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Gastrointestinal Infections (gastrointestinal + infections)
Selected AbstractsThe Helicobacter hepaticus hefA Gene is Involved in Resistance to AmoxicillinHELICOBACTER, Issue 1 2009Clara Belzer Abstract Background:, Gastrointestinal infections with pathogenic Helicobacter species are commonly treated with combination therapies, which often include amoxicillin. Although this treatment is effective for eradication of Helicobacter pylori, the few existing reports are less clear about antibiotic susceptibility of other Helicobacter species. In this study we have determined the susceptibility of gastric and enterohepatic Helicobacter species to amoxicillin, and have investigated the mechanism of amoxicillin resistance in Helicobacter hepaticus. Materials and methods:, The minimal inhibitory concentration (MIC) of antimicrobial compounds was determined by E -test and agar/broth dilution assays. The hefA gene of H. hepaticus was inactivated by insertion of a chloramphenicol resistance gene. Transcription was measured by quantitative real-time polymerase chain reaction. Results:, Three gastric Helicobacter species (H. pylori, H. mustelae, and H. acinonychis) were susceptible to amoxicillin (MIC < 0.25 mg/L). In contrast, three enterohepatic Helicobacter species (H. rappini, H. bilis, and H. hepaticus) were resistant to amoxicillin (MIC of 8, 16, and 6,64 mg/L, respectively). There was no detectable ,-lactamase activity in H. hepaticus, and inhibition of ,-lactamases did not change the MIC of amoxicillin of H. hepaticus. A H. hepaticus hefA (hh0224) mutant, encoding a TolC-component of a putative efflux system, resulted in loss of amoxicillin resistance (MIC 0.25 mg/L), and also resulted in increased sensitivity to bile acids. Finally, transcription of the hefA gene was not responsive to amoxicillin, but induced by bile acids. Conclusions:, Rodents are frequently colonized by a variety of enterohepatic Helicobacter species, and this may affect their global health status and intestinal inflammatory responses. Animal facilities should have treatment strategies for Helicobacter infections, and hence resistance of enterohepatic Helicobacter species to amoxicillin should be considered when designing eradication programs. [source] Probiotics and gastrointestinal diseasesJOURNAL OF INTERNAL MEDICINE, Issue 1 2005Å. SULLIVAN Abstract. There is increasing evidence indicating health benefits by consumption of foods containing microorganisms, i.e. probiotics. A number of clinical trials have been performed to evaluate the effects in the prevention and treatment of gastrointestinal diseases caused by pathogenic microorganisms or by disturbances in the normal microflora. Gastrointestinal infections caused by Helicobacter pylori, traveller's diarrhoea, rotavirus diarrhoea, antibiotic-associated diarrhoea (AAD) and Clostridium difficile -induced diarrhoea are conditions that have been studied. There are also studies performed on the preventive effect of probiotics on radiation-induced diarrhoea and diarrhoea in tube-fed patients. Inflammatory bowel disease and irritable bowel syndrome, two idiopathic conditions where alterations in the normal microflora have been implicated as responsible for initiation, are two further areas where the use of probiotics has been regarded as promising. The results from clinical studies have not been conclusive in that the effects of probiotics have been strain-dependent and different study designs have been used. Treatment of acute diarrhoea in children and prevention of AAD are the two most justified areas for the application of probiotics. [source] Growth-induced changes in the proteome of Helicobacter pyloriELECTROPHORESIS, Issue 5-6 2006Christina Uwins Abstract Helicobacter pylori is a major human pathogen that is responsible for a number of gastrointestinal infections. We have used 2-DE to characterise protein synthesis in bacteria grown either on solid agar-based media or in each of two broth culture media (Brucella and brain heart infusion (BHI) broth). Significant differences were observed in the proteomes of bacteria grown either on agar-based or in broth media. Major changes in protein abundance were identified using principal component analysis (PCA), which delineated the profiles derived for the three key growth conditions (i.e. agar plates, Brucella and BHI broth). Proteins detected across the gel series were identified by peptide mass mapping and Edman sequencing. A number of proteins associated with protein synthesis in general as well as specific amino acid synthesis were depressed in broth-grown bacteria compared to plate-grown bacteria. A similar reduction was also observed in the abundance of proteins involved in detoxification. Two of the most abundant spots, identified as UreB and GroEL, in plate-grown bacteria showed a >140-fold drop in abundance in bacteria grown in Brucella broth compared to bacteria grown on agar plates. Two protein spots induced in bacteria grown in broth culture were both identified as glyceraldehyde 3-phosphate dehydrogenase based on their N -terminal amino acid sequences derived by Edman degradation. The underlying causes of the changes in the proteins abundance were not clear, but it was likely that a significant proportion of the changes were due to the alkaline pH of the broth culture media. [source] Structural Studies of the O-Chain Polysaccharide from Plesiomonas shigelloides Strain 