of flagellar genes is regulated, but no sigma28-specific effector was identified . It was also unclear whether H . pylori possessed a checkpoint for flagellar synthesis, and no gene encoding an anti-sigma28 factor, FlgM, could be identified by sequence similarity searches . To investigate the sigma28-dependent regulation, a new approach based on genomic data was used . Two-hybrid screening with the H . pylori proteins identified a protein of unknown function (HP1122) interacting with the sigma28 factor and defined the C-terminal part of HP1122 (residues 48-76) as the interaction domain . HP1122 interacts with region 4 of sigma28 and prevents its association with the beta-region of H . pylori RNA polymerase . Thus, HP1122 presented the characteristics of an anti-sigma28 factor . This was confirmed in H . pylori by RNA dot-blot hybridization and electron microscopy . The level of sigma28-dependent flaA transcription was higher in a HP1122-deficient strain and was decreased by the overproduction of HP1122 . The overproduction of HP1122 also resulted in H . pylori cells with highly truncated flagella . These results demonstrate that HP1122 is the H . pylori anti-sigma28 factor, FlgM, a major regulator of flagellum assembly . Potential anti-sigma28 factors were identified in Campylobacter jejuni, Pseudomonas aeruginosa and Thermotoga maritima by sequence homology with the C-terminal region of HP1122.

Clin Oral Implants Res, 2001 Aug, 12(4), 287 - 94
Treatment of peri-implantitis by local delivery of tetracycline . Clinical, microbiological and radiological results; Mombelli A et al.; The purpose of this study was to investigate the clinical, microbiological and radiological effects of peri-implantitis therapy by local delivery of tetracycline . In 25 partially edentulous patients, 30 implants with radiographic evidence of circumferential bone loss, and peri-implant probing depths > or =5 mm were treated with polymeric tetracycline HCl-containing fibers . Clinical and microbial parameters were recorded at baseline, and 1, 3, 6, and 12 months (M) after treatment . Standardized radiographs were obtained at baseline, M3, and one year after treatment . Two patients were discontinued from the study after 180 days because of persisting active peri-implantitis with pus formation . The remaining subjects showed a significant decrease of mean peri-implant probing depth from 6.0 to 4.1 mm (M1, P<0.001), which was maintained over 12 months . In comparison to baseline, the bleeding tendency was significantly reduced after one month, and thereafter (P<0.001) . No significant recession of the mucosal margin was noted . The radiologically determined distance from the shoulder of the implant to the bottom of the bony defect decreased slightly, but not significantly, from 5.2 to 4.9 mm . At M1, M3 and M6, mean total anaerobic cultivable bacterial counts were significantly lower than at baseline (P<0.001) . A significant decrease in frequency of detection was noted for Prevotella intermedia/nigrescens, Fusobacterium sp., Bacteroides forsythus, and Campylobacter rectus (P<0.01) . Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Eikenella corrodens had very low baseline frequencies that could not be significantly suppressed further . In conclusion, therapy of peri-implantitis by local delivery of tetracycline had a positive effect on clinical and microbiological parameters.

Ann Trop Med Parasitol, 2001 Jul, 95(5), 509 - 13
Dysentery in patients infected with human immunodeficiency virus in Zimbabwe: an emerging role for Schistosoma mansoni and Escherichia coli O157?
Gwavava C, Chihota VN, Gangaidzo IT, Gumbo T.
Information on bloody diarrhoea in HIV-positives is scarce . A prospective study was therefore performed, in Zimbabwe, to determine and compare the pathogens associated with bloody diarrhoea in 25 antiretroviral-naive HIV-infected patients and 15 non-HIV-infected patients . Stool cultures and colonic biopsies were performed . Shigella was isolated from 18 (45%) of the subjects, Schistosoma mansoni from eight (16%), Escherichia coli H7:O157 from three (8%) and Campylobacter jejunii from two (5%) . There was no evidence of Salmonella, Entamoeba histolytica or cytomegalovirus infection . Shigella dysenteriae type-1 occurred more often in the HIV-negatives than the HIV-positives (P = 0.02) . Although HIV-associated bloody diarrhoea in Zimbabwe appears to be most frequently caused by Shigella, it may also be commonly the result of infection with Sc . mansoni or shiga-toxin-producing E . coli . A larger study specifically to examine the role of Sc . mansoni and E . coli O157 is warranted.

Contemp Top Lab Anim Sci, 2000 Mar, 39(2), 47 - 9
Colitis in a female tamarin (Saguinus mystax); Chen PH et al.; An adult wild-caught female tamarin (Saguinus mystax) housed in a biomedical research facility was found moribund and extremely dehydrated, with severe diarrhea . She initially responded to supportive therapy but died 3 days later . Necropsy findings included hyperemia of the colonic mucosa, mesenteric lymphadenopathy, acanthocephalid parasites (Prosthenorchis elegans) embedded in the mucosa of the terminal ileum and cecum, and free filarid nematodes (Dipetalonema sp.) in the abdominal cavity . Campylobacter sp . was recovered from the colon . With the exception of changes associated with the parasites, significant histologic changes were limited to the colon . Changes consistent with acute enteric viral infection were found against a background of chronic inflammation . Enterocytes were variably hypertrophied, degenerate, and attenuated . Numerous epithelial syncytial cells were present, and some affected cells (uni- as well as multinucleated) contained intranuclear inclusions . Lymphoid follicles were mildly depleted and contained rare syncytia . Measles (Morbillivirus) infection was confirmed by using immunohistochemistry, reverse transcriptase polymerase chain reaction, and Southern blot analysis . In contrast to the cutaneous rash, respiratory involvement, and low mortality characteristic of Old World monkeys with measles, severe diarrhea with high mortality occurs in New World monkeys with this disease . In addition, our case differs from previous reports of measles in New World monkeys in that syncytial cell formation apparently was limited to the colon of our animal.

Emerg Infect Dis, 2001, 7(3 Suppl), 588 - 92
A one-year study of foodborne illnesses in the municipality of Uppsala, Sweden; Lindqvist R et al.; Surveillance was enhanced and a retrospective interview study performed in 1998-99 to determine incidence, causes, and costs of foodborne illnesses in Uppsala, Sweden . Sixty-eight percent of the detected foodborne illness incidents were single cases, and 32% were outbreaks . Most (85%) of the incidents came to the attention of the municipal authorities through telephone calls from affected persons . Calicivirus, Campylobacter spp., and Staphyloccocus aureus were the most common etiological agents; meat, meat products, and mixed dishes were the most implicated food categories . The incidence of foodborne illness was estimated to be 38 cases per 1,000 inhabitants per year . The estimated average costs per illness were 2,164 Swedish Krona (SEK) ($246) to society and 500 SEK ($57) to the patient . The annual cost of foodborne illnesses in Sweden was estimated to be 1,082 million SEK ($123 million).

Acta Clin Belg, 2000 Nov-Dec, 55(6), 307 - 11
A Campylobacter coli foodborne outbreak in Belgium; Ronveaux O et al.; In May 1995, the Scientific Institute of Public Health was informed of an outbreak of gastrointestinal illness in a congregational school in the Brussels area . The field investigation identified 24 cases with mild to severe gastrointestinal and general symptoms of acute bacterial enterocolitis . Campylobacter coli was detected in the stools of 5 patients . A retrospective cohort study suggested that a mixed salad (containing ham and feta cheese) was the probable source of infection, but the route of contamination remained unknown . The rapid investigation of such episodes of collective foodborne infections is essential for the implementation of adequate control measures.

Acta Clin Belg, 2000 Nov-Dec, 55(6), 300 - 6
Analysis of foodborne disease in Belgium in 1997; Van Loock F et al.; Foodborne disease represents a major problem for public health in industrialized countries, albeit with a low lethality . Foodborne diseases are defined as a group of viral, bacterial or parasitic gastrointestinal infections transmitted by means of food . Proper food-hygiene practices and surveillance of individual diseases and in particular outbreaks are the first steps in targeting their prevention . The incidence of this illness is difficult to estimate . In the Netherlands a yearly incidence of gastrointestinal infections of 500 per 1,000 inhabitants is estimated, of which most are foodborne . To set up priorities in the actions to undertake, to establish the most frequent risks, to develop preventive efforts and to answer to international requirements, accurate data on foodborne disease from Belgium are required . In order to co-ordinate the initiatives in the Belgian context, a working group was set up in 1995 . In 1997 a total of 2,013 persons with foodborne disease were identified as part of 140 outbreaks, 22 of which occurred with 10 cases or more . Salmonella Enteritidis (88 outbreaks) was identified as the main pathogen in foodborne disease, followed by S . Typhimurium (11), S . Hadar (4) . Eggs and meat products were identified as the main food-items involved, although it remains difficult to obtain proper intervention studies allowing to identify the specific cause(s) . In 1997, a total of 12,732 human Salmonella isolates and 5,617 Campylobacter isolates were identified by the respective national reference laboratories . Salmonella isolates from Belgium accounted in 1997 for more than a fifth of all Salmonella isolates in the EU . The final objective of the working group is the implementation of a surveillance system for all risk factors concerned with the development of food-related illness, including an early warning system and an efficient analysis of microbiological criteria relating to human health, food and food production, including livestock . An essential element of this surveillance is communication of the results, risks and measures for prevention between all the departments, institutions and public health authorities concerned.

Pediatr Neurol, 2001 Jul, 25(1), 71 - 4
Three patients with ophthalmoplegia associated with Campylobacter jejuni; Kuroki S et al.; Cranial polyneuropathy is idiopathic in most patients . Idiopathic cranial polyneuropathy is an acute postinfectious syndrome, along with Guillain-Barre syndrome and Miller Fisher syndrome, in which the common preceding pathogen is Campylobacter jejuni . Serum anti-GQ1b antibodies are elevated in Miller Fisher syndrome and Guillain-Barre syndrome with ophthalmoplegia . Three patients with idiopathic cranial polyneuropathy with predominant ocular involvement are presented . C . jejuni isolated from stool specimens belonged to Penner serotypes O:4, O:23, and O:33 . Serum anti-GQ1b antibodies were elevated in all patients but demonstrated rapid reduction concomitant with clinical recovery . All patients recovered completely . Because both preceding C . jejuni infection and elevated anti-GQ1b antibodies decreasing with time were seen in all patients, the pathogenesis of idiopathic cranial polyneuropathy with ophthalmoplegia may be similar to that of Miller Fisher syndrome.

Lasers Med Sci, 2001, 16(3), 218 - 23
Inhibition of interleukin-1beta production and gene expression in human gingival fibroblasts by low-energy laser irradiation; Nomura K et al.; Human gingival fibroblast (hGF) cells reside in gingival tissues which are challenged frequently by oral bacteria . Lipopolysaccharide (LPS) from periodontal pathogens can penetrate gingival tissues and stimulate the production of interleukin-1beta (IL-1beta), which has been implicated in inflammation and bone resorption . The anti-inflammatory effects of low-energy laser irradiation have been reported, but the mechanisms of this biostimulatory effect have not been fully elucidated . Primary cultured hGF cells were challenged with LPS isolated from Campylobacter rectus, a known periodontal disease-associated pathogen, and irradiated by a Ga-Al-As diode low-energy laser (830 nm, 3.95-7.90 J/cm2) . The hGF cells cultured medium showed a marked elevation of IL-1beta production by LPS, which was significantly inhibited by laser irradiation in a dose-dependent manner . By reverse transcription-polymerase chain reaction (RT-PCR) analysis, this inhibitory effect was involved in the reduction of IL-1beta mRNA levels but not that of the IL-1beta converting enzyme.

J Antimicrob Chemother, 2001 Aug, 48(2), 235 - 40
Antimicrobial susceptibilities of Campylobacter strains isolated from food animals in Belgium; Van Looveren M et al.; Campylobacter spp . are a frequent cause of diarrhoea in man, originating mostly from poultry . It has been suggested that the veterinary use of antibiotics is largely responsible for resistance in human isolates, particularly to quinolones . During a 6 month period from June to December 1998, 677 Campylobacter isolates were obtained from healthy poultry and pigs . Samples were taken at Belgian slaughterhouses . Species identification was performed by biochemical tests, multiplex PCR and SDS-PAGE of whole-cell proteins . The in vitro susceptibility to six antimicrobial drugs was determined by the agar dilution method . Campylobacter jejuni was found more often in poultry than Campylobacter coli (79% C . jejuni versus 21% C . coli) . In pigs the situation was reversed (6 versus 94%) . Erythromycin resistance was significantly higher (P < 0.05) in C . coli, particularly in C . coli isolated from pigs (67.2%) . Alarmingly high rates of resistance to ciprofloxacin were also noted, particularly for C . coli from broilers (62.1%) . The latter indicates that resistance of Campylobacter in humans could derive from animals.

Acta Gastroenterol Belg, 2001 Apr-Jun, 64(2), 197 - 200
Crohn's disease, ulcerative colitis or indeterminate colitis--how important is it to differentiate?
Geboes K.
In most patients coming to the general practitioner or specialist with a history of bloody diarrhoea, bacteria or drugs are the most likely causative agents and it will be possible to make a diagnosis fairly easily . Because of differences in treatment, ulcerative colitis (UC) and Crohn's disease (CD) must however seriously be considered especially in younger patients, with severe symptoms and whenever the history is prolonged . A variety of colitides may indeed be clinically confused with UC and CD . Pathological mimics that should not be missed include infectious diseases such as Campylobacter colitis, yersiniosis, amoebiasis and others; drug-induced diseases (due to nonsteroidal antiinflammatory drugs...); diverticular disease-associated colitis; intestinal endometriosis; intestinal vasculitis and Behcet's disease and iatrogenic conditions such as graft-versus-host-disease and radiation colitis . In most situations a precise diagnosis of these conditions should be possible when all data are available . The term "indeterminate colitis" is used, when a diagnosis of chronic idiopathic inflammatory bowel disease (IBD) is suggested, but the differential diagnosis between UC and CD can not be solved . This occurs in approximately 5% of all patients with IBD . Diagnostic problems can occur in acute fulminant colitis, acute prolonged colitis, chronic relapsing disease and pouchitis . Indeterminate colitis is essentially a temporary diagnosis . Surgical and medical treatment of these patients can be difficult . When surgical treatment is indicated, the type of surgery must be seriously considered . The clinical course of patients with indeterminate colitis is usually more severe when compared with classical UC and these patients require often more severe medical treatment . Diagnostic problems can also arise in longstanding IBD, either UC and CD . Relapse of symptoms can be due to intercurrent infection (CMV is one of the candidates) . Medical treatment can influence the microscopic features and induce a discontinuous inflammation in UC, reminiscent of CD . In cases of doubt, the original biopsies should be reviewed to ascertain the diagnosis, and orient treatment.

J Infect Dis, 2001 Sep 1, 184(5), 606 - 9 Epub 2001 Jul 26.
Relationship of Campylobacter toxigenicity in vitro to the development of postinfectious irritable bowel syndrome; Thornley JP et al.; Campylobacter enteritis is associated with a significant risk of developing irritable bowel syndrome, but the mechanism is unknown . This study ascertained bowel symptoms in 93 patients 3 months after Campylobacter jejuni enteritis infection . The infecting organisms were cultured, and the effects of culture supernatants on toxin-sensitive epithelial cell monolayers (HEp-2, Green monkey kidney epithelial {Vero}, and CHO-K1) were investigated . In all, 50, 43, and 41 of the isolates showed toxigenic effects on HEp-2, CHO-K1, and Vero cells, respectively . Persistently changed bowel habit was reported by 9 of 50 persons with HEp-2 toxin-positive infections but by only 2 of 43 with isolates negative for toxin (chi2=4.0; P<.05) . Toxicity to HEp-2 and Vero cells was associated with significantly increased numbers of days with loose stools 6 months after C . jejuni enteritis infection (both, P<.05) . Thus, long-term symptoms that occur Campylobacter infection are significantly associated with bacterial toxicity.

J Appl Microbiol, 2001 Aug, 91(2), 217 - 24
The ability of Fla-typing schemes to discriminate between strains of Campylobacter jejuni; Petersen L et al.; AIMS: The aim of this investigation was to compare the usefulness of two previously published flagellin PCR-RFLP typing (Fla-typing) techniques for the subtyping of Campylobacter jejuni strains, in terms of ease of use and discriminatory power . METHODS AND RESULTS: Six groups of isolates, which were epidemiologically unrelated but with similar Fla-types, and five groups of epidemiologically related poultry isolates, with similar PFGE profiles, were used in the comparison . The Fla-typing methods used varied in the number and length of fla-genes amplified and the restriction enzymes used . In addition, the use of separately amplified PCR fragments of both the flaA and flaB genes to generate RFLP profiles was investigated . CONCLUSION: The results clearly demonstrated that both previously published methods exhibit some advantages over the other . However, optimal discrimination was obtained by the use of separately amplified PCR fragments of both fla-genes . SIGNIFICANCE AND IMPACT OF THE STUDY: The subtyping of Camp . jejuni isolates is considered essential for epidemiological purposes . Genotyping methods are now more frequently used but have yet to be standardized . Fla-typing is a rapid and easy to use method with acceptable discriminatory power . However, the discriminatory power of the currently published Fla-typing techniques may be further improved by incorporating RFLP profiles of both fla-genes.

Curr Gastroenterol Rep, 2001 Aug, 3(4), 285 - 92
Infectious complications of cirrhosis; Brann OS; Infectious complications in cirrhotic patients can cause severe morbidity and mortality . Bacterial infections are estimated to cause up to 25% of deaths in cirrhotic patients . The most frequent are urinary tract infection, spontaneous bacterial peritonitis, respiratory tract infection, and bacteremia . It has been said that cirrhosis is the most common form of acquired immunodeficiency, exceeding even AIDS . The specific risk factors for infection in cirrhotic patients are low serum albumin, gastrointestinal bleeding, intensive care unit admission for any cause, and therapeutic endoscopy . Certain infectious agents are more virulent and more common in patients with liver disease . These include Vibrio, Campylobacter, Yersinia, Plesiomonas, Enterococcus, Aeromonas, Capnocytophaga, and Listeria species, as well as organisms from other species . Spontaneous bacterial peritonitis is a frequent, severe, life-threatening complication of patients with ascites . Current observations and recommendations regarding treatment and prophylaxis are reviewed . A brief synopsis of miscellaneous infections encountered in cirrhotic patients is also included.

Postepy Hig Med Dosw, 2001, 55(2), 211 - 32
{Molecular mimicry of bacterial polysaccharides and their role in etiology of infectious and autoimmune diseases}; Korzeniowska-Kowal A et al.; Molecular mimicry is one of the most important pathogenic factor of microorganism and is defined as a structural similarity of microbial molecules to host tissue contributing to the pathogenicity . Mimicry can be observed at the molecular, serological and functional level . In the review the infectious diseases have been discussed where the mimicry phenomenon may occur, and also autoimmune disease where due to the molecular mimicry bacterial structures are potent to induce adverse immune reactions . The cross-reacting molecules mimicking the host structures comprise colominic acid, sialic acid containing capsular polysaccharides of Streptococcus group B, phosphocholine containing antigen, lipopolysaccharides of Campylobacter jejuni contributing in induction of Guillain-Barre syndrome or Lewis antigen containing lipopolysaccharides of Helicobacter pylori inducing gut carcinoma . Knowledge on the phenomenon of molecular mimicry is important when new conjugate vaccine has to be constructed, because great care should be paid not to induce autoantibodies with synthetic immunogen . Investigation of microbial factors reveal that many autoimmune diseases are of infection etiology.

Water Sci Technol, 2001, 43(12), 67 - 71
Waterborne epidemics in Finland in 1998-1999; Miettinen IT et al.; Fourteen waterborne epidemics occurred in Finland during 1998-1999 . About 7,300 illness cases were registered in these outbreaks . All except one of the waterborne epidemics were associated with undisinfected groundwaters . An equal number of waterborne epidemics occurred in public and private water systems, but most cases of illness occurred in public water systems . The three largest epidemics comprised 6,700 illness cases . Insufficient purification treatment unable to remove Norwalk-like viruses caused the only waterborne epidemic in a surface water plant . The main reasons for groundwater outbreaks were floods and surface runoffs which contaminated water . Norwalk-like viruses caused eight and Campylobacter three of the outbreaks . In two cases the epidemic ceased by the exhaustion of susceptible persons in the exposed community but in most cases it was terminated by changing the water source, boiling the drinking water, and starting chlorination.

J Biol Chem, 2001 Sep 14, 276(37), 34862 - 70 Epub 2001 Jul 18.
Identification of the carbohydrate moieties and glycosylation motifs in Campylobacter jejuni flagellin; Thibault P et al.; Flagellins from three strains of Campylobacter jejuni and one strain of Campylobacter coli were shown to be extensively modified by glycosyl residues, imparting an approximate 6000-Da shift from the molecular mass of the protein predicted from the DNA sequence . Tryptic peptides from C . jejuni 81-176 flagellin were subjected to capillary liquid chromatography-electrospray mass spectrometry with a high/low orifice stepping to identify peptide segments of aberrant masses together with their corresponding glycosyl appendages . These modified peptides were further characterized by tandem mass spectrometry and preparative high performance liquid chromatography followed by nano-NMR spectroscopy to identify the nature and precise site of glycosylation . These analyses have shown that there are 19 modified Ser/Thr residues in C . jejuni 81-176 flagellin . The predominant modification found on C . jejuni flagellin was O-linked 5,7-diacetamido-3,5,7,9-tetradeoxy-l-glycero-l-manno-nonulosonic acid (pseudaminic acid, Pse5Ac7Ac) with additional heterogeneity conferred by substitution of the acetamido groups with acetamidino and hydroxyproprionyl groups . In C . jejuni 81-176, the gene Cj1316c, encoding a protein of unknown function, was shown to be involved in the biosynthesis and/or the addition of the acetamidino group on Pse5Ac7Ac . Glycosylation is not random, since 19 of the total 107 Ser/Thr residues are modified, and all but one of these are restricted to the central, surface-exposed domain of flagellin when folded in the filament . The mechanism of attachment appears unrelated to a consensus peptide sequence but is rather based on surface accessibility of Ser/Thr residues in the folded protein.

J Food Prot, 2001 Jul, 64(7), 982 - 6
Comparison of methods for recovery and enumeration of Campylobacter from freshly processed broilers; Line JE et al.; Most traditional Campylobacter detection and enumeration procedures are difficult and time consuming . Estimations of Campylobacter populations by the most probable number (MPN) method are especially laborious . The objective of this collaborative study, performed in duplicate in Agricultural Research Service and Food Safety Inspection Service laboratories, was to compare two MPN procedures (utilizing different selective enrichment broths and plating media) to the direct plating technique for enumeration of Campylobacter from freshly processed (postchill, postdrip) broiler chicken carcasses . Results obtained from the direct plating of carcass rinse samples on Campy-cefex agar were not significantly different (P > 0.05) from an MPN procedure employing Hunt's Campylobacter selective enrichment broth followed by recovery on modified Campylobacter charcoal differential agar . However, both of these procedures provided significantly (P < 0.05) better recovery than a second MPN procedure using Rosef's selective enrichment broth followed by plating on Mueller-Hinton blood agar with antibiotics . The direct plating method offers a more simple, less expensive, more rapid alternative to traditional MPN procedures for estimating Campylobacter populations associated with freshly processed broiler carcasses.

Diagn Microbiol Infect Dis, 2001 May-Jun, 40(1-2), 45 - 9
Activity of BMS284756 (T-3811) tested against anaerobic bacteria, Campylobacter jejuni, Helicobacter pylori and Legionella spp; Rhomberg PR et al.; BMS284756, a novel des-fluoro (6) quinolone (formerly T-3811), was tested for activity and spectrum using reference agar dilution (AD) and Etest (AB BIODISK, Solna, Sweden) methods . The antimicrobial activities of BMS284756, ciprofloxacin, gatifloxacin, levofloxacin, and trovafloxacin were evaluated against Campylobacter jejuni (38 strains), Helicobacter pylori (21 strains), Legionella spp . (66 strains), and 197 anaerobic isolates . BMS284756 (MIC(90), 0.008 microg/mL) was four-fold more active than gatifloxacin and trovafloxacin against H . pylori strains . Gatifloxacin and BMS284756 (MIC(50), 0.03 microg/mL) were > or = two-fold more active than levofloxacin against C . jejuni, but their spectrums were judged equivalent overall (89.4% susceptible) . Against the Legionella spp., ciprofloxacin and levofloxacin (MIC(90), 0.25 microg/mL) had two-fold greater activity compared to gatifloxacin or BMS284756, but all strains were considered inhibited at clinically achievable levels . BMS284756 and trovafloxacin (MIC(90), 2 and 4 microg/mL, respectively) were four-to-eight-fold more potent than other comparators against the Gram-negative anaerobic species . Against the Gram-positive anaerobes (dominated by Clostridium difficile; 61 strains), BMS284756 activity was generally reduced, but equivalent or superior to trovafloxacin (68% inhibited at < or = 4 microg/mL) . Inter-method comparisons (Etest versus AD) of BMS284756 MIC values showed a high correlation for C . jejuni and anaerobes (93.3 to 97.6% +/- two log (2) dilution steps) . In conclusion, BMS284756 was very active against C . jejuni, H . pylori, Legionella spp . and most anaerobes, thus the potential role of this des-fluoro compound for treatment of infections caused by these fastidious species warrants further investigation.

Diagn Microbiol Infect Dis, 2001 May-Jun, 40(1-2), 11 - 9
Development of a ceuE-based multiplex polymerase chain reaction (PCR) assay for direct detection and differentiation of Campylobacter jejuni and Campylobacter coli in Thailand; Houng HS et al.; A novel ceuE-based multiplex PCR system was developed as an efficient diagnostics test to detect and differentiate C . jejuni and C . coli . There is no cross reactivity between C . jejuni and C . coli . In addition, the assay does not produce a positive signal from other enteric bacteria including Salmonella, Shigella and Escherichia coli strains . Campylobacter detection sensitivity was determined to be equivalent to previously reported PCR for other enteric bacteria . We also noticed that silicon dioxide extraction can improve Campylobacter detection sensitivity from infected stool samples . It was demonstrated that the PCR assay developed in this study had a much better Campylobacter detection rate than the traditional culturing method (77% versus 56%) . However, we also identified small numbers of culture positive stools (8%, or 16 out of 202 samples) that did not yield PCR positive results for Campylobacter . These PCR negative/culture positive stools were proven to be inhibitory to PCR amplification.

Prev Vet Med, 2001 Jul 19, 50(1-2), 89 - 100
Risk factors for Campylobacter spp . contamination in French broiler-chicken flocks at the end of the rearing period; Refregier-Petton J et al.; Our objectives were to identify risk factors for contamination of French broiler flocks by Campylobacter . We used 75 broiler farms in western France . A questionnaire was administered to the farmers and samples of fresh droppings were taken to assess the Campylobacter status of the broiler flocks . 42.7% of the flocks were positive for Campylobacter spp . The risk of contamination of the broiler flocks by Campylobacter was increased in summer/autumn, in houses with static air distribution, when two or more people took care of the flock, in poultry farms with three or more houses and when the drinking water for the chickens was acidified . The presence of litter-beetles in the change room also increased the risk of contamination . The administration of an antibiotic treatment following a disease decreased the risk of a flock being contaminated by Campylobacter.

Am J Epidemiol, 2001 Jul 15, 154(2), 166 - 73
Pathogenicity and convalescent excretion of Campylobacter in rural Egyptian children; Rao MR et al.; Campylobacter infection in developing countries has not received much public health attention because of the observation that infections are not associated with disease beyond the first 6 months of life . A cohort of 397 Egyptian children aged less than 3 years, who were observed twice weekly during 1995--1998, experienced an incidence of 0.6 episodes of Campylobacter diarrhea per child-year . A total of 13% of the Campylobacter diarrheal episodes were characterized by severe dehydration . Age-specific incidence rates (episodes per year) were 0.9 in infants aged less than 6 months, 1.5 in those 6--12 months, and 0.4 and 0.2 in the second and third years of life, respectively . Convalescent excretion of Campylobacter after a diarrheal episode might be enhancing transmission and contributing to this high incidence . Observed risk factors for Campylobacter diarrhea were poor hygienic conditions and the presence of animals in the house . Regardless of the child's age, a first infection by Campylobacter was associated with diarrhea (odds ratio = 2.45; 95% confidence interval: 1.61, 3.71); however, subsequent infections were associated with diarrhea only in children aged less than 6 months . This observation that natural infection did not confer protection during the first 6 months of life poses a challenge to vaccine development.

Clin J Pain, 2001 Jun, 17(2), 110 - 4
Screening of patients with complex regional pain syndrome for antecedent infections; van de Vusse AC et al.; OBJECTIVE: This study was designed to investigate whether Complex Regional Pain Syndrome type I (CRPS I) could be linked to any previous infection . PATIENTS: Fifty-two patients with CRPS I of one extremity were screened for the presence of antibodies against mostly neurotropic microorganisms . RESULTS: Of these 52 patients, none had antibodies against Treponema pallidum, Borrelia burgdorferi, or HTLV-1 . Only four patients were positive for Campylobacter jejuni . For cytomegalovirus, Epstein-Barr virus, herpes simplex virus, and Toxoplasma gondii, seroprevalences were similar to control values . The total seroprevalence of Parvovirus B 19 in our CRPS population was 77%, which was significantly higher than in an independent Dutch population group (59%) . Seroprevalence in lower extremity CRPS 1 (94%) was significantly higher than in upper extremity CRPS I patients (68%) . In this study all patients were seropositive for varicella zoster virus (VZV) antibodies, but a high prevalence of VZV antibodies is similar to its prevalence in a normal population (>90%) . CONCLUSIONS: In this study we found a significantly higher seroprevalence of Parvovirus B19 in CRPS I and this is most striking in lower extremity CRPS I patients . Further serologic research in other geographic areas is needed to provide additional information about a potential role of Parvovirus B 19 or other microorganisms in the etiopathogenesis of CRPS I.

J Appl Microbiol, 2001 Jul, 91(1), 38 - 46
Enumeration of Campylobacter in New Zealand recreational and drinking waters; Savill MG et al.; AIMS: To use a published polymerase chain reaction (PCR) method for the detection and identification of thermotolerant Campylobacter species (Camp . jejuni, Camp . coli and Camp . lari) in tandem with a Most Probable Number (MPN) technique to enumerate these species in water samples . METHODS AND RESULTS: An initial study of 42 river water samples compared the use of conventional culture and PCR methods for the detection of Campylobacter in MPN enrichment tubes . It was found that all samples positive by culture were also positive by PCR . Thirty-seven percent more MPN tubes were positive by PCR compared with culture . The MPN/PCR technique was subsequently applied to 96 additional samples collected from rivers, drinking, roof and shallow ground water . Campylobacter was especially prevalent in river water (60% positive) and shallow ground water (75% positive) samples . Drinking water (29.2% positive) and roof water (37.5% positive) also contained Campylobacter, but the numbers detected were very low (maximum 0.3 and 0.56 MPN 100 ml-1, respectively) . CONCLUSION: River waters contained Campylobacter at higher levels than any other water type and in a high percentage of the samples . Although Campylobacter was present in treated drinking water, the levels detected were low . SIGNIFICANCE AND IMPACT OF THE STUDY: These results suggest that water may act as a significant transmission route for human campylobacteriosis.

Poult Sci, 2001 Jun, 80(6), 825 - 8
Detection of Campylobacter spp . in ceca and crops with and without enrichment; Musgrove MT et al.; The purpose of this experiment was to determine how sampling method (direct plating or enrichment) affected the rate of Campylobacter spp . isolation from crop and cecal samples . In four separate trials, 32 New York-dressed broiler carcasses were obtained from commercial plants (n = 128) . Crops and ceca were removed aseptically, direct plated, and enriched . Samples were direct-plated on Campy-Cefex plates that were incubated at 42 C for 36 to 48 h under a microaerobic atmosphere (5% O2, 10% CO2, 85% N2) . After direct plating, samples were enriched in Bolton broth at 37 C for 4 h and 42 C for 20 h under a microaerobic atmosphere before plating onto Campy-Cefex plates . Campylobacter spp . was detected in 95.3% of direct-plated crop samples and 99.2% of enriched crop samples . Campylobacter spp . was detected in 100% of direct-plated cecal samples and 63.3% of enriched cecal samples . All 128 crop and cecal samples were positive for the organism by one or both methods . Mean counts of Campylobacter spp . were 3.6 log10 cfu/g of crop sample and 6.8 log10 cfu/g of cecal sample . For these two sample types, both of which tend to be contaminated with many viable cells, direct plating is sufficient for isolation of Campylobacter . Direct plating also provides an estimate of contamination level . Enrichment of cecal samples resulted in a decreased rate of detection and did not allow estimation of numbers of Campylobacter . The large numbers of non-Campylobacter species that inhabit the intestinal tract may out-compete Campylobacter during enrichment, confounding detection.

J Immunol, 2001 Jul 15, 167(2), 926 - 34
Negative selection of T cells by Helicobacter pylori as a model for bacterial strain selection by immune evasion; Wang J et al.; The majority of humans infected with Helicobacter pylori maintain a lifelong infection with strains bearing the cag pathogenicity island (PAI) . H . pylori inhibits T cell responses and evades immunity so the mechanism by which infection impairs responsiveness was investigated . H . pylori caused apoptotic T cell death, whereas Campylobacter jejuni did not . The induction of apoptosis by H . pylori was blocked by an anti-Fas Ab (ZB4) or a caspase 8 inhibitor . In addition, a T cell line with the Fas rendered nonfunctional by a frame shift mutation was resistant to H . pylori-induced death . H . pylori strains bearing the cag PAI preferentially induced the expression of Fas ligand (FasL) on T cells and T cell death, whereas isogenic mutants lacking these genes did not . Inhibiting protein synthesis blocked FasL expression and apoptosis of T cells . Preventing the cleavage of FasL with a metalloproteinase inhibitor increased H . pylori-mediated killing . Thus, H . pylori induced apoptosis in Fas-bearing T cells through the induction of FasL expression . Moreover, this effect was linked to bacterial products encoded by the cag PAI, suggesting that persistent infection with this strain may be favored through the negative selection of T cells encountering specific H . pylori Ags.

Med Clin (Barc), 2001 Jun 2, 116(20), 761 - 4
{Anti-GQ1b antibodies: usefulness of its detection for the diagnosis of Miller-Fisher syndrome}; Rojas-Garcia R et al.; BACKGROUND: To study the presence of anti-GQ1b antibodies as a tool for the diagnosis of Miller-Fisher syndrome (MFS) . PATIENTS AND METHOD: We studied 54 patients with probable diagnosis of MFS and 10 patients diagnosed as Guillain-Barre syndrome plus ophthalmoplegia (1 case), Bickerstaff's encephalitis (1 case), relapsing ophthalmoplegia (7 cases) and relapsing diplopia (1 case) . Results were compared with 130 patients with other disimmune neuropathies . Antibodies were detected by ELISA and checked by thin layer chromatography . Campylobacter jejuni serology was studied using a complement fixation test . RESULTS: Diagnosis of MFS was confirmed in 38 patients . A 97.3% were positive for GQ1b, being all negative for Campylobacter jejuni serology . A second test after 4-5 weeks of nadir was negative in 84.2% (16/19), concomitant with clinical recovery . CONCLUSIONS: Anti-GQ1b antibodies are useful markers for the differential diagnosis of MFS, specially with some acute brainstem disorders . Testing must be performed during the first four weeks of clinical course . This correlation between the triad ataxia, arreflexia and ophthalmoplegia and anti-GQ1b antibodies confirms that they are highly specific of MFS.

Clin Infect Dis, 2001 Aug 1, 33(3), 280 - 8 Epub 2001 Jul 05.
Etiology of gastroenteritis in sentinel general practices in the netherlands; de Wit MA et al.; Data from a general practice-based, case-control study on gastroenteritis and the pathogens related to this disease were used to study the association between specific pathogens and the infected patients' ages and symptoms . For comparison, the occurrence of these pathogens in control patients, stratified by age, also is presented . In children with gastroenteritis who were <5 years of age, rotavirus (in 21% of patients) and Norwalk-like virus (NLV; in 15%) were the most common pathogens . Among patients who were 5-14 years of age, Campylobacter species (in 16% of patients) and Giardia lamblia (in 10%) were the most common pathogens . In the older patients, Campylobacter species was also the most common pathogen (8% to 15% of patients) . In addition, several symptoms in case patients were associated with specific pathogens . Blood in the stool was associated with infection with Campylobacter species . In patients with fever, Salmonella species, Campylobacter species, and rotavirus were detected relatively often . Vomiting was associated with NLV and rotavirus . This is the first study in The Netherlands and one of the first studies in the world that has investigated a broad range of pathogens recovered from an unselected population of patients who had consulted general practitioners because of gastroenteritis.

