GASTROENTERITIS
(Diagnosis, Diagnostics, Immunodiagnosis,
Immunodiagnostics, Pathogenesis, Vaccines
& Drugs)
ABSTRACTS
1245. Altuntas B. Gul H. Yarali N.
Ertan U. Etiology of chronic diarrhea.
Indian Journal of Pediatrics.
66(5):657-61, 1999 Sep-Oct.
Abstract
With worldwide use of oral rehydration solutions, the treatment of
acute diarrhea does not pose much of a
problem. However, chronic diarrhea is still harmful, especially for the growth
and development status of the children. Between January 1993 to December 1996,
patients who suffered from chronic diarrhea for more than one month duration
and admitted to Dr. Sami Ulus Children's Hospital were evaluated for
epidemiological and etiologic factors. Seventy consecutive patients were
evaluated. The mean age was 40.8 months and 52% were males. Malnutrition was
detected in 80% of cases. Etiologic factors included celiac disease 30%, cow
milk allergy 17%, bacterial and parasitic factors 26%, cystic fibrosis 10% and
postinfectious gastroenteritis 10%. Eosinophilic gastroenteritis, chronic nonspecific diarrhea, pseudo-obstruction,
neurofibromatosis and inflammatory
bowel disease were rarely detected. Celiac disease and cow milk allergy were implicated as the most
common causes of chronic diarrhea. The
vicious cycle of faulty nutrition, malnutrition and infection and postinfectious enteropathy were also significant
factors in the etiology of chronic
diarrhea. It may be considered that cow milk
protein prick test, sweat test, immunologic tests and mucosal
biopsies should be performed for the
definite diagnosis of chronic diarrhea.
1246.
Asbury AK. New
concepts of Guillain-Barre syndrome. [Review] [78 refs] Journal of Child Neurology. 15(3):183-91, 2000 Mar.
Abstract
Guillain-Barre syndrome is an acute autoimmune
polyradiculoneuropathy with a clinical presentation of flaccid paralysis with
areflexia, variable sensory disturbance, and elevated cerebrospinal fluid
protein without pleocytosis. Although
Guillain-Barre syndrome previously had been viewed as a unitary disorder with variations, it currently is viewed as
a group of syndromes with several
distinctive subtypes. These include the
principal subtype prevalent in the Western world (acute
inflammatory demyelinating
polyradiculoneuropathy, and others, each with distinctive electrodiagnostic and pathologic features,
including acute motor axonal
neuropathy), acute motor-sensory axonal neuropathy, Miller Fisher syndrome, and perhaps others. The clinical
and pathologic features of these
Guillain-Barre syndrome subtypes are reviewed, and the role of antecedent infections, particularly
Campylobacter jejuni gastroenteritis,
and the role of antiganglioside antibody responses are reviewed
with respect to pathogenesis. Treatment
of Guillain-Barre syndrome includes
both important supportive measures and immunotherapies,
specifically high-dose intravenous
immunoglobulin and plasma exchange. [References: 78]
1247.
Carrigan DR.
Adenovirus infections in immunocompromised patients. [Review] [05 refs]
American Journal of Medicine.
102(3A):71-4, 1997 Mar 17.
Abstract
Adenovirus infections have been reported in as many as one-fifth
of bone marrow transplant (BMT)
recipients and patients with acquired immunodeficiency syndrome (AIDS), and in
a lesser, though still prominent, proportion of organ transplant recipients.
The relative contributions of primary infections versus reactivations from
latency in immunocompromised patients remain unclear. Compared with adult BMT
recipients, pediatric BMT recipients
appear to be infected by adenovirus more frequently and earlier in the post-transplant period. The diagnosis
of adenovirus infection is complicated
by the existence of > 40 viral serotypes, although certain subgroups are more likely to be involved in
certain patient populations.
Adenoviruses are responsible for a broad range of clinical diseases
that may be associated with high mortality,
including pneumonia, hepatitis,
encephalitis, hemorrhagic cystitis, and gastroenteritis. The clinical
and histopathologic features of
adenovirus disease may resemble those of
cytomegalovirus disease, potentially complicating the diagnosis. Risk factors for clinical adenovirus disease
include the number of sites from which
the virus is cultured and, in BMT recipients, the presence of moderate to severe acute graft-versus-host
disease. [References: 05]
1248. Estes MK.
Ball JM. Guerrero RA. Opekun AR.
Gilger MA. Pacheco SS.
Graham
DY. Norwalk virus vaccines: challenges and progress. [Review] [31 refs] Journal of Infectious Diseases. 181 Suppl 2:S367-73, 2000 May.
Abstract
Human caliciviruses (HuCVs) are the major cause of outbreaks of acute nonbacterial gastroenteritis throughout the
world. An increasing recognition of the
clinical significance of these viruses as human pathogens causing foodborne and waterborne disease indicates that
an effective vaccine would be useful.