302,73 (Serotype O1)EUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 18 2008Giuseppina Pieretti Abstract Plesiomonas shigelloides is a Gram-negative bacterium belonging to the Enterobacteriaceae family. It has been found in an aquatic environment in the tropical and subtropical regions and is responsible for many gastrointestinal infections in humans, which take place from drinking untreated water or eating uncooked shellfish. Plesiomonas shigelloides has also been reported to provoke extraintestinal infections such as meningitis and bacteremia in immunocompromised adults and neonates. Despite the emerging importance of this pathogenic microorganism, only three different O-antigens have been characterised so far. The structure of the O-chain of the lipopolysaccharide (LPS) from Plesiomonasshigelloides strain 302,73 (serotype O1) was determined by chemical analysis, 1D and 2D NMR spectroscopy and MALDI-TOF mass spectrometry. The polysaccharide was constituted by a linear pentasaccharidic repeating unit as follows: ,3)-,- L -PneNAc4OAc(1,4)-,- L -FucNAc(1,4)-,- L -FucNAc(1,4)-,- L -FucNAc(1,3)-,- D -QuiNAc4NHb(1, (PneNAc = 2-acetamido-2,6-dideoxy-talose, Hb = (S)-3-hydroxybutanoyl) PneNAc O -acetylation was not stoichiometric and was found to be about 75,%. The position of the O -acetyl group and the amount of acetylation were deduced by NMR spectroscopic analysis. All the monosaccharides included in the repeating unit were deoxyamino sugars, which most probably, together with the presence of O -acetyl groups, were responsible for the recovery of the LPS in the phenol layer of the phenol/water extract of dried bacteria cells.(© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2008) [source] Environmental factors in inflammatory bowel disease: A co-twin control study of a Swedish-Danish twin populationINFLAMMATORY BOWEL DISEASES, Issue 10 2006Jonas Halfvarson MD Abstract Background: Genetics and environmental factors are implicated in the etiology of inflammatory bowel disease (IBD). We studied environmental factors in a population-based Swedish-Danish twin cohort using the co-twin control method. Subjects and Methods: A questionnaire was sent to 317 twin pairs regarding markers of exposures in the following areas: infections/colonization and diet as well as smoking, appendectomy, and oral contraceptives. Odds ratios (OR) were calculated by conditional logistic regression. When confounding appeared plausible, multivariate conditional logistic regression was added. The questions were also divided into topic groups, and adjustment was made for multiple testing within each of the groups. Results: The response rate to the questionnaire was 83%. In consideration of the study design, only discordant pairs were included (Crohn's disease [CD], n = 102; ulcerative colitis [UC], n > = 125). Recurrent gastrointestinal infections were associated with both UC (OR, 8.0; 95% confidence interval [CI], 1.0,64) and CD (OR, 5.5; 95% CI, 1.2,25). Hospitalization for gastrointestinal infections was associated with CD (OR, 12; 95% CI, 1.6,92). Smoking was inversely associated with UC (OR, 0.4; 95% CI, 0.2,0.9) and associated with CD (OR, 2.9; 95% CI, 1.2,7.1). Conclusions: The observed associations indicate that markers of possible infectious events may influence the risk of IBD. Some of these effects might be mediated by long-term changes in gut flora or alterations in reactivity to the flora. The influence of smoking in IBD was confirmed. [source] Necrotizing vasculitis with a polyarteritis nodosa-like pattern and selective immunoglobulin A deficiency: case report and review of the literatureJOURNAL OF CUTANEOUS PATHOLOGY, Issue 9 2008Sabela Paradela Selective immunoglobulin A deficiency (IgAD) is a primary immunodeficiency disease characterized by low levels (< 7 mg/dl) of serum immunoglobulin (Ig) A and normal serum levels of IgG and IgM. Patients with IgAD have increased risk for recurrent respiratory and gastrointestinal infections, autoimmune disease, asthma and allergy. A 26-year-old woman was admitted with sudden onset of painful cutaneous lesions on her lower extremities, pyrexia and arthromyalgia. Her medical history was remarkable for recurrent respiratory tract infections, self-limited episodes of acute diarrhea, atopy, splenomegaly and a 4-year history of a lung granulomatous lesion. Laboratory and imaging tests ruled out severe life-threatening infection, connective tissue disease and neoplasm. Serum protein electrophoresis showed a low IgA serum level (6.67 mg/dl), with normal serum levels of IgG and IgM, conducting to a diagnosis of selective IgAD. A skin biopsy showed necrotizing vasculitis without any sign of internal organ disease. We report a patient with IgAD and granulomatous involvement of lungs, spleen and medium-sized arteries of the skin. Although IgAD results from a failure of B-cell differentiation, we propose that deregulated immune response with production of cross-reactive antibodies and hyperstimulation of T cells and macrophages could contribute to this widespread granulomatous reaction. [source] Extraintestinal focal infections in adults with nontyphoid Salmonella bacteraemia: predisposing factors and clinical outcomeJOURNAL OF INTERNAL MEDICINE, Issue 1 2007P.