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Steib C, Gross M. [Traveller's diarrhoea: Which pathogens? When, whom and how to treat?]. MMW Fortschr Med 2022; 164:36-39. [PMID: 35650496 DOI: 10.1007/s15006-022-1079-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Christian Steib
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Internistisches Klinikum München Süd, Am Isarkanal 36, 81379, München, Deutschland.
| | - Manfred Gross
- Klinik für Allgemeine Innere Medizin und Gastroenterologie, Internistisches Klinikum München Süd, Am Isarkanal 36, 81379, München, Deutschland
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Abstract
It is recognised that infective endocarditis is frequently a challenging diagnosis to make, as it may present with a range of non-specific symptoms. A middle-aged man was admitted with an 8-day history of profuse non-bloody diarrhoea and vomiting. He had no medical history and no identifiable risk factors for infective endocarditis, and so this in combination with the patient's atypical symptoms presented a diagnostic challenge. The patient was eventually diagnosed with a Staphylococcus aureus right-sided infective endocarditis. This case report explores the events which led to this diagnosis and demonstrates a number of unique learning points. It also highlights the importance of maintaining an open mind and being prepared to revise an initial diagnosis in the face of medical uncertainty.
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Affiliation(s)
| | | | - Waheed Akhtar
- Lincolnshire Heart Centre, United Lincolnshire Hospitals NHS Trust, Lincoln, Lincolnshire, UK
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3
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Lin S, Pan H, Xiao WJ, Gong XH, Kuang XZ, Teng Z, Zhang X, Wu HY. [Epidemiologic characteristics of Norovirus among adult patients with infectious diarrhea, in Shanghai, 2013-2018]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:883-888. [PMID: 31484248 DOI: 10.3760/cma.j.issn.0254-6450.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objective: To investigate the epidemiologic characteristics of Norovirus among adult patients suffering from infectious diarrhea in Shanghai, so as to provide evidence for developing related strategies on prevention and control of the disease. Methods: Diarrheal outpatients were monitored at the 'Intestinal clinic' from 22 hospitals involved in the sentinel surveillance program in Shanghai. Information on demographic and epidemiologic features of the patients was collected while data and clinical, fecal specimens were collected and sent to the district CDC for Norovirus detection. Positive rates of Norovirus were also compared in various populations and seasons during 2013-2018. Multivariate logistic regression model was adopted to fit into the comparisons between non-Norovirus and Norovirus groups. Results: 19.28% of the 12 083 diarrheal cases were found to have carried the Norovirus, with GⅡgroup the most commonly identified genotype. Rates of detection was seen higher in males (20.78%) than in females (17.73%). 30-44 year-old were found having the highest positive rate (21.51%). The positive rates were found the highest (23.60%) in the year of 2015. All the above shown differences were statistically significant (P<0.05). Diarrheal patients affected with Norovirus would present watery stool (75.94%) and vomiting (35.84%). Data from the multivariate logistic analysis showed that factors as: being males, 30-44 years old, officials/clerks, in winter season and with histories of travelling etc., were related to higher risks on Norovirus infection. Conclusions: Infectious diarrhea caused by Norovirus occurred all year round, with seasonal peaks seen in winter and spring, in Shanghai. Specific prevention and control measures should be taken on Norovirus- caused infectious diarrhea, according to the difference on age, gender and season.
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Affiliation(s)
- S Lin
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
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Shin HJ, Kang SH, Moon HS, Sung JK, Jeong HY, Kim JS, Joo JS, Lee ES, Kim SH, Lee BS. Serum procalcitonin levels can be used to differentiate between inflammatory and non-inflammatory diarrhea in acute infectious diarrhea. Medicine (Baltimore) 2018; 97:e11795. [PMID: 30095641 PMCID: PMC6133584 DOI: 10.1097/md.0000000000011795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In this study, we assess the possibility of using procalcitonin levels to differentiate between inflammatory diarrhea and non-inflammatory diarrhea in acute infectious diarrhea.We reviewed the records of 1176 patients who had symptoms of diarrhea, fever (≥37.8 °C), and abdominal pain between March 2011 and May 2015. After applying exclusion criteria, a sample of 514 patients was considered for study. The patient sample was divided into Group A and Group B for inflammatory diarrhea and non-inflammatory diarrhea, respectively. The assessment involved comparing the laboratory characteristics with the clinical characteristics of the groups.The characteristics of Group A, such as white blood cell (WBC), C-reactive protein (CRP), absolute neutrophil count (ANC), and procalcitonin levels, were relatively higher than those of Group B (P < .001 for Group A). A receiver operator characteristic (ROC) analysis revealed that the highest area-under-the-curve (AUC) value of procalcitonin (0.797; 95% confidence interval [CI] [0.760, 0.831]; P < .001), could be used to differentiate between the 2 groups. Procalcitonin exhibited a sensitivity and a specificity of 87.03% and 68.75%, respectively, at a 0.08 ng/mL cut-off level.Procalcitonin was a good candidate biomarker of inflammatory diarrhea than other inflammatory markers.