Allergol Immunopathol (Madr), 2001 May-Jun, 29(3), 113 - 8
{Common variable immunodeficiency . Review}; Iglesias Alzueta J et al.; Common variable immunodeficiency (CVI) is a primary immunodeficiency characterized by deficient antibody production . The cause of this immunodeficiency is unknown; several in vitro studies have revealed a significant number of alterations that could explain the hypogammaglobulinemia present in this syndrome . Among those described are primary B cell alterations, numerical and functional T cell abnormalities, and defects in the interaction between accessory cells . The alteration typical of CVI is the failure of B lymphocytes to differentiate from antibody-producing cells, resulting in deficient immunoglobulin secretion . Among the T cell abnormalities described are a diminished proliferative response to mitogens and antigens, alterations in the level of production of several cytokines, especially reduction in the production of IL-2, diminished antigen-specific T cells and increase basal apoptosis after stimulation . Antigen presenting cells, monocytes and dendritic cells can also present alterations and contribute to deficient antigen response . The clinical manifestations of these patients is variable; most present recurrent bacterial infections due to encapsulated bacteria, especially sinusitis, otitis, bronchitis, and pneumonias . A few patients can present mycobacterial or fungal infection and occasionally Pneumocystis carinii . Viral infection is uncommon in these patients although some suffer recurrent herpes zoster infection . Clinical features of septicemia and central nervous system infections are less frequent . The incidence of digestive tract infections in these patients is high . The most common cause of diarrhea is Giardia lamblia; Salmonella, Shigella and Campylobacter are also common pathogens . Autoimmune disease is also more prevalent in these patients than in the general population . The most frequently associated diseases are hemolytic anemia, idiopathic thrombocytopenic purpura and autoimmune neutropenia . Cancer is also frequently associated with CVI, the most common forms being lymphoproliferative syndromes, especially non-Hodgkin's lymphoma . Granulomas are a unusual manifestation in some patients with CVI; their localization varies but the most commonly affected organs are the spleen and lungs . Some authors have compared these granulomas with those characterizing sarcoidosis, especially when appearing in the lung . Diagnosis of CVI is usually by exclusion of other diseases, such as cystic fibrosis, immotile cilia syndrome or allergic processes . CVI should be suspected in all patients with recurrent bacterial infections especially those localized in the respiratory tract . Other primary immunodeficiencies which present clinical findings similar to CVI and which should be ruled out are selective IgG subclass deficiency, IgA deficiency and selective deficiency in the response to polysaccharide antigens with normal immunoglobulin levels . The serum hypogammaglobulinemia present in all patients with CVI provides the diagnostic key . The age at which clinical manifestations appear, the absence of familial antecedents and the presence of circulating B lymphocytes form the basis of the differential diagnosis between X-linked agammaglobulinemia and autosomal recessive forms . The treatment of choice of patients with CVI is treatment with human gamma-globulin . Currently, the most common route of administration is intravenous; these molecules have a half-life of approximately 21 days and a high degree of safety concerning the possible transmission of viral infections . Adverse reactions are generally few and clinically unimportant . The most frequently used doses oscillate between 200 and 400 mg/kg body weight every 2-4 weeks . Both the dose and its frequency should be personalized for each patient . Early diagnosis of patients with CVI, application of treatment with appropriate antibiotics for infections and treatment with gamma-globulins prevent long-term complications of this disease and dramatically improve the quality of life and life expectancy of these patients.

J Clin Microbiol, 2001 Jul, 39(7), 2713 - 6
Basis of the superiority of cefoperazone amphotericin teicoplanin for isolating Campylobacter upsaliensis from stools; Byrne C et al.; The optimum method for isolating Campylobacter upsaliensis from stools has not been clearly defined . In a preliminary study, cefoperazone amphotericin teicoplanin (CAT) selective medium isolated six C . upsaliensis strains which were not detected using modified cefoperazone charcoal deoxycholate (mCCDA) . In order to identify the factors that underlie the superiority of CAT over mCCDA for isolating C . upsaliensis, we examined the effect of incubation time and antibiotic content of culture media on the growth of C . upsaliensis isolates using semiquantitative methods . The recovery of a subgroup of C . upsaliensis isolates from seeded stool specimens was also evaluated . Differences in growth of C . upsaliensis on CAT and mCCDA were modest and were not explained by the antibiotic profiles of the two media . Recovery of C . upsaliensis from spiked human feces on CAT was superior to that on mCCDA at lower concentrations of organisms (10(3) CFU/ml) . We conclude that although CAT is more suitable than mCCDA for the isolation of C . upsaliensis from stools, the superiority of CAT for detecting this organism is not accounted for by the antibiotic composition of the medium.

J Clin Microbiol, 2001 Jul, 39(7), 2548 - 57
Genomic heterogeneity and O-antigenic diversity of Campylobacter upsaliensis and Campylobacter helveticus strains isolated from dogs and cats in Germany; Moser I et al.; A serotyping scheme based on heat-stable surface antigens was established for 101 Campylobacter upsaliensis and 10 Campylobacter helveticus strains isolated from 261 dogs and 46 cats of different ages originating from two geographically distinct regions in Germany . The prevalence of C . upsaliensis varied between 27.8% in juvenile dogs (<12 months of age) and 55.4% in adult dogs (P < 0.05) . Of the cats, 19.6% harbored C . upsaliensis, whereas 21.7% carried C . helveticus . Of the C . upsaliensis isolates from both host species, 93.1% belonged to five different serogroups, two of them being prevalent at rates of 47.5 and 27.7%, with different frequencies in both regions . Six (54.6%) of the C . helveticus isolates also belonged to serotypes found among C . upsaliensis strains, whereas five (45.4%) possessed an O antigen unique for C . helveticus . In contrast, a considerable degree of genomic diversity of the isolates was assessed by macrorestriction analyses with the endonucleases SmaI and XhoI, using pulsed-field gel electrophoresis as well as enterobacterial repetitive intergenic consensus sequence PCR (ERIC PCR) . Restriction with SmaI pointed towards the existence of clonal groups associated to some extent with serotypes, while restriction with XhoI disintegrated these groups to smaller noncoherent subgroups . Analysis of ERIC PCR profiles did not exhibit any associations with serotypes . In conclusion these data demonstrate the genomic heterogeneity among C . upsaliensis strains and indicate that the combination of SmaI restriction with serotyping is a useful tool to investigate the expansion of clonal groups of C . upsaliensis.

J Clin Microbiol, 2001 Jul, 39(7), 2412 - 7
Helicobacter winghamensis sp . nov., a novel Helicobacter sp . isolated from patients with gastroenteritis; Melito PL et al.; From 1997 to 1999 seven isolates of Campylobacter-like organisms from five patients that were exhibiting symptoms of gastroenteritis, including fever, stomach malaise, and diarrhea, were investigated . The organisms were isolated from stool samples and found to exhibit a diverse colony morphology; hence multiple isolates were submitted from one of the patients . All isolates were found to be identical . The organisms were catalase, urease, alkaline phosphatase, and nitrate negative but oxidase and indoxyl acetate positive . They grew at 37 degrees C but not at 42 degrees C, and three of the isolates from two different patients were sensitive to nalidixic acid and cephalothin . Full 16S rRNA sequence analysis not only grouped these organisms within the Helicobacter genus but also differentiated them from previously identified Helicobacter species . The closest relative by phylogenetic analysis was Helicobacter sp . flexispira taxon 1 . Electron microscopy showed that these isolates had one or two bipolar flagella; however, the periplasmic fibers, a characteristic of the known Helicobacter sp . flexispira taxa, were not observed . The present isolates also lacked a flagellar sheath, a trait shared with four other Helicobacter spp., H . canadensis, H . mesocricetorum, H . pullorum, and H . rodentium . On the basis of the unique phenotypic properties of these isolates and 16S rRNA sequence analysis, we propose the classification of a new Helicobacter species, Helicobacter winghamensis sp . nov.

J Clin Microbiol, 2001 Jul, 39(7), 2386 - 90
Evaluation of methods for subtyping Campylobacter jejuni during an outbreak involving a food handler; Fitzgerald C et al.; In October 1998, the Centers for Disease Control and Prevention (CDC) assisted in an investigation of an outbreak of campylobacteriosis at a school in Salina, Kansas . Twenty-two isolates were submitted from the Kansas state public health laboratory to CDC, 9 associated with the outbreak and 13 epidemiologically unrelated sporadic isolates . Pulsed-field gel electrophoresis (PFGE) using SmaI and SalI was initially used to validate the epidemiologic data . We then tested the ability of other subtyping techniques to distinguish the outbreak-associated isolates from unrelated sporadic isolates . The methods employed were somatic O serotyping, PCR-restriction fragment length polymorphism (RFLP) analysis of flaA, DNA sequence analysis of 582 bp of flaA that included the short variable region (SVR), and sequencing of the entire flaA gene . PFGE was the most discriminatory technique, yielding 11 SmaI and 10 SalI restriction profiles . All outbreak isolates were indistinguishable by PFGE, somatic O serotyping, and sequencing of the 582-bp region of the flaA gene . fla typing by PCR-RFLP grouped one sporadic isolate with the outbreak strain . Analysis of the DNA sequence of a 582-bp segment of flaA produced strain groupings similar to that generated by PCR-RFLP but further differentiated two flaA PCR-RFLP types (with a 1-bp difference in the 582-bp region) . Two sporadic strains were distinct by flaA PCR-RFLP but differed only by a single base substitution in the 582-bp region . The entire flaA gene was sequenced from strains differing by a single base pair in the 582-bp region, and the data revealed that additional discrimination may in some cases be obtained by sequencing outside the SVR . PFGE was superior to all other typing methods tested for strain discrimination; it was crucial for understanding the Kansas outbreak and, when SmaI was used, provided adequate discrimination between unrelated isolates.

Appl Environ Microbiol, 2001 Jul, 67(7), 3115 - 21
Comparison of genotypes and serotypes of Campylobacter jejuni isolated from Danish wild mammals and birds and from broiler flocks and humans; Petersen L et al.; The incidence of human infection with Campylobacter jejuni is increasing in most developed countries and the reason for this is largely unknown . Although poultry meat is considered to be a major source, it is evident that other reservoirs exist, possibly common to humans and poultry . Environmental sources are believed to be important reservoirs of Campylobacter infection in broiler chicken flocks . We investigated the potential importance of wildlife as a source of infection in commercial poultry flocks and in humans by comparing the serotype distributions, fla types, and macrorestriction profiles (MRPs) of C . jejuni isolates from different sources . The serotype distribution in wildlife was significantly different from the known distributions in broilers and humans . Considerable sero- and genotype diversity was found within the wildlife collection, although two major groups of isolates within serotype O:12 and the O:4 complex were found . Common clonal lines among wildlife, chicken, and/or human isolates were identified within serotype O:2 and the O:4 complex . However, MRPs of O:12 and O:38 strains isolated from wildlife and other sources indicated that some clonal lines propagated in a wide selection of animal species but were not detected in humans or broilers in this study . The applied typing methods successfully identified different clonal groups within a strain collection showing large genomic diversity . However, the relatively low number of wildlife strains with an inferred clonal relationship to human and chicken strains suggests that the importance of wildlife as a reservoir of infection is limited.

Vet Microbiol, 2001 Sep 20, 82(2), 141 - 54
Serotype and genotype diversity and hatchery transmission of Campylobacter jejuni in commercial poultry flocks; Petersen L et al.; We investigated the genotype and serotype diversity of Campylobacter coli and C . jejuni in two parent flocks of adult hens and their offspring over two rotations in order to evaluate the role of hatchery mediated transmission and/or vertical transmission of campylobacters in broiler flocks . In total, 314 C . jejuni and 32 C . coli isolates from parent and broiler flocks and from the surroundings of broiler houses were typed by flagellin gene PCR/RFLP (fla-typing), and selected isolates were also typed by serotyping and macrorestriction profiling using PFGE (MRP/PFGE) . The combined typing results showed that the broiler flocks could be colonised by 1-3 different Campylobacter clones and parent flocks could be colonised by 2-6 different clones . C . coli was isolated from up to 36% of birds in one parent flock, whereas only C . jejuni was isolated from broiler flocks . C . jejuni clones from different flocks were clearly discriminated by fla-typing as well as by MRP/PFGE, except for a few cases where individual isolates belonging to two different clones were found to have altered fla-types . Similarly, one C . coli clone showed pronounced fla-type variation . The present results lead to the conclusion that vertical transmission or horizontal transmission via the hatchery are not significant transmission routes of C . jejuni to broiler chickens under Danish conditions . In the cases where more than one Campylobacter clone simultaneously colonised flocks, we found that the different clones coexisted in flocks rather than excluding each other.

J Clin Periodontol, 2001 Jul, 28(7), 617 - 27
Untreated periodontal disease in Indonesian adolescents . Subgingival microbiota in relation to experienced progression of periodontitis; Timmerman MF et al.; BACKGROUND/AIMS: In an Indonesian population deprived of regular dental care, the experienced progression of disease between baseline (1987) and follow-up (1994) was investigated in relation to the composition of the subgingival microbiota at follow-up . At baseline the age ranged from 15 to 25 years . Clinical and microbiological evaluation was completed in 158 of the 167 subjects available at follow-up . METHODS: Plaque index (PI), pocket depth (PD), bleeding on probing (BOP), and attachment loss (AL) were scored at the approximal surfaces of all teeth and subgingival calculus on the approximal surfaces of the Ramfjord teeth only (number of sites with subgingival calculus: NSC) . A pooled sample of the deepest pocket in each quadrant was evaluated using microbiological culture techniques . RESULTS: At baseline the mean values of the clinical parameters were AL=0.35 mm, PI=1.01, BOP=0.80 PD=3.25 mm and NSC=6.04 and at follow-up AL=0.75 mm, PI=1.16, BOP=1.19, PD=3.34 mm and NSC=5.85 . All parameters except PD and NSC showed a statistically significant increase . At follow-up the prevalence of Actinobacillus actinomycetemcomitans was 40%, of Porphyromonas gingivalis 67%, of Prevotella intermedia 66%, of Fusobacterium nucleatum 79%, of Bacteroides forsythus 16%, of Campylobacter rectus 4%, and of P . micros 6% . No differences in clinical parameters were found between groups with or without these micro-organisms . In 129 subjects AL of > or =2 mm at > or =1 site was found . Logistic regression showed three significant odds-ratio's for experienced progressive periodontitis: Plaque index (12.2), gender (3.4) and Actinobacillus actinomycetemcomitans (2.9) . CONCLUSIONS: The results of this retrospective study suggest that plaque is the most important parameter related to experienced disease progression, and that the presence of A . actinomycetemcomitans may be associated with increased chance of disease progression.

J Clin Periodontol, 2001 Jul, 28(7), 597 - 609
Change in subgingival microbial profiles in adult periodontitis subjects receiving either systemically-administered amoxicillin or metronidazole; Feres M et al.; AIM: The current investigation evaluated changes in levels and proportions of 40 bacterial species in subgingival plaque samples during, immediately after and up to 1 year after metronidazole or amoxicillin therapy combined with SRP . METHOD: After baseline clinical and microbiological monitoring, 17 adult periodontitis subjects received full mouth SRP and 14 days systemic administration of either metronidazole (250 mg, TID, n=8) or amoxicillin (500 mg, TID, n=9) . Clinical measurements including % of sites with plaque, gingival redness, bleeding on probing and suppuration, pocket depth (PD) and attachment level (AL) were made at baseline, 90, 180 and 360 days . Subgingival plaque samples were taken from the mesial surface of all teeth in each subject at baseline, 90, 180 and 360 days and from 2 randomly selected posterior teeth at 3, 7, and 14 days during and after antibiotic administration . Counts of 40 subgingival species were determined using checkerboard DNA-DNA hybridization . Significance of differences over time was determined using the Quade test and between groups using ANCOVA . RESULTS: Mean PD was reduced from 3.22+/-0.12 at baseline to 2.81+/-0.16 (p<0.01) at 360 days and from 3.38+/-0.23 mm to 2.80+/-0.14 mm (p<0.01) in the amoxicillin and metronidazole treated subjects respectively . Corresponding values for mean AL were 3.21+/-0.30 to 2.76+/-0.32 (p<0.05) and 3.23+/-0.28 mm to 2.94+/-0.23 mm (p<0.01) . Levels and proportions of Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola were markedly reduced during antibiotic administration and were lower than baseline levels at 360 days . Counts (x10(5), +/-SEM) of B . forsythus fell from baseline levels of 0.66+/-0.16 to 0.04+/-0.02, 0.13+/-0.04, 0.10+/-0.03 and 0.42+/-0.19 in the amoxicillin group at 14, 90, 180 and 360 days respectively (p<0.001) . Corresponding values for metronidazole treated subjects were: 1.69+/-0.28 to 0.02+/-0.01, 0.20+/-0.08, 0.22+/-0.06 and 0.22+/-0.08 (p<0.001) . Counts of Campylobacter species, Eubacterium nodatum, Fusobacterium nucleatum subspecies, F . periodonticum and Prevotella nigrescens were also detected at lower mean levels during and immediately after therapy, but gradually increased after withdrawal of the antibiotics . Members of the genera Actinomyces, Streptococcus and Capnocytophaga were minimally affected by metronidazole . However, amoxicillin decreased the counts and proportions of Actinomyces species during and after therapy . CONCLUSIONS: The data suggest that metronidazole and amoxicillin are useful in rapidly lowering counts of putative periodontal pathogens, but must be accompanied by other procedures to bring about periodontal stability.

J Antimicrob Chemother, 2001 Jul, 48 Suppl 1, 77 - 80
Recommendations for susceptibility tests on fastidious organisms and those requiring special handling; King A; Fastidious organisms present problems in antimicrobial susceptibility testing related to particular cultural requirements or slow growth . Methods for commonly isolated fastidious organisms, including haemolytic streptococci, Neisseria spp . and Haemophilus spp., are included in the description of the standardized disc diffusion method . However, some further information is given here for Haemophilus influenzae and Neisseria spp . Other less commonly isolated fastidious organisms are detailed and modifications of the disc diffusion method are given for Campylobacter spp . and rapidly growing anaerobes . For those organisms where disc diffusion methodology is not recommended, Brucella spp., Helicobacter pylori and Leigionella spp., MIC determinations are often needed, although disc diffusion test results may be useful as screens for resistance . Where disc diffusion can be used it is important to use the correct medium and to include appropriate controls . Methodology is also given for testing isolates of Stenotrophomonas maltophilia, which are affected by both medium and temperature.

J Neurol Neurosurg Psychiatry, 2001 Jul, 71(1), 123 - 4
Range of cross reactivity of anti-GM1 IgG antibody in Guillain-Barré syndrome; Koga M et al.; The cross reactivity of anti-GM1 IgG antibody with various gangliosides and asialo-GM1 in serum samples from 27 patients with Guillain-Barre syndrome was investigated . An enzyme linked immunosorbent assay (ELISA) absorption study showed that anti-GM1 IgG antibody cross reacted with asialo-GM1 in 52% of the patients, GM1b in 41%, GD1b in 22%, and GalNAc-GD1a in 19%, and that it did not cross react with GM2, GT1b, or GQ1b . The antibody that cross reacted with GD1b was associated with a high frequency of cranial nerve involvement and negative Campylobacter jejuni serology . Anti-GM1 IgG antibody has a broad range of cross reactivity which may contribute to various clinical variations of Guillain-Barre syndrome.

Int J Syst Evol Microbiol, 2001 May, 51(Pt 3), 819 - 26
Differentiation between Campylobacter hyoilei and Campylobater coli using genotypic and phenotypic analyses; Dep MS et al.; Genotypic and phenotypic methods were applied to investigate differences between the closely related species Campylobacter hyoilei and Campylobacter coli . A unique DNA sequence from C . hyoilei was used to design a specific PCR assay that amplified a DNA product of 383 bp for all C . hyoilei strains, but not other Campylobacter species, including C . coli . The PCR assay could detect 100 fg pure C . hyoilei DNA, 2 x 10(2) c.f.u . ml(-1) using cultured cells and 8.3 x 10(3) c.f.u . 0.1 g(-1) in faeces . The C . hyoilei sequence utilized for specific detection and identification of this species showed similarities to sequences from bacteriophages Mu, P2 and 186, suggesting lysogination of the ancestral C . hyoilei genome . Activities of a set of 15 enzymes that participate in a variety of cellular functions, including biosynthesis, catabolism, energy generation, maintenance of redox balance and phosphate utilization, were tested using sets of strains of C . hyoilei and C . coli . Comparison of mean rates of enzyme activities revealed significant differences between species in the values determined for seven of these activities . Both the genetic and phenotypic data indicate that C . hyoilei is a unique Campylobacter species.

J Infect Dis, 2001 Jul 15, 184(2), 221 - 6 Epub 2001 Jun 08.
Molecular population genetic analysis of Campylobacter jejuni HS:19 associated with Guillain-Barré syndrome and gastroenteritis; Nachamkin I et al.; Infection with Campylobacter jejuni serotype HS:19 is associated with the development of Guillain-Barre syndrome (GBS) . To determine whether a particular HS:19 clone is associated with GBS, multilocus enzyme electrophoresis (MLEE) was used to analyze a worldwide collection of isolates . There were 34 electropherotypes (ETs) in 3 phylogenetic clusters among 83 C . jejuni isolates . Cluster I contained all HS:19 strains, and a single ET (ET4) accounted for most HS:19 strains . HS:19 strains did not occur in any of the other clusters . ET4 contained isolates from different geographic locations, indicating global spread of this clone . Furthermore, ET4 contained isolates from patients with uncomplicated enteritis and GBS, as well as isolates from animal sources . The results of this study show that HS:19 strains comprise a clonal, although not monomorphic, population, which is distinct from non-HS:19 strains within C . jejuni . A unique clone associated with GBS was not identified by use of MLEE.

J Infect Dis, 2001 Jul 15, 184(2), 215 - 20 Epub 2001 Jun 08.
Absence of clonality of Campylobacter jejuni in serotypes other than HS:19 associated with Guillain-Barré syndrome and gastroenteritis; Engberg J et al.; Guillain-Barre syndrome (GBS) is recognized as a complication that occurs after Campylobacter infection . Certain Penner serotypes, such as HS:19, are linked particularly to GBS in some parts of the world, and there is good evidence for restricted genetic diversity in these isolates . However, GBS also occurs after Campylobacter infection due to other serotypes . Therefore, we asked whether Campylobacter jejuni non-HS:19 serotypes associated with GBS have a clonal structure and differ from strains isolated from patients with Campylobacter gastroenteritis . A worldwide selected population of C . jejuni non-HS:19 strains associated with GBS and gastroenteritis was analyzed by use of multilocus enzyme electrophoresis, automated ribotyping, pulsed-field gel electrophoresis, and flagellin gene typing . The results show that these isolates represent a heterogenic population and do not constitute a unique population across serotypes . No epidemiologic marker for GBS-associated strains was identified.

Curr Microbiol, 2001 Sep, 43(3), 209 - 14
Potential intervention of Campylobacter jejuni in the modulation of murine immune response; Pancorbo PL et al.; Campylobacter jejuni has been reported to produce different toxins that may modulate the immune response in both animals and humans . The effect of C . jejuni enterotoxin on the immune response was investigated in two groups of Balb/c mice . One of them was inoculated intraperitoneally with 1010 colony forming units (CFU) of an enterotoxigenic strain (CCUG 7580), and the second one with a non-enterotoxigenic strain (CCUG 7440) . The number of polymorphonuclear (PMN) cells from spleen increased in both enterotoxigenic and non-enterotoxigenic strains as a consequence of C . jejuni infection . Notwithstanding, lymphocyte proliferation stimulated by lipopolysaccharide (LPS) was increased by both enterotoxigenic and non-enterotoxigenic strains . Interleukin-2 (IL-2) production from splenic cells was increased significantly by infection with the enterotoxigenic strain . Both enterotoxigenic and non-enterotoxigenic strains reduced the splenic response to sheep erythrocytes; the response was significantly suppressed for immunoglobulin M (Ig M) and for immunoglobulin G (Ig G) synthesis . These results suggest that C . jejuni is able to modify some components of the immune response in mice, and also that the enterotoxigenic strain has more immunomodulating activity than the non-enterotoxigenic strain.

J Food Prot, 2001 Jun, 64(6), 770 - 6
Survival and death of Salmonella typhimurium and Campylobacter jejuni in processing water and on chicken skin during poultry scalding and chilling; Yang H et al.; Salmonella Typhimurium and Campylobacter jejuni were inoculated in scalding water, in chilled water, and on chicken skins to examine the effects of scalding temperature (50, 55, and 60 degrees C) and the chlorine level in chilled water (0, 10, 30, and 50 ppm), associated with the ages of scalding water (0 and 10 h) and chilled water (0 and 8 h), on bacterial survival or death . After scalding at 50 and 60 degrees C, the reductions of C . jejuni were 1.5 and 6.2 log CFU/ml in water and <1 and >2 log CFU/cm2 on chicken skins; the reductions of Salmonella Typhimurium were <0.5 and >5.5 log CFU/ml in water and <0.5 and >2 log CFU/cm2 on skins, respectively . The age of scalding water did not significantly (P > 0.05) affect bacterial heat sensitivity . However, the increase in the age of chilled water significantly (P < 0.05) reduced the chlorine effect . In 0-h chilled water . C . jejuni and Salmonella Typhimurium were reduced by 3.3 and 0.7 log CFU/ml, respectively, after treatment with 10 ppm of chlorine and became nondetectable with 30 and 50 ppm of chlorine . In 8-h chilled water, the reduction of C . jejuni and Salmonella Typhimurium was <0.5 log CFU/ml with 10 ppm of chlorine and ranged from 4 to 5.5 log CFU/ml with 50 ppm of chlorine . Chlorination of chilled water did not effectively reduce the bacteria attached on chicken skins . The D-values of Salmonella Typhimurium and C . jejuni were calculated for the prediction of their survival or death in the poultry scalding and chilling.

Neurology, 2001 Jun 12, 56(11), 1467 - 72
Gastroenteritis-associated Guillain-Barré syndrome on the Caribbean island Curaçao; van Koningsveld R et al.; BACKGROUND: The number of patients with Guillain-Barre syndrome (GBS) who have been observed in Curacao, the Netherlands Antilles, may be increasing . METHODS: Clinical and serologic data were obtained from records of patients admitted between 1987 and 1999 and fulfilling National Institute of Neurological and Communicative Disorders and Stroke criteria for GBS . When possible, serum and stool samples were collected . The results were compared with a large Dutch epidemiologic study . RESULTS: The authors identified 49 patients, an overall crude incidence rate (IR) in Curacao of 2.53/100,000 inhabitants (95% CI 1.87 to 3.35) (Dutch study 1.18, rate ratio (RR) of 2.14, p < 0.001) . The IR in Curacao increased from 1.62 in 1987 to 1991 to 3.10 in 1992 to 1999, RR 5.22 (95% CI 2.48 to 10.2, p = 0.02) . The IR showed a curvilinear shape within a year . In comparison with the Dutch group, patients from Curacao had a more severe course of the disease, with a mortality rate of 23% (3.4% in the Dutch group, p < 0.001), a higher percentage of preceding gastroenteritis (p < 0.001), and less sensory involvement (p < 0.001) . In 8 of 10 serum samples, evidence was found for a recent infection with Campylobacter jejuni . CONCLUSIONS: The authors found a steady increase in incidence of GBS over the years in association with a more pronounced seasonal preponderance and a more severe course . The clinical characteristics suggest a role for C jejuni.

Infect Immun, 2001 Jul, 69(7), 4358 - 65
CdtA, CdtB, and CdtC form a tripartite complex that is required for cytolethal distending toxin activity; Lara-Tejero M et al.; Campylobacter jejuni encodes a cytolethal distending toxin (CDT) that causes cells to arrest in the G(2)/M transition phase of the cell cycle . Highly related toxins are also produced by other important bacterial pathogens . CDT activity requires the function of three genes: cdtA, cdtB, and cdtC . Recent studies have established that CdtB is the active subunit of CDT, exerting its effect as a nuclease that damages the DNA and triggers cell cycle arrest . Microinjection of CdtB into target cells led to G(2)/M arrest and cytoplasmic distention, in a manner indistinguishable from that caused by CDT treatment . Despite this progress, nothing is known about the composition of the CDT holotoxin or the function of CdtA and CdtC . We show here that, when applied individually, purified CdtA, CdtB, or CdtC does not exhibit toxic activity . In contrast, CdtA, CdtB, and CdtC when combined, interact with one another to form an active tripartite holotoxin that exhibits full cellular toxicity . CdtA has a domain that shares similarity with the B chain of ricin-related toxins . We therefore proposed that CDT is a tripartite toxin composed of CdtB as the enzymatically active subunit and of CdtA and CdtC as the heterodimeric B subunit required for the delivery of CdtB.

J Med Primatol, 2001 Feb, 30(1), 20 - 5
A prevalence survey for zoonotic enteric bacteria in a research monkey colony with specific emphasis on the occurrence of enteric Yersinia; Vore SJ et al.; Transmissible pathogenic and opportunistic zoonotic enteric bacteria comprise a recognized occupational health threat to exposed humans from non-human primates (NHPs) . In an effort to evaluate the occurrence of selected enteric organisms with zoonotic and biohazard potential in a research colony setting, we performed a prevalence study examining 61 juvenile and young adult rhesus macaques participating in a transplant immunology project . Primary emphasis was directed specifically to detection of pathogenic enteric Yersinia, less well-documented and reported NHP pathogens possessing recognized significant human disease potential . NHPs were surveyed by rectal culture during routine health monitoring on three separate occasions, and samples incubated using appropriate media and specific selective culture methods . Enteric organisms potentially transmissible to humans were subcultured and identified to genus and species . Significant human pathogens of the Salmonella/Shigella, Campylobacter, and enteric Yersinia groups were not isolated throughout the survey, suggesting prevalence of these organisms may generally be quite low.

J Bacteriol, 2001 Jul, 183(13), 3958 - 66
The iron- and temperature-regulated cjrBC genes of Shigella and enteroinvasive Escherichia coli strains code for colicin Js uptake; Smajs D et al.; A cosmid library of DNA from colicin Js-sensitive enteroinvasive Escherichia coli (EIEC) strain O164 was made in colicin Js-resistant strain E . coli VCS257, and colicin Js-sensitive clones were identified . Sensitivity to colicin Js was associated with the carriage of a three-gene operon upstream of and partially overlapping senB . The open reading frames were designated cjrABC (for colicin Js receptor), coding for proteins of 291, 258, and 753 amino acids, respectively . Tn7 insertions in any of them led to complete resistance to colicin Js . A near-consensus Fur box was found upstream of cjrA, suggesting regulation of the cjr operon by iron levels . CjrA protein was homologous to iron-regulated Pseudomonas aeruginosa protein PhuW, whose function is unknown; CjrB was homologous to the TonB protein from Pseudomonas putida; and CjrC was homologous to a putative outer membrane siderophore receptor from Campylobacter jejuni . Cloning experiments showed that the cjrB and cjrC genes are sufficient for colicin Js sensitivity . Uptake of colicin Js into sensitive bacteria was dependent on the ExbB protein but not on the E . coli K-12 TonB and TolA, -B, and -Q proteins . Sensitivity to colicin Js is positively regulated by temperature via the VirB protein and negatively controlled by the iron source through the Fur protein . Among EIEC strains, two types of colicin Js-sensitive phenotypes were identified that differed in sensitivity to colicin Js by 1 order of magnitude . The difference in sensitivity to colicin Js is not due to differences between the sequences of the CjrB and CjrC proteins.

J Periodontol, 2001 May, 72(5), 666 - 71
Smoking affects the subgingival microflora in periodontitis; van Winkelhoff AJ et al.; BACKGROUND: Tobacco smoking has been identified as one major risk factor for destructive periodontal disease . Scaling and root planing have been shown to be less effective in smokers with periodontitis . The aim of the present study was to compare the subgingival microbial flora of treated and untreated smokers and non-smokers . METHODS: Four independent adult patient groups with periodontitis were included in this investigation: 88 untreated smokers (U-S); 90 untreated non-smokers (U-NS); 119 treated non-smokers (T-NS); and 171 treated smokers (T-S) . Clinical variables included cumulative plaque index (CPI), probing depth (PD), clinical attachment level (CAL), cumulative bleeding index (CBI), and cumulative suppuration index (CSI) . Paper point samples from the deepest bleeding pocket in each quadrant of the dentition were analyzed for the presence and levels of 6 periodontal bacterial pathogens using anaerobic culture techniques . RESULTS: U-S showed a higher mean cumulative plaque index than U-NS (3.5 versus 2.7) . Mean PD and mean CAL were higher in the T-S in comparison to the T-NS group (7.0 versus 6.6 mm and 5.6 versus 4.7 mm, respectively) . Microbiological characteristics of U-S were a higher prevalence of Prevotella intermedia/nigrescens and higher mean levels of Peptostreptococcus micros (Pm) and Fusobacterium nucleatum (Fn) . T-S patients were characterized by higher prevalence of Bacteroides forsythus (Bf), Pm, and Campylobacter rectus (Cr) and higher mean levels of Pm and Fn . The mean percentage of B . forsythus tended to be higher in the T-S group than in the T-NS group (6.9% versus 5.6%) . The relative risk to be infected with Bf, Pm, and Cr was statistically higher in smokers (odds ratios: 1.9, 1.9, and 1.6, respectively) . The chance to find > or =10% of Bf, Pm, and/or Fn was 3.3 higher in smokers when A . actinomycetemcomitans and P gingivalis were absent . Detection of > or =20% Pm/Fn in treated patients was strongly associated with smoking (odds ratio 13.8, P= 0.002) . CONCLUSIONS: Smoking is a determining factor for the composition of the subgingival microflora in adult patients with periodontitis and may select for a specific cluster of periodontal pathogens, notably Bf, Pm, Fn, and Cr . On the basis of these observations, smoking, among other criteria, may be one parameter to use in deciding to treat refractory periodontitis in smokers with a systemic antibiotic therapy directed against smoking-associated periodontal bacteria.

Microbios, 2001, 105(411), 77 - 85
Lactobacilli in human dental caries and saliva; Smith SI et al.; Samples (98 plaque and 72 saliva) from 93 patients with dental caries were investigated for Lactobacillus species which comprised 65 (62.5%) of 104 isolates . Yeasts (20.1%), Streptococcus spp . (8.7%), Staphylococcus spp . (2.9%) and a few unidentified species (5.8%), were also found . The Lactobacillus isolates were L . brevis (24.6%) L . fermentum (18.5%) L . casei (16.9%), L . delbrueckii (15.4%), L . plantarum (9.23%), L . acidophilus (7.69%), L . jensenii (4.62%), L . salivarius (1.54%) and L . gasseri (1.54%) . The most common species was L . brevis (24.6%) . The strains tested for beta-lactamase production showed 75.4% positive . All the Lactobacillus strains were tested for bacteriocin production against Escherichia coli, Salmonella spp., Shigella dysenteriae, S . sonnei, Klebsiella spp . and Campylobacter sp . All the lactobacilli except L . jensenii produced bacteriocin against at least one of the indicator organisms . The involvement of Lactobacillus in dental caries was established, although its role and mechanism is not well understood . The ability of Lactobacillus spp . to protect their host against certain diseases by inhibiting the growth of potential pathogens was evident.

Parasitology, 2000, 121 Suppl, S23 - 38
Malnutrition and parasitic helminth infections; Stephenson LS et al.; The Global Burden of Disease caused by the 3 major intestinal nematodes is an estimated 22.1 million disability-adjusted life-years (DALYs) lost for hookworm, 10.5 million for Ascaris lumbricoides, 6.4 million for Trichuris trichiura, and 39.0 million for the three infections combined (as compared with malaria at 35.7 million) (World Bank, 1993; Chan et al . 1994); these figures illustrate why some scarce health care resources must be used for their control . Strongyloides stercoralis is the fourth most important intestinal worm infection; its nutritional implications are discussed, and the fact that its geographic distribution needs further study is emphasized . Mechanisms underlying the malnutrition induced by intestinal helminths are described . Anorexia, which can decrease intake of all nutrients in tropical populations on marginal diets, is likely to be the most important in terms of magnitude and the probable major mechanism by which intestinal nematodes inhibit growth and development . We present a revised and expanded conceptual framework for how parasites cause/aggravate malnutrition and retard development in endemic areas . Specific negative effects that a wide variety of parasites may have on gastrointestinal physiology are presented . The synergism between Trichuris and Campylobacter, intestinal inflammation and growth failure, and new studies showing that hookworm inhibits growth and promotes anaemia in preschool (as well as school-age) children are presented . We conclude by presenting rationales and evidence to justify ensuring the widest possible coverage for preschool-age children and girls and women of childbearing age in intestinal parasite control programmes, in order to prevent morbidity and mortality in general and specifically to help decrease the vicious intergenerational cycle of growth failure (of low-birth-weight/intrauterine growth retardation and stunting) that entraps infants, children and girls and women of reproductive age in developing areas.

Biol Pharm Bull, 2001 May, 24(5), 570 - 4
Cloning and sequencing of the astA gene encoding arylsulfate sulfotransferase from Salmonella typhimurium; Kang JW et al.; Arylsulfate sulfotransferase (ASST) transfers a sulfate group from a phenolic sulfate ester to a phenolic acceptor substrate . In the present study, the gene encoding ASST was cloned from a genomic library of Salmonella typhimurium . The gene was subcloned into the vector pKF3 and was sequenced . A recombinant clone harboring the gene was directly identified using a fluorescent assay . Sequencing revealed two contiguous open reading frames (ORFs) on the same strand . Based on amino acid sequence homology, ORF1 and ORF2 are designated as astA and dsbA, respectively . The deduced amino acid sequence of astA from S . typhimurium was highly similar to those of the Enterobacter amnigenus, Klebsiella, and Campylobacter jejuni ASSTs, encoded by the astA genes . However, an ASST activity assay revealed a different acceptor specificity . Using p-nitrophenyl sulfate (PNS) as a donor substrate, phenol is the best acceptor substrate, followed by alpha-naphthol, resorcinol, tyramine, acetaminophen, and tyrosine.