This article reviews the current
challenges that exist for the development of a vaccine for the HuCVs
as well as the status of development of
a candidate vaccine. HuCVs are viruses
that exhibit a restricted tropism for infection of the gastrointestinal tract
of humans, and a volunteer model of infection and disease is available. As pathogens with a restricted host range,
the HuCVs are excellent models for
understanding the mechanisms that mediate and
regulate viral infection of the gastrointestinal tract and mucosal immunity in humans. [References: 31]
1249. Glass RI.
Noel J. Ando T. Fankhauser R. Belliot G. Mounts A. Parashar UD. Bresee JS. Monroe SS. The
epidemiology of enteric caliciviruses from humans: a reassessment using new
diagnostics. [Review] [70 refs] Journal of Infectious Diseases. 181 Suppl 2:S254-61, 2000 May.
Abstract
In the United States, acute gastroenteritis is one of the most
commonly noted illnesses on hospital discharge records and death certificates,
yet few of these cases have an etiologic diagnosis. The application of new molecular diagnostic methods has shown
caliciviruses (previously referred to
as the Norwalk family of viruses or small round structured viruses) to be the most common cause of acute
gastroenteritis (AGE) outbreaks in the
United States, and they may emerge as a common cause of sporadic cases
of AGE among both children and adults.
Novel molecular methods have permitted
outbreak strains to be traced back to their common source and have led
to the first identification of virus in
implicated vehicles of infection-water,
shellfish, and foods contaminated both at their source and by food handlers. The broad application
of these methods to routine diagnosis
in hospitals and public health laboratories is advancing our appreciation of the full burden of
calicivirus-associated diarrhea, and it
is opening new avenues for its prevention and control. [References: 70]
1250.
Pang XL. Honma S.
Nakata S. Vesikari T. Human
caliciviruses in acute gastroenteritis of young children in the community.
Journal of Infectious Diseases. 181
Suppl 2:S288-94, 2000 May.
Abstract
Episodes of acute gastroenteritis in prospectively followed
children between 2 months and 2 years
of age were examined for rotaviruses, enteric adenoviruses, astroviruses, and
human caliciviruses, including both
Norwalk-like viruses (NLVs) and Sapporo-like viruses (SLVs), using PCR
and reverse transcription (RT)-PCR
assays. A virus was identified in 60%
(502/832) of all episodes and in 85% of the moderately severe or
severe episodes. Human caliciviruses
were as common as rotaviruses, both being
detected in 29% of the cases. NLVs accounted for a 20% etiologic share
of all cases; the clinical picture was
a moderately severe disease with
vomiting as a predominant symptom. SLVs were detected in 9% of the
cases, the clinical picture being a
mild diarrheal disease. Astroviruses were
found in 10% and enteric adenoviruses in 6% of the cases. Diagnosis
with PCR and RT-PCR methods increases
the detection of all gastroenteritis
viruses, particularly human caliciviruses. As a group, human
caliciviruses are common causative
agents of gastroenteritis in children <2 years of age in Finland, and, of these, NLVs cause more
severe disease than SLVs.
1251. Seth A.
Aneja S. Hyperglycemia in malnourished children with dehydrating
gastroenteritis. Indian Journal of Pediatrics.
62(3):353-5, 1995 May-Jun.
Abstract
Fifty patients with grade III and IV malnutrition with
diarrhoeal dehydration were studied.
Hyperglycemia was present in 5 cases at
admission. Serum sodium levels were normal in all of them except one
case who had hyponatremia. Blood sugar
levels were normal in all the cases
after rehydration with ORS. Possible mechanisms in pathogenesis of hyperglycemia are discussed.
1252. van Duijkeren E. Houwers DJ. A critical assessment of antimicrobial treatment in
uncomplicated Salmonella enteritis.
[Review] [52 refs] Veterinary Microbiology.
73(1):61-73, 2000 Apr 4.
Abstract
The human and veterinary literature on the effect of
antimicrobials on the clinical and
bacteriological cure in uncomplicated Salmonella gastroenteritis is reviewed. Comparison of data on the efficacy
of conventional antimicrobials
(chloramphenicol, neomycin, ampicillin,
amoxycillin, tetracycline, trimethoprim/sulfonamide combinations) and
the newer fluoroquinolones indicate
that quinolones may shorten the course of
clinical disease in contrast to the conventional antimicrobials. Postconvalescent excretion of Salmonella was
not affected by the conventional
antimicrobials whereas the data on the fluoroquinolones in this respect are conflicting. The
fluoroquinolones are the drugs of choice
in human medicine for severe Salmonella infections and for the
elimination of the carrier state. These
drugs have not been evaluated in this respect
in veterinary medicine. Well designed prospective
placebo-controlled studies regarding
the effect of antimicrobials, especially the
fluoroquinolones, on the clinical cure and the postconvalescent
shedding of Salmonella in animals are
imperative to develop optimal therapeutic
strategies. [References: 52]
1253. Vipond
IB. Pelosi E. Williams J. Ashley
CR. Lambden PR. Clarke IN.
Caul EO. A diagnostic EIA for detection of the prevalent SRSV strain in
United Kingdom outbreaks of
gastroenteritis. Journal of Medical Virology.
61(1):132-7, 2000 May.
Abstract
Small round structured viruses (SRSVs) are the major cause of
outbreaks of gastroenteritis in the UK.