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Affiliation(s)
- Hae Jin Shin
- Division of Gastroenterology, Department of Internal Medicine, Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Chungcheongbuk-do
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jong Seok Joo
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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Malysh NG, Chemych ND, Zaritsky AM. [INCIDENCE, PREDISPOSING RISK FACTORS FOR THE DEVELOPMENT AND SPREADING OF ACUTE INTESTINAL INFECTIONS IN THE NORTH-EASTERN REGION OF UKRAINE]. Gig Sanit 2016; 95:287-292. [PMID: 27266031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Using data of the branch statistical reporting of the State Sanitary and Epidemiological Service in Sumy region and Sumy Regional State Laboratory of Veterinary Medicine, the incidence rate, modern risk factors for the development and spreading of acute infectious diarrheas were determined in the North-Eastern region of Ukraine. Under the current conditions incidence rate indices of acute intestinal infections and food toxicoinfections are within the range of 159.8-193.6 per 100 thousands. pop. Seasonal and epidemical rises are associated with a species of the agent. In the etiological structure of acute diarrheal infections there are dominated viruses, of food toxicoinfections--Klebsiellae pneumoniae, Staphylococcus aureus and Enterobacter cloacae (p < 0.05). Predictors of the complication of epidemiological situation of Shigella infections are the gain in the detection of bacterially contaminated samples of milk and dairy products (r = 0.75), for food toxicoinfections caused by Klebsiellae pneumoniae and Enterobacter cloacae--pastry with cream and cooking meat products (r = 0.64; r = 0.75). Epizootic situation in the region affects on the salmonellosis incidence rate of the population (r = 0.89). There were revealed correlations between the selection of E. coli bacteria from swabs taken from the enterprises of catering, in child care centers and the levels of incidence rates of salmonellosis, acute intestinal infections of unknown etiology (r = 0.59; r = 0.60). Timely detection and sanitation of Shigella carriers are a powerful instrument to reduce the incidence rate of shigellosis (r = 0.83).
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Bellanger AP, Scherer E, Cazorla A, Grenouillet F. Dysenteric syndrome due to Balantidium coli: a case report. New Microbiol 2013; 36:203-205. [PMID: 23686128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 01/13/2013] [Indexed: 06/02/2023]
Abstract
A 28-year-old man was hospitalized for a dysenteric syndrome that had developed during the previous days. Physical examination revealed abdominal pains, fever, vomiting and more than ten liquid stools per day. Fresh stool examination showed numerous mobile ciliated trophozoites of Balantidium coli. The patient reported having been on a hike the previous weekend during which he had drunk water through a hydration pouch bladder. Complete resolution was observed after intravenous rehydration and ten days of oral treatment with metronidazole (Flagyl®). Balantidium coli is the largest ciliate protozoan able to infect humans. This parasite is common in pigs and has a worldwide distribution. Human infections, a rare event in industrialised countries, are usually acquired by ingestion of food or water contaminated by mammal faeces. Human B. coli infections are easily treated but may be severe and even fatal if neglected.
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7
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Gonzales S C, Bada M C, Rojas G R, Bernaola A G, Chávez B C. [Clinical practice guideline on the diagnosis and treatment of pediatric acute infectious diarrhea in Peru - 2011]. Rev Gastroenterol Peru 2012; 32:100-105. [PMID: 22866342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Affiliation(s)
- Paul Kelly
- Centre for Digestive Diseases, Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London.