Jpn J Cancer Res, 2001 May, 92(5), 488 - 93
Low expression myeloperoxidase genotype negatively associated with Helicobacter pylori infection; Hamajima N et al.; Our previous study revealed that a polymorphism of the interleukin (IL) 1B gene, encoding the pro-inflammatory cytokine IL-1 beta, influenced the prevalence of persistent Helicobacter pylori (HP) infection . In this paper, a polymorphism of another inflammation-related enzyme, myeloperoxidase (MPO), was examined with respect to association with the HP infection . The polymorphism is due to a G-to-A transition at - 463 in the promoter region of MPO . The G allele is the wild type with normal expression, while the A allele is a low expression allele . The subjects were 241 non-cancer outpatients (118 males and 123 females) aged 39 to 69 who participated in an HP eradication program at Aichi Cancer Center Hospital . High-molecular weight Campylobacter-Associated-Protein (HM-CAP) ELISA (Enteric Products Ins., Westbury, NY) was used for the identification of HP-infected participants . The frequency was 79.7% (192 / 241) for the GG genotype, 19.5% (47 / 241) for the GA genotype, and 0.8% (2 / 241) for the AA genotype . The sex-age-adjusted odds ratio (OR) relative to GG was 0.69 (95% confidence interval (CI), 0.35 -- 1.35) for individuals with the A allele, but among male participants the OR was 0.31 (0.11 -- 0.84) . Subgroup analysis revealed significantly reduced ORs with the GA / AA genotypes for current smokers (0.19, 0.04 -- 0.96), and for those who were occasional / no milk drinkers (0.25, 0.09 -- 0.72) . These findings are consistent with the results for IL-1B in our earlier study, suggesting that inflammatory responses in the gastric mucosa may influence persistent HP infection, and that smoking and milk intake may be effect-modifiers.

J Clin Microbiol, 2001 Jun, 39(6), 2283 - 6
Comparative study using amplified fragment length polymorphism fingerprinting, PCR genotyping, and phenotyping to differentiate Campylobacter fetus strains isolated from animals; Wagenaar JA et al.; A collection of Campylobacter fetus strains, including both C . fetus subsp . fetus and C . fetus subsp . venerealis, were phenotypically identified to the subspecies level and genotypically typed by PCR and amplified fragment length polymorphism (AFLP) analysis . Phenotypic subspecies determination methods were unreliable . Genotyping of the strains by PCR and AFLP showed a clear discrimination between the two subspecies.

J Clin Microbiol, 2001 Jun, 39(6), 2166 - 72
Coinfection of enteric Helicobacter spp . and Campylobacter spp . in cats; Shen Z et al.; During a 6-year period, 64 of 227 commercially reared cats had microaerobic bacteria isolated from their feces . All the isolates were initially identified as Campylobacter-like organisms based on biochemical and phenotypic characteristics . DNA extractions from 51 of these isolates were subjected to PCR using primers specific for Helicobacter spp . and Campylobacter spp . Of the isolates, 92% (47 of 51 isolates) were positive for Campylobacter spp., 41% (21 of 51 isolates) were positive for Helicobacter spp., 33% (17 of 51 isolates) were positive for both genera, 59% (30 of 51 isolates) were positive only for Campylobacter spp., and 8% (4 of 51) were positive only for Helicobacter spp . Sixteen of the 47 Campylobacter-positive cultures were positive for more than one Campylobacter spp . Based on a species-specific PCR assay, 83% of the isolates were identified as Campylobacter helveticus, 47% of the isolates were identified as Campylobacter upsaliensis, and 6% of the isolates were classified as Campylobacter jejuni . The 1.2-kb PCR products of the 16S rRNA genes of 19 Helicobacter species isolates were subjected to restriction fragment length polymorphism (RFLP) analysis . Of the five different RFLP patterns obtained, two clustered with Helicobacter ("Flexispira") taxon 8, one clustered with Helicobacter bilis, one clustered with Helicobacter canis, and the remaining pattern was closely related to a novel Helicobacter sp . strain isolated from a woodchuck . The sequence data for the 16S rRNA genes of 10 Helicobacter spp . validated the RFLP-based identification of these isolates . This study demonstrated that biochemical and phenotypic characteristics of microaerobic organisms in cat feces were insufficient to characterize mixed Helicobacter and Campylobacter infections . Molecular structure-based diagnostics using genus- and species-specific PCR, RFLP analysis, and 16S rRNA sequence analysis enabled the identification of multiple microaerobic species in individual animals . The clinical relevance of enteric Helicobacter and Campylobacter coinfection in cats will require further studies.

J Clin Microbiol, 2001 Jun, 39(6), 2134 - 9
Etiology of children's diarrhea in Montevideo, Uruguay: associated pathogens and unusual isolates; Torres ME et al.; We studied microorganisms associated with infant diarrhea in a group of 256 children admitted to a public pediatric hospital in Montevideo, Uruguay . Diagnostic procedures were updated to optimize detection of potential pathogens, which were found in 63.8% of cases, and to be able to define their characteristics down to molecular or antigenic type . Coinfection with two or more agents was detected in more than one-third of positive studies . Escherichia coli enteric virotypes, especially enteropathogenic E . coli (EPEC), were shown to be prevalent . Rotavirus, Cryptosporidium, Campylobacter (mainly Campylobacter jejuni), and Shigella flexneri were also often identified . Enterotoxigenic E . coli, Salmonella, and Giardia lamblia were sporadically recognized . Unusual findings included two enteroinvasive E . coli strains, one Shigella dysenteriae 2 isolate, and a non-O:1 Vibrio cholerae culture . EPEC bacteria and S . flexneri (but not Salmonella) showed unusually frequent antimicrobial resistance, especially towards beta-lactam antibiotics, which is the subject of ongoing work.

Appl Environ Microbiol, 2001 Jun, 67(6), 2739 - 45
Evidence that certain clones of Campylobacter jejuni persist during successive broiler flock rotations; Petersen L et al.; Through the national surveillance program for Campylobacter spp., nine broiler chicken farms that were infected with Campylobacter jejuni in at least five rotations in 1998 were identified . One additional farm, located at the island of Bornholm where divided slaughter is used extensively, was also selected . Twelve broiler houses located on 10 farms were included in the study . The C . jejuni isolates collected from the selected houses during the surveillance were typed using fla typing and macrorestriction profiling (MRP), and a subset of the isolates, representing each of the identified clones, was serotyped according to the Penner scheme . Pulsed-field gel electrophoresis typing using SmaI and KpnI revealed that the majority of houses (11 of 12) carried identical isolates in two or more broiler flocks . Such persistent clones were found in 63% of all flocks (47 of 75) . The majority of persistent clones (7 of 13) had fla type 1/1, but MRPs distinguished between isolates from different houses, and fla type 1/1 clones belonged to different serotypes . Seven houses carried persistent clones that covered an interval of at least four broiler flock rotations, or at least one half year . The dominant fla type (1/1) was represented by 44% of isolates, or by at least one isolate from 31 of 62 broiler flocks . This significantly exceeded the prevalence of fla type 1/1 C . jejuni isolates that we have estimated from other studies and suggests that isolates carrying this fla type are overrepresented in flocks with recurrent Campylobacter problems . The MRPs of clones belonging to fla type 1/1 serotype O:2 isolated from persistently infected flocks shared a high percentage of bands compared to the remaining isolates, indicating that some clones that have the ability to cause persistent infections in broiler farms are highly related to each other.

Appl Environ Microbiol, 2001 Jun, 67(6), 2636 - 40
Changes in the carriage of Campylobacter strains by poultry carcasses during processing in abattoirs; Newell DG et al.; The recent development of simple, rapid genotyping techniques for Campylobacter species has enabled investigation of the determinative epidemiology of these organisms in a variety of situations . In this study we have used the technique of fla typing (PCR-restriction fragment length polymorphism analysis of the flaA and flaB genes) to identify the sources of strains contaminating the carcasses of five campylobacter-positive and two campylobacter-negative broiler flocks during abattoir processing . The results confirmed that, in the United Kingdom, individual broiler flocks are colonized by a limited number of subtypes of Campylobacter jejuni or C . coli . In some but not all cases, the same subtypes, isolated from the ceca, contaminated the end product as observed in carcass washes . However, the culture methodology, i.e, use of direct plating or enrichment, affected this subtype distribution . Moreover, the number of isolates analyzed per sample was limited . fla typing also indicated that some campylobacter subtypes survive poultry processing better than others . The extent of resistance to the environmental stresses during processing varied between strains . The more robust subtypes appeared to contaminate the abattoir environment, surviving through carcass chilling, and even carrying over onto subsequent flocks . From these studies it is confirmed that some campylobacter-negative flocks reach the abattoir but the carcasses from such flocks are rapidly contaminated by various campylobacter subtypes during processing . However, only some of these contaminating subtypes appeared to survive processing . The sources of this contamination are not clear, but in both negative flocks, campylobacters of the same subtypes as those recovered from the carcasses were isolated from the crates used to transport the birds . In one case, this crate contamination was shown to be present before the birds were loaded.

J Int Assoc Physicians AIDS Care, 1995 Jul, 1(6), 30 - 3
HIV and peripheral neuropathy; Germaniskis L et al.; AIDS: Manifestations and treatments of many types of common illnesses associated with peripheral neuropathy (PN) in HIV-infected people are presented . Specific topics examine Guillain-Barre syndrome, chronic inflammatory demyelinating neuropathy, mononeuritis multiplex, distal symmetrical polyneuropathy, CMV polyradiculopathy, neurotoxic neuropathy, and Campylobacter jejuni infection . Physicians who treat HIV-1 patients should be aware that PNs are common, disabling, and treatable complications of HIV-1 disease and that treatment efficacy depends on making the correct diagnosis using neurological examinations and electrodiagnostic studies .

Mol Microbiol, 2001 May, 40(3), 769 - 77
A phase-variable capsule is involved in virulence of Campylobacter jejuni 81-176; Bacon DJ et al.; Campylobacter jejuni strain 81-176 (HS36, 23) synthesizes two distinct glycan structures, as visualized by immunoblotting of proteinase K-digested whole-cell preparations . A site-specific insertional mutant in the kpsM gene results in loss of expression of a high-molecular-weight (HMW) glycan (apparent Mr 26 kDa to > 85 kDa) and increased resolution of a second ladder-like glycan (apparent Mr 26-50 kDa) . The kpsM mutant of 81-176 is no longer typeable in either HS23 or HS36 antisera, indicating that the HMW glycan structure is the serodeterminant of HS23 and HS36 . Both the kpsM-dependent HMW glycan and the kpsM-independent ladder-like structure appear to be capsular in nature, as both are attached to phospholipid rather than lipid A . Additionally, the 81-176 kpsM gene can complement a deletion in Escherichia coli kpsM, allowing the expression of an alpha2,8 polysialic acid capsule in E . coli . Loss of the HMW glycan in 81-176 kpsM also increases the surface hydrophobicity and serum sensitivity of the bacterium . The kpsM mutant is also significantly reduced in invasion of INT407 cells and reduced in virulence in a ferret diarrhoeal disease model . The expression of the kpsM-dependent capsule undergoes phase variation at a high frequency.

Can J Microbiol, 2001 Apr, 47(4), 322 - 31
Comparison of the activity spectra against pathogens of bacterial strains producing a mutacin or a lantibiotic; Morency H et al.; The increase of drug resistance among bacterial pathogens is currently a major threat in hospital settings . New and more efficient antibiotic compounds have to be developed to fight infectious diseases . In the present work, a deferred antagonism test was used to determine the activity of different bacterial strains producing either a mutacin or a lantibiotic against bacterial pathogens . The mutacins A, B, C, D, I, K, L, M, and nisins A and Z were active against all enterococci tested . Mutacins A and B, and nisins A and Z inhibited all the staphylococci tested . Except for the strains producing mutacins P, Q, and X, all the other producing strains inhibited the streptococci tested . Mutacins A, B, I, J, T, nisins A and Z, and epidermin inhibited the two antibiotic-resistant strains of Neisseria gonorrhoeae tested . Mutacins A, B, C, D, and nisins A and Z inhibited Campylobacter jejuni and Helicobacter pylori . Thus, the wide activity spectra of nisin A and Z are confirmed . These results also indicate that many of the mutacins, especially those of groups A, B, C, D, I, J, K, L, M, and T, could be candidates for further development as useful antibiotics.

J Clin Periodontol, 2001 Jun, 28(6), 576 - 82
PCR detection of 5 putative periodontal pathogens in dental plaque samples from children 2 to 12 years of age; Okada M et al.; BACKGROUND, AIMS: The purpose of this study was to detect the presence of Prevotella intermedia, P . nigrescens, Bacteroides forsythus, Treponema denticola, and Campylobacter rectus in plaque samples from 119 children, collected from their toothbrushes using a polymerase chain reaction (PCR) . METHOD: The subjects were 24, 83, and 12 children with healthy gingiva, gingivitis, and periodontitis, respectively, ranging in age from 2-12 years old . Plaque samples were collected from all erupted teeth sites using a sterile toothbrush . The mean concentration of DNA recovered from the plaque samples was approximately 640 microg/ml, which was deemed sufficient for performing a PCR-based survey . RESULTS: The prevalence by PCR in healthy, gingivitis, and periodontitis subjects was 0.0%, 6.0% and 25.0% for P . intermedia, 45.8%, 79.5% and 50.0% for P . nigrescens, 33.3%, 63.9% and 58.3% for B . forsythus, 0.0%, 18.1% and 16.7% for T . denticola, and 100% in duplicate for C . rectus, respectively . CONCLUSION: Our survey indicated that P . intermedia and T . denticola were more associated with periodontal diseases, B . forsythus and P . nigrescens had a moderate prevalence in all clinical groups, while C . rectus were the most commonly detected species in the oral cavities of children suggesting establishment in their early years.

J Food Prot, 2001 May, 64(5), 730 - 3
Effects of feed withdrawal and transport on cecal environment and Campylobacter concentrations in a swine surgical model; Harvey RB et al.; The objective of the present study was to evaluate how feed withdrawal and transportation influenced the cecal environment and cecal populations of Campylobacter in swine . Four miniature Yucatan gilts (8.8 kg), naturally infected with Campylobacter jejuni, were surgically implanted with cecal cannulas . The gilts were fasted for 48 h . Samples of cecal contents were collected for 7 days prior to and for 7 days after the fast, and mean values were determined for pH, volatile fatty acids (VFA), and CFU enumeration of C . jejuni . This was replicated three times . In another trial, gilts (full-fed) were transported in a livestock trailer for 4 h and cecal samples were collected before and after transport and analyzed for pH, VFA, and CFU . Following a 48-h fast, cecal pH increased (P < 0.05) by 1 unit; acetic and propionic acids decreased (P < 0.05) by 61% and 71%, respectively; and there was a twofold log10 increase (P < 0.05) in CFU/g cecal content of C . jejuni . Values of pH, VFA, and CFU of C . jejuni did not change in cecal samples from gilts following transportation . These data are important for food safety considerations because feed withdrawal, commonly associated with shipping and slaughter, can increase Campylobacter concentrations in the pig intestinal tract.

J Food Prot, 2001 May, 64(5), 645 - 51
Genotypic variation among arcobacter isolates from a farrow-to-finish swine facility; Hume ME et al.; Arcobacter spp . were isolated from nursing sows and developing pigs on three farms of a farrow-to-finish swine operation and market-age pigs at slaughter . Isolates were identified by polymerase chain reaction and genotypic fragment patterns were examined by pulsed-field gel electrophoresis (PFGE) . Incidences of Arcobacter-positive samples increased progressively as the pigs aged, resulting in all of the pens at the end of the growth cycle in the finishing barn containing Arcobacter-positive feces . However, only 10 of 350 cecal samples from slaughtered pigs were positive . There was little similarity between genotypic patterns for Arcobacter collected from the three farms . The level of genotypic variation revealed by PFGE suggested that pigs in this farrow-to-finish operation were colonized by multiple Arcobacter parent genotypes that may have undergone genomic rearrangement, common to members of Campylobacteraceae, during successive passages through the animals . Additionally, the level of genotypic diversity seen among Arcobacter isolates from farms of a single farrow-to-finish swine operation suggests an important role for genotypic phenotyping as a source identification and monitoring tool during outbreaks.

J Food Prot, 2001 May, 64(5), 630 - 4
Enrichment media for isolation of Campylobacter jejuni from inoculated ground beef and chicken skin under normal atmosphere; Wonglumsom W et al.; The efficiency of Hunt broth containing Oxyrase was compared with the gas replacement method for detection of Campylobacter jejuni in inoculated ground beef and chicken skin . Five strains of C . jejuni were inoculated individually into samples and cultured with various media under conditions generated by either flushing with a mixture of gases or supplementing with Oxyrase . Oxyrase media added with 7% lysed blood, 2.5% charcoal, or 6% ground cooked meat were compared with examinations from chicken skin samples . Campylobacter counts from enrichments were performed at 6, 12, 20, and 28 h of incubation . From inoculated ground beef, counts at 20 h increased by 4 to 7 log CFU/ml depending on strains and initial concentration of inocula . The efficiencies of Hunt medium using gassing and those with Oxyrase added were similar (P > 0.05) . Broth containing 0.15 U/ml of Oxyrase without blood effectively supported the growth of all strains (P > 0.05) . From inoculated chicken skin, 20-h incubation counts increased by 3.0 to 7.5 log CFU/ml for the gassing method and by 2.7 to 7.3 log CFU/ml for supplementation with 0.6 U/ml of Oxyrase and blood . The addition of 7% lysed sheep blood provided better Campylobacter growth than supplementing with 2.5% charcoal or 6% ground cooked meat . Enrichment media incorporating with Oxyrase is a simple, convenient, and time-saving method to replace flushing with mixed gas for isolation of Campylobacter jejuni.

Planta Med, 2001 Apr, 67(3), 263 - 9
Microbiological status of commercially available medicinal herbal drugs--a screening study; Czech E et al.; One hundred and thirty-eight medicinal herbal drugs obtained from different suppliers were examined for microbial contaminants and for the detectability of pathogenic microorganisms . For this purpose, several microbiological standard parameters (total aerobic mesophilic count, enterobacteria, coliforms, aerobic sporeformers, yeasts and moulds, enterococci, lactobacilli, pseudomonades and aeromades) and selective methods for the detection of indicator microorganisms and pathogens (E . coli, enterohaemorrhagic E . coli {EHEC}, Salmonella, Campylobacter jejuni, Pseudomonas aeruginosa, Bacillus cereus, Clostridium perfringens, Listeria, coagulase-positive staphylococci, Candida albicans, potentially aflatoxigenic moulds) were applied . The microbial load of the samples varied considerably . While none of the samples contained EHEC, Salmonellae, Pseudomonas aeruginosa, Listeriae, Staphylococcus aureus or Candida albicans, four samples were E . coli positive, two samples were presumptively Campylobacter jejuni positive and nine herbal drugs contained a potentially aflatoxigenic mould flora . Further details regarding different viable count classes as well as preparation techniques are discussed.

J Infect Dis, 2001 Jun 1, 183(11), 1701 - 4 Epub 2001 Apr 25.
Antimicrobial-resistant bacterial diarrhea in rural western Kenya; Shapiro RL et al.; Bacterial diarrheal diseases cause substantial morbidity and mortality in sub-Saharan Africa, but data on the epidemiology and antimicrobial susceptibility patterns of enteric bacterial pathogens are limited . Between May 1997 and April 1998, a clinic-based surveillance for diarrheal disease was conducted in Asembo, a rural area in western Kenya . In total, 729 diarrheal specimens were collected, and 244 (33%) yielded >or=1 bacterial pathogen, as determined by standard culture techniques; 107 (44%) Shigella isolates, 73 (30%) Campylobacter isolates, 45 (18%) Vibrio cholerae O1 isolates, and 33 (14%) Salmonella isolates were identified . Shigella dysenteriae type 1 accounted for 22 (21%) of the Shigella isolates . Among 112 patients empirically treated with an antimicrobial agent and whose stool specimens yielded isolates on which resistance testing was done, 57 (51%) had isolates that were not susceptible to their antimicrobial treatment . Empiric treatment strategies for diarrheal disease in western Kenya need to be reevaluated, to improve clinical care.

J Infect Dis, 2001 Jun 1, 183(11), 1607 - 16 Epub 2001 May 01.
Secretion of the virulence-associated Campylobacter invasion antigens from Campylobacter jejuni requires a stimulatory signal; Rivera-Amill V et al.; Campylobacter jejuni are a common cause of human diarrheal illness . Previous work has demonstrated that C . jejuni synthesize a novel set of proteins upon coculturing with epithelial cells, some of which are secreted . The secreted proteins have been collectively referred to as Campylobacter invasion antigens (Cia proteins) . Metabolic labeling experiments revealed that Cia protein synthesis and secretion are separable and that secretion is the rate-limiting step of these processes . Additional work indicated that Cia protein synthesis is induced in response to bile salts and various eukaryotic host cell components . Host cell components also can induce Cia protein secretion . Culturing C . jejuni on plates supplemented with the bile salt deoxycholate retarded the inhibitory effect of chloramphenicol on C . jejuni invasion, as judged by the gentamicin-protection assay . These data suggest that the coordinate expression of the genes encoding the Cia proteins is subject to environmental regulation.

J Autoimmun, 2001 May, 16(3), 241 - 56
Molecular mimicry in Campylobacter jejuni and Helicobacter pylori lipopolysaccharides: contribution of gastrointestinal infections to autoimmunity; Moran AP et al.; Molecular mimicry of host structures by the saccharide portion of lipopolysaccharides (LPS) of the gastrointestinal pathogens Campylobacter jejuni and Helicobacter pylori is thought to be associated with the development of autoimmune sequelae . C . jejuni, a leading cause of gastroenteritis, is the most common antecedent infection in Guillain-Barre syndrome (GBS), an inflammatory neuropathy . Chemical analyses of the core oligosaccharides of neuropathy-associated C . jejuni strains have revealed structural homology with human gangliosides . Serum antibodies against gangliosides are found in one third of GBS patients but are generally absent in enteritis cases . Collective data suggest that the antibodies are induced by antecedent infection with C . jejuni, and subsequently react with nerve tissue causing damage . The O-chains of most H . pylori strains express Lewis blood group antigens which are thought to have a role in camouflage of the bacterium as these antigens are also present on human gastric epithelial cells . In chronic H . pylori infections, bacterial expression of Lewis antigens is suggested to be involved in the induction of autoantibodies against the Lewis antigen-expressing gastric proton pump . Many aspects of the autoimmune mechanisms in C . jejuni -associated GBS and H . pylori -induced atrophic gastritis remain unclear, such as the involvement of T cells and the role of host factors .

Eur J Oral Sci, 2001 Feb, 109(1), 34 - 9
Periodontal infections and pre-term birth: early findings from a cohort of young minority women in New York; Mitchell-Lewis D et al.; The aim of this report is to provide early data from an ongoing study examining (i) the relationship between periodontal infections and pre-term low birth weight (PLBW) in a cohort of young, minority, pregnant and post-partum women; and (ii) the effect of periodontal interventions on pregnancy outcome . During the first 2 yr of the study, 213 women were enrolled and examined clinically for dental plaque, calculus, bleeding on probing, and probing depth . Birth outcome data were available for 164 women, including one group (n = 74) subjected to oral prophylaxis during pregnancy, and a second group (n=90) who received no prenatal periodontal treatment . Subgingival plaque samples were available from 145 subjects (4 samples/subject) and were analyzed by checkerboard DNA hybridization with respect to 12 bacterial species . The prevalence of PLBW was 16.5% (27 cases) in this cohort . No differences in clinical periodontal status were observed between PLBW cases and women with normal birth outcome . However, PLBW mothers had significantly higher levels of Bacteroides forsythus and Campylobacter rectus, and consistently elevated counts for the other species examined . PLBW occurred in 18.9% of the women who did not receive periodontal intervention (17 cases), and in 13.5% (10 cases) of those who received such therapy.

Helicobacter, 2001 Mar, 6(1), 24 - 30
The accuracy of serologic diagnosis of Helicobacter pylori infection in school-aged children of mixed ethnicity; Tindberg Y et al.; The present study evaluated two non-invasive diagnostic methods for H . pylori infection in children, i.e . an in-house ELISA using sonicated Campylobacter jejuni antigen for absorption of cross-reacting antibodies and an immunoblot kit (Helico Blot 2.0, Genelabs, Singapore) . 13C -Urea breath test (13C-UBT) was used as reference METHOD: Sera and questionnaires were collected from 695/858 (81%) Swedish school children with mixed ethnic backgrounds within a cross-sectional, community-based study . Of 133 children with an ELISA OD value of > or = 0.1, all were screened with immunoblot and 107 made a 13C-UBT . The negative controls were 34/37 children from three school classes with an ELISA OD value of < 0.1 and volunteering for a 13C-UBT . An adjusted cut-off level for the ELISA of OD value 0.22 resulted in a sensitivity of 97.8%, a specificity of 95.8% and a concordance index of 97.2% . The Helico Blot 2.0 had a sensitivity of 97.8%, a specificity of 93.8% and a concordance index of 96.5% . The best concordance was seen for the 26.5 kDa (98.6%), 30 kDa (95.7%) and 19.5 kDa (91.5%) antigens . The corresponding concordance index for CagA was 78%, for VacA 73.8% and for the 35kDa antigen 68.8% . A significant difference in the distribution of the 19.5 and 26.5 kDa bands but not of CagA/VacA was noted by ethnic background . With an adjusted cut-off level for the enzyme-linked immunosorbent assay (ELISA), both non-invasive methods were found to have an adequate performance in a pediatric population . The differences in antibody response patterns by ethnic background represent a caveat in the interpretation of serological studies.

Acta Neurol Scand, 2001 May, 103(5), 278 - 87
Antecedent symptoms in Guillain-Barré syndrome: an important indicator for clinical and serological subgroups; Koga M et al.; OBJECTIVES: To examine whether Guillain-Barre syndrome (GBS) can be classified in clinical and immunological subgroups based on the type of prior illness . Background - The existence of antecedent symptoms supports the diagnosis of GBS in patients who experience acute muscle weakness progression . However, little is known about additional meanings of determining antecedent symptoms . MATERIALS AND METHODS: Prospective investigation of prior infectious illness in GBS and related disorders (n=176) . RESULTS: The frequent antecedent symptoms in GBS and related disorders were fever (52%), cough (48%), sore throat (39%), nasal discharge (30%), and diarrhea (27%) . Patients who had sore throats or coughs frequently had ophthalmoparesis (respectively P=0.0004, P=0.001) and IgG anti-GQ1b antibody (P=0.01, P=0.007) . Fever was associated with bulbar palsy (P=0.047) and headache with facial palsy (P=0.04) . Patients with diarrhea often had anti-ganglioside IgG (anti-GM1 {P=0.0006} and anti-GM1b {P=0.008}), IgM (anti-GM1 {P=0.03}, anti-GM1b {P=0.02}, and anti-GalNAc-GD1a {P=0.047}) antibodies and rarely showed ophthalmoparesis or bulbar palsy (respectively P=0.02, P=0.04) . Diarrhea and abdominal pain were closely associated with Campylobacter jejuni serology (respectively P<0.0001, P=0.01), whereas other symptoms were not related to pathogens such as cytomegalovirus, Epstein-Barr virus, or Mycoplasma pneumoniae . CONCLUSIONS: Our comprehensive study showed that GBS preceded by sore throat, cough, fever, headache, or diarrhea respectively forms clinical or serological subgroups, or both . This association is not necessarily dependent on infection by the known trigger pathogens.

Acta Neurol Scand, 2001 May, 103(5), 267 - 77
Axonal Guillain-Barré syndrome: a critical review; Chowdhury D et al.; Axonal Guillain-Barre Syndrome (GBS) was first described by Feasby et al . in 1986, challenging the existent notion of GBS being a primarily demyelinating disease . The severe course and slow recovery commonly seen in these patients was ascribed to axonal degeneration . Other authors challenged this claim on several grounds . Amidst these controversies, epidemics of a similar illness were reported from China, which were given the acronym AMAN, having exclusive motor involvement in contrast to the cases already described in which both motor and sensory involvement were present (AMSAN) . Pathologically, Wallerian degeneration, minimal lymphocytic response, absent demyelination or inflammation and periaxonal macrophages are prominent features . Ultrastructural studies have revealed node of Ranvier to be the prime target of immune attack . A frequent occurrence of antecedent Campylobacter jejuni infection and a strong association between elevated titres of IgG GM1 and axonal GBS on a background of preceding C . jejunii infection has been observed and molecular mimicry between lipopolysaccharides of C . jejuni and neural epitopes has been proposed as a mechanism of injury . Clinically axonal variant is similar to AIDP, but a more severe course, with frequent respiratory involvement, ventilator dependence and significant residue may be seen . Diagnosis is essentially electrophysiological . Treatment is similar to AIDP, preferential benefit of either IVIG or plasmapheresis needs to be further evaluated . A critical review of existing literature in axonal GBS is presented.

J Periodontal Res, 2001 Apr, 36(2), 108 - 13
Antimicrobial activity of silver nitrate against periodontal pathogens; Spacciapoli P et al.; Metal ions were evaluated as potential antimicrobial agents suitable for local delivery in the oral cavity for the treatment of periodontitis . Silver nitrate, copper chloride, and zinc chloride were tested for antimicrobial activity in in vitro killing assays conducted in phosphate buffered saline with a series of oral bacteria including gram-negative periodontal pathogens and gram-positive streptococci . Copper and zinc salts failed to exhibit strong and consistent activity against periodontal pathogens . In contrast, silver at a concentration of 0.5 microg/mL produced a 3 log10 reduction in colony forming units (CFU)/mL or greater against all periodontal pathogens tested including Porphyromonas gingivalis, Prevotella intermedia, Prevotella denticola, Bacteroides forsythus, Fusobacterium nucleatum vincentii, Campylobacter gracilis, Campylobacter rectus, Eikenella corrodens, and Actinobacillus actinomycetemcomitans . In comparison, substantially higher concentrations of silver nitrate failed to kill oral streptococci . A silver nitrate concentration of 25 microg/mL produced log10 reductions in CFU/mL of 3.5-5 in killing assays performed in human serum against P . gingivalis, demonstrating the ability of silver to retain activity in a biological medium similar to that encountered in vivo in the periodontal pocket . These results identify silver nitrate, an antimicrobial that may possess advantages over traditional antibiotics, as a potential agent for controlled release local delivery in the oral cavity for the treatment of periodontitis.

J Periodontol, 2001 Mar, 72(3), 368 - 73
Relationship of periodontopathic bacteria with early-onset periodontitis in Down's syndrome; Amano A et al.; BACKGROUND: Down's syndrome (DS) patients often develop severe early-onset marginal periodontitis in early adulthood; however, there is little information available on the microbiology of DS periodontitis . METHODS: Subgingival plaque specimens were taken from 67 DS young adults and 41 age-matched systemically healthy individuals with mental disabilities (MD) . The prevalence of 10 possible periodontopathic bacterial species, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Treponema denticola, Prevotella intermedia, Prevotella nigrescens, Capnocytophaga ochracea, Capnocytophaga sputigena, Campylobacter rectus, and Eikenella corrodens, were investigated in their subgingival plaque samples using a polymerase chain reaction method . The detection of P . gingivalis fimA genotypes was also performed in P . gingivalis-positive samples . RESULTS: Although DS subjects generally develop an earlier and more extensive periodontal breakdown than those with MD, no significant differences were observed in the bacterial profiles . The profiles of subjects with periodontitis were significant in DS, but not in MD . The prevalence of P . gingivalis, B . forsythus, and P . intermedia were significant in the DS periodontitis group, compared to DS gingivitis group . Moreover, the occurrence of P . gingivalis with the type II fimA gene was significantly related to periodontitis in both DS and MD, with odds ratios of 6.32 and 12.03, respectively . CONCLUSIONS: These results suggest that early-onset periodontitis in DS is mainly due to the more susceptible host for the causative microbial agents including P . gingivalis with type II fimA.

J Clin Microbiol, 2001 May, 39(5), 1917 - 21
Comparison of two methods for serotyping Campylobacter spp; McKay D et al.; Two serotyping schemes (Penner and Laboratory of Enteric Pathogens {LEP}) based on soluble heat-stable antigens were used to analyze 3,788 Campylobacter sp . isolates . A significant percentage (36.6%) was untypeable using LEP serotyping; greater cross-reaction was also observed . The relative discrimination capabilities of the techniques were similar . Penner serotyping fulfils more of the requisite criteria for typing methods.

J Clin Microbiol, 2001 May, 39(5), 1889 - 94
Rapid pulsed-field gel electrophoresis protocol for subtyping of Campylobacter jejuni; Ribot EM et al.; We developed a rapid pulsed-field gel electrophoresis (PFGE) protocol for subtyping Campylobacter isolates based on the standardized protocols used by PulseNet laboratories for the subtyping of other food-borne bacterial pathogens . Various combinations of buffers, reagents, reaction conditions (e.g., cell suspension concentration, lysis time, lysis temperature, and restriction enzyme concentration), and electrophoretic parameters were evaluated in an effort to devise a protocol that is simple, rapid, and robust . PFGE analysis of Campylobacter isolates can be completed in 24 to 30 h using this protocol, whereas the most widely used current protocols require 3 to 4 days to complete . Comparison of PFGE patterns obtained in six laboratories showed that subtyping results obtained using this protocol are highly reproducible.

Plasmid, 2001 Mar, 45(2), 127 - 33
Molecular characterization of a cryptic plasmid from Campylobacter jejuni; Luo N et al.; Campylobacter jejuni is a leading bacterial cause of human enterocolitis . Molecular genetic characterization of this pathogen has been hampered by the lack of genetic tools that are functional in this organism . Cloning vectors commonly used in other organisms usually do not replicate within C . jejuni . To develop a system for functional analysis of C . jejuni genes, a small plasmid (pCJ01) identified in a poultry isolate of C . jejuni was sequenced and characterized in this study . By using inverse PCR, the full sequence of pCJ01 was amplified and subsequently determined . Results indicate that pCJ01 is a circular molecule of 3212 bp, with a G + C content of 33.5% . A typical plasmid replication origin with iteron sequences is identified upstream of the DNA sequences encoding replication initiation proteins . Four open reading frames (ORFs) are present in pCJ01 . ORF1 and ORF2 share high homology with the putative RepA and RepB proteins, respectively, of known C . coli plasmids . ORF3 and ORF4, of unknown function, do not exhibit homology with any sequences deposited in the GenBank database . Hydropathy analysis predicts that ORF3 and ORF4 contain multiple stretches of hydrophobic amino acids, suggesting that they may encode transmembrane proteins . Since pCJ01 is a small plasmid and can be readily prepared from C . jejuni, it may be modified for use in molecular characterization of C . jejuni virulence genes .

No Shinkei Geka, 2001 Mar, 29(3), 265 - 9
{A case of infected subdural hematoma due to Campyrobacter fetus}; Ishii N et al.; A 20-year-old male presented fever, nausea and headache 1 week after eating uncooked liver . On admission, it was revealed he had suffered a closed head injury 3 months before without unconsciousness . On admission, computed tomography scan showed a left chronic subdural hematoma . Gd-DTPA magnetic resonance images revealed unusual enhancement of the capsule and linear enhancement of the subarachnoid space . The patient underwent burr hole irrigation and drainage . The culture of the hematoma content showed Campylobacter fetus . Therefore, the diagnose was infected subdural hematoma . A drainage operation and administration of antibiotics were effective . Our case suggests that enhanced magnetic resonance images are useful for diagnosis and follow-up of infected subdural hematoma.

Int J Syst Evol Microbiol, 2001 Mar, 51(Pt 2), 651 - 60
Campylobacter hominis sp . nov., from the human gastrointestinal tract; Lawson AJ et al.; Sequences of 16S rDNA of a novel campylobacter from faeces of healthy humans were previously shown to originate from a new taxon, 'Candidatus Campylobacter hominis', which could not be cultured . Since phylogenetic analysis suggested that anaerobic conditions might be required for growth, an isolation strategy was developed employing initial non-selective membrane filtration onto fastidious anaerobe agar . Campylobacters were then isolated from the resulting mixed microbial flora by a dilution strategy and/or by immunomagnetic separation with genus-specific polyclonal antibody . Isolates were identified by a genus and taxon-specific PCR assay, and 16S rDNA nucleotide sequence analysis was carried out . All isolates exhibited the typical Campylobacter characteristics of being non-fermentative, oxidase-positive, catalase-negative and Gram-negative . Unusually, however, they were straight rods lacking flagella . The 16S rDNA nucleotide sequence analysis, DNA and mol% G+C were consistent with a new Campylobacter species whose nearest phylogenetic neighbours were Campylobacter gracilis and Campylobacter sputorum . The unique species status of the isolates was further confirmed by taxonomic analysis of 47 phenotypic characteristics . The name Campylobacter hominis sp . nov . is proposed for the new species, the type strain of which is NCTC 13146T (= LMG 19568T).