-L. Chen Abstract. Background., Nontyphoid Salmonella (NTS) isolates lead to not only self-limited, acute gastrointestinal infections, but also bacteraemia with or without extraintestinal focal infections (EFIs). The risk factors associated with EFIs in adults with NTS bacteraemia were not clearly elucidated. Methods., In a medical center in southern Taiwan, patients aged ,18 years with NTS bacteraemia between January 1999 and June 2005 were included for analysis. Results., Of 129 patients, 51 (39.5%) were complicated with EFIs. The most common EFI was mycotic aneurysm, followed by pleuropulmonary infections and spinal osteomyelitis. Compared to patients with primary bacteraemia, those with EFIs had higher leucocyte counts (P = 0.004) and higher serum levels of C-reactive protein (P < 0.0001). The development of EFIs was associated with a higher mortality, more severe septic manifestations, longer hospital stays and duration of antimicrobial therapy. Univariate analysis revealed that diabetes mellitus (P = 0.02), hypertension (P = 0.02) and chronic lung disease (P = 0.006) were significantly associated with EFIs. However, patients with malignancy (P = 0.01) and immunosuppressive therapy (P = 0.03) were less likely to develop EFIs. On the basis of multivariate analysis, an independent factor for the occurrence of EFIs was age [adjusted odds ratio (aOR) 1.05; 95% confidence interval (CI) 1.02,1.07; P < 0.0001], whilst malignancy was negatively associated with EFIs (aOR 0.16; 95% CI 0.14,0.78; P = 0.01). Conclusion., Amongst patients with NTS bacteraemia, EFIs often occurred in the aged, and were associated with a higher mortality and morbidity. Recognition of specific host factors is essential for identification of EFIs which often demand early surgical interventions and prolonged antimicrobial therapy. [source] Medical Problems of Internationally Adopted Children Presenting to a Travel Medicine Clinic in NepalJOURNAL OF TRAVEL MEDICINE, Issue 6 2006DTM&H, Johnnie A. Yates MD Dermatologic, respiratory, and gastrointestinal infections were the most commonly diagnosed conditions among adopted Nepali children presenting to a travel medicine clinic in Kathmandu. Surveillance and early treatment of infections in international adoptees in their birth country may help prevent the importation of infectious diseases. [source] Breastfeeding protects against infectious diseases during infancy in industrialized countries.MATERNAL & CHILD NUTRITION, Issue 3 2009A systematic review Abstract Firstly, this review was performed to assess the effect of breastfeeding on infections during infancy in industrialized countries. Secondly, the effect of duration and exclusiveness of breastfeeding were explored. Studies were identified using Medline, Cochrane Library, Science Citation Index and by a manual search from bibliographies of articles from August 1986 to January 2008. Follow-up, case,control and randomized controlled trial (RCT) studies performed in an industrialized country, published in English, with breastfeeding as a determinant, with overall infections, gastrointestinal or respiratory tract infections as a major outcome, and at least 40 participants in the study were included. Using Bauchner's criteria published in a review in 1986, two reviewers and a peer reviewer assessed the internal validity of those studies. Twenty-one studies that met the inclusion and internal validity criteria were included. These included 16 follow-up and four case,control studies and one RCT. Four out of five studies observed decreased effects on overall infections in breastfed infants. With regard to gastrointestinal infections, six out of eight studies suggested that breastfeeding had a protective effect. Thirteen out of 16 studies concluded that breastfeeding protects infants against respiratory tract infections. Five studies combined duration and exclusiveness of breastfeeding. All studies observed a protective dose/duration-response effect on gastrointestinal or respiratory tract infections. These studies strongly suggest that breastfeeding protects infants against overall infections, gastrointestinal and respiratory tract infections in industrialized countries. The optimal duration of exclusive breastfeeding for protection against infectious diseases needs to be studied in more detail. [source] Predicting the incidence of human campylobacteriosis in Finland with time series analysisAPMIS, Issue 8 2009AYAKO SUMI Sumi A, Hemilä H, Mise K, Kobayashi N. Predicting the incidence of human campylobacteriosis in Finland with time series analysis. APMIS 2009; 117: 614,22. Human campylobacteriosis is a common bacterial cause of gastrointestinal infections. In this study, we tested whether spectral analysis based on the maximum entropy method (MEM) is useful in predicting the incidence of campylobacteriosis in five provinces in Finland, which has been accumulating good quality incidence data under the surveillance program for water- and food-borne infections. On the basis of the spectral analysis, we identified the periodic modes explaining the underlying variations of the incidence data in the years 2000,2005. The optimum least squares fitting (LSF) curve calculated by using the periodic modes reproduced the underlying variation of the incidence data. We extrapolated the LSF curve to the years 2006 and 2007 and predicted the incidence of campylobacteriosis. Our study suggests that MEM spectral analysis allows us to model temporal variations of the disease incidence with multiple periodic modes much more effectively than using the Fourier model, which has been previously used for modeling seasonally varying incidence data. [source] | ||||||||||