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9
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Kai A, Konishi N, Obata H. [Diarrheagenic Escherichia coli]. Nihon Rinsho 2010; 68 Suppl 6:203-207. [PMID: 20942038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Akemi Kai
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health
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Kai A, Yokoyama K. [Campylobacter]. Nihon Rinsho 2010; 68 Suppl 6:179-182. [PMID: 20942033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Akemi Kai
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health
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12
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Vinz H. Acute purulent appendicitis. Dtsch Arztebl Int 2010; 107:72; author reply 72. [PMID: 20186313 PMCID: PMC2828243 DOI: 10.3238/arztebl.2010.0072a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Heinrich Vinz
- *Ärztliches Mitglied der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Schlichtungsstelle, Hans-Böckler-Allee 3, 30173 Hannover, Germany,
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Naruszewicz-Lesiuk D, Czarkowski MP. [Problems of epidemiology of acute infectious diseases in the areas affected by flooding in July 1997 in Poland]. Przegl Epidemiol 2010; 64:349-354. [PMID: 20976945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In 1997, Poland experienced a flood of high-intensity. Some predicted major threats from communicable diseases caused by deterioration of the sanitary-epidemiological conditions. On the basis of data from 1997, in this article is presented range of counter epidemic measures recommended in the conditions of public health treats caused by natural disasters like floods. Fears regarding health effects of flood were confronted with surveillance data on infectious diseases reported in 1997.
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Affiliation(s)
- Danuta Naruszewicz-Lesiuk
- Zakład Epidemiologii Narodowego Instytutu Zdrowia Publicznego--Państwowego Zakładu Higieny w Warszawie.
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Abstract
BACKGROUND Acute infectious enteritis is one of the more common childhood diseases worldwide, especially in the first three years of life. Every year, in Germany, one in six children under age 5 is taken to a physician at least once because of infectious diarrheal disease. 10% of the children presenting with rotavirus infection are admitted to hospital. The existing national and international recommendations for the treatment of acute infectious diarrheal disease are inadequately followed, despite the high level of evidence on which they are based. METHODS Selective literature search based on national and international guidelines. RESULTS AND CONCLUSIONS The therapeutic goal is to replace the fluid and electrolyte losses resulting from diarrhea and vomiting. The administration of a hypotonic oral rehydration solution (ORS) is indicated to treat impending dehydration (infants aged up to 6 months with diarrhea and/or more than 8 watery stools in the last 24 hours and/or more than 4 episodes of vomiting in the last 24 hours), or when mild or moderate dehydration is already present. Oral rehydration with ORS given in frequent, small amounts over 3-4 hours is successful in more than 90% of cases. Regular feeding can be begun immediately afterward. Laboratory testing of blood or stool is usually unnecessary. Children who can be rehydrated orally or through a nasogastric tube should not be given intravenous fluids.
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Affiliation(s)
- Sibylle Koletzko
- Abteilung für Pädiatrische Gastroenterologie und Hepatologie, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München.
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Nayeri F, Nilsson I, Brudin L, Almer S. Stability of faecal hepatocyte growth factor determination. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 64:589-97. [PMID: 15370465 DOI: 10.1080/00365510410002850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In order to evaluate the accuracy and reproducibility of determination of hepatocyte growth factor (HGF) levels in faeces, the stability of HGF in samples processed in different ways was investigated. An ELISA method was used for determination of HGF concentrations. Faeces samples from healthy controls and patients with infectious diarrhoea were studied. It was found that faeces HGF concentration remained stable irrespective of whether samples were freeze-thawed several times, kept for 6, 12 or 24 h at room temperature or refrigerated for 6, 12, 24 or 36 h; the levels of HGF did not change significantly when samples were freeze-dried. Adding protease inhibitor to the faeces samples did not affect the HGF levels. There were no significant differences between HGF levels using phosphate buffered saline (PBS) (pH 7.4) or NaCL as buffer, but it was observed that levels of HGF were significantly lower in the samples that were diluted in distilled water. Although both HGF and albumin through various mechanisms may increase in faeces during infectious diarrhoea, there was no significant correlation between faeces HGF levels and albumin levels, which might indicate local production of HGF in the bowel in response to infection. It is concluded that determination of faeces HGF levels is feasible with a high degree of stability. Increased HGF levels in faeces might represent a local production of HGF during bowel injury and might be of use as a diagnostic and monitoring assay.
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Affiliation(s)
- F Nayeri
- Division of Infectious Diseases, Linköping University Hospital, Linköping, Sweden.
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Davydov BN, Sorokina AA, Bogomolov BP. [Stomatological status changes in patients with sharp dysentery and salmonellosis]. Stomatologiia (Mosk) 2009; 88:76-78. [PMID: 20041523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Liu YZ, Huang YW, Jin M, Zhang H, Liu FQ, Wang J, Hu SX, Ou XH, Duan ZJ. [Pathogenic diagnosis of an unexplained epidemic event of infectious diarrhea]. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi 2008; 22:461-463. [PMID: 19544646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To determine the pathogen of an unexplained epidemic event of infectious diarrhea by laboratory diagnosis of suspected cases samples. METHODS 28 samples from 28 suspected cases (22 fecal samples, 3 vomitus samples, 3 anus swab samples) were tested for Norovirus by RT-PCR. Sequencing and phylogenetic analysis were acomplished of 5 positive samples. RESULTS 160 of 5694 population were ill with an attack rate of 2.81%. The peak period was 7-9, March. 14 of 28 samples were tested Norovirus positive.Sequencing and phylogenetic analysis showed Norovirus type GII/4 was the causative agent and it had highest identity (97. 9%) with epidemic strain 2006b. CONCLUSION The epidemic event ofinfectious diarrhea were caused by GII/4 Norovirus strains.