Diagnosis is problematic due to insensitive electron microscopy (EM) or
technically demanding reverse transcription
polymerase chain reaction (RT-PCR) techniques. We have studied
outbreaks of non-bacterial gastroenteritis
using an EIA based upon recombinant
capsid protein from the currently prevalent circulating strain of
SRSV (Lordsdale Genotype II) and
compared its performance against EM and RT-PCR
assays. Faecal specimens sent to the Bristol Public Health Laboratory
for outbreak investigation from
December 1996 to December 1997 were applied
retrospectively to the SRSV EIA and results compared with the routine
EM and RT-PCR that had been carried out
prospectively. Overall, the three tests
identified SRSVs in specimens from 70% of the outbreaks (213/305) investigated.
Of the 213 total positive outbreaks, the EIA identified 71%, that compared favourably with EM (63%) and
RT-PCR (84%). The Lordsdale Genotype II
SRSV EIA provides a simple cost-effective assay that will for the first time make detection of currently
circulating SRSV strains associated
with UK outbreaks available to all routine laboratories. The EIA format makes the assay widely applicable
to non-specialist laboratories, unlike
the RT-PCR assay, and the improved sensitivity over EM will allow uccessful screening of UK outbreaks alongside
commercial EIAs currently available for
adenovirus, astrovirus and rotavirus.
Furthermore, the assay will allow rapid identification of emerging SRSV strains. Copyright 2000 Wiley-Liss, Inc.
1674.
Angulo FJ. Johnson KR. Tauxe RV.
Cohen ML. Origins and consequences of antimicrobial-resistant
nontyphoidal Salmonella: implications for the use of fluoroquinolones in food
animals. Microbial Drug Resistance.
6(1):77-83, 2000 Spring.
Abstract
Human Salmonella infections are common; most infections are
self-limiting, however severe disease may occur. Antimicrobial agents, while
not essential for the treatment of Salmonella gastroenteritis, are essential
for the treatment of thousands of patients each year with invasive infections.
Fluoroquinolones and third-generation cephalosporins are the drugs-of-choice
for invasive Salmonella infections in humans; alternative antimicrobial choices are limited by
increasing antimicrobial resistance, limited efficacy, and less desirable
pharmacodynamic properties. Antimicrobial-resistant Salmonella results from the
use of antimicrobial agents in food animals, and these antimicrobial resistant
Salmonella are subsequently transmitted to humans, usually through the food
supply. The antimicrobial resistance patterns of isolates collected from
persons with Salmonella infections show more resistance to antimicrobial agents
used in agriculture than to antimicrobial agents used for the treatment of
Salmonella infections in humans. Because of the adverse health consequences in
humans and animals associated with the increasing prevalence of
antimicrobial-resistant Salmonella, there is an urgent need to emphasize
non-antimicrobial infection control strategies, such as improved sanitation and hygiene, to develop guidelines
for the prudent usage of antimicrobial agents, and establishment of adequate
public health safeguards to minimize the development and dissemination of
antimicrobial resistance and dissemination of Salmonella resistant to these
agents.
1675. Cappendijk VC. Hazebroek FW. The impact of diagnostic delay
on the course of acute appendicitis. Archives of Disease in Childhood. 83(1):64-6, 2000 Jul.
Abstract
BACKGROUND: The diagnosis of acute appendicitis is often delayed,
which may complicate the further course
of the disease. AIMS: To review
appendectomy cases in order to determine the incidence of
diagnostic delay, the underlying
factors, and impact on the course of the disease. METHODS: Records of all children who underwent appendectomy from
1994 to 1997 were reviewed. The 129
cases were divided into group A (diagnostic
period within 48 hours) and group B (diagnostic period 48 hours or
more). RESULTS: In the group with diagnostic delay, significantly more children
had first been referred to a paediatrician rather than to a surgeon. In almost
half of the cases in this group initial diagnosis was not appendicitis but
gastroenteritis. The perforation rate in group A was 24%,and in group B, 71%.
Children under 5 years of age all presented in the delayed group B and had a
perforation rate of 82%. The delayed group showed a higher number of
postoperative complications and a longer
hospitalisation period. CONCLUSIONS: Appendicitis is hard to diagnose when, because of a progressing disease
process, the classical clinical picture
is absent. The major factor in diagnostic delay is suspected gastroenteritis. Early surgical consultation
in a child with deteriorating gastroenteritis is advised. Ultrasonographs can
be of major help if abdominal signs and symptoms are non-specific for
appendicitis.
1676.
Gomez N. Wigdorovitz A. Castanon S.
Gil F. Ordas R. Borca MV.
Escribano JM. Oral immunogenicity of the plant derived spike
protein from swine-transmissible
gastroenteritis coronavirus.Archives of Virology. 145(8):1725-32, 2000.
Abstract
Transgenic plants represent an inexpensive alternative to
classical fermentation systems for
production of recombinant subunit vaccines.
Transgenic potato plants were created that express the N-terminal
domain of the glycoprotein S (N-gS)
from Transmissible gastroenteritis
coronavirus (TGEV), containing the major antigenic sites of the
protein. Extracts from potato tubers
expressing N-gS were inoculated
intraperitoneally to mice, and the vaccinated mice developed serum
IgG specific for TGEV. Furthermore,
when potato tubers expressing N-gS were
fed directly to mice, they developed serum antibodies specific for gS protein, demonstrating the oral
immunogenicity of the plant derived spike protein from TGEV.
1677.
Kim L. Hayes J. Lewis P.