East Afr Med J, 2001 Jan, 78(1), 40 - 4
Foodborne diseases in Kenya; Ombui JN et al.; OBJECTIVES: To determine the occurrence of foodborne disease outbreaks in Kenya and the efforts employed to combat them . DESIGN: Cross-sectional survey . SETTING: Forty two districts in Kenya between 1970 and 1993 . STUDY SUBJECTS: Foodborne disease outbreak episodes due to Staphylococcus aureus, Clostridium perfringens, Clostridium botulinum, Bacillus cereus, Escherichia coli, Campylobacter jejuni, Yersinia enterocolitica, Listera monocytogenes, chemicals, aflatoxin, plant and animal poisons . OUTCOME MEASURES: Number and aetiological causes of foodborne disease outbreaks reported in the study period . RESULTS: Thirty seven food poisoning outbreaks were reported to the Ministry of Health from various parts of the country in the study period 1970 to 1993, and only 13 of these involving a total of 926 people were confirmed to be due to particular aetiological agents . Foods that were involved included milk and milk products, meat and meat products, maize flour, bread, scones and other wheat products, vegetables and lemon pie pudding . A high number of food poisoning cases were treated as outpatients in various health facilities . CONCLUSION: Under-reporting, inadequate investigation of outbreaks and inadequate diagnostic facilities suggest that foodborne disease outbreaks are more than is recorded by the Ministry of Health.

Appl Environ Microbiol, 2001 May, 67(5), 2388 - 92
Study of the infectivity of saline-stored Campylobacter jejuni for day-old chicks; Hald B et al.; The culturability of three Campylobacter jejuni strains and their infectivity for day-old chicks were assessed following storage of the strains in saline . The potential for colonization of chicks was weakened during the storage period and terminated 3 to 4 weeks before the strains became nonculturable . The results from this study suggest that the role of starved and aged but still culturable campylobacters may be diminutive, but even more, that the role of viable but nonculturable stages in campylobacter epidemiology may be negligible . Even high levels of maternally derived anti-campylobacter outer membrane protein serum antibodies in day-old chicks did not protect the chicks from campylobacter colonization.

Appl Environ Microbiol, 2001 May, 67(5), 2248 - 54
Survival of Campylobacter jejuni during stationary phase: evidence for the absence of a phenotypic stationary-phase response; Kelly AF et al.; When Campylobacter jejuni NCTC 11351 was grown microaerobically in rich medium at 39 degrees C, entry into stationary phase was followed by a rapid decline in viable numbers to leave a residual population of 1% of the maximum number or less . Loss of viability was preceded by sublethal injury, which was seen as a loss of the ability to grow on media containing 0.1% sodium deoxycholate or 1% sodium chloride . Resistance of cells to mild heat stress (50 degrees C) or aeration was greatest in exponential phase and declined during early stationary phase . These results show that C . jejuni does not mount the normal phenotypic stationary-phase response which results in enhanced stress resistance . This conclusion is consistent with the absence of rpoS homologues in the recently reported genome sequence of this species and their probable absence from strain NCTC 11351 . During prolonged incubation of C . jejuni NCTC 11351 in stationary phase, an unusual pattern of decreasing and increasing heat resistance was observed that coincided with fluctuations in the viable count . During stationary phase of Campylobacter coli UA585, nonmotile variants and those with impaired ability to form coccoid cells were isolated at high frequency . Taken together, these observations suggest that stationary-phase cultures of campylobacters are dynamic populations and that this may be a strategy to promote survival in at least some strains . Investigation of two spontaneously arising variants (NM3 and SC4) of C . coli UA585 showed that a reduced ability to form coccoid cells did not affect survival under nongrowth conditions.

J Neurol Neurosurg Psychiatry, 2001 May, 70(5), 693 - 5
Comparative study of preceding Campylobacter jejuni infection in Guillain-Barré syndrome in Japan and The Netherlands; Koga M et al.; A comparative study was made in Japan and The Netherlands of the presence of preceding Campylobacter jejuni infections in Guillain-Barre syndrome (GBS) . It was conducted in two laboratories using different serological criteria . The Japanese results showed no significant difference in the frequency of C jejuni infection between the Japanese (17/88, 19%) and Dutch (21/132, 16%) patients with GBS . The Dutch investigation showed a higher frequency in Dutch patients (45/132; 34%) than in Japanese patients(20/88; 23%), but the difference did not reach significance . Although the frequencies of preceding C jejuni infection have been reported to be higher in Asian countries than in western countries, the findings of this collaborative study show that the incidence of antecedent C jejuni infection in GBS in Japan is not higher than in The Netherlands and that serological assays vary considerably between laboratories.

J Food Prot, 2001 Apr, 64(4), 538 - 41
Quantification of the contamination of chicken and chicken products in the netherlands with Salmonella and Campylobacter; Dufrenne J et al.; The research described in this contribution provides quantitative data on contamination levels with Salmonella and Campylobacter in chicken and chicken products in The Netherlands at retail level using the most probable number method and direct counting . Most samples contained <10 Salmonella per carcass, both in fresh (89%) and frozen (68%) products, contamination levels with Campylobacter varied from <10 (18%) to more than 5,500 (18%) per fresh carcass . Most frozen samples (57%) contained < 10 Campylobacter per carcass.

J Food Prot, 2001 Apr, 64(4), 503 - 8
Microbial contamination occurring on lamb carcasses processed in the United States; Duffy EA et al.; Lamb carcasses (n = 5,042) were sampled from six major lamb packing facilities in the United States over 3 days during each of two visits (fall or winter, October through February; spring, March through June) in order to develop a microbiological baseline for the incidence (presence or absence) of Salmonella spp . and for populations of Escherichia coli after 24 h of chilling following slaughter . Samples also were analyzed for aerobic plate counts (APC) and total coliform counts (TCC) . Additionally, incidence (presence or absence) of Campylobacter jejuni/coli on lamb carcasses (n = 2,226) was, determined during the slaughtering process and in the cooler . All samples were obtained by sponge-sampling the muscle-adipose tissue surface of the flank, breast, and leg of lamb carcasses (100 cm2 per site; 300 cm2 total) . Incidence of Salmonella spp . in samples collected from chilled carcasses was 1.5% for both seasons combined, with 1.9% and 1.2% of fall or winter and spring samples being positive, respectively . Mean (log CFU/cm2) APC, TCC, and E . coli counts (ECC) on chilled lamb carcasses across both seasons were 4.42, 1.18, and 0.70, respectively . APC were lower (P < 0.05) in samples collected in the spring versus fall or winter, while TCC were higher in samples collected in the spring . There was no difference (P > 0.05) between ECC from samples collected in the spring versus winter . Only 7 out of 2,226 total samples (0.3%) tested positive for C . jejuni/coli, across all sampling sites . These results should be useful to the lamb industry and regulatory authorities as new regulatory requirements for meat inspection become effective.

Int J Adult Orthodon Orthognath Surg, 2000 Winter, 15(4), 321 - 30
Comparison of microbial composition in the subgingival plaque of adult crowded versus non-crowded dental regions; Chung CH et al.; It has been reported in the literature that certain species of bacteria (periodontopathogens) present in the subgingival plaque are associated with destructive periodontal disease . The purpose of this study was to investigate and compare the presence and proportional distribution of periodontopathogens in the subgingival plaque of adult crowded versus non-crowded dental regions . Thirty adult patients with anterior dental crowding were selected from the Orthodontic Clinic of the University of Pennsylvania . After orthodontic records were taken and the periodontal examination was performed, subgingival plaque samples were collected from crowded (experimental) and contralateral non-crowded regions (control) of each patient . The presence of 9 periodontopathic species, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Eikenella corrodens, Campylobacter rectus, Capnocytophaga species, Fusobacterium species, Peptostreptococcus micros, Porphyromonas gingivalis, and Bacteroides forsythus, was determined using culture and immunofluorescence techniques . The bacterial morphotype was also determined by the use of dark-field microscopy . It was found that supragingival plaque accumulation in crowded regions was significantly greater than in non-crowded regions . Analysis of the bacteria showed that the samples from crowded regions consistently contained more species of periodontopathogens than the samples from non-crowded regions . Morphologically, more spirochetes and motile rods were present in the crowded-region samples . In terms of the presence of individual periodontopathogens, Fusobacterium species, Capnocytophaga species, C rectus, and P micros were significantly more common in the crowded samples than in the non-crowded samples . It was concluded that: (1) more plaque accumulated in crowded areas; (2) more species of periodontopathogens were present in the subgingival plaque of crowded regions; (3) morphologically, more spirochetes and motile rods were present in crowded areas; and (4) Fusobacterium species, Capnocytophaga species, C rectus, and P micros were present more often in crowded areas than in non-crowded areas (P < 0.05).

J Am Geriatr Soc, 2001 Mar, 49(3), 304 - 7
Outbreak of campylobacteriosis at a senior center; Winquist AG et al.; OBJECTIVES: In August 1997, campylobacteriosis was diagnosed in four older persons in one Connecticut town . We investigated this outbreak to determine its cause and to identify appropriate preventive measures . We also analyzed surveillance data to assess the impact of campylobacteriosis among persons age 65 years and older in Connecticut . DESIGN: The outbreak was investigated through a case-control study and an environmental investigation . Surveillance data were from population-based, active foodborne disease surveillance . SETTING: The outbreak and environmental studies were conducted at a senior center identified as the one eating place common to all four patients . Active surveillance data were from three Connecticut counties during 1996/1997 . PARTICIPANTS: We administered a questionnaire to senior center attendees . A case was defined as onset of diarrhea with fever or abdominal cramps during August 20-25 in a person who ate at the senior center during August 18-20 . Respondents without illness meeting the case definition who ate at the senior center during August 18-20 were controls . MEASUREMENTS: Case-control study participants were asked about symptoms of gastrointestinal illness and meals and foods eaten at the center . The environmental investigation gathered information about food preparation procedures and facilities . Active surveillance data were analyzed to determine age-specific annual campylobacteriosis incidence rates and proportions of cases involving hospitalization . RESULTS: For the case-control study, there were 66 respondents (16 case patients, 50 controls), representing approximately 52% of August 18-20 attendees . Case patients were more likely than controls to have eaten at a Hawaiian luau at the center . The most strongly implicated food was sweet potatoes . Review of food preparation procedures identified multiple opportunities for cross-contamination from raw meats to other foods . In Connecticut's active surveillance area during 1996/1997, the annual campylobacteriosis incidence rate was highest among young adults, but the proportion of hospitalized cases was highest among persons age 70 years and older . CONCLUSION: Campylobacter transmission occurred at the luau, likely because of cross-contamination in the kitchen . This investigation emphasizes the importance of strict separation of raw meats from other foods during preparation . Careful attention to these measures is particularly important when an older population is served.

Lett Appl Microbiol, 2001 Apr, 32(4), 253 - 6
Role of batch depletion of broiler houses on the occurrence of Campylobacter spp . in chicken flocks; Hald B et al.; AIMS: The effect of batch depletion of broiler houses for campylobacter occurrence in broiler flocks was estimated in 10 flocks, each comprising a separate female and male batch . METHODS AND RESULTS: The chicks were sampled first by cloacal swabs in the broiler houses before the start of the depopulation and secondly, on arrival at the abattoir . Females were slaughtered at 5 weeks of age, males at 6 weeks . The number of campylobacter-positive batches increased from five to seven female batches, and from five to 10 male batches, between the two sampling rounds . CONCLUSION: It is concluded that batch depletion of broiler houses increased the prevalence of Campylobacter spp.-infected broilers in the flocks, that the introduction occurred when catching the first batch, and that campylobacter spreads through the entire flock within a week . SIGNIFICANCE AND IMPACT OF THE STUDY: The results from this study emphasize the need to manage depopulation of broiler houses as quickly as possible and in one batch only.

Mol Microbiol, 2001 Apr, 40(1), 214 - 24
Transposon mutagenesis of Campylobacter jejuni identifies a bipartite energy taxis system required for motility; Hendrixson DR et al.; Campylobacter jejuni constitutes the leading cause of bacterial gastroenteritis in the United States and a major cause of diarrhoea worldwide . Little is known about virulence mechanisms in this organism because of the scarcity of suitable genetic tools . We have developed an efficient system of in vitro transposon mutagenesis using a mariner-based transposon and purified mariner transposase . Through in vitro transposition of C . jejuni chromosomal DNA followed by natural transformation of the transposed DNA, large random transposon mutant libraries consisting of approximately 16 000 individual mutants were generated . The first genetic screen of C . jejuni using a transposon-generated mutant library identified 28 mutants defective for flagellar motility, one of the few known virulence determinants of this pathogen . We developed a second genetic system, which allows for the construction of defined chromosomal deletions in C . jejuni, and demonstrated the requirement of sigma28 and sigma54 for motility . In addition, we show that sigma28 is involved in the transcription of flaA and that sigma54 is required for transcription of three other flagellar genes, flaB and flgDE . We also identified two previously uncharacterized genes required for motility encoding proteins that we call CetA and CetB, which mediate energy taxis responses . Through our analysis of the Cet proteins, we propose a unique mechanism for sensing energy levels and mediating energy taxis in C . jejuni.

Emerg Infect Dis, 2001 Mar-Apr, 7(2), 337 - 41
Emerging mechanisms of fluoroquinolone resistance; Hooper DC; Broad use of fluoroquinolones has been followed by emergence of resistance, which has been due mainly to chromosomal mutations in genes encoding the subunits of the drugs' target enzymes, DNA gyrase and topoisomerase IV, and in genes that affect the expression of diffusion channels in the outer membrane and multidrug-resistance efflux systems . Resistance emerged first in species in which single mutations were sufficient to cause clinically important levels of resistance (e.g., Staphylococcus aureus and Pseudomonas aeruginosa) . Subsequently, however, resistance has emerged in bacteria such as Campylobacter jejuni, Escherichia coli, and Neisseria gonorrhoeae, in which multiple mutations are required to generate clinically important resistance . In these circumstances, the additional epidemiologic factors of drug use in animals and human-to-human spread appear to have contributed . Resistance in Streptococcus pneumoniae, which is currently low, will require close monitoring as fluoroquinolones are used more extensively for treating respiratory tract infections.

J Biol Chem, 2001 Jul 6, 276(27), 24557 - 64 Epub 2001 Apr 05.
Tungstate Uptake by a highly specific ABC transporter in Eubacterium acidaminophilum; Makdessi K et al.; The Gram-positive anaerobe Eubacterium acidaminophilum contains at least two tungsten-dependent enzymes: viologen-dependent formate dehydrogenase and aldehyde dehydrogenase . (185)W-Labeled tungstate was taken up by this organism with a maximum rate of 0.53 pmol min(-)1 mg(-)1 of protein at 36 degrees C . The uptake was not affected by equimolar amounts of molybdate . The genes tupABC coding for an ABC transporter specific for tungstate were cloned in the downstream region of genes encoding a tungsten-containing formate dehydrogenase . The substrate-binding protein, TupA, of this putative transporter was overexpressed in Escherichia coli, and its binding properties toward oxyanions were determined by a native polyacrylamide gel retardation assay . Only tungstate induced a shift of TupA mobility, suggesting that only this anion was specifically bound by TupA . If molybdate and sulfate were added in high molar excess (>1000-fold), they were also slightly bound by TupA . The K(d) value for tungstate was determined to be 0.5 microm . The genes encoding the tungstate-specific ABC transporter exhibited highest similarities to putative transporters from Methanobacterium thermoautotrophicum, Haloferax volcanii, Vibrio cholerae, and Campylobacter jejuni . These five transporters represent a separate phylogenetic group of oxyanion ABC transporters as evident from analysis of the deduced amino acid sequences of the binding proteins . Downstream of the tupABC genes, the genes moeA, moeA-1, moaA, and a truncated moaC have been identified by sequence comparison of the deduced amino acid sequences . They should participate in the biosynthesis of the pterin cofactor that is present in molybdenum- and tungsten-containing enzymes except nitrogenase.

J Bacteriol, 2001 May, 183(9), 2937 - 42
Roles of rpoN, fliA, and flgR in expression of flagella in Campylobacter jejuni; Jagannathan A et al.; Three potential regulators of flagellar expression present in the genome sequence of Campylobacter jejuni NCTC 11168, the genes rpoN, flgR, and fliA, which encode the alternative sigma factor sigma(54), the sigma(54)-associated transcriptional activator FlgR, and the flagellar sigma factor sigma(28), respectively, were investigated for their role in global regulation of flagellar expression . The three genes were insertionally inactivated in C . jejuni strains NCTC 11168 and NCTC 11828 . Electron microscopic studies of the wild-type and mutant strains showed that the rpoN and flgR mutants were nonflagellate and that the fliA mutant had truncated flagella . Immunoblotting experiments with the three mutants confirmed the roles of rpoN, flgR, and fliA in the expression of flagellin.

Food Addit Contam, 2001 Feb, 18(2), 129 - 36
A survey of ethnic foods for microbial quality and aflatoxin content; Candlish AAG et al.; A range of ethnic foods was examined for their microbiological content in relation to total viable counts (TVC) of aerobic bacteria, counts of presumptive coliforms, yeast and mould counts; presence of Salmonella spp., Listeria monocytogenes, Escherichia coli O157:H7 and Campylobacter spp.; total enumeration of Clostridium perfringens, Staphylococcus aureus and Bacillus spp.; identification of moulds and the presence of total aflatoxins . Samples, which included cereals, nuts, dried fruits, herbs and spices, were obtained from local retail outlets and distributors . It was established that three samples of pistachio nuts contained significant levels of aflatoxins . The concentration of total aflatoxins in these three nut samples ranged from 15 to 259 microg/kg of sample . Only two other samples contained trace amounts of aflatoxins, all other samples analysed were found to be free of any detectable level of aflatoxins . TVCs, coliform counts and yeast and mould counts varied widely depending on the matrix tested . Generally, rice, wheat and peanuts produced low counts whereas other nuts, gram flour and spices produced much higher counts . Cl . perfringens, Staph . aureus, and Bacillus spp . were common in spices, nuts and gram flour, however, Listeria monocytogenes was only detected in four samples and in no sample could Salmonella spp, E . coli O157:H7 or Campylobacter spp . be detected.

FEMS Microbiol Lett, 2001 Apr 1, 197(1), 23 - 7
Shared antigenicity between Helicobacter pylori and periodontopathic Campylobacter rectus strains; Ishihara K et al.; Periodontopathic Campylobacter rectus strains possess 41- and 68-kDa proteinaceous antigens which share antigenicity with antigens of Helicobacter pylori strains . H . pylori strains have a 54-kDa antigen which reacts with C . rectus strains . We found that the salivary IgA levels against H . pylori were correlated with those against C . rectus . These cross-reactive antigens of C . rectus may affect the serological diagnosis of H . pylori infections, especially when saliva is used . It is possible that these cross-reacting antigens may relate to the induction of immunopathological responses against both microorganisms.

Curr Infect Dis Rep, 2001 Apr, 3(2), 116 - 122
Campylobacter Enteritis and the Guillain-Barré Syndrome; Nachamkin I; Campylobacter jejuni is one of the most common causes of bacterial gastroenteritis in the United States and worldwide with approximately 2.4 million infections per year in the United States . A now clearly recognized sequelae following Campylobacter infection is the Guillain-Barre syndrome, an acute immune-mediated attack on the peripheral nervous system . How Campylobacter induces Guillain-Barre syndrome is the subject of intense investigation, and this article discusses some of the recent advances in our understanding of the clinical, epidemiologic, and pathogenic features of the disease.

Clin Infect Dis, 2001 Apr 15, 32(8), 1201 - 6 Epub 2001 Mar 28.
Campylobacter jejuni Infections: update on emerging issues and trends; Allos BM; Infection with Campylobacter jejuni is one of the most common causes of gastroenteritis worldwide; it occurs more frequently than do infections caused by Salmonella species, Shigella species, or Escherichia coli O157:H7 . In developed countries, the incidence of Campylobacter jejuni infections peaks during infancy and again during early adulthood . Most infections are acquired by the consumption and handling of poultry . A typical case is characterized by diarrhea, fever, and abdominal cramps . Obtaining cultures of the organism from stool samples remains the best way to diagnose this infection . An alarming recent trend is the rapid emergence of antimicrobial agent--resistant Campylobacter strains all over the world . Use of antibiotics in animals used for food has accelerated this trend . It is fortunate that complications of C . jejuni infections are rare, and most patients do not require antibiotics . Guillain-Barre syndrome is now recognized as a post-infectious complication of C . jejuni infection, but its incidence is <1 per 1000 infections . Careful food preparation and cooking practices may prevent some Campylobacter infections.

J Clin Microbiol, 2001 Apr, 39(4), 1494 - 500
Development of an immunoassay for rapid detection of ganglioside GM(1) mimicry in Campylobacter jejuni strains; Prendergast MM et al.; Mimicry of peripheral nerve gangliosides by Campylobacter jejuni lipopolysaccharides (LPSs) has been proposed to induce cross-reacting antiganglioside antibodies in Guillain-Barre syndrome (GBS) . Because current methods for LPS characterization are labor-intensive and inhibit the screening of large numbers of strains, a rapid GM(1) epitope screening assay was developed . Biomass from two agar plates of confluent growth yielded sufficient LPS using a novel phenol-water and ether extraction procedure . Extracts of LPS were reacted with cholera toxin (GM(1) ligand), peanut agglutinin (Gal beta1-->3GalNAc ligand), and anti-GM(1) antibodies . After the assay was validated, 12 of 59 (20%) C . jejuni serostrains, including four serotypes that have not previously been associated with GBS, reacted with two or more anti-GM(1) ganglioside reagents . Subsequently, LPS extracts from 5 of 7 (71%) C . jejuni isolates and 2 of 3 (67%) C . jejuni culture collection strains bore GM(1) structures . Overall, the assay system was reliable, efficient, and reproducible and may be adapted for large-scale epidemiological studies.

J Clin Microbiol, 2001 Apr, 39(4), 1353 - 9
Molecular characterization of invasive and noninvasive Campylobacter jejuni and Campylobacter coli isolates; Carvalho AC et al.; Campylobacter jejuni is one of the most common causes of bacterial diarrhea worldwide and is the primary bacterial cause of food-borne illness . Adherence to and invasion of epithelial cells are the most important pathogenic mechanisms of Campylobacter diarrhea . Molecular characterization of invasive and noninvasive Campylobacter isolates from children with diarrhea and symptom-free children was performed by random amplified polymorphic DNA techniques (RAPD) . A distinct RAPD profile with a DNA band of 1.6 kb was observed significantly more frequently among invasive (63%) than among noninvasive (16%) Campylobacter isolates (P = 0.000005) . The 1.6-kb band was named the invasion-associated marker (IAM) . Using specifically designed primers, a fragment of 518 bp of the iam locus was amplified in 85% of invasive and 20% of noninvasive strains (P = 0.0000000) . Molecular typing with a PCR-restriction fragment length polymorphism assay which amplified the entire iam locus showed a HindIII restriction fragment polymorphism pattern associated mainly with invasive strains . Although cluster analysis of the RAPD fingerprinting showed genetic diversity among strains, two main clusters were identified . Cluster I comprised significantly more pathogenic and invasive isolates, while cluster II grouped the majority of nonpathogenic, noninvasive isolates . These data indicate that most of the invasive Campylobacter strains could be differentiated from noninvasive isolates by RAPD analysis and PCR using specific primers that amplify a fragment of the iam locus.

Appl Environ Microbiol, 2001 Apr, 67(4), 1581 - 6
Genomic relatedness within five common Finnish Campylobacter jejuni pulsed-field gel electrophoresis genotypes studied by amplified fragment length polymorphism analysis, ribotyping, and serotyping; Hanninen ML et al.; Thirty-five Finnish Campylobacter jejuni strains with five SmaI/SacII pulsed-field gel electrophoresis (PFGE) genotypes selected among human and chicken isolates from 1997 and 1998 were used for comparison of their PFGE patterns, amplified fragment length polymorphism (AFLP) patterns, HaeIII ribotypes, and heat-stable (HS) serotypes . The discriminatory power of PFGE, AFLP, and ribotyping with HaeIII were shown to be at the same level for this selected set of strains, and these methods assigned the strains into the same groups . The PFGE and AFLP patterns within a genotype were highly similar, indicating genetic relatedness . The same HS serotypes were distributed among different genotypes, and different serotypes were identified within one genotype . HS serotype 12 was only associated with the combined genotype G1 (PFGE-AFLP-ribotype) . These studies using polyphasic genotyping methods suggested that common Finnish C . jejuni genotypes form genetic lineages which colonize both humans and chickens.

Appl Environ Microbiol, 2001 Apr, 67(4), 1429 - 36
Use of pulsed-field gel electrophoresis and flagellin gene typing in identifying clonal groups of Campylobacter jejuni and Campylobacter coli in farm and clinical environments; Fitzgerald C et al.; Although campylobacters have been isolated from a wide range of animal hosts, the association between campylobacters isolated from humans and animals in the farm environment is unclear . We used flagellin gene typing and pulsed-field gel electrophoresis (PFGE) to investigate the genetic diversity among isolates from animals (cattle, sheep, and turkey) in farm environments and sporadic cases of campylobacteriosis in the same geographical area . Forty-eight combined fla types were seen among the 315 Campylobacter isolates studied . Six were found in isolates from all four hosts and represented 50% of the total number of isolates . Seventy-one different SmaI PFGE macrorestriction profiles (mrps) were observed, with 86% of isolates assigned to one of 29 different mrps . Fifty-seven isolates from diverse hosts, times, and sources had an identical SmaI mrp and combined fla type . Conversely, a number of genotypes were unique to a particular host . We provide molecular evidence which suggests a link between campylobacters in the farm environment with those causing disease in the community.

Commun Dis Public Health, 2000 Dec, 3(4), 274 - 6
Family clusters of campylobacter infection; Ribeiro CD et al.; Possible family clusters of campylobacter infection among isolates referred to a single, large public health laboratory were reviewed to determine the proportion of clusters associated with more than one strain of campylobacter . A total of 23 clusters, each made up of members of a single household infected within two months of each other, were identified between September 1996 and January 1999 . These accounted for about 5% of all campylobacter infections confirmed during the study period . Thirteen of these families were infected with single strains of C . jejuni and one with C . coli . In ten families specimens were taken over intervals ranging from six to 56 days . In eight clusters more than one strain of C . jejuni was identified and in one family two patients were infected with C . jejuni and one with C . lari . These findings are consistent with the observation that potential sources of campylobacter infection may be contaminated with more than one strain.

C R Acad Sci III, 2001 Feb, 324(2), 115 - 22
Influence of gangliosides or LPS-like gangliosides on the tumoricidal activity of adherent leukocytes; Thomas C et al.; We previously showed that highly metastatic clones derived from the poorly metastatic human melanoma cell line M4Be are very radiosensitive provided that they are deficient in complex gangliosides . Here, we report that the highly metastatic clone 4 appears more sensitive to activated adherent leukocytes than M4Be via a transmembrane TNF-alpha-dependent mechanism . Adherent leukocytes (AL) were freshly isolated from different blood donors and were activated with Esherichia coli lipopolysaccharide (LPS) . These AL contain 80% (73-93%) monocytes, 15% (6-20%) B lymphocytes and 5% (1-8%) T lymphocytes . The tumour cell survival following contact with AL was estimated with a clonogenic assay where isolated tumour cells were plated for 14 days with AL . We show on the one hand that either exogenous bovine brain GM1 gangliosides or Campylobacter jejuni LPS with GM1-like structure (LPS-like GM1) significantly decrease the hypersensitivity of clone 4 to AL . On the other hand, the cleaving with neuraminidase of more than 50% of the sialic residues bound to endogenous gangliosides in resistant M4Be cells significantly increases their sensitivity to AL . Thus, our highly metastatic cells appear both very sensitive to activated AL when they are deficient in complex gangliosides and resistant to AL when they are transiently exposed to exogenous gangliosides or LPS-like gangliosides . These in vitro data may reflect the paradoxidal behaviour of highly metastatic cells in vivo which appear both very sensitive to physiological stresses and able to survive to form secondary tumours.

Neurology, 2001 Mar 27, 56(6), 758 - 65
Preceding infections, immune factors, and outcome in Guillain-Barré syndrome; Hadden RD et al.; OBJECTIVE: To test the hypothesis that different preceding infections influence the neurophysiologic classification and clinical features of Guillain-Barre syndrome (GBS) . METHODS: We tested pretreatment sera, 7 +/- 3 (mean +/- SD) days from onset, from 229 patients with GBS in a multicenter trial of plasma exchange and immunoglobulin, for serological markers of infection, adhesion molecules, and cytokine receptors, and compared these with neurophysiologic and clinical features . RESULTS: Recent infection by Campylobacter jejuni was found in 53 patients (23%), cytomegalovirus in 19 (8%), and Epstein-Barr virus in four (2%) . Patients with C . jejuni infection were more likely than others to have neurophysiologic criteria of axonal neuropathy or inexcitable nerves, antiganglioside GM(1) antibodies, pure motor GBS, lower CSF protein, and worse outcome . Patients with cytomegalovirus infection were younger and more likely than others to have raised serum concentrations of molecules important in T lymphocyte activation and migration, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble leukocyte selectin, and soluble interleukin-2 receptor (sIL-2R) . Concentrations of sICAM-1 and soluble tumor necrosis factor receptor were higher in patients with inexcitable nerves than those with demyelinating neurophysiology . Logistic regression analysis showed death or inability to walk unaided at 48 weeks were associated with diarrhea, inexcitable nerves, severe arm weakness, age over 50, raised sIL-2R concentration and absence of immunoglobulin (Ig) M antiganglioside GM(1) antibodies . CONCLUSIONS: Subtypes of GBS defined by preceding infections were only approximately associated with different patterns of clinical, neurophysiologic, and immunologic features . A single infectious agent caused more than one type of pathology in GBS, implying interaction with additional host factors . Most patients had no identified infection.

J Bacteriol, 2001 Apr, 183(8), 2553 - 9
Allelic diversity and recombination in Campylobacter jejuni; Suerbaum S et al.; The allelic diversity and population structure of Campylobacter jejuni were studied by multilocus nucleotide sequence analysis . Sequences from seven housekeeping genes were obtained from 32 C . jejuni isolates isolated from enteritis patients in Germany, Hungary, Thailand, and the United States . Also included was strain NCTC 11168, the complete genomic sequence of which has recently been published . For all loci analyzed, multiple strains carried identical alleles . The frequency of synonymous and nonsynonymous sequence polymorphisms was low . The number of unique alleles per locus ranged from 9 to 15 . These alleles occurred in 31 different combinations (sequence types), so that all but two pairs of strains could be distinguished from each other . Sequences were analyzed for evidence of recombination by the homoplasy test and split decomposition . These analyses showed that intraspecific recombination is frequent in C . jejuni and has generated extensive diversity of allelic profiles from a small number of polymorphic nucleotides.

J Food Prot, 2001 Feb, 64(2), 252 - 4
Difficulty in recovering inoculated Campylobacter jejuni from dry poultry-associated samples; Cox NA et al.; We inoculated 5 cm2 of clean chick pads, 5 g of clean pine shavings, and fresh unsanitized broiler breeder eggshell halves with a cell suspension of Campylobacter jejuni in physiological saline . Inoculation levels were 10(2), 10(3), or 10(4) cells per sample . The samples were allowed to remain at room temperature for 15, 30, or 60 min before addition of enrichment broth . When chick pad samples were inoculated with 102 cells, by 15 min 40% of the samples had detectable levels of Campylobacter, and by 30 to 60 min Campylobacter could be detected in only 20% of the samples . With samples of pine shavings, only 25% of those inoculated with 103 cells were positive for Campylobacter after 15 min and only 5% were positive for Campylobacter after 30 min . When 104 cells were inoculated onto litter, Campylobacter was recovered from 20% of the samples at 15 min and 15% of the samples after 30 min . Eggshells were also found to be a harsh environment . When the inoculum was 102 at 15 min, 8 of 10 samples were positive for Campylobacter but at 60 min only 10% of the samples remained positive for Campylobacter . The current cultural methods may not be adequate for recovering low numbers of Campylobacter from dry samples . Campylobacter may be present but culturally undetectable in the commercial hatchery and hatchery environment.

J Food Prot, 2001 Feb, 64(2), 184 - 8
Presence and level of Campylobacter, coliforms, Escherichia coli, and total aerobic bacteria recovered from broiler parts with and without skin; Berrang ME et al.; This study was undertaken to determine if broiler chicken parts without skin are less contaminated with Campylobacter than those with skin . Samples were taken in a commercial plant from defeathered carcasses before evisceration . Bacterial counts from rinse of aseptically removed meat samples were lower than those from stomached skin samples . No Campylobacter were recovered from meat collected from the breasts or thighs, and only 2 of 10 drumstick meat samples had detectable levels of Campylobacter . However, 9 of 10 breast skin, 10 of 10 thigh skin, and 8 of 10 drumstick skin samples were positive for Campylobacter, with between 2 and 3 log10 CFU/g of Campylobacter . Breasts, thighs, and drumsticks were removed from broiler carcasses following evisceration before entering the chill tank . There was a significant difference (50 to 90%) in the levels of Campylobacter on breasts, thighs, and drumsticks with and without skin . Similar trends were noted for coliform, Escherichia coli, and total aerobic bacterial counts from samples collected in the plant . Broiler part samples were also collected at retail outlets . These samples were either skin on and skinned in the laboratory or skin off at purchase . Aseptic removal of skin from broiler breasts, thighs, and drumsticks did not cause change in Campylobacter, coliform, E . coli, or total aerobic counts recovered from the skinned part . Likewise, parts purchased without skin did not have different bacterial counts than paired parts purchased with the skin on . Consumers should not expect to significantly lower the number of bacteria present on a chicken breast, thigh, or drumstick by removing the skin.

J Food Prot, 2001 Feb, 64(2), 172 - 8
Extent of microbial contamination in United States pork retail products; Duffy EA et al.; To determine the extent of microbiological contamination of U.S . pork, 384 samples of retail pork were collected from 24 stores in six cities, including (i) whole-muscle, store-packaged pork; (ii) fresh, store-packaged ground pork and/or pork sausage; (iii) prepackaged ground pork and/or pork sausage; and (iv) whole-muscle, enhanced (injected or marinated; 60% store-packaged, 40% prepackaged) pork . Additional samples (n = 120) of freshly ground pork and/or pork sausage were collected from two hot-boning sow/boar sausage plants, two slaughter and fabrication plants, and two further-processing plants . Samples were analyzed for aerobic plate counts (APC), total coliform counts (TCC), Escherichia coli counts (ECC), and incidences of Salmonella spp., Listeria monocytogenes, Campylobacter jejuni, Campylobacter coli, and Yersinia enterocolitica . Mean log APC and TCC were highest (P < 0.05) for store-ground pork, while whole-muscle, enhanced products and prepackaged ground products had the lowest (P < 0.05) APC . Mean log APC and TCC were higher (P < 0.05) in samples from the slaughter and fabrication plants than in samples from hot-boning and further processing plants . Mean log ECC were lower (P < 0.05) in samples from further-processing plants compared to slaughter and fabrication plants and hot-boning, sow and boar sausage plants . L . monocytogenes was detected in 26.7% of plant samples and 19.8% of retail samples and was present more frequently in ground products . Y . enterocolitica was detected most often in whole-muscle, store-packaged cuts (19.8%) and in store-ground product (11.5%) . Salmonella spp . were found in 9.6% of retail samples and 5.8% of plant samples, while C . jejuni and C . coli were found in 1.3% of retail samples and 6.7% of plant samples . Pork products exposed to the most handling and processing appeared to be of the poorest microbiological quality . These results should be useful in risk assessments that are directed at the identification of actions that could enhance food safety.

FEMS Microbiol Lett, 2001 Mar 15, 196(2), 189 - 93
The iron-induced ferredoxin FdxA of Campylobacter jejuni is involved in aerotolerance; van Vliet AH et al.; A gene encoding a putative 2{4Fe--4S} ferredoxin (FdxA) was identified upstream of, and divergent to the peroxide stress defense gene ahpC of the microaerophilic pathogen Campylobacter jejuni . The transcription start site of fdxA was located 27 and 28 bp upstream of the fdxA start codon . Transcriptional fusions of the fdxA promoter to a lacZ reporter gene demonstrated that expression of fdxA is iron-induced, and thus oppositely regulated to the iron-repressed ahpC gene . Insertional mutagenesis of the fdxA gene did not affect microaerobic growth of C . jejuni, but significantly reduced aerotolerance of C . jejuni . The fdxA gene is the first reported iron-induced gene of C . jejuni, and encodes a novel component of its oxidative stress defense.