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Affiliation(s)
- Yun-zhi Liu
- Center for Disease Control Hunan Pronice, Changsha 410005, China
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18
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Abstract
Enterotoxigenic Escherichia coli (ETEC) is an important cause of diarrhea in infants and in travelers from developed to underdeveloped countries, especially in regions of poor sanitation. The ETEC are acquired by the ingestion of contaminated food and water, and adults living in endemic areas develop immunity. The disease condition manifests as a minor discomfort to a severe cholera-like syndrome and requires colonization by the microorganism and the elaboration of one or more enterotoxins. The ETEC attach to the epithelial cells of the gastrointestinal tract and release substances that affect the normal functioning of the tract, thereby resulting in diarrhea, and subsequently millions of deaths everyday, particularly in children. The prevention of the spread of this strain of diarrheagenic E. coli depends on ensuring appropriate sanitary measures; hand-washing and proper preparation of food; chlorination of water supplies; and appropriate sewage treatment and disposal. Parenteral or oral fluid and electrolyte replacement is used to prevent dehydration, and broad-spectrum antibiotics are used in chronic or life-threatening cases, but in most cases, should be avoided because of severe side effects.
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Affiliation(s)
- Anthony I Okoh
- Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, South Africa.
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19
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Abstract
BACKGROUND Although treatment with empirical antibiotics is recommended for dysenteric or invasive bacterial diarrhoea, overuse is common in clinical practice worldwide. Recent information on the use of antibiotics in Thai children with acute diarrhoea is lacking. OBJECTIVE To survey the appropriate use of empirical antibiotics in children with acute diarrhoea in hospitals in southern Thailand and evaluate the association between their use and clinical features. METHODS Outpatient medical records of children aged 2 months to 5 years with acute diarrhoea seen at ten hospitals in southern Thailand (five community and five general hospitals) during January to December 2004 were reviewed. Children with diarrhoeal symptoms lasting >7 days, who were immunocompromised, who had an underlying disease or whose medical records were inadequate were excluded. Appropriate use of empirical antibiotics was defined as: use of an antibiotic in a child with a history of bloody-mucous diarrhoea, who had a faecal WBC count of >10 cells/HPF, or no prescription of antibiotics in watery, non-bloody diarrhoea. RESULTS There were 2882 patient encounters, 70% of which were children under 2 years of age. Invasive bacterial diarrhoea comprised 6.9% of the total number of cases. Of the 2882 patient encounters, 50.3%, 36.4% and 13.3% were seen by general practitioners, paediatricians or other medical personnel, respectively. Antibiotics had been used appropriately in 44.1% of cases. Of the 55.9% of cases identified as inappropriate use, 55.2% involved unnecessary antibiotic prescriptions in non-indicated cases. The prevalence of appropriate use was significantly higher in general hospitals than in community hospitals (51% vs 37.1%, p<0.05). Medical trainees were more likely to prescribe antibiotics more appropriately than staff physicians (76.9% vs 44.2%, p<0.05). Multivariate analysis showed that a history of fever (OR 1.25, 95% CI 1.04-1.50), watery-mucous stool (OR 2.54, 95% CI 1.94-3.32), mushy-mucous stool (OR 2.62, 95% CI 1.28-5.35), bloody-mucous stool (OR 6.97, 95% CI 4.17-11.64), stool frequency of 5-10 times/day (OR 1.41, 95% CI 1.16-1.70), body temperature 38.6-39.5 degrees C (OR 1.86, 95% CI 1.17-2.98) and a faecal WBC count of even 1-10 cells/HPF (OR 3.24, 95% CI 1.55-6.77) were associated with antibiotic use. CONCLUSION Overuse of antibiotics in the treatment of acute diarrhoea in children is common. The prevalence differs between different levels of hospitals and different types of medical personnel. Physicians might mistake some patients' clinical features of diarrhoea as features of dysentery, leading to unnecessary prescription of antibiotics.
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Affiliation(s)
- Seksit Osatakul
- Department of Paediatrics, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand.