Parwani AV. Chang KO. Saif LJ.
Molecular characterization and pathogenesis of transmissible gastroenteritis coronavirus (TGEV) and
porcine respiratory coronavirus (PRCV)
field isolates co-circulating in a swine herd. Archives of Virology. 145(6):1133-47, 2000.
Abstract
TGEV replicates in intestinal enterocytes and causes diarrhea in
young pigs. PRCV, a spike (S) gene
deletion mutant of TGEV with an altered
respiratory tissue tropism, causes mild or subclinical respiratory infections. Comparisons of TGEV and PRCV
strains suggest that tropism and pathogenicity are influenced by the S gene and
ORF3, respectively. Recently, outbreaks
of TGE of reduced virulence were reported in the field. We investigated a similar suspect TGEV outbreak of
reduced virulence in nursery pigs from
a swine herd in the Midwest. A TGEV strain (BW021898B) was isolated in swine
testicular cells from gut contents of a diarrheic pig and three PRCV strains
(BW126, BW154, BW155) were isolated from nasal swabs from normal
TGEV-seronegative sentinel pigs in contact with the diarrheic pigs. Sequence
analysis of the TGEV isolate in the partial S gene and ORF3/3a and ORF3-1/3b
revealed high homology with enteropathogenic TGEV strains. Gnotobiotic pig
inoculation and histopathological results revealed that this TGEV isolate
retained virulence even though in the
field outbreak the diarrheal disease was of
reduced severity. Sequence analysis of the S gene deletion region of
the three PRCV isolates revealed identical
deletions between nt 105-752, which differ from deletions previously reported
among PRCV strains. The three PRCV isolates had variable sequence changes in
ORF 3/3a and ORF 3-1/3b, affecting the ORF size and amino acid sequence. Thus,
sequence analysis and pathogenicity studies indicate that this TGEV isolate
resembles other enteropathogenic TGEV strains. Therefore, the reduced severity
of TGE observed in this herd may be due to the ongoing PRCV infections, which
induce antibodies cross-reactive with TGEV and result in decreased disease
severity. The results outlined in this study highlight the need to monitor the
molecular epidemiology of TGEV/PRCV strains with sensitive differential
diagnostic assays, followed by sequence analysis of the critical regions to
identify changes and pathogenicity studies to confirm the disease potential of
the TGEV isolates.
1678.
Lee JY. Medellin MV. Tumpkin C. Allergic reaction to gemfibrozil
manifesting as eosinophilic gastroenteritis. Southern Medical Journal. 93(8):807-8, 2000 Aug.
Abstract
Eosinophilic gastroenteritis (EGE) is a rare condition of unknown
etiology characterized by eosinophilic infiltration of the gastrointestinal
(GI) tract. Previous associations with a drug or food allergy, allergic
rhinitis, atopic dermatitis, and elevated IgE levels suggest an atopic
predisposition in the pathogenesis of this disorder. Diagnostic criteria are GI
symptoms, eosinophilic infiltration proven by biopsy of the GI tract, and
absence of parasitic infection. We describe a case of EGE manifested as an
allergy to gemfibrozil.
1679.
Lee WS. Lee SP. Boey CC. Pre-admission management of acute
gastroenteritis in children: too much or too little?. Medical Journal of
Malaysia. 54(1):22-5, 1999 Mar.
Abstract
Two hundred and ninety five children admitted with acute
gastroenteritis from January 1, 2024 to
December 31, 2023 to the Paediatric unit,
University of Malaya Medical Centre, Kuala Lumpur, were reviewed. Eighty-nine percent of children received
treatment before admission. Information
regarding the type of treatment received were available in 152 (52%) cases. Eighty percent of them were
prescribed medications, 40% were prescribed glucose-electrolyte mixtures, and
13% were advised a change of formula. Only 18 children (12%) were advised to
take glucose-electrolyte mixtures alone. The four most common prescribed drugs
were: antibiotics (43%), antipyretics (39%), antidiarrhoeal agents (30%), and
antiemetics (24%). The use of antibiotics, antiemetics and antidiarrhoeal drugs
for children with acute gastroenteritis among primary care doctors appears to
be common. The use of glucose-electrolyte mixtures was uncommon.
1680.
Lu PL. Hsueh PR. Hung CC.
Chang SC. Luh KT. Lee CY.
Bacteremia due to Campylobacter species: high rate of resistance to macrolide and quinolone antibiotics. Journal
of the Formosan Medical Association.
99(8):612-7, 2000 Aug.