Emerg Infect Dis, 2001 Jan-Feb, 7(1), 82 - 91
Gastroenteritis in sentinel general practices,The Netherlands; de Wit MA et al.; From 1996 to 1999, the incidence of gastroenteritis in general practices and the role of a broad range of pathogens in the Netherlands were studied . All patients with gastroenteritis who had visited a general practitioner were reported . All patients who had visited a general practitioner for gastroenteritis (cases) and an equal number of patients visiting for nongastrointestinal symptoms (controls) were invited to participate in a case-control study . The incidence of gastroenteritis was 79.7 per 10,000 person years . Campylobacter was detected most frequently (10% of cases), followed by Giardia lamblia (5%), rotavirus (5%), Norwalk-like viruses (5%) and Salmonella (4%) . Our study found that in the Netherlands (population 15.6 million), an estimated 128,000 persons each year consult their general practitioner for gastroenteritis, slightly less than in a comparable study in 1992 to 1993 . A pathogen could be detected in almost 40% of patients (bacteria 16%, viruses 15%, parasites 8%).

Emerg Infect Dis, 2001 Jan-Feb, 7(1), 24 - 34
Quinolone and macrolide resistance in Campylobacter jejuni and C . coli: resistance mechanisms and trends in human isolates; Engberg J et al.; The incidence of human Campylobacter jejuni and C . coli infections has increased markedly in many parts of the world in the last decade as has the number of quinolone-resistant and, to a lesser extent, macrolide-resistant Campylobacter strains causing infections . We review macrolide and quinolone resistance in Campylobacter and track resistance trends in human clinical isolates in relation to use of these agents in food animals . Susceptibility data suggest that erythromycin and other macrolides should remain the drugs of choice in most regions, with systematic surveillance and control measures maintained, but fluoroquinolones may now be of limited use in the empiric treatment of Campylobacter infections in many regions.

Methods Cell Sci, 2000, 22(2-3), 209 - 15
Flow cytometric detection of host cell apoptosis induced by bacterial infection; Konkel ME et al.; We detail two methods for detection of cell death induced by infection of a human monocytic cell line with invasive Campylobacter bacteria . Staining with a natural ligand for exposed phosphatidylserine residues coupled with propidum iodide discriminated between apoptosis and necrosis . Additionally, cells infected with a bacterial strain expressing green fluorescent protein stained with dye sensitive to mitochondrial membrane potential demonstrated a direct association of bacteria with dying cells . Analyses of cells stained by these methods employing flow cytometry enumerated proportions of cell populations undergoing either apoptosis or necrosis after bacterial infection in vitro.

Poult Sci, 2001 Mar, 80(3), 278 - 83
Effect of lactic acid administration in the drinking water during preslaughter feed withdrawal on Salmonella and Campylobacter contamination of broilers; Byrd JA et al.; The crop is a known source of Salmonella and Campylobacter contamination . We evaluated the use of selected organic acids (0.5% acetic, lactic, or formic) in drinking water during a simulated 8-h pretransport feed withdrawal (FW) . Salmonella typhimurium was recovered from 53/100 control crops and from 45/100 of crops from acetic acid-treated broilers . However, treatment with lactic acid (31/100) or formic acid (28/76) caused significant (P < 0.05) reduction in incidence . Reductions of recovered incidence were also associated with reduced numbers of S . typhimurium recovered (e.g., control, log 1.45 cfu/crop; lactic acid, 0.79 cfu/crop) . In an additional commercial farm study, broilers were provided 0.44% lactic acid during a 10-h FW (4 h on the farm and 6 h transport) and pre-FW crop, post-FW crop, and pre-chill carcass wash samples were collected for Campylobacter and Salmonella detection . Crop contamination with Salmonella was significantly reduced by lactic acid treatment (6/175) as compared with controls (29/175) . Importantly, Salmonella isolation incidence in prechill carcass rinses was significantly reduced by 52.4% with the use of lactic acid (26/175 vs . 55/176) . Crop contamination with Campylobacter was significantly reduced by lactic acid treatment (62.3%) as compared with the controls (85.1%) . Lactic acid also reduced the incidence of Campylobacter found on pre-chill carcass rinses by 14.7% compared with the controls . These studies suggest that incorporation of lactic acid in the drinking water during pretransport FW may reduce Salmonella and Campylobacter contamination of crops and broiler carcasses at processing.

Mol Microbiol, 2001 Mar, 39(6), 1546 - 9
Bile-induced 'pili' in Campylobacter jejuni are bacteria-independent artifacts of the culture medium; Gaynor EC et al.; In 1996, it was reported that the enteric pathogen Campylobacter jejuni produces pilus-like appendages in response to bile salts such as deoxycholate (DOC), and that the formation of these appendages requires the putative peptidase PspA . Pili were known to be important virulence determinants in other pathogenic bacteria but had never before been observed for C . jejuni . We report here that these appendages are not pili, but are instead a bacteria-independent morphological artifact of the growth medium . Furthermore, the pspA gene is not required for their formation . Broth cultures containing a threshold concentration of DOC inoculated with no bacteria produced identical abundant, fibrous, pilus-like structures as those cultures that had been inoculated with C . jejuni . These fibres were also found in growth media from DOC-containing pspA:CmR mutant cultures . These results are consistent with the absence of candidate pilin monomers in protein gel analyses as well as the dearth of pilin-like genes and pilus formation gene clusters in the C . jejuni genome.

Am J Epidemiol, 2001 Mar 15, 153(6), 610 - 4
Incidence of Guillain-Barré syndrome following infection with Campylobacter jejuni; McCarthy N et al.; Evidence of recent or ongoing Campylobacter jejuni infection has been found in approximately one out of every four cases of Guillain-Barre syndrome (GBS) . It is increasingly accepted that C . jejuni infection is an important causal factor for GBS . However, the likelihood of GBS' occurring following an episode of C . jejuni gastroenteritis has not been measured . The authors measured the incidence of GBS in a large cohort of persons with laboratory-confirmed C . jejuni infection . Cases of C . jejuni infection were derived from the Swedish national laboratory reporting system for the years 1987--1995 . Follow-up for GBS was carried out using the Swedish national hospital inpatient register . Nine cases of GBS were detected in the cohort, which comprised 29,563 cases of C . jejuni infection--a rate of 30.4 per 100,000 (95% confidence interval: 13.9, 57.8) . This compares with an expected incidence of 0.3 per 100,000 in a 2-month period in the general population . GBS is an important but rare complication of C . jejuni infection . The risk of developing GBS during the 2 months following a symptomatic episode of C . jejuni infection is approximately 100 times higher than the risk in the general population.

Antimicrob Agents Chemother, 2001 Apr, 45(4), 1298 - 301
Bactericidal activities of milk lipids; Sprong RC et al.; The bactericidal capacity of digestion products of bovine milk triglycerides and membrane lipids was tested in vitro using Escherichia coli O157:H7, Salmonella enteritidis, Campylobacter jejuni, Listeria monocytogenes, and Clostridium perfringens . C10:0 and C12:0 fatty acids and digestion products of sphingolipids appeared to be effective bactericidal agents, whereas digestion products of phosphoglycerides were moderately bactericidal . Thus, milk fat sphingolipids and triglycerides, particularly those containing C10:0 and C12:0 fatty acids, may protect against food-borne gastroenteritis.

J Neurol Neurosurg Psychiatry, 2001 Apr, 70(4), 560 - 2
Indicators of rapid clinical recovery in Guillain-Barré syndrome; Kuwabara S et al.; To elucidate the features of patients with Guillain-Barre syndrome who show markedly rapid clinical recovery, clinical, serological, and electrophysiological data of 80 consecutive patients were reviewed . Antigangliosides, and Campylobacter jejuni and Haemophilus influenzae antibodies were measured by enzyme linked immunosorbent assays . Nine (11%) patients showed rapid recovery (improvement by two or more Hughes grades within 2 weeks) . They often had electrodiagnosis of acute motor axonal neuropathy (AMAN; 67%), preserved tendon reflexes (44%), anti-GM1 antibodies (89%), preceding H influenzae infection (44%), and received immunoglobulin treatment (44%) . On the other hand six patients with poor prognosis often had AMAN (100%) and anti-GM1 antibody (83%), but a higher incidence of preceding C jejuni infection (83%) . It is concluded that patients with Guillain-Barre syndrome with AMAN and anti-GM1 antibodies have either faster or slower recoveries . Among the axonal subgroup of patients with Guillain-Barre syndrome, preserved tendon reflexes, H influenzae infection, and the patient having received immunoglobulin treatment may be indicators of rapid recovery.

Infect Immun, 2001 Apr, 69(4), 2462 - 9
Guillain-Barré syndrome- and Miller Fisher syndrome-associated Campylobacter jejuni lipopolysaccharides induce anti-GM1 and anti-GQ1b Antibodies in rabbits; Ang CW et al.; Campylobacter jejuni infections are thought to induce antiganglioside antibodies in patients with Guillain-Barre syndrome (GBS) and Miller Fisher syndrome (MFS) by molecular mimicry between C . jejuni lipopolysaccharides (LPS) and gangliosides . We used purified LPS fractions from five Campylobacter strains to induce antiganglioside responses in rabbits . The animals that received injections with LPS from GBS-associated strains developed anti-GM1 and anti-GA1 antibodies . Animals injected with LPS from one MFS-related C . jejuni strain produced anti-GQ1b antibodies . Rabbits that were injected with Penner O:3 LPS had a strong anti-LPS response, but no antiganglioside reactivity was observed . The antiganglioside specificity in the rabbits reflected the specificity in the patients from whom the strains were isolated . In conclusion, our results indicate that an immune response against GBS- and MFS-associated C . jejuni LPS results in antiganglioside antibodies . These results provide strong support for molecular mimicry as a mechanism in the induction of antiganglioside antibodies following infections.

Infect Immun, 2001 Apr, 69(4), 2237 - 44
Evidence that the Campylobacter fetus sap locus is an ancient genomic constituent with origins before mammals and reptiles diverged; Tu ZC et al.; Campylobacter fetus bacteria, isolated from both mammals and reptiles, may be either subsp . fetus or subsp . venerealis and either serotype A or serotype B . Surface layer proteins, expressed and secreted by genes in the sap locus, play an important role in C . fetus virulence . To assess whether the sap locus represents a pathogenicity island and to gain further insights into C . fetus evolution, we examined several C . fetus genes in 18 isolates . All of the isolates had 5 to 9 sapA or sapB homologs . One strain (85-387) possessed both sapA and sapB homologs, suggesting a recombinational event in the sap locus between sapA and sapB strains . When we amplified and analyzed nucleotide sequences from portions of housekeeping gene recA (501 bp) and sapD (450 bp), a part of the 6-kb sap invertible element, the phylogenies of the genes were highly parallel . Among the 15 isolates from mammals, serotype A and serotype B strains generally had consistent positions . The fact that the serotype A C . fetus subsp . fetus and subsp . venerealis strains were on the same branch suggests that their differentiation occurred after the type A-type B split . Isolates from mammals and reptiles formed two distinct tight phylogenetic clusters that were well separated . Sequence analysis of 16S rRNA showed that the reptile strains form a distinct phylotype between mammalian C . fetus and Campylobacter hyointestinalis . The phylogenies and sequence results showing that sapD and recA have similar G + C contents and substitution rates suggest that the sap locus is not a pathogenicity island but rather is an ancient constituent of the C . fetus genome, integral to its biology.

Biotechniques, 2001 Mar, 30(3), 602 - 6, 608-10
PCR-ELISAs for the detection of Campylobacter jejuni and Campylobacter coli in poultry samples; Grennan B et al.; Campylobacter species, primarily Campylobacter jejuni and Campylobacter coli, are regarded as a major cause of human gastrointestinal disease, commonly acquired by eating undercooked chicken . We describe a PCR-ELISA for the detection of Campylobacter species and the discrimination of C . jejuni and C . coli in poultry samples . The PCR assay targets the 16S/23S ribosomal RNA intergenic spacer region of Campylobacter species with DNA oligonucleotide probes designed for the specific detection of C . jejuni, C . coli, and Campylobacter species immobilized on Nucleo-Link wells and hybridized to PCR products modified with a 5' biotin moiety . The limit of detection of the PCR-ELISA was 100-300 fg (40-120 bacterial cells) for C . jejuni and C . coli with their respective species-specific oligonucleotide probes and 10 fg (4 bacterial cells) with the Campylobacter genus-specific probe . Testing of poultry samples, which were presumptive positive for Campylobacter following culture on the Malthus V analyzer, with the PCR-ELISA determined Campylobacter to be present in 100% of samples (n = 40) with mixed cultures of C . jejuni/C . coli in 55% . The PCR-ELISA when combined with culture pre-enrichment is able to detect the presence of Campylobacter and definitively identify C . jejuni and C . coli in culture-enriched poultry meat samples.

Mol Microbiol, 2001 Mar, 39(5), 1225 - 36
JlpA, a novel surface-exposed lipoprotein specific to Campylobacter jejuni, mediates adherence to host epithelial cells; Jin S et al.; A 1116 bp open reading frame (ORF), designated jlpA, encoding a novel species-specific lipoprotein of Campylobacter jejuni TGH9011, was identified from recombinant plasmid pHIP-O . The jlpA gene encodes a polypeptide (JlpA) of 372 amino acid residues with a molecular mass of 42.3 kDa . JlpA contains a typical signal peptide and lipoprotein processing site at the N-terminus . The presence of a lipid moiety on the JlpA molecule was confirmed by the incorporation of {3H}-palmitic acid . Immunoblotting analysis of cell surface extracts prepared using glycine-acid buffer (pH 2.2) and proteinase K digestion of whole cells indicated that JlpA is a surface-exposed lipoprotein in C . jejuni . JlpA is loosely associated with the cell surface, as it is easily extracted from the C . jejuni outer membrane by detergents, such as sarcosyl and Triton X-100 . JlpA is released to the culture medium, and its concentration increases in a time-dependent fashion . The adherence of both insertion and deletion mutants of jlpA to HEp-2 epithelial cells was reduced compared with that of parental C . jejuni TGH9011 . Adherence of C . jejuni to HEp-2 cells was inhibited in a dose-dependent manner when the bacterium was preincubated with anti-GST-JlpA antibodies or when HEp-2 cells were preincubated with JlpA protein . A ligand-binding immunoblotting assay showed that JlpA binds to HEp-2 cells, which suggests that JlpA is C . jejuni adhesin.

Ann Rheum Dis, 2001 Apr, 60(4), 337 - 43
Frequency of triggering bacteria in patients with reactive arthritis and undifferentiated oligoarthritis and the relative importance of the tests used for diagnosis; Fendler C et al.; OBJECTIVE: Reactive arthritis (ReA) triggered by Chlamydia trachomatis or enteric bacteria such as yersinia, salmonella, Campylobacter jejuni, or shigella is an important differential diagnosis in patients presenting with the clinical picture of an undifferentiated oligoarthritis (UOA) . This study was undertaken to evaluate the best diagnostic approach . PATIENTS AND METHODS: 52 patients with ReA, defined by arthritis and a symptomatic preceding infection of the gut or the urogenital tract, and 74 patients with possible ReA, defined by oligoarthritis without a preceding symptomatic infection and after exclusion of other diagnoses (UOA), were studied . The following diagnostic tests were applied for the identification of the triggering bacterium: for yersinia induced ReA-stool culture, enzyme immunoassay (EIA), and Widal's agglutination test for detection of antibodies to yersinia; for salmonella or campylobacter induced ReA-stool culture, EIA for the detection of antibodies to salmonella and Campylobacter jejuni; for infections with shigella-stool culture; for infections with Chlamydia trachomatis-culture of the urogenital tract, microimmunofluorescence and immunoperoxidase assay for the detection of antibodies to Chlamydia trachomatis . RESULTS: A causative pathogen was identified in 29/52 (56%) of all patients with ReA . In 17 (52%) of the patients with enteric ReA one of the enteric bacteria was identified: salmonella in 11/33 (33%) and yersinia in 6/33 (18%) . Chlamydia trachomatis was the causative pathogen in 12/19 (63%) of the patients with urogenic ReA . In patients with the clinical picture of UOA a specific triggering bacterium was also identified in 35/74 (47%) patients: yersinia in 14/74 (19%), salmonella in 9/74 (12%), and Chlamydia trachomatis in 12/74 (16%) . CONCLUSIONS: Chlamydia trachomatis, yersinia, and salmonella can be identified as the causative pathogen in about 50% of patients with probable or possible ReA if the appropriate tests are used.

Rev Inst Med Trop Sao Paulo, 2001 Jan-Feb, 43(1), 21 - 4
Etiology of acute diarrhea among children in Ribeirão Preto-SP, Brazil; Medeiros MI et al.; To study the main enteropathogens causing diarrhea in the region of Ribeirao Preto regarding serogroups and serotypes, the feces of 1836 children under 10 years old, from both sexes, attack of acute gastroenteritis, were analysed during a period of 4 years in Adolfo Lutz Institute - Ribeirao Preto, SP . The pathogens identified by standard methods were the following: Escherichia coli, Salmonella spp., Shigella spp., Campylobacter spp., Yersinia spp., and Cryptosporidium spp . Positive samples were 22.8% (419) with 1.7% association of pathogens . Larger isolates were mainly from children 0 to 11 months old . Enteropathogenic E . coli (EPEC) was most frequent (8.7%) with predominance of serogroup O119 (40.2%), followed by Shigella (6.2%), 63.6% of which S . sonnei.

Pathol Biol (Paris), 2000 Oct, 48(8), 764 - 9
{Pediatric nosocomial diarrhea}; Languepin J et al.; Nosocomial diarrhea are an important cause of childhood morbidity and mortality . Rotavirus has been recognized as the most important cause of nosocomial gastroenteritidis particularly in infants during winter months . Nosocomial diarrhea are also, caused by bacterial pathogen like Clostridium difficile, Salmonella, Shigella, Campylobacter . Clostridium difficile toxin assay should be considered for patients who are receiving antibiotics . Modifications of hygiene procedures and preventive measures are necessary in order to reduce nosocomial infection.

Pathol Biol (Paris), 2000 Oct, 48(8), 733 - 44
{Role of the microbiology laboratory in the diagnosis of nosocomial diarrhea}; Decre D et al.; Diarrhea that occurs in hospitalized patients is frequent and may be due to infectious or noninfectious causes . In adults with nosocomial diarrhea, the most commonly detected agent is Clostridium difficile; in children, rotaviruses are predominant . Various studies have shown that bacterial enteric pathogens (e.g . Salmonella spp., Shigella spp., Campylobacter spp...) or parasites are common causes of community-acquired diarrhea but rarely cause nosocomial enteritis . Stool cultures for these pathogens and ova and parasite examination should not be performed in patients hospitalized for more than three days unless there are plausible clinical or epidemiological reasons to do so . In contrast, C . difficile toxins assay (and rotavirus screening in children) should be primarily requested . The detection of C . difficile toxin B by stool cytotoxicity assay remains the 'gold standard' . Identification of toxin A (or A + B) can also be performed by immuno-enzymatic (ELISA) tests: results may be obtained in three hours . Electronic microscopy is the standard method for rotavirus diagnosis but tests using latex agglutination or immuno-enzymatic assay are now available . Various typing methods have been developed and may be routinely used in epidemiological investigations.

J Bacteriol, 2001 Apr, 183(7), 2384 - 8
In vitro transposition system for efficient generation of random mutants of Campylobacter jejuni; Colegio OR et al.; Campylobacter jejuni is the most common cause of food-borne illnesses in the United States . Despite the fact that the entire nucleotide sequence of its genome has recently become available, its mechanisms of pathogenicity are poorly understood . This is in part due to the lack of an efficient mutagenesis system . Here we describe an in vitro transposon mutagenesis system based on the Staphylococcus aureus transposable element Tn552 that allows the efficient generation of insertion mutants of C . jejuni . Insertions occur randomly and throughout the entire bacterial genome . We have tested this system in the isolation of nonmotile mutants of C . jejuni . Demonstrating the utility of the system, six nonmotile mutants from a total of nine exhibited insertions in genes known to be associated with motility . An additional mutant had an inactivating insertion in sigma 54, implicating this transcription factor in flagellum regulation . The availability of this efficient system will greatly facilitate the study of the mechanisms of pathogenesis of this important pathogen.

Microbiology, 2001 Mar, 147(Pt 3), 735 - 43
Campylobacter upsaliensis exerts a cytolethal distending toxin effect on HeLa cells and T lymphocytes; Mooney A et al.; Campylobacter upsaliensis is an emerging human enteropathogen . However, little is known about the pathogenesis of C . upsaliensis infection . In this study the authors demonstrate that C . upsaliensis whole-cell preparations and extracts produce a cytolethal distending toxin (CDT)-like effect on HeLa cells characterized by progressive distension and nuclear fragmentation culminating in cell death over 5 d . To further delineate the nature of this toxic effect in relation to CDT from other pathogens, the effect of C . upsaliensis on cellular events in epithelial cells and immunocytes was investigated . C . upsaliensis lysate-treated HeLa cells subjected to FACScan analysis using carboxyfluorescein diacetete succinimidyl ester (CFDA-SE) as a cell tracer demonstrated cell division arrest . Propidium iodide (PI) staining of HeLa cells revealed that cell cycle arrest occurred in G(2)/M . Human T lymphocytes exposed to C . upsaliensis lysates also showed cell cycle arrest in G(2)/M . Using a combination of Annexin V/PI staining and TUNEL assay, cytodistended HeLa cells were shown to undergo apoptotic cell death . These data provide the first insights into the virulence mechanisms of this novel enteropathogen.

Clin Diagn Lab Immunol, 2001 Mar, 8(2), 314 - 9
Antibody responses to Campylobacter infections determined by an enzyme-linked immunosorbent assay: 2-year follow-up study of 210 patients; Strid MA et al.; An enzyme-linked immunosorbent assay (ELISA) was adapted to measure immunoglobulin G (IgG), IgM, and IgA classes of human serum antibody to Campylobacter jejuni and Campylobacter coli . Heat-stable antigen, a combination of C . jejuni serotype O:1,44 and O:53 in the ratio 1:1, was used as a coating antigen in the ELISA test . A total of 631 sera from 210 patients with verified Campylobacter enteritis were examined at various intervals after infection, and a control group of 164 sera were tested to determine the cut-off for negative results . With a 90th percentile of specificity, IgG, IgM, and IgA showed a sensitivity of 71, 60, and 80%, respectively . By combining all three antibody classes, the sensitivity was 92% within 35 days after infection, whereas within 90 days after infection, a combined sensitivity of 90% was found (IgG 68%, IgM 52%, and IgA 76%) . At follow-up of the patients, IgG antibodies were elevated 4.5 months after infection but exhibited a large degree of variation in antibody decay profiles . IgA and IgM antibodies were elevated during the acute phase of infection (up to 2 months from onset of infection) . The antibody response did not depend on Campylobacter species or C . jejuni serotype, with the important exception of response to C . jejuni O:19, the serotype most frequently associated with Guillain-Barre syndrome . All of the patients infected with this serotype had higher levels of both IgM (P = 0.006) and IgA (P = 0.06) compared with other C . jejuni and C . coli serotypes.

J Infect Dis, 2001 Apr 1, 183(7), 1152 - 5 Epub 2001 Feb 28.
Sporadic Campylobacter jejuni infections in Hawaii: associations with prior antibiotic use and commercially prepared chicken; Effler P et al.; Campylobacter is the most common cause of bacterial foodborne illness in the United States, and Hawaii has the highest rate of Campylobacter jejuni infections in the nation . A case-control study was conducted to determine indigenous exposures that contribute to the high incidence of sporadic C . jejuni infection in Hawaii . A total of 211 case patients with diarrhea and confirmed Campylobacter infection was enrolled, along with 1 age- and telephone exchange-matched control subject for each patient . Participants were interviewed about illness, medicines, food consumption, food-handling practices, and exposure to animals . In matched logistic regression analyses, eating chicken prepared by a commercial food establishment in the 7 days before case illness onset (adjusted odds ratio {AOR}, 1.8; P=.03) and consuming antibiotics during the 28 days before illness onset (AOR, 3.3; P=.03) were significant independent predictors of illness . Further study of the association of Campylobacter illness with commercially prepared chicken and prior antibiotic use is needed.

Zhonghua Yi Xue Za Zhi, 2000 Dec, 80(12), 947 - 9
{Experimental study on an animal model of axonal form Guillain-Barre syndrome}; Wang Q et al.; OBJECTIVE: To investigate an animal model of axonal form Guillain-Barre syndrome (GBS) . METHODS: A strain of Campylobacter jejuni (Cj PENO: 19) from stools of a patient with axonal form GBS was isolated . After the lypopolysaccharides (LPS) were extracted from the strain, they were inoculated into 26 rabbits, 10 micrograms per week . RESULTS: Three rabbits showed paralysis, with an incidence rate of 11.54% . For the three rabbits, LPS was inoculated two, three and three times, respectively . Pathological examination showed serious axonal degeneration in the sciatic nerve . The electrophysiological features showed motor axon damage . CONCLUSION: The results suggested the presence of an axonal form GBS . LPS in Cj could play an important role in causing axonal form GBS.

Scand J Infect Dis, 2001, 33(2), 126 - 7
Campylobacter fetus subspecies fetus bacteremia associated with chorioamnionitis and intact fetal membranes; Viejo G et al.; Campylobacter fetus subspecies fetus was isolated from the blood of a patient with chorioamnionitis and intact fetal membranes . The mother improved after appropriate antibiotic treatment, but the infant died of neonatal infection a few minutes after delivery . This is a very unusual etiology of intra-amniotic infection.

Poult Sci, 2001 Feb, 80(2), 156 - 60
Comparison of mucosal competitive exclusion and competitive exclusion treatment to reduce Salmonella and Campylobacter spp . colonization in broiler chickens; Stern NJ et al.; Control of Salmonella spp . during the earliest phases of broiler production may provide the best opportunity to reduce human pathogens on processed broiler carcasses . Application of the "Nurmi concept" has been demonstrated to be an effective means in reducing Salmonella colonization among broiler chicks . In 1989, Aho et al . developed a competitive exclusion (CE) culture for control of Salmonella spp., whereas a mucosal competitive exclusion culture (MCE) developed in the United States was originally created to control Campylobacter colonization (Stern et al., 1995) . The major differences in the two patents were the higher level of anaerobic culture required, the degree of epithelial scraping and washing of the ceca, media used for subculturing, and the culture incubation temperatures (35 C vs . 42 C) . The CE and MCE were compared for efficacy in reducing Salmonella and Campylobacter colonization in broiler chicks . Nine adult birds (three for each of three replicates) were slaughtered, and each of a bird's paired ceca were used to produce corresponding antagonistic microflora, which were administered to day-of-hatch chicks . The chicks (a total of 210) were challenged 24 h later with Salmonella and Campylobacter and were killed 1 wk later, and levels of the pathogens were determined . Ninety CE-treated birds were significantly more colonized by Salmonella typhimurium than those 90 chicks treated with the MCE microflora (3.97 log 10 cfu/g cecal contents vs . 1.25 log 10 cfu/g cecal contents) . Also, Campylobacter spp . colonization of these birds was significantly higher for CE-treated birds when compared with MCE-treated birds (6.96 log 10 cfu/g cecal contents vs . 5.03 log 10 cfu/g cecal contents) . These results can be useful in developing intervention strategies to reduce chicken colonization by Salmonella and Campylobacter.

Poult Sci, 2001 Feb, 80(2), 151 - 5
Prevalence of Campylobacter and Salmonella at a squab (young pigeon) processing plant; Jeffrey JS et al.; Microbiological testing for Campylobacter and Salmonella was performed at a processing plant for squab (young pigeon) in three separate trials . Live birds, carcasses, and equipment were targeted for sampling during the preslaughter, pre-evisceration, and postevisceration stages of processing . The three trials represented 18 farms (1,110 squab), 1 farm (250 squab), and 23 farms (2,900 squab) . The overall prevalence of positive samples in Trial 1 was 1.4% for Salmonella spp . and 11.1% for C . jejuni; in Trial 2, 4.3 and 0% for Salmonella spp . and C . jejuni; and in Trial 3, 4.1 and 4.8% for Salmonella spp . and C . jejuni, respectively . These observations represent a significantly greater likelihood of having a positive sample for Campylobacter (twofold) or Salmonella (eightfold) at processing, compared with prevalences observed in our previous on-farm study . This finding suggests an overall increase in the number of carcasses contaminated or in the concentration of contamination during transport and processing . In the multifarm trials, only Trial 3 demonstrated a significant increase in the prevalence of positive samples from the preslaughter to the postevisceration stages of processing (P = 0.02), and only for Campylobacter . The prevalence of positive cultures from equipment surfaces were not different than carcasses during processing, therefore no additional critical control points were identified within this system . When pooled swabs were compared (Trial 1) to individual swabs (Trials 2 and 3), no statistical difference in the prevalence of Salmonella or Campylobacter was observed between trials . Direct plating from a pooled sample onto selective agar media (Trial 1) and single swab culture with enrichment followed by plating on selective agar (Trials 2 and 3) were compared for Campylobacter isolation . No statistical difference in C . jejuni prevalence was observed using either method; however, when the detection limit of each method was determined, single swabs with enrichment had greater sensitivity.

J Clin Microbiol, 2001 Mar, 39(3), 1097 - 104
Antimicrobial resistance and bacterial identification utilizing a microelectronic chip array; Westin L et al.; Species-specific bacterial identification of clinical specimens is often limited to a few species due to the difficulty of performing multiplex reactions . In addition, discrimination of amplicons is time-consuming and laborious, consisting of gel electrophoresis, probe hybridization, or sequencing technology . In order to simplify the process of bacterial identification, we combined anchored in situ amplification on a microelectronic chip array with discrimination and detection on the same platform . Here, we describe the simultaneous amplification and discrimination of six gene sequences which are representative of different bacterial identification assays: Escherichia coli gyrA, Salmonella gyrA, Campylobacter gyrA, E . coli parC, Staphylococcus mecA, and Chlamydia cryptic plasmid . The assay can detect both plasmid and transposon genes and can also discriminate strains carrying antibiotic resistance single-nucleotide polymorphism mutations . Finally, the assay is similarly capable of discriminating between bacterial species through reporter-specific discrimination and allele-specific amplification . Anchored strand displacement amplification allows multiplex amplification and complex genotype discrimination on the same platform . This assay simplifies the bacterial identification process greatly, allowing molecular biology techniques to be performed with minimal processing of samples and practical experience.

Appl Environ Microbiol, 2001 Mar, 67(3), 1185 - 9
Evidence for a genetically stable strain of Campylobacter jejuni; Manning G et al.; The genetic stability of selected epidemiologically linked strains of Campylobacter jejuni during outbreak situations was investigated by using subtyping techniques . Strains isolated from geographically related chicken flock outbreaks in 1998 and from a human outbreak in 1981 were investigated . There was little similarity in the strains obtained from the different chicken flock outbreaks; however, the strains from each of three chicken outbreaks, including strains isolated from various environments, were identical as determined by fla typing, amplified fragment length polymorphism (AFLP) analysis, and pulsed-field gel electrophoresis, which confirmed the genetic stability of these strains during the short time courses of chicken flock outbreaks . The human outbreak samples were compared with strain 81116, which originated from the same outbreak but has since undergone innumerable laboratory passages . Two main AFLP profiles were recognized from this outbreak, which confirmed the serotyping results obtained at the time of the outbreak . The major type isolated from this outbreak (serotype P6:L6) was exemplified by strain 81116 . Despite the long existence of strain 81116 as a laboratory strain, the AFLP profile of this strain was identical to the profiles of all the other historical P6:L6 strains from the outbreak, indicating that the genotype has remained stable for almost 20 years . Interestingly, the AFLP profiles of the P6:L6 group of strains from the human outbreak and the strains from one of the recent chicken outbreaks were also identical . This similarity suggests that some clones of C . jejuni remain genetically stable in completely different environments over long periods of time and considerable geographical distances.

Clin Infect Dis, 2001 Mar 1, 32(5), E97 - 9 Epub 2001 Feb 23.
Neonatal sepsis by Campylobacter jejuni: genetically proven transmission from a household puppy; Wolfs TF et al.; We report a case of neonatal Campylobacter jejuni sepsis in a 3-week-old infant who acquired the infection through transmission from a recently acquired household puppy . Genotyping of Campylobacter strains obtained from puppy and child resulted in highly homogeneous findings . This represents the first genetically proven C . jejuni dog-human transmission.

Carbohydr Res, 2001 Jan 30, 330(2), 223 - 9
Chemical structure of the core oligosaccharide of aerotolerant Campylobacter jejuni O:2 lipopolysaccharide; Hanniffy OM et al.; The structure of the core oligosaccharide of aerotolerant Campylobacter jejuni 0:2 lipopolysaccharide was determined and found to contain 3-deoxy-D-manno-octulosonic acid (Kdo), L-glycero-D-manno-heptose (LD-Hep), D-galactose, D-glucose, and phosphorylethanolamine (PEtn) . Based on 1H, 13C and 31P NMR spectroscopic studies including 2D COSY, TOCSY, ROESY and heteronuclear 1H-31P and HMQC experiments it was established that the oligosaccharide has the following structure: {structure: see text}.

Cell Mol Life Sci, 1999 Nov 30, 56(9-10), 755 - 63
Spread of antibiotic resistance with food-borne pathogens; Teuber M; This short review summarizes data on antibiotic resistance profiles of common food-borne pathogens like Salmonella sp., Escherichia coli, Campylobacter sp., Listeria monocytogenes, Clostridium perfringens, Staphylococcus aureus, and coagulase-negative staphylococci . As a flashlight on the literature of the last few years, it provides ample evidence that antibiotic resistance traits have entered the microflora of farm animals and the food produced from them . Molecular analysis of the resistance genes, where available, shows that the food microflora is not separated from its human counterpart and conjugative transfer of resistance genes has been demonstrated in vitro and in a few cases in vivo . For example, for Salmonella typhimurium, resistance towards tetracyclines has increased from zero in 1948 to a 98% level in certain epidemic populations of S . typhimurium DT104 in 1998 . The high incidence of food-borne pathogens in raw meat and milk together with a high level of therapeutic, prophylactic and nutritional application of antibiotics in agriculture reveals an antibiotic resistance problem of global dimensions . The resistance problem in human medicine will not be solved if there is a constant influx of resistance genes into the human microflora via the food chain.

Am J Vet Res, 2001 Feb, 62(2), 190 - 4
Epidemiologic features of Campylobacter jejuni isolated from poultry broiler houses and surrounding environments as determined by use of molecular strain typing; Nesbit EG et al.; OBJECTIVE: To genetically type Campylobacter jejuni isolates from broiler houses or the external environment to identify the source of Campylobacter organisms in broiler chickens . SAMPLE POPULATION: Environmental samples associated with broiler chickens, in commercial grow-out houses . PROCEDURE: Polymerase chain reaction (PCR) was used to amplify flaB, and the amplicon was digested with Sau3A to create a restriction fragment length polymorphism assay; PCR was also used to detect a transcribed spacer region in the 23S rRNA gene . RESULTS: Isolates possessing a 23S spacer region were more prevalent outside broiler houses than inside . Houses that had previously contained chickens or lacked biosecurity procedures were more likely to contain isolates possessing the 23S spacer . One house contained only isolates possessing the spacer, whereas an adjacent house contained only isolates lacking the spacer . The flaB type detected in broiler houses was different from the type detected in the environment; however, many isolates within the broiler houses contained untypable flaB genotypes . CONCLUSIONS AND CLINICAL RELEVANCE: Most isolates from within houses were genetically distinct from isolates from outside houses that were examined by bacteriologic culture, suggesting an undetected source of C jejuni . Detection of isolates containing the 23S spacer appeared to be an indicator of environmental contamination of the houses . The observation of completely different C jejuni genetic types simultaneously within adjacent houses suggests that some types do not compete successfully during the grow-out period . In addition, the diversity of genotypes identified within broiler houses indicates the complexity of the ecologic features of C jejuni in the chicken environment.

Endod Dent Traumatol, 2000 Oct, 16(5), 191 - 6
Assessment of periradicular microbiota by DNA-DNA hybridization; Sunde PT et al.; In the present study the "checkerboard" DNA-DNA hybridization technique was used to identify bacteria in periapical endodontic lesions of asymptomatic teeth . Thirty-four patients with root-filled teeth and apical periodontitis were divided into two groups, each containing 17 patients . In Group 1, a marginal incision was performed during surgery to expose the lesion, and in Group 2, a submarginal incision was applied . The gingiva and mucosa were swabbed with an 0.2% chlorhexidine gluconate solution prior to surgery . Bacterial DNA was identified in all samples from the two groups using 40 different whole genomic probes . The mean number (+/- SD) of species detected was 33.7 +/- 3.3 in Group 1 and 21.3 +/- 6.3 in Group 2 (P < 0.001) . The majority of the probe-detected bacteria were present in more lesions from Group 1 than from Group 2 . The differences were most notable for Campylobacter gracilis, Porphyromonas endodontalis, Propionibacterium acnes, Capnocytophaga gingivalis, Fusobacterium nucleatum ssp . nucleatum, Fusobacterium nucleatum ssp . polymorphum, Prevotella intermedia, Treponema denticola, Streptococcus constellatus and Actinomyces naeslundii I . Bacterial species such as Actinobacillus actinomycetemcomitans and Bacteroides forsythus were detected in more than 60% of the lesions from both groups . Also, P . endodontalis was abundant in periapical tissue . The data supported the idea that following a marginal incision, bacteria from the periodontal pocket might reach the underlying tissues by surgeon-released bacteremia . The study provided solid evidence that bacteria invade the periapical tissue of asymptomatic teeth with apical periodontitis . The detection of much more bacteria with the "checkerboard" DNA-DNA hybridization method than has previously been recovered by anaerobic culture indicated that the endodontic (and periodontal) microfloras should be redefined using molecular methods.

Mediators Inflamm, 2000, 9(5), 229 - 34
Plasma cytokine response in mice with bacterial infection; Abram M et al.; BACKGROUND: Exposure to microorganisms elicts the production of cytokines . These soluble factors enhance several innate immune functions and regulate the ensuing specific immune response aimed at limiting the spread of infection . AIM: This study was undertaken to quantify the plasma levels of pro-inflammatory cytokines during the course of primary Listeria monocytogenes and Campylobacter jejuni infection . Using an in vivo infection the relationship between endogenous cytokines and the bacterial number in the liver of infected animals was examined . METHODS: C57BL/6 mice were infected by the intraperitoneal route . At different time points we determined the number of colony-forming units of bacteria in the liver of infected animals and paralled these with the plasma levels of interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) measured by enzyme immunoassays . RESULTS: L . monocytogenes infection lasted 10-11 days . IFN-gamma production occurred in the early phase but was more pronounced after day 4, following the appearance of specific immunity . The duration of experimental campylobacteriosis was 15 days . Early IFN-gamma production was not significant but a progressive rise of this cytokine in plasma was seen during the second week post infection . Mice produced measurable amounts of plasma TNF-alpha immediately after being given viable L . monocytogenes, peaking on day 2-3 when the greatest number of bacteria was present in the examined organs . During C . jejuni infection plasma TNF-alpha was produced in a similar manner, but the highest concentrations were found a few days later than in listeriosis, in correlation with the different course of campylobacteriosis . The quantity of IL-6 increased and decreased in concordance with clearance of L monocytogenes and the clinical status of the animals . C . jejuni did not promote the induction of this cytokine . This is to some extent an unusual finding . With respect to the role of IL-6 in Th2 responses and antibody production, the appearance of this cytokine in campylobacteriosis was more expected . DISCUSSION: During systemic bacterial infection, a network of pro-inflammatory cytokines is activated and blood levels of these cytokines are elevated, albeit inconsistently, with large individual variations and depending on microbial characteristics and structure.

Avian Dis, 2000 Oct-Dec, 44(4), 983 - 8
Sequential spread of Campylobacter infection in a multipen broiler house; Shreeve JE et al.; Generally, colonization with Campylobacter jejuni is first detected in broilers 2-3 wk after hatching . Once introduced into a flock, this infection spreads very rapidly . The sources and routes of transmission of C . jejuni in broilers remain debatable . In this study, the spread of infection was monitored in a commercial multipen broiler house in which birds were contained in discrete groups and sampled sequentially . Colonization was monitored in two broiler flocks up to slaughter . Serotyping and fla typing methods were applied to differentiate all the C . jejuni strains isolated . In flock 1, colonization was first detected at 32 days of age in birds located at the rear of the house . By 40 days, nearly all the birds were infected with the same strain (fla type 1.9) . However, at 46 days of age, a second strain (fla type 3.7) was detected in some of the birds . These birds were also located toward the rear of the house . In flock 2, infection was detected at 5 wk of age . This infection was once again first detected in birds located at the rear of the house . In this flock, only a single fla type (1.1) was isolated throughout . A survey of the broiler house relative to the location of first point of infection indicated the use of an entrance door unprotected by boot dips . However, securing this door during the second flock study did not prevent infection.

Avian Dis, 2000 Oct-Dec, 44(4), 907 - 12
Genotyping Campylobacter jejuni strains isolated from the gut and oviduct of laying hens; Camarda A et al.; Campylobacter jejuni frequently colonizes the avian intestine . Recent evidence suggests that this organism can also colonize the oviduct of laying hens . However, the source and role of this colonization are unknown . Isolates from the ceca, cloacae, and oviducts of 11 laying hens in three intensive egg-producing flocks were genotyped by Fla typing with the restriction fragment length polymorphism of the polymerase chain reaction product of the flaA and flaB genes (fla typing) and pulsed-field gel electrophoresis (PFGE) . A diversity in fla types and PFGE types was observed within and between flocks . Individual birds could be colonized by different genotypes at various intestinal and oviduct sites . However, the oviduct of individual birds appeared to be colonized by only one genotype at the time of sampling . In two birds, matching isolates investigated from the intestinal and reproductive tracts were genotypically identical but different from those oviduct isolates found in other birds in the same flock . Interestingly, not all cecal isolates appeared to be equally able to colonize the oviduct . These results suggest that oviduct colonization may result from ascending infection via the cloaca and that some strains of C . jejuni may be better adapted than others to oviduct colonization.

J R Coll Physicians Lond, 2000 Nov-Dec, 34(6), 552 - 4
What proportion of dyspeptic patients having H . pylori breath test subsequently undergo endoscopy?
Besherdas K, Oben JA, Beck E, Vicary FR, Wong VS.
BACKGROUND: Helicobacter pylori (HP) testing in young patients with uncomplicated dyspepsia has been recommended . A test and treat strategy for dyspeptics positive for HP is recommended by the European H . pylori Study Group and the American Gastroenterology Association . OBJECTIVES: To assess the rates of re-referral for upper GI endoscopy (OGD) and outpatient (OPD) attendance in uncomplicated dyspeptic patients following assessment of HP status . METHODS: 190 patients under 50 years of age with uncomplicated dyspepsia (without alarm symptoms) referred from general practitioners (GPs) to the gastroenterology department underwent HP urea breath test (UBT) . GPs were informed of the results of UBT and recommended eradication therapy if positive, and if negative advised symptomatic treatment with an acid suppressant with/without a prokinetic . The patients were analysed for subsequent attendance at OGD or OPD in the following two years . RESULTS: HP was present in 93 of 190 patients . Twenty of 190 (10.5%) patients subsequently were re-referred and underwent OGD for continuing dyspeptic symptoms; a further 6 were seen in OPD but not endoscoped as they have been judged to have uncomplicated gastro-oesophageal reflux disease . At time of OGD all patients were negative on Campylobacter-like organism (CLO) test for HP . Findings at OGD were normal (9), hiatus hernia (6), gastritis (4) and duodenitis (1) . No case of peptic ulcer disease or gastric cancer has been identified . CONCLUSIONS: In this group of dyspeptic patients, adopting a test and treat policy after initial analysis of HP resulted in 10.5% being re-referred for subsequent OGD; findings in those endoscoped were normal or minimal . A test and treat strategy for H . pylori in uncomplicated dyspeptics therefore saves endoscopies and outpatient consultations without missing significant underlying pathology.

Schweiz Arch Tierheilkd, 2000 Dec, 142(12), 665 - 71
{Zoonoses as a risk when associating with livestock or animal products}; Jemmi T et al.; The risk of zoonotic disease transmission when handling livestock or animal products is substantial . In industrialized countries, the classical zoonotic diseases such as tuberculosis or brucellosis are no longer in the foreground . Latent zoonoses such as salmonellosis and campylobacteriosis can cause serious disease in humans and have become a major public health problem during the past years . Since animals infected with these pathogens show only mild transient disease or no clinical signs at all, new concepts in the entire production line ("stable to table") are necessary in order to avoid human infection . Two emerging viruses with zoonotic potential--avian influenza virus and Nipah virus--have been found in Asia in 1997 and 1999 . Both diseases had a major impact on disease control and public health in the countries of origin . In order to cope threats from infectious diseases, in particular those of public health relevance, a combined effort among all institutions involved will be necessary . The proposed "European Center for Infectious Diseases" and the "Swiss center for zoonotic diseases" could be a potential approach in order to achieve this goal.

Rev Sci Tech, 2000 Apr, 19(1), 226 - 39
Bacterial food-borne zoonoses; Thorns CJ; In many countries of the world, bacterial food-borne zoonotic infections are the most common cause of human intestinal disease . Salmonella and Campylobacter account for over 90% of all reported cases of bacteria-related food poisoning world-wide . Poultry and poultry products have been incriminated in the majority of traceable food-borne illnesses caused by these bacteria, although all domestic livestock are reservoirs of infection . In contrast to the enzootic nature of most Salmonella and Campylobacter infections, Salmonella Enteritidis caused a pandemic in both poultry and humans during the latter half of the 20th Century . Salmonella Typhimurium and Campylobacter appear to be more ubiquitous in the environment, colonising a greater variety of hosts and environmental niches . Verocytotoxin-producing Escherichia coli O157 (VTEC O157) also emerged as a major food-borne zoonotic pathogen in the 1980s and 1990s . Although infection is relatively rare in humans, clinical disease is often severe, with a significant mortality rate among the young and elderly . The epidemiology of VTEC O157 is poorly understood, although ruminants, especially cattle and sheep, appear to be the major source of infection . The dissemination of S . Enteritidis along the food chain is fairly well understood, and control programmes have been developed to target key areas of poultry meat and egg production . Recent evidence indicates that these control programmes have been associated with an overall reduction of S . Enteritidis along the food chain . Unfortunately, existing controls do not appear to reduce the levels of Campylobacter and VTEC O157 infections . Future control strategies need to consider variations in the epidemiologies of food-borne zoonotic infections, and apply a quantitative risk analysis approach to ensure that the most cost-effective programmes are developed.

Clin Infect Dis, 2001 Feb 15, 32(4), 573 - 80 Epub 2001 Feb 09.
Etiology of bloody diarrhea among patients presenting to United States emergency departments: prevalence of Escherichia coli O157:H7 and other enteropathogens; Talan D et al.; Escherichia coli O157:H7 and other Shiga toxin-producing E . coli (STEC) infections have been associated with bloody diarrhea . The prevalence of enteropathogens among patients with bloody diarrhea was determined by a prospective study at 11 US emergency departments . Eligible patients had bloody stools, > or =3 loose stool samples per 24-h period, and an illness lasting <7 days . Among 873 patients with 877 episodes of bloody diarrhea, stool samples for culture were obtained in 549 episodes (62.6%) . Stool cultures were more frequently ordered for patients with fever, >10 stools/day, and visibly bloody stools than for patients without these findings . Enteropathogens were identified in 168 episodes (30.6%): Shigella (15.3%), Campylobacter (6.2%), Salmonella (5.8%), STEC (2.6%), and other (1.6%) . Enteropathogens were isolated during 12.5% of episodes that physicians thought were due to a noninfectious cause . The prevalence of STEC infection varied by site from 0% to 6.2% . Hospital admissions resulted from 195 episodes (23.4%) . These data support recommendations that stool samples be cultured for patients with acute bloody diarrhea.

J Pathol, 2001 Feb, 193(2), 218 - 23
Frequent molecular identification of Campylobacter but not Helicobacter genus in bile and biliary epithelium in hepatolithiasis; Harada K et al.; Bacterial infection of the biliary tree and bile stasis may be causally related to hepatolithiasis, but which bacterial species are involved and their roles in the pathogenesis of hepatolithiasis have not been ascertained . Recently, the Helicobacter genus was detected in human bile and biliary mucosal samples by molecular techniques, and its association with several biliary diseases has been suggested . The Campylobacter genus, which is closely related to the Helicobacter genus, has also recently been identified as causative of human gastrointestinal diseases . This study attempted to elucidate whether Helicobacter and/or Campylobacter bacteria are present in bile samples and biliary mucosal specimens from hepatolithiasis patients and whether they are involved in the pathogenesis of hepatolithiasis . The 16S rRNA gene of the Helicobacter and of the Campylobacter genus was examined by polymerase chain reaction in DNA samples extracted from bile and/or microdissected biliary epithelium from 69 patients with hepatolithiasis and control patients with choledocholithiasis, cholecystolithiasis, and normal gall bladders . The Helicobacter genus was detected in 1 of 8 (13%) biliary epithelial samples in hepatolithiasis and 1 of 10 (10%) bile samples in choledocholithiasis . The Campylobacter genus was detected in 3 of 14 (21%) bile samples and 5 of 8 (63%) epithelial samples in hepatolithiasis, and in 2 of 15 (13%) bile samples and 1 of 8 (13%) epithelial samples in cholecystolithiasis . The detection rate for Campylobacter in biliary epithelium of hepatolithiasis was significantly higher than in the bile or biliary epithelium of control groups (p<0.05) . By a phylogenetic analysis based on nucleotide sequences, the Campylobacter genuses detected in hepatolithiasis were clustered with C . rectus or C . showae . The frequent detection of the Campylobacter 16S rRNA gene in bile, and especially in biliary epithelium of hepatolithiasis, suggests a pathogenetic relationship with Campylobacter infection.

Curr Treat Options Gastroenterol, 2001 Feb, 4(1), 23 - 38
Foodborne Illnesses; Gill CJ et al.; Foodborne illnesses cause a substantial human and financial burden . Despite sanitary infrastructure improvements, the incidence of foodborne bacterial infections due to non-typhoidal salmonellae (NTS), Campylobacter jejuni, and enterohemorrhagic Escherichia coli (EHEC) has risen over the last two decades . Overall, viruses account for two thirds of all foodborne illness . Most foodborne illnesses are self-limited . Supportive therapy with rehydration and the correction of electrolyte abnormalities is usually sufficient . Antibiotics play a beneficial role in the treatment of patients with certain foodborne diseases, such as listeriosis and typhoid fever, and all patients with tissue invasive or bloodstream infections . Immunocompromised patients should be treated presumptively . Antibiotics are of variable efficacy for the treatment of many infections limited to the gastrointestinal tract, and recommendations differ between pathogens . Antibiotics are generally helpful for shigellosis and cholera, and possibly beneficial for campylobacteriosis . However, antibiotics are potentially harmful in uncomplicated NTS and EHEC gastroenteritis and generally should not be used . Toxin-mediated food poisoning usually does not require specific therapy . The exception is botulism, for which botulinum antitoxin is highly efficacious if used early in the course of illness . Empiric therapy for gastroenteritis is possibly beneficial, though the magnitude of benefit is modest and incurs the risk of inadvertently treating NTS or EHEC . The choice of antibiotic should be based on local resistance patterns and the results of susceptibility testing.

Diagn Microbiol Infect Dis, 2001 Jan, 39(1), 55 - 9
Characterization of culture-derived spiral bacteria by 16S ribosomal RNA gene sequence analysis; Hayden RT et al.; Broad range amplification and sequence analysis of the 16S ribosomal RNA gene was used to identify three spiral-form organisms . The agents were identified as Campylobacter fetus, "Flexispira rappini", and Borrelia burgdorferi, respectively, using either proprietary or public sequence databases . In each case, the rDNA sequence showed 99-100% homology with known sequence data . Sequence-based analysis for each isolate required only 2-3 days, whereas traditional means of identification took 8-12 days to complete . The identification of spirochetes and vibrio-like agents from human clinical samples is often time consuming and results may be difficult to interpret, sometimes due to atypical phenotypic characteristics . Analysis of 16S rDNA or other molecular targets may provide a way to accurately and rapidly characterize isolates that are recalcitrant to speciation.

Curr Opin Microbiol, 2001 Feb, 4(1), 35 - 40
Deciphering Campylobacter jejuni cell surface interactions from the genome sequence; Linton D et al.; The completion of the Campylobacter jejuni genome sequence is a landmark in Campylobacter research . Discoveries directly arising from these data include the identification of a capsular polysaccharide, extensive capacity for phase variable gene expression and lipo-oligosaccharide structural phase variation . The recent identification of a unique system of general protein glycosylation in C . jejuni, a C . jejuni protein that is translocated into eukaryotic cells, and plasmid-encoded components of a putative type IV secretion system are likely to be significant in terms of the host-pathogen interaction.

J Hosp Infect, 2001 Feb, 47(2), 79 - 83
Rational protocols for testing faeces in the investigation of sporadic hospital-acquired diarrhoea; Gopal Rao G et al.; Many recent studies have demonstrated that routine examination of faeces for conventional enteric pathogens such as salmonella, shigella, campylobacter and parasites in patients who develop sporadic hospital-acquired diarrhoea is unnecessary and wasteful . In this paper the advantages and disadvantages of a restricted testing protocol in patients with hospital-acquired diarrhoea are reviewed . Practical issues for safe implementation of such a protocol are also discussed .

J Appl Microbiol, 2001 Feb, 90(2), 285 - 93
Evaluation of numerical analysis of PFGE-DNA profiles for differentiating Campylobacter fetus subspecies by comparison with phenotypic, PCR and 16S rDNA sequencing methods; On SL et al.; AIMS: To assess the efficacy of numerical analysis of PFGE-DNA profiles for identification and differentiation of Campylobacter fetus subspecies . METHODS AND RESULTS: 31 Camp . fetus strains were examined by phenotypic, PCR- and PFGE-based methods, and the 16S rDNA sequences of 18 strains compared . Numerical analysis of PFGE-DNA profiles divided strains into two clusters at the 86% similarity level . One cluster contained 19 strains clearly identified as Camp . fetus subsp . venerealis . The other cluster comprised 12 strains, of which 10 were unambiguously identified as Camp . fetus subsp . fetus . The remaining two strains were identified as Camp . fetus subsp . venerealis by either phenotypic or PCR methods, but not both . At higher similarity levels, clusters containing isolates from each of two countries were identified, suggesting that certain clones predominate in certain geographical regions . CONCLUSION: Numerical analysis of PFGE-DNA profiles is an effective method for differentiating Camp . fetus subspecies . SIGNIFICANCE AND IMPACT OF THE STUDY: Critical comparison of PFGE, PCR, 16S rDNA sequencing and phenotypic methods for differentiation of Camp . fetus subspecies was attained . Novel phenotypic markers for distinguishing subspecies were identified . Evidence for dominant clones of each subspecies in certain countries was provided.

J Neuroimmunol, 2001 Feb 15, 113(2), 260 - 7
Guillain-Barré syndrome with IgM antibody to the ganglioside GalNAc-GD1a; Kaida K et al.; We analyzed the characteristics of 29 Guillain-Barre syndrome (GBS) patients with IgM anti-GalNAc-GD1a antibodies . Fourteen of them had had an antecedent cytomegalovirus infection (CMV group) and 12 gastrointestinal infection (G-I group) . Most of the G-I group patients (nine of 12) were subsequent to Campylobacter jejuni infection . Electrophysiological results in both groups patients predominantly indicated demyelinating neuropathy . The CMV group patients were characterized by slow progression and frequent facial and sensory deficits . IgM antibodies in their sera recognized an epitope shared by GalNAc-GD1a and GM2 . The G-I group patients frequently showed motor type of GBS with cranial nerves spared . IgM antibodies specific to GalNAc-GD1a were present in their sera.

Eur J Heart Fail, 2001 Jan, 3(1), 105 - 7
Campylobacter myocarditis; loose bowels and a baggy heart; Cox ID et al.; We report an unusual case of acute myocarditis associated with Campylobacter jejuni enterocolitis leading to severe impairment of left ventricular systolic function . Contrast-enhanced cardiac magnetic resonance imaging was used to confirm the presence of acute myocardial inflammation and its resolution.

Biochem Biophys Res Commun, 2001 Jan 12, 280(1), 380 - 7
MOMP, a divergent porin from Campylobacter: cloning and primary structural characterization; Labesse G et al.; We report a structural analysis at the molecular level of MOMP from Campylobacter, a gram-negative bacteria responsible for diarrhea . The corresponding gene was cloned and sequenced . Sequence comparison of seven MOMP sequences (three extracted from protein databases and four determined in this study) from distinct strains indicated alternation of preserved and divergent regions . No other significant sequence similarities could be detected . Comparison of MOMP with the crystal structures of other porins strongly suggested that it might adopt a similar fold and revealed the conservation of the monomer-monomer interface . The conservation clustered in the regions comprising or interacting with the loop L2 . On the contrary, strands not involved in the interface are more divergent . Proteolysis assays and biochemical treatment supported the proposed model . Our study suggested that MOMP belong to the maltoporin super-family sharing common structural motifs . In view of this model we discuss its specificity and its global stability .

J Clin Microbiol, 2001 Feb, 39(2), 762 - 4
Flagella as a potential marker for Campylobacter jejuni strains associated with Guillain-Barré syndrome; Tsang RS et al.; Campylobacter jejuni recovered from patients with Guillain-Barre syndrome (GBS) in different geographical locations and bearing different heat-labile and heat-stable antigens were found to have identical amino acid sequences in their flagellar flaA short variable region, suggesting that it may be a potentially useful marker for GBS association.

J Clin Microbiol, 2001 Feb, 39(2), 754 - 7
Agilent 2100 bioanalyzer for restriction fragment length polymorphism analysis of the Campylobacter jejuni flagellin gene; Nachamkin I et al.; The Agilent 2100 bioanalyzer (Agilent Technologies, Palo Alto, Calif.) utilizes capillary electrophoresis on a microchip device (LabChip 7500; Caliper Technologies, Mountain View, Calif.) that is capable of rapidly sizing small DNA fragments . To determine whether the system could replace conventional restriction fragment length polymorphism (RFLP) typing by agarose gel electrophoresis, we compared the analyzer with conventional flagellin RFLP for typing Campylobacter jejuni . Ninety-seven isolates representing 46 Fla types were initially analyzed . Correct Fla types were detected in 59% of the isolates . The major problem with the system was in resolving samples containing multiple DNA fragments differing from 8 to 20 bp . Overall, the bioanalyzer has the potential to replace conventional RFLP analysis by gel electrophoresis, but improvements in the chip separation are needed.

Appl Environ Microbiol, 2001 Feb, 67(2), 848 - 51
Competitive exclusion of heterologous Campylobacter spp . in chicks; Chen HC et al.; Chicken and human isolates of Campylobacter jejuni were used to provide oral challenge of day-old broiler chicks . The isolation ratio of the competing challenge strains was monitored and varied, depending upon the isolates used . A PCR-restriction fragment length polymorphism assay of the flagellin gene (flaA) was used to discriminate between the chick-colonizing isolates . Our observations indicated that the selected C . jejuni colonizers dominated the niche provided by the chicken ceca . Chicken isolates from the flaA type 7 grouping generally had numerical superiority over the human isolates when they were administered in our 1-day-old chick model . Our results suggest that it is possible to use combinations of C . jejuni chicken isolates as a defined bacterial preparation for the competitive exclusion of human-pathogenic C . jejuni in poultry.

J Med Microbiol, 2000 Apr, 49(4), 305 - 11
HLA molecules, bacteria and autoimmunity; Ebringer A et al.; It has been well established that many diseases are linked to HLA antigens . Two of the most interesting HLA associations may provide some insight into the pathogenesis of rheumatic inflammatory conditions . In ankylosing spondylitis (AS), 96% of patients possess HLA-B27, whilst the frequency of this marker in the general population is c . 8% . In rheumatoid arthritis (RA), >90% of patients possess either HLA-DR1 or some subtypes of HLA-DR4, whilst the frequency of this marker in the general population is c . 35% . The association between HLA-B27 and reactive arthritis (ReA) has also been well established . Furthermore, it has been shown that ReA is triggered by infection via the gastrointestinal tract due to Yersinia, Salmonella or Campylobacter spp . and in the genitourinary tract due to chlamydia . In a similar way, microbiological and immunological studies have revealed an association between Klebsiella pneumoniae in AS and Proteus mirabilis in RA . This article reviews the possible pathological implications of the associations between HLA-B27, K . pneumoniae and AS, as well as HLA-DR1/DR4, P . mirabilis and RA.

Int J Syst Evol Microbiol, 2000 Nov, 50 Pt 6, 2231 - 7
Recommended minimal standards for describing new species of the genus Helicobacter; Dewhirst FE et al.; The International Committee of Systematic Bacteriology Subcommittee on the taxonomy of Campylobacter and related bacteria has agreed in principle on minimum requirements for the description of new species of the genus Helicobacter . These requirements include the recommendation that the description of a putative new species or subspecies be based on examination of at least five strains in order to provide a measure of phenotypic and genotypic variation . Recommendations for required phenotypic and molecular data are presented . The requirements are consistent with the polyphasic approach to bacterial systematics.

Oral Microbiol Immunol, 2000 Apr, 15(2), 103 - 11
Profile of subgingival microbiota in children with mixed dentition; Kamma JJ et al.; A diversity of microbial species has been detected in children's oral flora at an early age . To investigate the composition of the subgingival microbiota of different groups of teeth in children with mixed dentition, 40 systemically healthy children, aged 7-8 years, randomly chosen, were examined . Subgingival plaque samples were taken from the mesiobuccal sites of 21, 41, 16 and 36 permanent teeth and 53, 73, 64 and 84 deciduous teeth . The samples were cultured for bacterial isolation anaerobically and in 10% CO2 plus air using selective and nonselective media . Forty-five different microbial species were isolated from both permanent and deciduous teeth . Streptococcus sanguis (79-70%), Streptococcus mitis (66-65%), Prevotella melaninogenica (51-57%), Eikenella corrodens (51-52%), Capnocytophaga gingivalis (46-34%), Capnocytophaga ochracea (45-45%), Actinomyces naeslundii (39-60%) and Prevotella intermedia (42-35%) were among the most frequently detected species in permanent and deciduous teeth respectively . Several suspected periodontal pathogens, such as Porphyromonas gingivalis, Prevotella loescheii, Campylobacter gracilis, Bacteroides forsythus, Campylobacter concisus, Peptostreptococcus micros and Selenomonas sputigena, albeit less frequently detected, were present in the microbiota of these children . The bacterial species Streptococcus constellatus, Peptostreptococcus micros, Pseudoramibacter alactolyticus, E . corrodens and Fusobacterium nucleatum were associated with non-bleeding permanent and deciduous teeth whereas Streptococcus intermedius, C . concisus, P . intermedia and P . loescheii were associated with bleeding.

Oral Microbiol Immunol, 2000 Dec, 15(6), 393 - 6
Porphyromonas gingivalis platelet aggregation activity: outer membrane vesicles are potent activators of murine platelets; Sharma A et al.; Recent evidence has established an association between chronic periodontitis and cardiovascular disease . Periodontitis is a chronic inflammatory disease caused by a small group of gram-negative bacteria, of which Porphyromonas gingivalis is considered an important causative agent . It has been proposed that dental plaque bacteria and their products can disseminate into the bloodstream from the site of infection and promote thromboembolic events associated with atherosclerosis and myocardial infarction . In this regard, Streptococcus sanguis and P . gingivalis have been shown to induce platelet aggregation in vitro . Here we report that P . gingivalis was able to induce platelet aggregation, and that oral strains of Actinobaillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, Fusobacterium nucleatum, Prevotella intermedia and Trepenoma denticola failed to aggregate platelets when tested for platelet aggregation activity under similar conditions . Additionally, we show that vesicles (outer membrane evaginations that are shed into the environment by the bacteria) of P . gingivalis are potent inducers of mouse platelet aggregation in vitro . In summary, our data show that i) initial adherence of the bacterium to platelet may be facilitated by P . gingivalis fimbriae and ii) P . gingivalis vesicles possess platelet aggregation-inducing activity.

Eur J Clin Microbiol Infect Dis, 2000 Nov, 19(11), 843 - 51
Improved microbiological techniques using the polymerase chain reaction and pulsed-field gel electrophoresis for diagnosis and follow-up of enterohaemorrhagic Escherichia coli infection; Welinder-Olsson C et al.; The aims of the present investigation were to evaluate the microbiological diagnostic procedures, especially polymerase chain reaction (PCR) versus culture and seroagglutination, in relation to the clinical features of enterohaemorrhagic Escherichia coli (EHEC) infection and to study the status of EHEC in the western part of Sweden . During 1997 and 1998, stool specimens from 3,948 patients were analysed by PCR for the presence of EHEC with verotoxin (VT)1- and/or VT2-producing DNA sequences . The stool specimens were also cultured for Escherichia coli O157:H7, Salmonella, Campylobacter, Shigella and Yersinia . Fifty-five patients were positive by PCR . Thirty-nine patients were positive for EHEC by PCR and culture . Of these, 29 were infected with EHEC serogroup O157:H7 strains . All EHEC isolates were analysed by pulsed-field gel electrophoresis (PFGE); 17 different clones were identified . Studies on the duration of the presence of EHEC in the gut showed that EHEC often disappears rather quickly, i.e . within 2 weeks . In one patient, however, EHEC remained for several months . In conclusion, PCR, rather than culture and agglutination, should be the method of choice for microbiological diagnosis of EHEC infection . PCR is more sensitive than culture for detecting EHEC in the gut.

Muscle Nerve, 2001 Jan, 24(1), 54 - 8
Intravenous immunoglobulin therapy for Guillain-Barré syndrome with IgG anti-GM1 antibody; Kuwabara S et al.; To compare the effects of intravenous immunoglobulin (IVIg) therapy and plasmapheresis for the IgG anti-GM1-positive subtype of Guillain-Barre syndrome (GBS), clinical and electrophysiological recoveries were analyzed in 24 patients treated with IVIg (n = 10) or plasmapheresis (n = 14) . At entry, there were no significant differences between the two patient groups in age, sex, clinical severity (Hughes grade), sum scores of distally evoked amplitudes of compound muscle action potentials (CMAPs), and frequency of Campylobacter jejuni infection . The patients treated with IVIg had significantly lower Hughes grade scores 1, 3, and 6 months after onset (P = 0.03), and a higher probability to regain independent locomotion at 6 months {P(logrank) = 0.044} . In the IVIg group, markedly rapid recovery (improvement by two or more Hughes grade scores within 4 weeks) was more frequent (6 of 10 vs . 3 of 14, P = 0 . 03), and delayed recovery (unable to walk independently at 6 months) was less frequent (0 of 10 vs . 4 of 14, P = 0.06) . CMAP sum score at 6 months tended to be greater for the IVIg group (P = 0.07) . For the IgG anti-GM1-positive subgroup of GBS patients, IVIg therapy may be a more efficacious treatment than plasmapheresis .

Clin Microbiol Rev, 2001 Jan, 14(1), 177 - 207
Endocarditis due to rare and fastidious bacteria; Brouqui P et al.; The etiologic diagnosis of infective endocarditis is easily made in the presence of continuous bacteremia with gram-positive cocci . However, the blood culture may contain a bacterium rarely associated with endocarditis, such as Lactobacillus spp., Klebsiella spp., or nontoxigenic Corynebacterium, Salmonella, Gemella, Campylobacter, Aeromonas, Yersinia, Nocardia, Pasteurella, Listeria, or Erysipelothrix spp., that requires further investigation to establish the relationship with endocarditis, or the blood culture may be uninformative despite a supportive clinical evaluation . In the latter case, the etiologic agents are either fastidious extracellular or intracellular bacteria . Fastidious extracellular bacteria such as Abiotrophia, HACEK group bacteria, Clostridium, Brucella, Legionella, Mycobacterium, and Bartonella spp . need supplemented media, prolonged incubation time, and special culture conditions . Intracellular bacteria such as Coxiella burnetii cannot be isolated routinely . The two most prevalent etiologic agents of culture-negative endocarditis are C . burnetti and Bartonella spp . Their diagnosis is usually carried out serologically . A systemic pathologic examination of excised heart valves including periodic acid-Schiff (PAS) staining and molecular methods has allowed the identification of Whipple's bacillus endocarditis . Pathologic examination of the valve using special staining, such as Warthin-Starry, Gimenez, and PAS, and broad-spectrum PCR should be performed systematically when no etiologic diagnosis is evident through routine laboratory evaluation.

Verh K Acad Geneeskd Belg, 2000, 62(5), 439 - 69
Antibiotic resistance and policy in Belgium; Goossens H; Antibiotic resistance is increasing worldwide, also in Belgium . A few examples to illustrate this problem: S . pneumoniae are becoming increasingly resistant to penicillin and erythromycin; resistance of S . pyogenes to erythromycin is increasing year-by-year; Salmonella and Campylobacter are becoming more and more resistant to the fluoroquinolones . In hospitals, the problem of methicillin-resistant Staphylococcus aureus appears to be decreasing, but two clones of ceftazidime-resistant Enterobacter aerogenes are spreading throughout the Belgian hospitals . Antibiotic resistance has become a serious health care issue both in hospitals and in the community . The popular press has termed some of the multiresistant organisms "killer bugs" or "superbugs" . Infection with such organisms has been associated with treatment failures, higher morbidity and mortality and increased costs . In this paper, we will review the problems of antibiotic resistance in the community setting . We will briefly discuss those pathogens with important consequences of morbidity and mortality in the community, such as: Streptococcus pneumoniae, Streptococcus pyogenes, Neisseria meningitidis, the enteric pathogens Salmonella and Campylobacter, and the urinary tract pathogen E . coli . This resistance has in response to various conditions and opportunities, such as: clustering and overcrowding, increased number of immunodeficient patients, increased elderly population, population mobility, increased use of (broad-spectrum) antibiotics, over-the-counter sale and self-dosing with antibiotics, inappropriate antibiotic prescriptions and lack of compliance, fewer resources for education and infection control, decreased funding for public health surveillance . In Belgium, we should be able to develop, implement and evaluate a good antibiotic policy . Our country has a wealth of information on antibiotic consumption in hospitals and the community . This information has been used for benchmarking of antibiotic consumption in hospitals . A unique system for reimbursement of prophylactic use of antibiotics in surgery was developed which resulted in a more adequate use of antibiotics . However, a policy should not be limited to the human ecosystem . Therefore, a Coordination Commission for Antibiotic Policy was installed recently by the Ministers of Social Affairs, Public Health and Agriculture.

Eur J Epidemiol, 2000, 16(8), 713 - 8
A population-based longitudinal study on the incidence and disease burden of gastroenteritis and Campylobacter and Salmonella infection in four regions of The Netherlands; de Wit MA et al.; The aim of this study was to estimate the incidence of gastroenteritis and Campylobacter and Salmonella infection in the Dutch population, the disease burden, and the percentage of patients with gastroenteritis that consults a general practitioner . A sample of 6243 persons was invited to participate in the study, i.e . completing a questionnaire and submitting stool samples . The follow-up period was 17 weeks . In total, 2206 persons participated (= 35%), contributing 660 person years . The incidence (standardised by age and gender) of first episodes of gastroenteritis was 45 per 100 person years . Among patients with gastroenteritis, Salmonella and Campylobacter were cultured in 1.6 and 4.5%, respectively . The standardised incidence of first Campylobacter infections was 9 per 100 person years, of first Salmonella infections 4 per 100 person years . For 22% of the episodes of gastroenteritis, a general practitioner was consulted (either by phone or by practice visit) . For 52% of the episodes, medicine were used . For 34% of the episodes, absence from school was reported and for 15%, absence from work was reported . Despite of possible biases, we can conclude that the incidence of gastroenteritis is very high and causes considerable use of medication, consultation of general practitioners and absence from work and school.

Infect Control Hosp Epidemiol, 2000 Dec, 21(12), 775 - 9
Comparison of three methods to recover vancomycin-resistant enterococci (VRE) from perianal and environmental samples collected during a hospital outbreak of VRE; Reisner BS et al.; OBJECTIVE: To establish an efficient and sensitive technique for recovering vancomycin-resistant enterococci (VRE) from perianal and environmental samples collected during implementation of control measures for an outbreak of VRE . DESIGN: Perianal and environmental samples were collected in triplicate on sterile swabs . One swab was used to inoculate a selective broth medium containing 6 pg of vancomycin and 8 pg of ciprofloxacin per mL, one to inoculate Campylobacter agar containing 10 microg/mL of vancomycin, and one to inoculate Enterococcosel agar containing 8 microg/mL of vancomycin . SETTING: Samples were collected in the intensive care units of a 600-bed university hospital over a period of 2 months . SAMPLE SELECTION: Patients and their immediate environment were sampled if they resided in a ward with a patient known to be colonized or infected with VRE . RESULTS: Of the 88 perianal samples obtained from 63 patients, 37 were positive for VRE by broth culture, with 36 also recovered on both types of solid media (sensitivity, 97.3%; negative predictive value, 98.1%) . Of the initial samples collected from each of the 63 patients, 20 were positive for VRE by all methods . Of the 500 environmental samples cultured, 139 were positive for VRE in broth, with only 33 recovered on Campylobacter agar (sensitivity, 23.7%; negative predictive value, 77.2%) and 22 on Enterococcosel agar (sensitivity, 15.8%; negative predictive value, 75.2%) . CONCLUSIONS: Our data indicate that, when performing surveillance cultures during an outbreak of VRE, use of an enrichment broth medium is required to recover VRE contaminating environmental surfaces; however, direct inoculation to selective solid medium is adequate to recover VRE in patient perianal specimens.

Int J Food Microbiol, 2000 Dec 5, 62(1-2), 1 - 5
The emergence and spread of antibiotic resistance in food-borne bacteria; Threlfall EJ et al.; Since the early 1990s there has been a dramatic increase in resistance to antimicrobial drugs in Salmonella enterica and Campylobacter spp., and to a lesser extent in Vero cytotoxin-producing Escherichia coli O157 from cases of human infection in developed countries . For S . Typhimurium a particularly important aspect of this increase has been the widespread dissemination of a multiply drug-resistant (MR) strain of definitive phage type (DT) 104 in food animals since the early 1990s . The use of antimicrobials for prophylaxis in food producing animals has been an important factor in the emergence of strains with resistance to certain antimicrobials . It is hoped that recently introduced Codes of Practice for the prophylactic use of antimicrobials in food animals will result in a decline in the occurrence of drug resistant strains in the food chain.