Abstract
BACKGROUND AND PURPOSE: Although the rate of isolation of
Campylobacter from stool specimens in
Taiwan is similar to those in other developed
countries, Campylobacter bacteremia has rarely been reported in
Taiwan, and the patterns of
antimicrobial susceptibility of blood isolates to various antimicrobial agents remain unknown in the Taiwanese
population. The purpose of this study
was to determine the clinical characteristics of patients with Campylobacter infection in a university hospital in
Taiwan and the antimicrobial susceptibility patterns of the Campylobacter
isolates. METHODS: We retrospectively reviewed medical records of all patients
with Campylobacter bacteremia treated in a university hospital between January
1991 and March 1999. Minimum inhibitory concentrations of 13 antimicrobial
agents to 10 stored blood isolates were determined using the E-test. RESULTS: Approximately
half (52%) of the 21 patients had chronic liver disease and one-quarter had
hepatobiliary or gastrointestinal malignancies. Thirteen (62%) patients had
conditions that were associated with gastroenteritis. Other clinical
manifestations associated with Campylobacter infection included cellulitis,
perinatal sepsis, peritonitis, vascular catheter-related infection, and primary
bacteremia. The duration of illness was generally short: approximately half
(52%) of the 21 patients had fever lasting for only 1 day. Antimicrobial
susceptibility testing of the 10 isolates revealed that most of the blood
isolates were resistant to erythromycin and nalidixic acid (100% and 90%,
respectively), while the rate of cross-resistance between erythromycin and azithromycin
was 70%, and that between nalidixic acid and ciprofloxacin was 67%.
CONCLUSIONS: Our observations suggest that Campylobacter bacteremia should be
included in the differential diagnosis of patients with chronic liver disease
or malignancies involving the hepatobiliary system or gastrointestinal tract
who present with fever and gastroenteritis. Clinicians in Taiwan should be
alert to the high rate of resistance of Campylobacter isolates to macrolide and
quinolone antibiotics.
1681.
Marsh WW. Infectious diseases of gastrointestinal tract in adolescents.
[Review] [27 refs] Adolescent Medicine.
11(2):263-78, 2000 Jun.
Abstract
This article reviews the following gastrointestinal
infections: esophagitis, gastritis,
duodenitis including duodenal ulcers, and
enteritis (gastroenteritis). The epidemiology, risk factors,
microbiology and pathogenesis, diagnosis, treatment, morbidity/mortality, and
prevention are discussed in relation to the most important pathogens. The
symptoms and pathogenesis of esophagitis caused by Candida albicans and herpes simplex are contrasted with the
symptoms of esophagitis caused by Helicobacter pylori and gastroesophageal
reflux disease (GERD). The incidence of
gastritis and gastric and duodenal ulcers caused by H. pylori is discussed. The treatment regimens of H.
pylori infection recommended by the CDC
are presented. Endoscopic findings in esophagitis, gastritis, and duodenal ulcers are presented and discussed.
The difference in symptoms caused by
viral agents (Norwalk virus), bacterial agents (enterotoxigenic E. coli), and parasites (Giardia lamblia and
Cryptosporidium parvum) are compared
and contrasted. The symptoms of infections of the terminal small bowel caused
by Salmonella and Campylobacter jejuni and the symptoms of pure colonic
infection, dysentery, caused by Shigella and enteroinvasive E. coli and
Entamoeba histolytica are discussed. The treatment regimens for enteritis are
presented. [References: 27]
1682.
Melito PL. Woodward DL. Bernard KA.
Price L. Khakhria R. Johnson WM.
Rodgers FG. Differentiation of clinical Helicobacter pullorum isolates
from related Helicobacter and Campylobacter species. Helicobacter. 5(3):142-7,
2000 Sep.
Abstract
BACKGROUND: Helicobacter pullorum, first detected in the liver and intestinal contents of poultry, was defined
as a new species in 1994. This organism has since been isolated from humans
with gastroenteritis. Phenotypic as
well as genotypic methods have been used to identify H. pullorum associated with cases of human
disease. MATERIALS AND METHODS:
Clinical isolates were submitted for identification to the National Laboratory for Enteric Pathogens by
Provincial Public Health Laboratories within Canada. Phenotypic
characterization was conducted using a variety of growth and biochemical tests
including oxidase, catalase, indoxyl acetate, H2S production in triple sugar
iron (TSI) agar, antimicrobial susceptibility testing, and fatty acid analysis.
Genotypic identification was performed using a polymerase chain reaction-restriction
fragment-length polymorphism (PCR-RFLP) analysis of a 1-kb fragment of the
Helicobacter 16S rRNA gene. RESULTS: During the last 7 years (1993-1999) a
total of 11 isolates of H. pullorum were detected from patients with
gastroenteritis for inclusion in this study. Typically, these isolates were
oxidase and catalase positive, produced optimal growth at 42 degrees C, and
produced H2S in TSI. Of these 11 isolates, 1 showed DNase activity, while
another did not produce H2S in TSI, and only 2 showed tolerance to 1% bile.
Antimicrobial susceptibility assays indicated that 6 of the 11 strains were
resistant to nalidixic acid. The fatty acid profiles of the isolates were
similar to each other and provided a distinguishing profile from the other
related species. Genetically identical and distinct species-specific
restriction fragment-length polymorphism (RFLP) patterns were produced using
the restriction enzymes Bsr I and Dde I. CONCLUSION: Phenotypic and genotypic
procedures were used to identify H. pullorum.
Interspecies phenotypic variability was apparent and supported the use
of a polyphasic approach for identification. Similarities to the more prominent human pathogens Campylobacter coli
and C. lari were also noted. The use of a combination of phenotypic and, in
particular, genotypic markers for H. pullorum should prove valuable both for
epidemiological investigations and for the diagnosis of disease related to this
emerging human pathogen.
1683. Noppornpanth S. Poovorawan Y. Comparison between RT-PCR and
rapid agglutination test for diagnosis of human rotavirus infection. Southeast
Asian Journal of Tropical Medicine & Public Health. 30(4):707-9, 1999 Dec.
Abstract
Rotavirus represents the major cause of dehydrating diarrhea among
infants and young children on worldwide scale and has recently become the
target of research aimed at developing a vaccine. To that end, screening tests
of clinical specimens ought to provide high sensitivity and specificity. Hence,
in order to achieve that aim we compared a commercially available latex
agglutination (LA) kit with reverse transcription polymerase chain reaction
(RT-PCR) using primers amplifying the gene for the major neutralization antigen
in 71 stool samples of children with acute
gastroenteritis during November 1998-April 1999. Based on accuracy
(76.05%), specificity (86.8%) and sensitivity (63.6%) determined for LA with
RT-PCR serving as the gold standard, we recommend LA for field studies where
speed and simplicity are crucial. Yet, for the purpose of further studies as to
epidemiology and vaccine trials RT-PCR with its higher specificity and
sensitivity will be required.
1684.
Svensson L. Diagnosis of foodborne viral infections in patients. [Review] [64
refs] International Journal of Food Microbiology. 59(1-2):117-26, 2000 Jul 25.
Abstract
A significant global problem is the microbiological contamination
of foods and water. The microorganisms associated with about half of the
foodborne disease outbreaks still go unrecognized, primarily as a result of inadequate
diagnostic methods and sampling. A significant amount of food-and waterborne
diseases are associated with viruses, information that has been obtained only
in recent years. Improved diagnostic methods have established that
caliciviruses are the most important non-bacterial
pathogens associated with food- and waterborne outbreaks, and are
the major cause of seafood-associated gastroenteritis. [References: 64]
1685. Vinje
J. Koopmans MP. Simultaneous detection
and genotyping of "Norwalk-like viruses" by oligonucleotide array in
a reverse line blot hybridization format. Journal of Clinical
Microbiology. 38(7):2595-601, 2000 Jul.
Abstract
"Norwalk-like viruses" (NLVs) are the most common cause
of outbreaks of nonbacterial
gastroenteritis worldwide. To date, the method most widely used for typing of NLV strains is sequencing
and subsequent phylogenetic analysis of
reverse transcription (RT)-PCR products, which has revealed the existence of stable distinct lineages
(genotypes). This typing method is rather costly, not routinely used in
clinical laboratories, and not very suitable for the analysis of large numbers
of samples. Therefore, we have
developed a rapid and simple method for genotyping of NLVs. The method, designated reverse line blot hybridization,
is based on the nucleotide divergence of a region of the gene for RNA
polymerase which can be used to classify NLVs into genotypes. NLV RNA was
amplified by RT-PCR and then hybridized to 18 different membrane-bound
oligonucleotides that were able to discriminate among 13 NLV genotypes.
Application of the method to a panel of 132 positive stool samples from 34
outbreaks and 20 sporadic cases of
gastroenteritis collected in a 6-year period (1994 to 1999) resulted in
successful genotyping of 124 samples (94%), as confirmed by phylogenetic analysis. The nucleotide
sequences of the remaning eight strains
(6%) from three outbreaks did not cluster with the known NLV genotypes.
Phylogenetic analysis of the complete and partial open reading frame 2 (capsid
gene) sequences of these strains revealed the existence of one novel genotype (Alphatron) and one
potentially novel genotype (Amsterdam).
This novel method, which allows simultaneous detection and genotyping of NLVs,
is useful in the diagnosis and typing of NLVs obtained from outbreaks and in
large-scale epidemiological studies.
2178. Anonymous. From the Centers for Disease Control and Prevention. Foodborne outbreak of group A rotavirus gastroenteritis among college students--District of Columbia, March-April 2000. JAMA. 285(4):405-6, 2001 Jan 24-31.
2179. No abstract.
2180. Dingle KE. Colles FM. Wareing DR. Ure R. Fox AJ. Bolton FE. Bootsma HJ. Willems RJ. Urwin R. Maiden MC. Multilocus sequence typing system for Campylobacter jejuni. Journal of Clinical Microbiology. 39(1):14-23, 2001 Jan.
Abstract
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 (http://mlst.zoo.ox.ac.uk), 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.
2181. No abstract.
2182. Hohmann EL. Nontyphoidal salmonellosis. [Review] [28 refs] Clinical Infectious Diseases. 32(2):263-9, 2001 Jan 15.
Abstract
Nontyphoidal Salmonella are important foodborne pathogens that cause gastroenteritis, bacteremia, and subsequent focal infection. These hardy bacteria are especially problematic in a wide variety of immunocompromised individuals, including (but not limited to) patients with malignancy, human immunodeficiency virus, or diabetes, and those receiving corticosteroid therapy or treatment with other immunotherapy agents. Endovascular infection and deep bone or visceral abscesses are important complications that may be difficult to treat. The site of infection and the individual's immune status influence treatment choices. The harbingers of resistance of nontyphoidal Salmonella to both fluoroquinolones and third-generation cephalosporins have been reported recently, and such resistance is likely to be a therapeutic problem in the future. The current report presents a brief overview of the problems and trends associated with salmonellosis that are of interest to the infectious diseases clinician. [References: 28]
2183. Kalabalikis P. Hatzis T. Papadatos J. Gionis D. Danou F. Vlachos P. Paraquat poisoning in a family. Veterinary & Human Toxicology. 43(1):31-3, 2001 Feb.