J Clin Microbiol, 2001 Jan, 39(1), 279 - 84
Detection and initial characterization of novel capsular polysaccharide among diverse Campylobacter jejuni strains using alcian blue dye; Karlyshev AV et al.; We have recently demonstrated that most strains of Campylobacter jejuni produce capsular polysaccharide (CPS), which can be detected by immunoblotting with homologous Penner antisera on polyvinylidene difluoride membranes (A . V . Karlyshev, D . Linton, N . A . Gregson, A . J . Lastovica, and B . W . Wren, Mol . Microbiol . 35:529-541, 2000) . In this report, we describe a universal and rapid staining procedure using Alcian blue for C . jejuni CPS, which does not rely on the availability of antisera and identifies CPS in untypeable strains . Furthermore, Alcian blue staining identified CPS in its lipid-free form directly on Tricine gels, and we demonstrate that CPS is thermostable and is accumulated in the culture supernatant in a lipid-free form . The identification of a newly described CPS and its lipid-free form in C . jejuni should prove invaluable in studying the pathogenesis and epidemiology of this important pathogen.

J Clin Microbiol, 2001 Jan, 39(1), 14 - 23
Multilocus sequence typing system for Campylobacter jejuni; Dingle KE et al.; The gram-negative bacterium Campylobacter jejuni has extensive reservoirs in livestock and the environment and is a frequent cause of gastroenteritis in humans . To date, the lack of (i) methods suitable for population genetic analysis and (ii) a universally accepted nomenclature has hindered studies of the epidemiology and population biology of this organism . Here, a multilocus sequence typing (MLST) system for this organism is described, which exploits the genetic variation present in seven housekeeping loci to determine the genetic relationships among isolates . The MLST system was established using 194 C . jejuni isolates of diverse origins, from humans, animals, and the environment . The allelic profiles, or sequence types (STs), of these isolates were deposited on the Internet , forming a virtual isolate collection which could be continually expanded . These data indicated that C . jejuni is genetically diverse, with a weakly clonal population structure, and that intra- and interspecies horizontal genetic exchange was common . Of the 155 STs observed, 51 (26% of the isolate collection) were unique, with the remainder of the collection being categorized into 11 lineages or clonal complexes of related STs with between 2 and 56 members . In some cases membership in a given lineage or ST correlated with the possession of a particular Penner HS serotype . Application of this approach to further isolate collections will enable an integrated global picture of C . jejuni epidemiology to be established and will permit more detailed studies of the population genetics of this organism.

Curr Microbiol, 2001 Feb, 42(2), 139 - 43
Cloning and characterization of a Campylobacter jejuni iron-uptake operon; Galindo MA et al.; We report that C . jejuni modifies its outer membrane protein (OMP) repertoire when cultivated under iron-limiting conditions such as during incubation with epithelial cells . To identify genes encoding de novo expressed OMPs, a C . jejuni cosmid library was screened with antisera raised against proteins expressed in the presence of epithelial cells . A single clone was identified encoding an 80-kDa antigen . Sequence analysis of subclones identified an operon of three open reading frames (ORFs) encoding proteins that are homologous to the E . coli ferrichrome uptake system encoded by the fhu locus . Under low-iron conditions, C . jejuni expressed the 80-kDa OMP, indicating that its expression is regulated by the presence of iron . Southern blot analysis indicated that six of eleven isolates of C . jejuni harbor a fhuA homolog which, like all other DNA in this region sequenced thus far, is strikingly GC-rich (65%) compared with the C . jejuni genome (35% G+C).

Cell Mol Life Sci, 2000 Apr, 57(4), 527 - 33
Current cases in which epitope mimicry is considered a component cause of autoimmune disease: Guillain-Barré syndrome; Yuki N; Some patients develop Guillain-Barre syndrome (GBS) after the administration of bovine gangliosides . Patients with GBS subsequent to Campylobacter jejuni enteritis frequently have IgG antibody to GM1 ganglioside . Miller Fisher syndrome (MFS), a variant of GBS, is associated with IgG antibody to GQ1b ganglioside . Molecular mimicry between GM1 and lipopolysaccharide of C . jejuni isolated from patients with GBS, and between GQ1b and C . jejuni lipopolysaccharides from patients with MFS have been demonstrated . The molecular mimicry between infectious agents and gangliosides may function in the production of anti-ganglioside antibodies . This sugar mimicry is one possible cause of the Guillain-Barre and Miller Fisher syndromes; however, unidentified host factors may contribute to the development of these syndromes.

Cell Mol Life Sci, 2000 Nov, 57(12), 1793 - 801
Diet influences the colonisation of Campylobacter jejuni and distribution of mucin carbohydrates in the chick intestinal tract; Fernandez F et al.; The objectives of this study were to evaluate the effect of diet on the colonisation by Campylobacter jejuni of the chick caeca, and to determine whether the viscosity of the intestinal contents and mucin carbohydrates were altered by the diet . The diets investigated were maize based, wheat-based or wheat-based supplemented with xylanase . The xylanase-supplemented diet reduced the viscosity and lowered the numbers of Camp . jejuni . Feeding the enzyme-supplemented diet increased the amount of neutral and sulphated mucins in the goblet cells of the small and large intestines and caecum . An abundance of sulphated and carboxylated mucins was seen in the surface goblet cells of the large intestine with the maize- and wheat-based diets . Both the diet supplemented with xylanase and the maize diets increased crypt-surface glycosylation of the sialic acid residues . The analysed data from the combined sites showed significant differences in the amount of neutral and acidic mucins when comparing the wheat and the wheat plus xylanase diets . However, no changes were shown in the staining intensity of sulphated mucins between the three diets . Significant differences in the glycosylation of sialic acid and in the N-acetylglucosamine residues were shown between dietary groups . These results provide evidence that the wheat diet supplemented with xylanase leads to greater changes in the mucin composition and carbohydrate expression of goblet cell glycoconjugates, which are associated with a reduction in intestinal viscosity and decreased numbers of Camp . jejuni.

Lett Appl Microbiol, 2000 Dec, 31(6), 421 - 6
A rapid DNA isolation procedure for the identification of Campylobacter jejuni by the polymerase chain reaction; Englen MD et al.; We have developed an efficient process for rapidly isolating campylobacter DNA using mechanical disruption combined with the guanidine-based reagent DNAzol . Template DNA was isolated by this method from cultures of Campylobacter jejuni resistant to lysis by boiling or enzymes and identified following polymerase chain reaction (PCR) amplification using primers specific for the hippuricase gene . Direct detection of campylobacters in poultry-processing samples by PCR is demonstrated in chicken carcass rinses spiked with lysis-resistant C . jejuni . Our results indicate that this method of DNA isolation may be ideal for direct PCR detection of pathogenic bacteria in complex samples of widely varied origin, especially when the target organisms are difficult to lyse by other means.

Eur J Med Res, 2000 Nov 30, 5(11), 491 - 505
Dermatological infectiology--Quo vadis? Symposium, Ruhr-University, September 29-30, 2000 . Abstracts; Comparative in vitro activities of ABT-773 against 362 clinical isolates of anaerobic bacteria; Microbial Research Laboratory, Los Angeles County- University of Southern California Medical Center, Los Angeles, California 90033, USA . dcitron@hsc.usc.edu

The activity of ABT-773, a novel ketolide antibiotic, against clinical isolates of anaerobic bacteria was determined and compared to the activities of other antimicrobial agents . MICs at which 90% of isolates were inhibited (MIC(90)s) were </=0.06 microg/ml for Actinomyces spp., Clostridium perfringens, Peptostreptococcus spp., Propionibacterium spp., and Porphyromonas spp . The MIC(50)s and MIC(90)s were </=0.06 and >32 microg/ml, respectively, for Eubacterium spp., Lactobacillus spp., Clostridium difficile, and Clostridium ramosum . The MIC(90) for Bilophila wadsworthia, Bacteroides ureolyticus, and Campylobacter gracilis was 1 microg/ml, and that for Prevotella bivia and other Prevotella spp . was 0.5 microg/ml . The MIC(90) for Fusobacterium nucleatum was 8 microg/ml, and that for Fusobacterium mortiferum and Fusobacterium varium was >32 microg/ml . The MIC(90)s for the Bacteroides fragilis group were as follows: for B . fragilis, 8 microg/ml; for Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides distasonis, and Bacteroides uniformis, >32 microg/ml; and for Bacteroides vulgatus, 4 microg/ml . Telithromycin MICs for the B . fragilis group were usually 1 to 2 dilutions higher than ABT-773 MICs . For all strains, ABT-773 was more active than erythromycin by 4 or more dilutions, and for some strains this drug was more active than clindamycin.

J Appl Microbiol, 2000 Nov, 89(5), 892 - 9
The effect of thermal stress on Campylobacter coli; Moore JE et al.; AIM: Enteropathogenic Campylobacter jejuni, Camp . coli and Camp . lari are currently the most common cause of acute infectious diarrhoeal illness in the UK . Many domestic animals, including pigs, act as natural reservoirs for these organisms and infection may occur through the ingestion of contaminated foodstuffs . The safety of locally produced porcine liver was assessed in relation to the heat susceptibility of Campylobacter spp . present in eviscerated product . METHODS AND RESULTS: Heat susceptibility (D10) studies were performed on a wild-type strain of Camp . coli {NI39} isolated from porcine liver under standardized conditions . In addition, the effect of culture age and heating menstruum was determined . Thermal stress studies in phosphate-buffered saline showed Camp . coli NI39 to be heat sensitive (D10 = 8.-0, 30.8, 15.6, 10.3 s at 55.4, 57.4, 59.7, 61.2 degrees C, respectively; z = 6.10 degrees C) . However, non-logarithmic biphasic survivor curves were observed at higher temperatures ( > 56 degrees C), indicating the presence of a heat-resistant subpopulation (10(4)-10(5) cfu) which was not demonstrated when examining either Salmonella typhimurium or Listeria monocytogenes . CONCLUSIONS: The use of D10 values may be limited . Therefore, porcine liver, under processing, must be treated as a potential source of Campylobacter spp., and clearly defined F-values should be quantified through the use of empirically 'spiked' samples to ensure the eradication of campylobacters from the product, for each individual process being evaluated . SIGNIFICANCE AND IMPACT OF THE STUDY: It is important to define safe processing parameters in the manufacture of products which receive mild thermal processes in order to eliminate the risk of disease to man.

J Appl Microbiol, 2000 Nov, 89(5), 884 - 91
Comparison of three enrichment media for the isolation of Campylobacter spp . from foods; Baylis CL et al.; AIM: This study compared the performance of three Campylobacter enrichment broths: Bolton broth (BB), Campylobacter Enrichment broth (CEB) and Preston broth (PB) . METHODS AND RESULTS: Pure cultures of target and competitor organisms, and naturally-contaminated food samples, were used to establish the performance of these media . In pure culture the PB supported the growth of the greatest number of strains of Campylobacter spp . but failed to inhibit some competitor organisms . The CEB showed the opposite result, inhibiting all 15 competitor organisms used but failing to support the growth of five Campylobacter strains . By comparison, BB showed the best compromise between inhibition of competitors and growth of Campylobacter . CONCLUSIONS: Plates inoculated with BB and CEB food enrichments resulted in more Campylobacter growth than those inoculated with PB, which supported significantly less typical growth (P < or = 0.001) . The most common competitor organism isolated from PB was Escherichia coli, and Pseudomonas spp . were frequently isolated from BB and CEB . Both BB and CEB were better than PB for the isolation of Campylobacter from naturally-contaminated foods, although BB yielded more confirmed Campylobacter growth than CEB . SIGNIFICANCE AND IMPACT OF THE STUDY: This study highlighted differences in performance of media used to isolate Campylobacter spp . from foods.

Epidemiol Infect, 2000 Oct, 125(2), 269 - 75
Risk factors for indigenous campylobacter infection: a Swedish case-control study; Studahl A et al.; A case-control study was conducted in western Sweden (Alvsborg County) . The aim of the study was to identify any special food items or behaviours associated with an increased risk of contracting campylobacter infection . A total of 101 cases and 198 controls were matched for age, sex and district of residence . The following risk factors or risk behaviours were associated with campylobacter infection: drinking unpasteurized milk (OR 3.56, 95% CI 1.46-8.94), eating chicken (OR 2.29, 95% CI 1.29-4.23), or eating pork with bones (chops OR 2.02, 95% CI 1.17-3.64; loin of pork OR 1.83, 95% CI 1.07-3.12), barbecuing (OR 1.98, 95% CI 1.10-4.34), and living or working on a farm (farm OR 3.06, 95% CI 1.58-6.62, hen/chicken-breeder OR 3.32, 95% CI 1.56-6.78), daily contact with chickens or hens (OR 11.83, 95% CI 3.41-62.03).

Vet Pathol, 2000 Nov, 37(6), 589 - 96
Gastritis and intestinal metaplasia in Syrian hamsters infected with Helicobacter aurati and two other microaerobes; Patterson MM et al.; Chronic gastritis and intestinal metaplasia associated with naturally occurring colonization by Helicobacter aurati and two other microaerobic species were observed in Syrian hamsters . Thirty-five hamsters, between 7 and 12 months of age, were evaluated from two research and three commercial facilities . Microaerobic bacteria were cultured from the hamster stomachs . These bacteria included H . aurati, a fusiform, urease-positive species; a second novel helical, urease-negative Helicobacter sp.; as well as a smaller, urease-negative Campylobacter sp . Southern blot analysis detected Helicobacter spp . DNA in the gastric tissues of all 35 hamsters; 15 hamsters also had Campylobacter sp . DNA in their gastric tissues . When examined by light microscopy, argyrophilic bacteria consistent with H . aurati or the second Helicobacter sp . were present in antral sections of 12 out of the 15 hamsters where bacteria were seen, while 9 out of the 15 hamsters had bacteria resembling the Campylobacter sp . The presence of Helicobacter spp . but not the presence of Campylobacter sp . was significantly correlated to gastritis severity (P < 0.0001 for Helicobacter spp., P = 0.6025 for Campylobacter sp.) and intestinal metaplasia, as measured by numbers of goblet cells (P = 0.0239 for Helicobacter spp., P = 0.5525 for Campylobacter sp.) . Severely affected hamsters also had Giardia sp . within their metaplastic gastric pits . Hamsters with naturally occurring helicobacter-associated gastritis provide a model for studying the development of intestinal metaplasia and gastric giardiasis in H . pylori-infected humans.

Biochem J, 2000 Dec 15, 352 Pt 3, 637 - 43
Purification, characterization and sequence analysis of Omp50,a new porin isolated from Campylobacter jejuni; Bolla JM et al.; A novel pore-forming protein identified in Campylobacter was purified by ion-exchange chromatography and named Omp50 according to both its molecular mass and its outer membrane localization . We observed a pore-forming ability of Omp50 after re-incorporation into artificial membranes . The protein induced cation-selective channels with major conductance values of 50-60 pS in 1 M NaCl . N-terminal sequencing allowed us to identify the predicted coding sequence Cj1170c from the Campylobacter jejuni genome database as the corresponding gene in the NCTC 11168 genome sequence . The gene, designated omp50, consists of a 1425 bp open reading frame encoding a deduced 453-amino acid protein with a calculated pI of 5.81 and a molecular mass of 51169.2 Da . The protein possessed a 20-amino acid leader sequence . No significant similarity was found between Omp50 and porin protein sequences already determined . Moreover, the protein showed only weak sequence identity with the major outer-membrane protein (MOMP) of Campylobacter, correlating with the absence of antigenic cross-reactivity between these two proteins . Omp50 is expressed in C . jejuni and Campylobacter lari but not in Campylobacter coli . The gene, however, was detected in all three species by PCR . According to its conformation and functional properties, the protein would belong to the family of outer-membrane monomeric porins.

J Antimicrob Chemother, 2000 Dec, 46(6), 1023 - 7
In vitro activity of gemifloxacin (SB-265805) compared with 14 other antimicrobials against intestinal pathogens; Fernandez-Roblas R et al.; We studied the in vitro activity of gemifloxacin (SB-265805) and 14 comparator antimicrobials against 288 recent isolates of enteropathogenic bacteria (106 Salmonella: spp., 32 Hafnia alvei, 22 Yersinia enterocolitica, 21 Shigella: spp., 16 Aeromonas: spp . and 91 Campylobacter jejuni) . Gemifloxacin, the other fluoroquinolones and cefotaxime were very active against all microorganisms tested except for C . jejuni . Seventy-seven per cent of isolates of C . jejuni were inhibited by erythromycin < or =0.5 mg/L . Only one strain of C . jejuni was highly resistant to this antimicrobial agent . Of the compounds tested, gentamicin was the most active in vitro . The in vitro activity of the other antibiotics tested was variable . A quinolone could be a good choice for treating gastrointestinal infections when antimicrobial therapy is indicated . For C . jejuni, another antibiotic such as erythromycin should be considered.

Pediatr Infect Dis J, 2000 Nov, 19(11), 1060 - 7
Oral ciprofloxacin vs . intramuscular ceftriaxone as empiric treatment of acute invasive diarrhea in children; Leibovitz E et al.; BACKGROUND: Acute invasive diarrhea is a potentially serious condition in children . Because of the increasing resistance of enteric pathogens to commonly used oral antibiotics, intramuscular ceftriaxone has become the routine drug in the treatment of acute invasive diarrhea requiring an emergency visit in southern Israel . The inconvenience of this parenteral regimen created an increased need for oral pediatric formulations for the treatment of invasive diarrhea . OBJECTIVES: To evaluate the efficacy and safety of a suspension formulation of ciprofloxacin in the treatment of acute invasive diarrhea in infants and children . PATIENTS AND METHODS: From July 1996 through December 1997, 201 evaluable children ages 6 months to 10 years (35% <1 year; 70% <3 years) presenting with acute invasive diarrhea at the Pediatric Emergency Room were randomized to receive either ciprofloxacin suspension (10 mg/kg twice a day + im placebo; n = 95) or im ceftriaxone (50 mg/kg/day + placebo suspension; n = 106) for 3 days in a double blind manner . Stool cultures for Shigella, Salmonella, Campylobacter spp . and diarrheagenic Escherichia coli were obtained on Days 1, 3, 4 to 5 and 21 +/- 5 . Clinical response and safety were assessed on Days 1, 2, 3, 4 to 5 and 21 +/- 5 . RESULTS: We isolated 127 pathogens from 121 (60%) patients: 73 (57%) Shigella; 23 (18%) Salmonella; 18 (14%) E . coli; and 13 (10%) Campylobacter . Overall bacteriologic eradication on Day 4 to 5 was 99% for Shigella, 77% for Salmonella and 77% for Campylobacter, with no difference between the 2 groups . Clinical cure or improvement was observed in 100 and 99% of the ciprofloxacin and ceftriaxone groups, respectively . Serum ciprofloxacin values determined on Day 3 of the treatment were higher in the majority of patients than were the MIC50 and MIC90 values for the Shigella and Salmonella spp . isolated . Possible drug-related adverse events occurred in 13 patients {ciprofloxacin, 8 (8%); ceftriaxone, 5 (4.7%)} and were mild and transient . Joint examination was normal during and after completion of therapy in all patients . CONCLUSION: Oral ciprofloxacin was as safe and effective as intramuscular ceftriaxone for the empiric treatment of acute invasive diarrhea in ambulatory pediatric patients requiring an emergency room visit.

Acta Neurol Belg, 2000 Sep, 100(3), 167 - 70
Pathogenesis and treatment of inflammatory demyelinating polyradiculoneuropathy; Hughes RA; Inflammatory demyelinating polyradiculoneuropathy causes a spectrum of conditions ranging from acute (Guillain-Barre syndrome), through subacute to chronic forms . The pathogenesis of acute forms is related to antibody responses against glycolipid epitopes which mimic bacterial, especially Campylobacter jejuni, structures but T cells are also involved . The pathogenesis of chronic forms is poorly understood . Different forms differ in their responses to steroids . Chronic inflammatory demyelinating polyradiculoneuropathy responds to steroids but a variant multifocal motor neuropathy and the acute forms of inflammatory demyelinating polyradiculoneuropathy do not . Acute and chronic forms respond to plasma exchange and intravenous immunoglobulin.

Appl Environ Microbiol, 2000 Dec, 66(12), 5426 - 36
Detection on surfaces and in Caco-2 cells of Campylobacter jejuni cells transformed with new gfp, yfp, and cfp marker plasmids; Miller WG et al.; We have developed two sets of Campylobacter shuttle vectors containing either the gfp (green fluorescent protein), yfp (yellow fluorescent protein), or cfp (cyan fluorescent protein) reporter gene . In one set, the reporter gene is fused to a consensus Campylobacter promoter sequence (P(c)) . The other set contains a pUC18 multicloning site upstream of the reporter gene, allowing the construction of transcriptional fusions using known promoters or random genomic fragments . C . jejuni cells transformed with the P(c) fusion plasmids are strongly fluorescent and easily visualized on chicken skin, on plant tissue, and within infected Caco-2 cells . In each C . jejuni strain tested, these plasmids were maintained over several passages in the absence of antibiotic selection . Also, in many C . jejuni strains, >91% of the cells transformed with the P(c) fusion plasmids remained fluorescent after several days . Experiments with yellow fluorescent and cyan fluorescent C . jejuni transformants suggest that aggregates containing two or more strains of C . jejuni may be present in an enrichment broth culture . Colonies arising from these aggregates would be heterologous in nature; therefore, isolation of a pure culture of C . jejuni, by selecting single colonies, from an environmental sample may not always yield a single strain.

FEMS Microbiol Lett, 2000 Dec 1, 193(1), 161 - 9
Identification of taxonomic and epidemiological relationships among Campylobacter species by numerical analysis of AFLP profiles; On SL et al.; Amplified fragment length polymorphism (AFLP)-based profiling was performed on 138 strains representing all named Campylobacter species and subspecies . Profiles of 15/16 species comprised 6 to greater than 100 fragments and were subjected to numerical analysis . The mean similarity of 48 duplicate, outbreak and/or 'identical' strain profiles exceeded 94% . Species were clearly distinguished at the 17.90% similarity (S-) level in the dendrogram . Subspecies of Campylobacter jejuni and Campylobacter hyointestinalis, and biovars of Campylobacter lari and Campylobacter sputorum were distinguished at higher S-levels . All outbreak or 'genetically identical' strains of C . jejuni subsp . jejuni, Campylobacter coli, C . hyointestinalis and C . sputorum clustered at S-levels >92% and were distinguished from unrelated strains . Numerical analysis of AFLP profiles is useful for concurrent identification of taxonomic and epidemiological relationships among most Campylobacter species.

FEMS Microbiol Lett, 2000 Dec 1, 193(1), 89 - 94
Development of a multiplex PCR assay for the simultaneous detection and identification of Arcobacter butzleri, Arcobacter cryaerophilus and Arcobacter skirrowii; Houf K et al.; A multiplex PCR assay with five primers targeting the 16S and 23S rRNA genes was developed for the simultaneous detection and identification of Arcobacter butzleri, Arcobacter cryaerophilus and Arcobacter skirrowii . The selected primers amplify a 257-bp fragment from A . cryaerophilus, a 401-bp fragment from A . butzleri and a 641-bp fragment from A . skirrowii . No PCR product was generated for closely related bacteria including Campylobacter and Helicobacter species . The assay was useful to identify cultures after in vitro cultivation and to detect and identify A . butlzeri and A . cryaerophilus from poultry samples present in 24-h old enrichment in Arcobacter broth with cefoperazone, amphotericin and teicoplanin (CAT)-supplement.

Am J Physiol Gastrointest Liver Physiol, 2000 Dec, 279(6), G1129 - 34
Molecular physiology and pathophysiology of tight junctions V . assault of the tight junction by enteric pathogens; Sears CL; Studies of the impact of enteric pathogens and their virulence factors on the proteins comprising the tight junction and zonula adherens offer a novel approach to dissection of tight junctional complex regulation . Most studies to date provide only tantalizing clues that select pathogens may indeed assault the tight junctional complex . Information on critical human pathogens such as Campylobacter jejuni and Shigella and Salmonella subspecies is lacking . Mechanistic studies are currently sparse, but available results on pathogenic Escherichia coli and specific virulence factors such as the Rho-modifying and protease bacterial toxins indicate four major mechanisms by which these pathogens may act: 1) direct cleavage of tight junctional structural proteins; 2) modification of the actin cytoskeleton; 3) activation of cellular signal transduction; and 4) triggering transmigration of polymorphonuclear cells across the epithelial cell barrier . New therapeutics may evolve from detailed studies of these pathogens and the cellular processes and proteins they disrupt.

Curr Treat Options Gastroenterol, 2000 Jun, 3(3), 249 - 263
Bacterial Infections of the Colon; Hasan MS et al.; The colon is a common site of infection for a heterogeneous group of bacterial pathogens . The presentation of disease in the colon is generally in the form of distinct syndromes, and it is important for physicians to recognize the causative organisms, because specific treatment is highly effective . The flouroquinolones have emerged as the treatment of choice for most food-borne bacterial pathogens . Resistance to these agents is not a major issue at present except in Campylobacter . Clostridium difficile remains sensitive to both metronidazole and oral vancomycin . The majority of patients will respond to metronidazole, but oral vancomycin should be limited to severe cases of pseudomembranous colitis or treatment failures with metronidazole . Vancomycin is expensive and has the potential for the propagation of vancomycin resistance in other bacteria, notably enterococci . Patients appearing with proctitis should be screened for sexually transmitted diseases.

Curr Treat Options Neurol, 2000 Nov, 2(6), 507 - 516
Guillain-Barré Syndrome; van Der Meche FG et al.; Guillain-Barre syndrome (GBS) is an acute immune-mediated polyneuropathy . Two thirds of GBS patients are unable to walk at their most severe state of disease . Respiratory insufficiency and autonomic failure are probably the main causes of death . Optimal general care, physiotherapy and the availability of intensive care facilities at short distance are of great importance . Randomized controlled trials show that intravenous immune globulin (IVIg) and plasma exchange (PE) are equally effective in reducing the time to functional recovery . The combination of PE followed by IVIg, is not significantly better than IVIg or PE alone . Corticosteroids alone are not effective in GBS . Approximately 10% of GBS patients deteriorate after initial improvement or stabilization following IVIg or PE treatment, and often require repeated treatment . These "treatment related clinical fluctuations" are more frequently seen in relatively young patients with severe motor and sensory involvement associated with a preceding and possibly ongoing cytomegalovirus infection . Predominantly motor GBS is frequently preceded by a Campylobacter jejeuni infection . Diarrhea prior to GBS is associated with a worse predicted outcome . Further confirmation is needed to determine whether this is especially the case in those patients treated with PE . GBS patients who are unable to walk without assistance, and who are still within their first 2 weeks of the disease, need to be treated . One PE study showed that patients who are only mildly disabled showed positive progress from two plasma exchange sessions . Presently, due to its wide availability, ease of administration, and favorable side-effect profile, IVIg is considered to be the first-line treatment for patients with GBS . Current investigations are trying to determine if IVIg used in combination with methylprednisolone is even more effective in treating GBS.

Poult Sci, 2000 Nov, 79(11), 1689 - 93
Effects of hot water application after defeathering on the levels of Campylobacter, coliform bacteria, and Escherichia coli on broiler carcasses; Berrang ME et al.; Scalding has been found to lower the levels of Campylobacter on broiler carcasses . However, the numbers recovered from whole-carcass rinse samples increase following defeathering . This study was undertaken to examine the effect of a second scald applied after defeathering on microbial levels recovered from carcass rinses . Four treatments were evaluated: 1) immersion at 60 C for 28 s 30 min after defeathering, 2) immersion at 60 C for 28 s immediately after defeathering, 3) spray at 73 C for 20 s 30 min after defeathering, and 4) spray at 71 C for 20 s immediately after defeathering . As reported earlier, a significant increase in Campylobacter counts per mL whole carcass rinse was noted after carcasses were defeathered . However, when applied 30 min after defeathering, neither the immersion nor the spray second scald treatments lowered the Campylobacter counts . Likewise, neither treatment had any affect on Escherichia coli or coliform bacteria counts, even though total counts were slightly reduced by the treatments . When the second scald treatment immediately followed defeathering, the same trends were observed . Campylobacter counts after the second scald remained at the postpick levels, as did counts for E . coli and coliform bacteria, but total plate counts were slightly reduced . Overall, it would appear that a postscald treatment gentle enough not to alter the carcass appearance or meat quality would not effectively lower Campylobacter, E . coli, or coliform bacteria counts.

Ann Med, 2000 Oct, 32(7), 440 - 5
Campylobacters: the most common bacterial enteropathogens in the Nordic countries; Rautelin H et al.; Campylobacters have been known as important human pathogens since the late 1970s . Campylobacter jejuni and coli are the most common bacterial enteropathogens in the developed countries . During the past years an increasing incidence of campylobacteriosis has been reported in many developed countries . C . jejuni is the most common Campylobacter species while C . coli accounts for about 5-10% of the cases . Although the genome of C . jejuni NCTC 11168 strain was sequenced recently, the exact pathogenetic mechanisms are still not known . Furthermore, there are no reliable animal models available . The epidemiology of this common infection is not well understood; however, eating and handling poultry, contaminated drinking water, and contact with pet animals have been recognized as important risk factors . Most of the cases are sporadic although large water-borne outbreaks have also been reported . Discriminatory typing methods are helpful in tracing the sources and transmission routes . In addition to traditional serotyping, genotyping methods, such as pulsed-field gel electrophoresis, have been developed . As Campylobacter infections probably precede Guillan-Barre syndrome in many cases, a great interest has lately been focused on the possible triggering mechanisms underlying this phenomenon.

Postgrad Med J, 2000 Dec, 76(902), 790 - 1
Recurring febrile illness in a slaughterhouse worker; Ganeshram KN et al.; A slaughterhouse worker presented with fever and a pleuropericardial effusion . Conventional microbiology failed to identify the responsible organism . However, DNA sequencing definitively identified Campylobacter fetus ssp fetus, which is rare in immunocompetent individuals . Prolonged treatment was required to eradicate the infection.

Infect Immun, 2000 Dec, 68(12), 7137 - 40
DNA rearrangements in the flagellin locus of an flaA mutant of Campylobacter jejuni during colonization of chicken ceca; Nuijten PJ et al.; Campylobacter jejuni is an enteropathogen for humans but commensal for chickens . In both hosts, the flagella and motility are important colonization factors . The flagellin gene is duplicated in Campylobacter, but only one flagellin gene, flaA, is sufficient for motility . We found that, during colonization of the chicken intestine, a nonmotile flaA mutant of C . jejuni underwent rearrangements within its flagellin locus, thereby regaining its motility and colonization capacity . In contrast, in vitro motile revertants isolated from liquid culture showed different flagellin DNA rearrangements than after reversion in the chicken.

Infect Immun, 2000 Dec, 68(12), 6656 - 62
Sialylation of lipooligosaccharide cores affects immunogenicity and serum resistance of Campylobacter jejuni; Guerry P et al.; Three genes involved in biosynthesis of the lipooligosaccharide (LOS) core of Campylobacter jejuni MSC57360, the type strain of the HS:1 serotype, whose structure mimics GM(2) ganglioside, have been cloned and characterized . Mutation of genes encoding proteins with homology to a sialyl transferase (cstII) and a putative N-acetylmannosamine synthetase (neuC1), part of the biosynthetic pathway of N-acetylneuraminic acid (NeuNAc), have identical phenotypes . The LOS cores of these mutants display identical changes in electrophoretic mobility, loss of reactivity with cholera toxin (CT), and enhanced immunoreactivity with a hyperimmune polyclonal antiserum generated against whole cells of C . jejuni MSC57360 . Loss of sialic acid in the core of the neuC1 mutant was confirmed by fast atom bombardment mass spectrometry . Mutation of a gene encoding a putative beta-1,4-N-acetylgalactosaminyltransferase (Cgt) resulted in LOS cores intermediate in electrophoretic mobility between that of wild type and the mutants lacking NeuNAc, loss of reactivity with CT, and a reduced immunoreactivity with hyperimmune antiserum . Chemical analyses confirmed the loss of N-acetylgalactosamine (GalNAc) and the presence of NeuNAc in the cgt mutant . These data suggest that the Cgt enzyme is capable of transferring GalNAc to an acceptor with or without NeuNAc and that the Cst enzyme is capable of transferring NeuNAc to an acceptor with or without GalNAc . A mutant with a nonsialylated LOS core is more sensitive to the bactericidal effects of human sera than the wild type or the mutant lacking GalNAc.

Infect Immun, 2000 Dec, 68(12), 6535 - 41
Campylobacter jejuni cytolethal distending toxin mediates release of interleukin-8 from intestinal epithelial cells; Hickey TE et al.; Live cells of Campylobacter jejuni and Campylobacter coli can induce release of interleukin-8 (IL-8) from INT407 cells . Additionally, membrane fractions of C . jejuni 81-176, but not membrane fractions of C . coli strains, can also induce release of IL-8 . Membrane preparations from 81-176 mutants defective in any of the three membrane-associated protein subunits of cytolethal distending toxin (CDT) were unable to induce IL-8 . The presence of the three cdt genes on a shuttle plasmid in trans restored both CDT activity and the ability to release IL-8 to membrane fractions . However, CDT mutations did not affect the ability of 81-176 to induce IL-8 during adherence to or invasion of INT407 cells . When C . jejuni cdt genes were transferred on a shuttle plasmid into a C . coli strain lacking CDT, membrane preparations became positive in both CDT and IL-8 assays . Growth of C . jejuni in physiological levels of sodium deoxycholate released all three CDT proteins, as well as CDT activity and IL-8 activity, from membranes into supernatants . Antibodies against recombinant forms of each of the three CDT subunit proteins neutralized both CDT activity and the activity responsible for IL-8 release . The data suggest that C . jejuni can induce IL-8 release from INT407 cells by two independent mechanisms, one of which requires adherence and/or invasion and the second of which requires CDT.

Antimicrob Agents Chemother, 2000 Dec, 44(12), 3364 - 7
Photoactive porphyrin derivative with broad-spectrum activity against oral pathogens In vitro; Rovaldi CR et al.; Photodynamic therapy (PDT) has historically been used as a means to treat cancerous tumors but has recently been used to kill bacterial cells through the use of targeted photosensitizers . PDT is a potential adjunct to scaling and root planing in the treatment of periodontal disease . However, the effectiveness of porphyrin derivatives against microorganisms has been limited because some gram-negative bacteria are refractory to photodynamic treatment with these agents . We have designed a porphyrin derivative conjugated to a pentalysine moeity that endows the molecule with activity against gram-positive and gram-negative bacteria . Whereas the porphyrin, chlorin e6, showed in vitro activity against a limited spectrum of bacteria, chlorin e6 conjugated to pentalysine showed in vitro activity against all oral microorganisms tested, including Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum subsp . polymorphum, Actinomyces viscosus, and the streptococci . Potent antimicrobial activity (>/=5-log-unit reduction in the numbers of CFU per milliliter) was retained in the presence of up to 25% whole sheep blood . The use of potent, selective agents such as this chlorin e6-pentalysine conjugate to more effectively reduce the pathogenic bacteria in the periodontal pocket may be a significant tool for the treatment of periodontal disease.

J Food Prot, 2000 Nov, 63(11), 1594 - 7
Reduction of Campylobacter jejuni in a simulated chicken digestive tract by Lactobacilli cultures; Chang MH et al.; Studies were conducted to investigate the impact of a selected lactobacilli mixed culture on Campylobacter jejuni in simulated chicken digestive tract models . Veronal buffer solutions corresponding to the pH of successive segments of the chicken digestive tract were prepared . The lactobacilli mixtures were prepared by mixing four fresh lactobacilli cultures, including Lactobacillus acidophilus, Lactobacillus fermenentum, Lactobacillus crispatus, and Lactobacillus brevis . The C . jejuni and lactobacilli mixture were mixed with sterile poultry feed, and the previously prepared veronal buffer solutions were then added separately . The mixture was incubated at 41.1 degrees C for various lengths of time with periodic agitation . The feed passage time for five segments of the digestive tract were adopted: crop (pH 4.5), 30 min; proventriculus (pH 4.4), 15 min; gizzard (pH 2.6), 90 min; small intestine (pH 6.2), 90 min; and large intestine (pH 6.3), 15 min . The Campylobacter and lactobacilli were enumerated . An antagonistic effect on C . jejuni by the tested lactobacilli spp . was found in individual sections and the complete simulated digestive tract models . In the simulated complete chicken digestion system, no C . jejuni were found during the final incubation period when a lactobacilli mixture was present . The results of this in vitro study indicate the potential value of future in vivo studies.