Abstract
A familial occurrence of acute paraquat (PQ) poisoning is reported. The mother administered a PQ solution to their 3 children aged 8 y, 6 y and 15 mo and then ingested an unknown amount of the herbicide herself. In the absence of history or diagnostic signs, the poisoning was initially misdiagnosed as astroenteritis. Thirty h after the ingestions, serum PQ concentrations of the children were 60, <6 and 25 ng/ml respectively. Hemoperfusion was performed on all patients, and 2 of the children also received plasmapheresis and erythropheresis. The 3 children recovered fully but the mother died. According to these patients' data, the extracorporeal techniques had little effect on PQ removal, and the decreases in serum PQ were related to its urinary excretion.
2184. No abstract.
2585. Kuzuya M. Fujii R. Hamano M. Ohata R. Ogura H. Yamada M. Seroepidemiology of human group C rotavirus in Japan based on a blocking enzyme-linked immunosorbent assay. Clinical & Diagnostic Laboratory Immunology. 8(1):161-5, 2001 Jan.
Abstract
A novel blocking enzyme-linked immunosorbent assay (BL-ELISA) was developed for detection of antibodies to human group C rotavirus (CHRV). The specificity of the BL-ELISA was confirmed by using animal sera hyperimmunized to group A and group C rotaviruses and paired sera from five patients with acute CHRV gastroenteritis. Furthermore, there was concordance between the BL-ELISA and a neutralization assay for CHRV in 226 (95%) of 238 samples. By using the BL-ELISA, we determined the seroprevalence of CHRV in 704 serum samples obtained from nine different age groups of inhabitants of Okayama Prefecture, Japan, in 1992, 1994, and 1996. As a result, 211 sera (30%) were found to be positive for CHRV antibodies. The seroprevalence gradually increased with age and reached 52.7% in the oldest individuals. A further analysis of the youngest age group suggested that CHRVs predominantly prevail in persons older than 3 years of age in Japan. When comparing the three sampling years, a larger percentage of antibody-positive sera was detected in 1994 than in either 1992 or 1996 in individuals between 6 and 15 years of age, reflecting the occurrence of a CHRV outbreak among children during the winter of 1992 to 1993 that was previously documented. These results indicate that CHRV infections may occur more frequently in spite of the relatively low detection rate of the virus.
2186. Marteau PR. de Vrese M. Cellier CJ. Schrezenmeir J. Protection from gastrointestinal diseases with the use of probiotics. [Review] [92 refs] American Journal of Clinical Nutrition. 73(2 Suppl):430S-436S, 2001 Feb.
Abstract
Probiotics are nonpathogenic microorganisms that, when ingested, exert a positive influence on the health or physiology of the host. They can influence intestinal physiology either directly or indirectly through modulation of the endogenous ecosystem or immune system. The results that have been shown with a sufficient level of proof to enable probiotics to be used as treatments for gastrointestinal disturbances are 1) the good tolerance of yogurt compared with milk in subjects with primary or secondary lactose maldigestion, 2) the use of Saccharomyces boulardii and Enterococcus faecium SF 68 to prevent or shorten the duration of antibiotic-associated diarrhea, 3) the use of S. boulardii to preventfurther recurrence of Clostridium difficile-associated diarrhea, and 4) the use of fermented milks containing Lactobacillus rhamnosus GG to shorten the duration of diarrhea in infants with rotavirus enteritis (and probably also in gastroenteritis of other causes). Effects that are otherwise suggested for diverse probiotics include alleviation of diarrhea of miscellaneous causes; prophylaxis of gastrointestinal infections, which includes traveler's diarrhea; and immunomodulation. Trials of gastrointestinal diseases that involve the ecosystem are currently being performed, eg, Helicobacter pylori infections, inflammatory bowel disease, and colon cancer. [References: 92]
2187. No abstract.
2188. Shetty A. Mendall M. Diagnosing gastroenteritis and travellers' diarrhoea. [Review] [5 refs] Practitioner. 245(1620):192-4, 199-200, 204, 2001 Mar.
2180. Dingle KE. Colles FM. Wareing DR. Ure R. Fox AJ. Bolton FE. Bootsma HJ. Willems RJ. Urwin R. Maiden MC. Multilocus sequence typing system for Campylobacter jejuni. Journal of Clinical Microbiology. 39(1):14-23, 2001 Jan.
Abstract
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 (http://mlst.zoo.ox.ac.uk), 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.
2181. No abstract.
2182. Hohmann EL. Nontyphoidal salmonellosis. [Review] [28 refs] Clinical Infectious Diseases. 32(2):263-9, 2001 Jan 15.
Abstract
Nontyphoidal Salmonella are important foodborne pathogens that cause gastroenteritis, bacteremia, and subsequent focal infection. These hardy bacteria are especially problematic in a wide variety of immunocompromised individuals, including (but not limited to) patients with malignancy, human immunodeficiency virus, or diabetes, and those receiving corticosteroid therapy or treatment with other immunotherapy agents. Endovascular infection and deep bone or visceral abscesses are important complications that may be difficult to treat. The site of infection and the individual's immune status influence treatment choices. The harbingers of resistance of nontyphoidal Salmonella to both fluoroquinolones and third-generation cephalosporins have been reported recently, and such resistance is likely to be a therapeutic problem in the future. The current report presents a brief overview of the problems and trends associated with salmonellosis that are of interest to the infectious diseases clinician. [References: 28]
2183. Kalabalikis P. Hatzis T. Papadatos J. Gionis D. Danou F. Vlachos P. Paraquat poisoning in a family. Veterinary & Human Toxicology. 43(1):31-3, 2001 Feb.
Abstract
A familial occurrence of acute paraquat (PQ) poisoning is reported. The mother administered a PQ solution to their 3 children aged 8 y, 6 y and 15 mo and then ingested an unknown amount of the herbicide herself. In the absence of history or diagnostic signs, the poisoning was initially misdiagnosed as astroenteritis. Thirty h after the ingestions, serum PQ concentrations of the children were 60, <6 and 25 ng/ml respectively. Hemoperfusion was performed on all patients, and 2 of the children also received plasmapheresis and erythropheresis. The 3 children recovered fully but the mother died. According to these patients' data, the extracorporeal techniques had little effect on PQ removal, and the decreases in serum PQ were related to its urinary excretion.
2184. No abstract.
2585. Kuzuya M. Fujii R. Hamano M. Ohata R. Ogura H. Yamada M. Seroepidemiology of human group C rotavirus in Japan based on a blocking enzyme-linked immunosorbent assay. Clinical & Diagnostic Laboratory Immunology. 8(1):161-5, 2001 Jan.
Abstract
A novel blocking enzyme-linked immunosorbent assay (BL-ELISA) was developed for detection of antibodies to human group C rotavirus (CHRV). The specificity of the BL-ELISA was confirmed by using animal sera hyperimmunized to group A and group C rotaviruses and paired sera from five patients with acute CHRV gastroenteritis. Furthermore, there was concordance between the BL-ELISA and a neutralization assay for CHRV in 226 (95%) of 238 samples. By using the BL-ELISA, we determined the seroprevalence of CHRV in 704 serum samples obtained from nine different age groups of inhabitants of Okayama Prefecture, Japan, in 1992, 1994, and 1996. As a result, 211 sera (30%) were found to be positive for CHRV antibodies. The seroprevalence gradually increased with age and reached 52.7% in the oldest individuals. A further analysis of the youngest age group suggested that CHRVs predominantly prevail in persons older than 3 years of age in Japan. When comparing the three sampling years, a larger percentage of antibody-positive sera was detected in 1994 than in either 1992 or 1996 in individuals between 6 and 15 years of age, reflecting the occurrence of a CHRV outbreak among children during the winter of 1992 to 1993 that was previously documented. These results indicate that CHRV infections may occur more frequently in spite of the relatively low detection rate of the virus.
2186. Marteau PR. de Vrese M. Cellier CJ. Schrezenmeir J. Protection from gastrointestinal diseases with the use of probiotics.
[Review] [92 refs]
Source
American Journal of Clinical Nutrition. 73(2 Suppl):430S-436S, 2001 Feb.
Abstract
Probiotics are nonpathogenic microorganisms that, when ingested, exert a
positive influence on the health or physiology of the host. They can
influence intestinal physiology either directly or indirectly through
modulation of the endogenous ecosystem or immune system. The results that
have been shown with a sufficient level of proof to enable probiotics to
be used as treatments for gastrointestinal disturbances are 1) the good
tolerance of yogurt compared with milk in subjects with primary or
secondary lactose maldigestion, 2) the use of Saccharomyces boulardii and
Enterococcus faecium SF 68 to prevent or shorten the duration of
antibiotic-associated diarrhea, 3) the use of S. boulardii to prevent
further recurrence of Clostridium difficile-associated diarrhea, and 4)
the use of fermented milks containing Lactobacillus rhamnosus GG to
shorten the duration of diarrhea in infants with rotavirus enteritis (and
probably also in gastroenteritis of other causes). Effects that are
otherwise suggested for diverse probiotics include alleviation of diarrhea
of miscellaneous causes; prophylaxis of gastrointestinal infections, which
includes traveler's diarrhea; and immunomodulation. Trials of
gastrointestinal diseases that involve the ecosystem are currently being
performed, eg, Helicobacter pylori infections, inflammatory bowel disease,
and colon cancer. [References: 92]
2187. No abstract.
2188. Shetty A. Mendall M. Diagnosing gastroenteritis and travellers' diarrhoea. [Review] [5 refs] Practitioner. 245(1620):192-4, 199-200, 204, 2001 Mar.
2738. Asaeda G. The transport of ciguatoxin: a case report. Journal of Emergency Medicine. 20(3):263-5, 2001 Apr.
2739. Atmar RL. Estes MK. Diagnosis of noncultivatable gastroenteritis viruses, the human caliciviruses. [Review] [257 refs] Clinical Microbiology Reviews. 14(1):15-37, 2001 Jan.
2740. Peek RM Jr. IV. Helicobacter pylori strain-specific activation of signal transduction cascades related to gastric inflammation. [Review] [29 refs] American Journal of Physiology - Gastrointestinal & Liver Physiology. 280(4):G525-30, 2001 Apr.