J Infect Dis, 2001 Jan 1, 183(1), 164 - 7 Epub 2000 Nov 14.
An outbreak of Campylobacter jejuni infections associated with food handler contamination: the use of pulsed-field gel electrophoresis; Olsen SJ et al.; In 1998, an outbreak of Campylobacter jejuni infections occurred in Kansas among persons attending a school luncheon; community cases were also reported . In a cohort study of luncheon attendees, 27 (17%) of 161 persons reported illness . Consuming gravy (relative risk {RR}, 4.2; 95% confidence interval {CI}, 1.5-11.7) or pineapple (RR, 2.4; 95% CI, 1.0-5.7) was associated with illness . Both foods were prepared in a kitchen that served 6 other schools where no illness was reported . A cafeteria worker at the luncheon had a diarrheal illness and was the likely source of the outbreak . The pulsed-field gel electrophoresis (PFGE) patterns of the isolates from the food handler and those of 8 lunch attendees were indistinguishable . Isolates from 4 community patients differed . This was the first use of PFGE in a Campylobacter outbreak in the United States; its use was critical in determining that community cases were not linked.

Cytobios, 2000, 103(403), 91 - 101
Genotyping of clinical and chicken isolates of Campylobacter jejuni and Campylobacter coli; Smith SI et al.; Genomic DNA from 58 strains of Campylobacter made up of 48 Campylobacter jejuni and ten Campylobacter coli were digested with Sma I and analysed by pulsed-field gel electrophoresis (PFGE) . The cleavage of DNA by Sma I gave 22 distinct hybridization patterns . The two Campylobacter species were subtyped by PFGE . The average genomic size for C . jejuni by Sma I digestion was 1.73 Mb, while that of C . coli gave 1.7 Mb . Results from this study indicate that PFGE analysis by Sma I digested genomic DNA provides a reliable means of differentiating between and within species of Campylobacter and provides a practical approach to epidemiological studies of Campylobacter.

Gut, 2000 Dec, 47(6), 804 - 11
Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome; Spiller RC et al.; BACKGROUND AND AIMS: Post-dysenteric irritable bowel syndrome (PD-IBS) develops in up to 25% of patients following Campylobacter enteritis . Our aim was to define the pathological basis of this subgroup of IBS . METHODS: Twenty one patients (group 1) underwent serial rectal biopsy and gut permeability testing following acute Campylobacter enteritis as did 10 PD-IBS patients (group 2) and 12 asymptomatic controls . RESULTS: In group 1, enteroendocrine cell (EC) numbers were markedly increased initially and at six and 12 weeks (p<0.001) compared with controls . Gut permeability, as assessed by the lactulose/mannitol ratio, was significantly elevated, initially and at 12 weeks (p<0.005) . CD3, CD4, and CD8 lymphocyte counts in the lamina propria and intraepithelial lymphocytes (IEL) were significantly increased initially compared with controls . At visit 1, EC numbers were positively correlated with CD3 counts (r=0.6, p=0.01) . At one year, seven subjects (five with persistent loose stools) had rectal biopsies which showed significantly elevated EC, CD3, and IEL counts . In group 2, EC and IEL counts were significantly increased compared with controls (p<0.001), as was gut permeability (p<0.01) . CONCLUSION: Increased EC, T lymphocytes, and gut permeability are acute changes following Campylobacter enteritis which can persist for more than a year and may contribute to PD-IBS.

J Vet Med B Infect Dis Vet Public Health, 2000 Oct, 47(8), 635 - 9
Expression of invasiveness of Campylobacter jejuni ssp . jejuni after serial intraperitoneal passages in mice; Fernandez H et al.; We investigated the possibility of inducing the expression of invasiveness in 10 non-invading, laboratory-adapted Campylobacter jejuni ssp . jejuni strains, after serial intraperitoneal (i.p.) passage in mice . All the strains expressed invasive capacity after the first passage, with an increase in invasion rates and the number of internalized bacteria after each passage . These results suggest that i.p . passage enhances the expression of invasiveness in C . jejuni ssp . jejuni strains.

J Clin Periodontol, 2000 Nov, 27(11), 810 - 8
Microbiological parameters associated with IL-1 gene polymorphisms in periodontitis patients; Socransky SS et al.; BACKGROUND, AIMS: Polymorphisms in the cluster of IL-1 genes have been significantly associated with the severity of adult periodontitis . The purpose of this study was to compare microbiological parameters in IL-1 genotype negative and positive adult subjects with a range of periodontitis severities . METHOD: The study included 108 subjects in good general health . Clinical parameters were recorded at 6 sites/tooth excluding 3rd molars and included: plaque accumulation, gingival erythema, bleeding on probing, suppuration, pocket depth and attachment level . Subgingival plaque samples were collected from the mesiobuccal surface of up to 28 teeth in each subject (mean 25.3) providing a total of 2736 samples . The levels of 40 subgingival taxa were determined in each sample using checkerboard DNA-DNA hybridization . Fingerstick blood samples were collected for IL-1A (+4845) and IL-1B (+3954) genotyping using PCR-based methods . RESULTS: The proportion of IL-1 genotype positive subjects that exhibited mean counts of specific subgingival species above selected thresholds was significantly higher than the proportion of genotype negative subjects . Prominent among species that were detected at higher levels in genotype positive subjects were members of the "red" and "orange" complexes and included: Bacteroides forsythus, Treponema denticola, the Fusobacterium nucleatum subspecies, Fusobacterium periodonticum, Campylobacter gracilis, Campylobacter showae and Streptococcus constellatus . Streptococcus intermedius, Streptococcus gordonii and 3 Capnocytophaga species were also detected more frequently at high numbers in genotype positive subjects . Significantly higher mean counts of B . forsythus, Porphyromonas gingivalis, T . denticola, the F . nucleatum subspecies, F . periodonticum, Campylobacter rectus, C . showae, Eubacterium nodatum, S . constellatus, S . gordonii, and S . intermedius were detected at periodontal pockets >6 mm in subjects who were genotype positive when compared with genotype negative subjects . The increase was due to increased numbers of cells of these species rather than a major shift in proportion . CONCLUSION: The data suggest that genotype positive subjects more frequently had higher levels of "red" and "orange" complex species that are known to be strongly associated with measures of periodontal inflammation.

FEMS Immunol Med Microbiol, 2000 Nov, 29(3), 203 - 11
Uptake pathways of clinical and healthy animal isolates of Campylobacter jejuni into INT-407 cells; Biswas D et al.; Campylobacter jejuni isolates obtained from human and animal sources showed different invasion levels into human embryonic intestinal (INT-407) cells . There was no significant relation between the degree of invasion and cytotoxins production . The depolymerization of both microfilaments by cytochalasin-D and microtubules by colchicine, demecolcine and nocodazole or stabilization of microtubules by paclitaxel reduced the invasiveness of C . jejuni, although microfilament depolymerization showed greater inhibition than microtubule depolymerization . Interference with receptor-mediated endocytosis by G-strophanthin and monodansylcadaverine and inhibition of endosome acidification by monensin reduced the number of viable intracellular C . jejuni cells . Furthermore inhibition of only host protein kinases by staurosporine, but not phosphoinositide 3-kinase by wortmannin or protein kinase-C by calphostin-C, significantly reduced invasion of epithelial cells by C . jejuni . These data suggest that the internalization mechanism triggered by C . jejuni is strikingly different from the microfilament-dependent invasion mechanism exhibited by many of the well-studied enteric bacteria such as enteroinvasive strains of Escherichia coli, Salmonella typhimurium, Shigella flexneri, Yersinia enterocolitica and Yersinia pseudotuberculosis.

J Neuroimmunol, 2000 Nov 1, 111(1-2), 229 - 33
A case of Guillain-Barré syndrome following a family outbreak of Campylobacter jejuni enteritis; Ang CW et al.; We describe an outbreak of Campylobacter jejuni enteritis involving three family members of whom one developed Guillain-Barre syndrome (GBS) . The patients' serum reacted strongly with several gangliosides and with the lipopolysaccharide (LPS) fractions from the C . jejuni strains isolated from his family members . Only low titer anti-ganglioside antibodies were found in his siblings . HLA-typing did not indicate a locus associated with auto-antibody production . Comparing the immune response in GBS patients and C . jejuni enteritis patients can be of great value in determining the additional factors that lead to post-Campylobacter GBS . Ganglioside mimicry alone is necessary but not sufficient for the induction of anti-ganglioside antibodies . Other susceptibility factors are required to induce an anti-neural immune response.

J Clin Microbiol, 2000 Nov, 38(11), 3971 - 8
Identification of ciprofloxacin-resistant Campylobacter jejuni by use of a fluorogenic PCR assay; Wilson DL et al.; Fluoroquinolones are one class of antimicrobial agents commonly used to treat severe Campylobacter jejuni infection . C . jejuni strains resistant to high levels of the fluoroquinolone ciprofloxacin (MIC >/=16 microg/ml) have been predominantly characterized with a C-->T transition in codon 86 of gyrA . The gyrA gene encodes one subunit of DNA gyrase, which is a primary target for fluoroquinolone antibiotics . This study establishes a rapid PCR-based TaqMan method for identifying ciprofloxacin-resistant C . jejuni strains that carry the C-->T transition in codon 86 of gyrA . The assay uses real-time detection, eliminating the need for gel electrophoresis . Optimization of the assay parameters using purified Campylobacter DNA resulted in the ability to detect femtogram levels of DNA . The method should be useful for monitoring the development of ciprofloxacin resistance in C . jejuni . Compiled nucleotide sequence data on the quinolone resistance-determining region of gyrA in Campylobacter indicate that sequence comparison of this region is a useful method for tentative identification of Campylobacter isolates at the species level.

Epidemiol Infect, 2000 Aug, 125(1), 13 - 6
Epidemiologic application of pulsed-field gel electrophoresis to an outbreak of Campylobacter jejuni in an Austrian youth centre; Lehner A et al.; We report the first documented Campylobacter jejuni outbreak in an Austrian youth centre . Sixty-four children were involved of which 38 showed classical signs of campylobacter gastroenteritis . Since unpasteurized milk distributed by a local dairy was suspected to be the source of infection, stool samples were collected from 20 cows providing the milk . Five of the cows tested positive for C . jejuni . These isolates together with 37 clinical samples were compared by pulsed-field-gel electrophoresis (PFGE) . The PFGE patterns, using the restriction endonucleases SmaI and SalI, were identical for the human and bovine isolates.This finding confirmed that the outbreak was caused by the consumption of unpasteurized milk contaminated with C . jejuni.

J Appl Microbiol, 2000 Oct, 89(4), 719 - 25
Detection of a novel campylobacter cytotoxin; Lee A et al.; The culture filtrates from 10 Campylobacter species were screened for the presence of cytotoxins on a variety of selected tissue culture cell lines . Some Campylobacter jejuni strains showed no effects on tissue culture cell lines compared with other C . jejuni strains, especially C . jejuni 81116, which consistently produced a cytotoxin that was lethal to tissue culture cells . It was observed that CHO cells were the most sensitive cell line in detecting campylobacter cytotoxins . Samples containing the culture filtrate of C . jejuni 81116 prepared at various growth stages were used to determine the subcellular location of the cytotoxin . This C . jejuni 81116 cytotoxin appears to be a heat-stable toxin that is secreted from the cell during stationary phase; cytotoxin activity can be abolished with proteolytic enzymes.

Clin Infect Dis, 2000 Oct, 31(4), 1079 - 83 Epub 2000 Oct 25.
Empirical antimicrobial therapy for traveler's diarrhea; Adachi JA et al.; Over 7 million cases of traveler's diarrhea, defined as the passage of > or = 3 unformed stools in a 24-h period, occur each year among visitors to developing countries . Bacterial enteric pathogens are the most common etiologic agents isolated . Preliminary clinical results for patients with diarrhea predominantly caused by Campylobacter species have shown that azithromycin may be an effective alternative to fluoroquinolones for the treatment of traveler's diarrhea.

J Food Prot, 2000 Oct, 63(10), 1430 - 2
Diminution of Campylobacter colonization in neonatal pigs reared off-sow; Harvey RB et al.; Pigs may be a natural reservoir of Campylobacter and can be colonized as early as 24 h after birth . The purpose of the present study was to evaluate what effect early removal of piglets from Campylobacter-positive sows has on Campylobacter prevalence in neonates . In two trials, piglets were removed from sows within 24 h of birth and were reared in nurseries isolated from sows for 21 days . From the neonates rectal swabs were cultured for Campylobacter, and Campylobacter status of the isolated piglets was compared to that of littermates reared on sows . The nurseries consisted of wire-floored farrowing crates that were equipped with heaters and self-feeders . In trial I, the Campylobacter prevalence in nursery-reared piglets was 13 of 14 on day 2 and 0 of 14 on day 20 . Campylobacter prevalence in the sow-reared piglets was 8 of 9 from days 2 to 20 . In trial II, 12 of 29 on day 2, and 5 of 26 on day 20, of the nursery-reared piglets were culture positive for Campylobacter . For the sow-reared piglets, Campylobacter prevalence was 7 of 15 on day 1 and 15 of 15 (100%) on day 20 . These data suggest that successful permanent colonization of the gut by Campylobacter is probably related to constant exposure of piglets to Campylobacter-positive feces . Campylobacter prevalence may be diminished in neonates that are reared off-sow in isolated nurseries.

J Food Prot, 2000 Oct, 63(10), 1426 - 9
Milkborne campylobacter infection in Hungary; Kalman M et al.; In April 1998, an annual 2-day animal farm sale was held in Hodmezovasarhely, where 500 to 600 visitors consumed unpasteurized milk . The first signs of disease began 2 days after the end of the sale . Fifty-two people from a wide age range fell ill, primarily with inflammatory enteritis . These cases included 34 with Campylobacter positivity: 30 with Campylobacter jejuni and 4 with Campylobacter coli . Environmental samples (raw milk, udder swabs, and rectal swabs from 12 cows in the suspected herd) were tested 2 weeks after the first signs of the disease, and two rectal swabs were found to be positive for C . jejuni . Initially, the epidemic seemed to be sporadic and, accordingly, only 26 human and 2 animal Campylobacter isolates were reserved for randomly amplified polymorphic DNA analysis . This comparative analysis verified that fecally contaminated milk was the source of the outbreak . The DNA-banding patterns of 20 C . jejuni isolates (19 human and 1 animal) were identical . The antibiotic susceptibilities of the Campylobacter isolates were determined, and only six C . jejuni (human) isolates, one C . coli (human) isolate, and one C . jejuni (animal) isolate were resistant to tetracycline, both by disk diffusion and by E test (antimicrobial gradient strip for the quantitative determination of susceptibility or resistance of microorganisms) . No plasmid was detected in these tetracycline-resistant isolates . The endotoxin production of Campylobacter isolates was examined via the cytopathogenic effect on the Vero cell line . This effect exhibited various degrees of positivity in 19 cases . Only two human C . jejuni isolates displayed + + + + positivity . Both isolates were from patients who had required antibiotic therapy and hospital care.

J Food Prot, 2000 Oct, 63(10), 1315 - 20
A summary of reported foodborne disease incidents in Sweden, 1992 to 1997; Lindqvist R et al.; Reports of foodborne disease incidents in Sweden from 1992 to 1997 are summarized . The results are based on reports from the municipal environmental and public health authorities to the National Food Administration and from medical authorities to the Swedish Institute for Infectious Diseases Control . A total of 555 incidents, of which 84% were outbreaks, were reported, involving 11,076 ill people . In 66% of the incidents, no disease agent was determined . Bacterial agents were implicated in 25% and viruses in 8% of the incidents . Calicivirus was the most reported agent both in terms of incidents and cases . Mixed dishes was the food category most often implicated in outbreaks, and smorgasbord and casserole or stews were the subcategories that caused the most cases . The place of consumption was unknown in 8% of the incidents . In about 60% of the incidents, the implicated food was consumed in commercial food establishments; in approximately 20% of incidents, it was consumed at home . The average annual incidence of reported foodborne disease in Sweden was estimated to be 21 cases per 100,000 . The average annual incidence of reported foodborne salmonellosis and campylobacteriosis was estimated to be 2.0 and 0.6 cases per 100,000, respectively . The awareness and motivation to report foodborne diseases need to be improved, but additional sources of information are needed to counteract some of the limitations of reporting discussed in this work.

Dtsch Tierarztl Wochenschr, 2000 Aug, 107(8), 305 - 10
{Microbial contamination in human and animal drinking water}; Bohm R; Water plays an important roll in the epidemiology of a lot of infectious diseases . Groundwater as well as surface water contains generally microorganisms of several species, which cannot always differentiated properly in autochthonous flora and contaminants with health significance . Sources of bacterial or viral contaminants may be feces from man and/or animals but with different counts in ground and surface water . With respect to water used for supplying farm animals it is stated that it must have initially drinking water quality . Since it generally looses this quality in this supply system the following requirements shall be met: Free of Salmonellas and/or Campylobacter in 100 ml, no E . coli in 10 ml, total bacterial count at 37 degrees C less than 1000 cfu/ml and total bacterial count at 20 degrees C less than 10,000 cfu/ml.

Antimicrob Agents Chemother, 2000 Nov, 44(11), 3069 - 73
A novel action of the proton pump inhibitor rabeprazole and its thioether derivative against the motility of Helicobacter pylori; Tsutsui N et al.; The motility of Helicobacter pylori was maximum at 37 degrees C and at pH 6 . A newly developed proton pump inhibitor, rabeprazole (RPZ), and its thioether derivative (RPZ-TH) markedly inhibited the motility of H . pylori . The concentrations of the drug necessary to inhibit 50% of the motility were 0.25, 16, 16, and >64 microgram/ml for RPZ-TH, RPZ, lansoprazole, and omeprazole, respectively . No such inhibitory effects were observed with H(2) blockers or anti-H . pylori agents . The motilities of Campylobacter jejuni and C . coli-but not those of Vibrio cholerae O1 and O139, Vibrio parahaemolyticus, Salmonella enterica serovar Typhimurium, and Proteus mirabilis-were also inhibited . Prolonged incubation with RPZ or RPZ-TH inhibited bacterial growth of only H . pylori, except for a turbid colony mutant . The results indicate that RPZ and RPZ-TH have a characteristic inhibitory effect against the motility of H . pylori (spiral-shaped bacteria), which is distinguished from that against bacterial growth.

Infect Immun, 2000 Nov, 68(11), 6337 - 45
Role of catalase in Campylobacter jejuni intracellular survival; Day WA Jr et al.; The ability of Campylobacter jejuni to penetrate normally nonphagocytic host cells is believed to be a key virulence determinant . Recently, kinetics of C . jejuni intracellular survival have been described and indicate that the bacterium can persist and multiply within epithelial cells and macrophages in vitro . Studies conducted by Pesci et al . indicate that superoxide dismutase contributes to intraepithelial cell survival, as isogenic sod mutants are 12-fold more sensitive to intracellular killing than wild-type strains . These findings suggest that bacterial factors that combat reactive oxygen species enable the organism to persist inside host cells . Experiments were conducted to determine the contribution of catalase to C . jejuni intracellular survival . Zymographic analysis indicated that C . jejuni expresses a single catalase enzyme . The gene encoding catalase (katA) was cloned via functional complementation, and an isogenic katA mutant strain was constructed . Kinetic studies indicate that catalase provides resistance to hydrogen peroxide in vitro but does not play a role in intraepithelial cell survival . Catalase does however contribute to intramacrophage survival . Kinetic studies of C . jejuni growth in murine and porcine peritoneal macrophages demonstrated extensive killing of both wild-type and katA mutant strains shortly following internalization . Long-term cultures (72 h postinfection) of infected phagocytes permitted recovery of viable wild-type C . jejuni; in contrast, no viable katA mutant bacteria were recovered . Accordingly, inhibition of macrophage nitric oxide synthase or NADPH oxidase permitted recovery of katA mutant C . jejuni . These observations indicate that catalase is essential for C . jejuni intramacrophage persistence and growth and suggest a novel mechanism of intracellular survival.

Infect Immun, 2000 Nov, 68(11), 6168 - 75
Detection and characterization of autoagglutination activity by Campylobacter jejuni; Misawa N et al.; In several gram-negative bacterial pathogens, autoagglutination (AAG) activity is a marker for interaction with host cells and virulence . Campylobacter jejuni strains also show AAG, but this property varies considerably among strains . To examine the characteristics of C . jejuni AAG, we developed a quantitative in vitro assay . For strain 81-176, which shows high AAG, activity was optimal for cells grown for < or = 24 h, was independent of growth temperature, and was best measured for cells suspended in phosphate-buffered saline at 25 degrees C for 24 h . AAG activity was heat labile and was abolished by pronase or acid-glycine (pH 2.2) treatment but not by lipase, DNase, or sodium metaperiodate . Strain 4182 has low AAG activity, but extraction with water increased AAG, suggesting the loss of an inhibitor . Strain 6960 has weak AAG with no effect due to water extraction . Our study with clinical isolates suggests that C . jejuni strains may be grouped into three AAG phenotypes . A variant derived from strain 81116 that is flagellate but immotile showed the strong AAG exhibited by the parent strain, suggesting that motility per se is not necessary for the AAG activity . AAG correlated with both bacterial hydrophobicity and adherence to INT407 cells . Mutants which lack flagella (flaA, flaB, and flbA) or common cell surface antigen (peb1A) were constructed in strain 81-176 by natural transformation-mediated allelic exchange . Both AAG activity and bacterial hydrophobicity were abolished in the aflagellate mutants but not the peb1A mutant . In total, these findings indicate that C . jejuni AAG is highly associated with flagellar expression.

Microb Pathog, 2000 Nov, 29(5), 257 - 66
A 26 kDa protein of helicobacter pylori shows alkyl hydroperoxide reductase (AhpC) activity and the mono-cistronic transcription of the gene is affected by pH; Lundstrom AM et al.; The 26 kDa protein of Helicobacter pylori, with 67% amino acid identity to alkyl hydroperoxide reductase (AhpC) of Campylobacter jejuni, was studied . We wanted to evaluate it the protein has AhpC activity . Therefore, an Escherichia coli mutant defective for alkyl hydroperoxide reductase and a plasmid expressing the 26 kDa protein from H . pylori were used in complementation studies . The complemented E . coli mutant showed a decreased sensitivity to cumene hydroperoxide indicating that the 26 kDa protein of H . pylori has AhpC activity and could be of importance in the defence against oxidative stress . Furthermore, Northern blot analysis detected one mRNA transcript of approximately 700 bp which is in agreement with the gene being transcribed as a single gene with its own promoter . This promoter region was further characterized by primer extension experiments . Additional studies on how environmental factors, such as long term growth and pH, can affect the transcription of the gene were performed on two H . pylori strains . We found that low pH and long term growth repressed transcription of the gene . Attempts to construct a mutant deficient for the gene in H . pylori were unsuccessful .

Science, 2000 Oct 13, 290(5490), 354 - 7
A bacterial toxin that controls cell cycle progression as a deoxyribonuclease I-like protein; Lara-Tejero M et al.; Many bacterial pathogens encode a multisubunit toxin, termed cytolethal distending toxin (CDT), that induces cell cycle arrest, cytoplasm distention, and, eventually, chromatin fragmentation and cell death . In one such pathogen, Campylobacter jejuni, one of the subunits of this toxin, CdtB, was shown to exhibit features of type I deoxyribonucleases . Transient expression of this subunit in cultured cells caused marked chromatin disruption . Microinjection of low amounts of CdtB induced cytoplasmic distention and cell cycle arrest . CdtB mutants with substitutions in residues equivalent to those required for catalysis or magnesium binding in type I deoxyribonucleases did not cause chromatin disruption . CDT holotoxin containing these mutant forms of CdtB did not induce morphological changes or cell cycle arrest.

Schweiz Med Wochenschr, 2000 Sep 9, 130(36), 1265 - 71
{Diagnosis and course of myocarditis: a survey in the medical clinics of Zurich University Hospital 1980 to 1998}; Sauvant G et al.; The clinical picture of myocarditis/myopericarditis is of importance in differential diagnosis, especially in younger patients with suspected myocardial infarction . Myocarditis/myopericarditis commonly presents with chest pain, and the diagnosis is usually established on clinical grounds . However, endomyocardial biopsy is necessary to confirm the diagnosis . We evaluated the characteristics of acute myocarditis over the years 1980-1998 in 54 patients of the Department of Medicine of the University Hospital, Zurich . Two to 6 patients per year were hospitalised with this diagnosis . In most cases the diagnosis was established by a combination of criteria, such as a preceding infection of the upper respiratory tract, thoracic pain, ST segment elevations in different precordial leads followed by T wave inversions, arrhythmias, elevation of cardiac enzymes, reversible hypokinesia by echocardiography and normal coronary arteries . At least 3 of 5 criteria were requested . In a first step we analysed retrospectively all patients with acute myocarditis/myopericarditis in the years 1980-1993 . Among 30 cases of acute myocarditis/myopericarditis the following causes could be identified: one influenza B, one Toxoplasma gondii infection, 2 Epstein-Barr infections and one bacterial myocarditis with gram-negative rods . The aetiology of the other 25 cases remained unknown . The majority of myocarditis/myopericarditis healed without complications . One patient with Epstein-Barr myocarditis and one with Toxoplasma gondii infection died . Two patients developed dilated cardiomyopathy . In a second phase we analysed prospectively all cases with acute myocarditis/myopericarditis over the period 1994-1998: 24 patients with acute myocarditis/myopericarditis were hospitalised . At that time coronary angiography and endomyocardial biopsies were performed more frequently . We found 2 patients with giant cell myocarditis and 2 with Toxoplasma gondii infection and HIV, all of whom died . In addition, there were 2 patients with eosinophilic myocarditis, one with Lyme carditis, one with Epstein-Barr myocarditis, one with myopericarditis after Campylobacter enteritis and one histologically proven myocarditis after pneumonia with Haemophilus influenzae . The aetiology of the remaining 13 cases with myocarditis/myopericarditis could not be established . Three patients with probable viral myocarditis developed cardiogenic shock requiring intraaortic balloon pump, and fully recovered . The patient with Lyme carditis manifested with total atrioventricular block and was treated with a temporary pacemaker . One patient with lymphocytic myocarditis required heart transplantation because of terminal heart failure and one female patient with histologically proven diffuse lympho-monocytic myocarditis died of cardiogenic shock . All the other cases healed without complications . Serologies are of little diagnostic value and should be restricted to serologies with therapeutic implications . We believe that the apparent increase in myocarditis/myopericarditis in recent years is a result of better diagnostic tools, such as more specific cardiac enzyme tests, coronary angiography and endomyocardial biopsies . In most cases the therapy remains symptomatic . In elected, severe cases steroids and other immunosuppressive drugs are sometimes used.

Ann Neurol, 2000 Oct, 48(4), 624 - 31
Axonal Guillain-Barré syndrome: relation to anti-ganglioside antibodies and Campylobacter jejuni infection in Japan; Ogawara K et al.; To clarify the relations of the axonal form of Guillain-Barre syndrome (GBS) to anti-ganglioside antibodies and Campylobacter jejuni infection, 86 consecutive Japanese GBS patients were studied . Electrodiagnostic criteria showed acute inflammatory demyelinating polyneuropathy in 36% of the patients and acute motor axonal neuropathy (AMAN) in 38% . Frequent anti-ganglioside antibodies were of the IgG class and against GM1 (40%), GD1a (30%), GalNAc-GD1a (17%), and GD1b (21%) . Identified infections were C . jejuni (23%), cytomegalovirus (10%), Mycoplasma pneumoniae (6%), and Epstein-Barr virus (3%) . There was a strong association between AMAN and IgG antibodies against GM1, GD1a, GalNAc-GD1a, or GD1b . Almost all the patients with at least one of these antibodies had the AMAN pattern or rapid resolution of conduction slowing/block possibly because of early-reversible changes on the axolemma . C . jejuni infection was frequently associated with AMAN or anti-ganglioside antibodies, but more than half of the patients with AMAN or anti-ganglioside antibodies were C . jejuni-negative . These findings suggest that the three phenomena "axonal dysfunctions (AMAN or early-reversible conduction failure)," "IgG antibodies against GM1, GD1a, GalNAc-GD1a, or GD1b," and "C . jejuni infection" are closely associated but that microorganisms other than C . jejuni frequently trigger an anti-ganglioside response and elicit axonal GBS.

J Infect, 2000 Sep, 41(2), 180 - 2
Fatal prosthetic valve endocarditis due to Campylobacter fetus; Peetermans WE et al.; Campylobacter fetus subspecies fetus has a predilection for vascular endothelium . This report describes a case of a prosthetic valve infective endocarditis due to this microorganism . Despite adequate antibiotic combination treatment, valvular vegetations and perivalvular suppurative complications evolved, leading to valvular dysfunction, heart failure and death . Only three other cases of C . fetus prosthetic valve endocarditis have been described previously . Campylobacter fetus bacteraemia must be considered cautiously, because of the risk of late cardiac or vascular complications .

J Oral Maxillofac Surg, 2000 Oct, 58(10), 1137 - 42; discussion 1143-4
Reactive arthritis: preliminary microbiologic analysis of the human temporomandibular joint; Henry CH et al.; PURPOSE: The presence of Chlamydia trachomatis has been previously shown in the temporomandibular joint (TMJ) . This study investigated whether the presence of other bacteria associated with reactive arthritis (ReA) can be identified in the TMJ . MATERIALS AND METHODS: Posterior bilaminar tissue removed during TMJ surgery from 26 patients (24 F, 2 M) was evaluated for the presence of C . trachomatis, Mycoplasma fermentans, Mycoplasma genitalium, Campylobacter jejuni, Yersinia enterocolitica, Salmonella spp, and Shigella spp by highly specific polymerase chain reaction (PCR) assays . RESULTS: Bacterial DNA was identified in the TMJ as follows: C . trachomatis, 11 of 26 (42%); M . fermentans/orale, 6 of 26 (23%); M . genitalium, 9 of 26 (35%) . Nine of 26 TMJs (35%) had the presence of a single bacterial species . Eight of 26 TMJs (31%) had more than 1 species, as follows: C . trachomatis with either M . genitalium or M . fermentans/orale in 5 of 26 (19%), M . fermentans/orale with M . genitalium 2 of 26 (8%), and C . trachomatis/M . fermentans/orale/M . genitalium, 1 of 26 (4%) . A total of 17 of 26 (65%) of TMJs had the presence of bacteria identified in the TMJ . Campylobacter jejuni, Y . enterocolitica, Salmonella spp, and Shigella spp were not identified in any samples . CONCLUSIONS: The presence of M . genitalium in the human TMJ has not been previously reported . The presence of bacteria in the TMJ, either singly or concurrently with other bacteria, may serve as the pathogenetic mechanism of TMJ inflammation . The presence of 2 bacteria from the urogenital tract in the TMJ suggests that internal derangement of the TMJ may occur as a result of a sexually acquired infection.

Microbiol Immunol, 2000, 44(8), 643 - 52
Comparison of the oral bacterial flora in saliva from a healthy subject and two periodontitis patients by sequence analysis of 16S rDNA libraries; Sakamoto M et al.; The oral bacterial flora in the saliva from two patients with periodontitis and from a periodontally healthy subject were compared using a sequence analysis of 16S rDNA libraries without cultivation . 16S rDNAs were amplified from salivary DNA by PCR and cloned . Randomly selected clones were partially sequenced . On the basis of sequence similarities, the clones were classified into several clusters corresponding to the major phylum of the domain Bacteria . The major phylum in the libraries was the low G+C Gram-positive bacteria . There was no clonal sequence affiliated with periodontopathic bacteria in the salivary sample from the healthy subject, while a number of periodontal pathogens such as Campylobacter rectus, Prevotella intermedia, Porphyromonas gingivalis and Treponema socranskii were detected in the salivary samples from the patients with periodontitis . In addition, a number of previously uncharacterized and uncultured microorganisms were recognized . These organisms may have some role in periodontal disease . This study reveals some potential for a molecular-biological technique to analyze the oral microflora associated with periodontal disease, including previously uncharacterized and uncultured microorganisms, without cultivation.

Poult Sci, 2000 Sep, 79(9), 1351 - 5
An evaluation of the presence of pathogens on broilers raised on poultry litter treatment-treated litter; Pope MJ et al.; Two trials were conducted to evaluate the presence of salmonella, campylobacter, and generic Escherichia coli on broilers raised on Poultry Litter Treatment (PLT)-enhanced litter in comparison with those raised on untreated litter . Two Company A farms included three houses on each farm as the treated group and three houses per farm as controls . Two complete growouts were evaluated on each farm . The Company B study included 10 farms with two paired houses per farm, one house as the treated group and one house as the control . One growout was evaluated per farm . The pathogen sampling consisted of litter sampling and whole bird rinses on the farm and in the processing plant . Litter pH, ammonia concentration, total litter bacteria, temperatures, and humidity were also recorded . The study with Company A resulted in lower mean levels of pH, ammonia concentration, total litter bacteria, litter E . coli, and bird rinse counts for salmonella and E . coli in houses treated with PLT . The results for Company B closely resembled those for Company A, but also included campylobacter data, which showed no difference between treated and control groups . The data indicate that PLT may be a beneficial component for on-farm pathogen reduction.

Jpn J Antibiot, 2000 Jul, 53(7), 522 - 31
{Antibacterial activity of fosfomycin against the causative bacteria isolated from bacterial enteritis}; Fukuyama M et al.; The in vitro antibacterial activities of fosfomycin (FOM) and 3 fluoroquinolones against Salmonella spp., pathogenic Escherichia coli, Campylobacter spp . and Shigella spp . were investigated . The activity upon the environmental condition in the inflammation was compared with standard condition in vitro . On standard condition, the MIC90 of tosfloxacin (TFLX), norfloxacin (NFLX) and levofloxacin (LVFX) against E . coli (77 strains), Shigella spp . (50) and Salmonella spp . (41) were < or = 0.025-0.10, 0.10, and 0.05 microgram/ml, respectively . The MIC90 of FOM against those organisms was 0.39-1.56 micrograms/ml . The MIC90 of TFLX, NFLX, LVFX against Campylobacter spp . were 6.25, 100 and 3.13 micrograms/ml, respectively . The MIC90 of FOM was 50 micrograms/ml . The activity of FOM was unaffected by pH and in anaerobic condition . On the other hand, the activity of NFLX was decreased in low pH and in anaerobic condition . In the presence of horse blood and addition of Na+, the activities of both agents were unaffected . These results suggested that FOM is equally active with or superior to fluoroquinolone in the intestinal infection treatment.

J Microbiol Methods, 2000 Oct, 42(2), 115 - 9
Optimising recovery of Campylobacter spp . from the lower porcine gastrointestinal tract; Madden RH et al.; To determine the incidence of campylobacters in Northern Ireland pigs, ileal contents and anal swabs were taken shortly after death . Direct streaking onto Preston agar, and modified charcoal cefoperazone desoxycholate agar (mCCDA), were compared, as was enrichment in selective broths prior to streaking onto the corresponding solid medium . For anal swabs direct plating on mCCDA was most efficient, with 100% of samples positive, whilst for ileal contents enrichment in mCCD broth was best with 86% of samples positive . Although only 34% of ileal samples enriched in Preston broths were positive they yielded three species not isolated from mCCD broth, and hence indicated that some pigs were infected by at least two species of Campylobacter . Overall, the number of samples found to contain campylobacters, and the range of species isolated, was seen to be markedly affected by both the choice of selective medium and the isolation procedures.

Ann Epidemiol . 2000 Oct 1;10(7):473.
A definition for chronic sequelae applied to campylobacter and guillian-barre syndrome (Gbs); Parkin R et al.; PURPOSE: Chronic sequelae (CS) are increasingly important to drinking water risk assessment and management processes, but there has been relatively little scientific rigor in defining CS or reviewing the literature on water-related CS . Our purposes were to develop a scientific definition for CS and to evaluate the definition's practical merit.METHODS: We examined scientific publications for definitions of "chronic sequela." We developed a definition that is based on scientific concepts and that can be systematically applied to literature to assess whether pathogen-related health outcomes qualify as CS . As a case study, we conducted an extensive Medline search and tested our definition on the epidemiological and clinical literature linking Campylobacter and GBS.RESULTS: We defined "chronic sequela" as the secondary adverse health outcome that 1) occurs as a result of a previous infection by a microbial pathogen, and 2) is clearly distinguishable from the health events that initially result from the causative infection, and 3) lasts 3 months or more after recognition . The 12 Campylobacter and GBS studies (five epidemiological and seven clinical) revealed that current data reporting practices limit the evaluation of all three elements in our definition . Laboratory methods and criteria to characterize infection were not always adequately reported . Primary and secondary health events were always reported, but eight of the studies required obtaining additional articles to determine the GBS criteria used . Ten of the 12 articles contained duration data for the GBS symptoms.CONCLUSIONS: Much of the evidence needed to apply our definition was found in the studies reviewed, but changes in reporting practices would facilitate the scientific evaluation of pathogen-CS relationships and estimation of their public health magnitude.

J Clin Microbiol, 2000 Oct, 38(10), 3853 - 5
Evaluation of the Alexon-trend ProSpecT Campylobacter microplate assay; Tolcin R et al.; We evaluated stool specimens known to contain or be free of Campylobacter by traditional culture, using the ProSpecT Campylobacter microplate assay (Alexon-Trend, Ramsey, Minn.) . This rapid enzyme immunoassay for the detection of Campylobacter-specific antigens demonstrated 96% sensitivity and 99% specificity and is an acceptable alternative method of Campylobacter detection.

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