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Glasheen JJ, Carter JE, Prochazka AV. Value of repeat stool testing for Clostridium difficile. Am J Med 2007; 120:e11; authorr eply e13. [PMID: 17602913 DOI: 10.1016/j.amjmed.2006.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Accepted: 05/17/2006] [Indexed: 11/21/2022]
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Grover S, Hamilton MJ, Carr-Locke DL. Refractory Clostridium difficile-associated diarrhea. MedGenMed 2007; 9:46. [PMID: 17955101 PMCID: PMC1994858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Shilpa Grover
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Persson S, Olsen KEP, Scheutz F, Krogfelt KA, Gerner-Smidt P. A method for fast and simple detection of major diarrhoeagenic Escherichia coli in the routine diagnostic laboratory. Clin Microbiol Infect 2007; 13:516-24. [PMID: 17331124 DOI: 10.1111/j.1469-0691.2007.01692.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A multiplex PCR was developed for the detection of the following genes characteristic of diarrhoeagenic Escherichia coli (DEC): verocytotoxins 1 (vtx1) and 2 (vtx2), characteristic of verocytotoxin-producing E. coli (VTEC); intimin (eae), found in enteropathogenic E. coli (EPEC), attaching and effacing E. coli and VTEC; heat-stable enterotoxin (estA) and heat-labile enterotoxin (eltA), characteristic of enterotoxigenic E. coli (ETEC); and invasive plasmid antigen (ipaH), characteristic of enteroinvasive E. coli (EIEC) and Shigella spp. The method allowed the simultaneous identification of all six genes in one reaction, and included a 16S rDNA internal PCR control. When applied to pure cultures from a reference strain collection, all virulence genes in 124 different DEC strains and 15 Shigella spp. were identified correctly, and there were no cross-reactions with 13 non-E. coli species. The detection limit of the method was 10(2)-10(3) DEC CFU/PCR in the presence of 10(6) non-target cells. When the multiplex PCR was tested with colonies from plate cultures of clinical stool samples, it was a faster, more sensitive, less expensive and less laborious diagnostic procedure than DNA hybridisation. When used with DNA purified from spiked stool samples (by two different commercial kits), the method had a detection limit of 10(6) CFU/mL stool sample.
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Affiliation(s)
- S Persson
- Department of Bacteriology, Mycology and Parasitology, Unit of Gastrointestinal Infection, Statens Serum Institut, Copenhagen, Denmark.
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Abstract
Because athletes travel to competitions all over the world, sports medicine providers need to be able to diagnose and treat gastrointestinal infections. Traveler's diarrhea (TD) is by far the most common gastrointestinal illness. TD is a self-limited condition caused by bacteria, viruses, or parasites, and it can easily be treated. Nevertheless, there are preventative measures that should be taken to limit the exposure to TD in the first place.
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Price MF, Dao-Tran T, Garey KW, Graham G, Gentry LO, Dhungana L, Dupont HL. Epidemiology and incidence of Clostridium difficile-associated diarrhoea diagnosed upon admission to a university hospital. J Hosp Infect 2006; 65:42-6. [PMID: 17145108 DOI: 10.1016/j.jhin.2006.08.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2006] [Accepted: 08/31/2006] [Indexed: 10/23/2022]
Abstract
Patients with Clostridium difficile-associated diarrhoea (CDAD) may initially develop symptoms in the community and be subsequently diagnosed at hospital admission. At the present time there is no national surveillance system and no standardized case definition of CDAD in the USA, and baseline data on the incidence and epidemiology of CDAD are scarce. The objective of this study was to report the incidence of CDAD at a tertiary care hospital, and to determine the epidemiology of cases diagnosed within 48h of hospital admission, compared with cases of nosocomial CDAD diagnosed 48h or more after hospitalization. The average incidence was 4.0 cases/10 000 patient-days for CDAD on admission and 7.0 cases/10 000 patient-days for nosocomial CDAD. A significant difference was observed in CDAD rates on admission compared with nosocomial CDAD rates (P=0.017), but no differences were observed over time for either rate. Overall, 44% of cases had CDAD on admission and 56% of cases had nosocomial CDAD. Fifty-six (62%) patients with CDAD on admission had been admitted to the same hospital and 24 (27%) had been admitted to another hospital within the previous 90 days. Only eight (9%) patients had not been exposed to any healthcare services in the 90 days preceding hospital admission. A standardized case definition of healthcare-associated CDAD should include previous hospitalizations. Admitting physicians should consider C. difficile in the differential diagnosis of patients admitted with diarrhoea, with or without a history of admission to healthcare facilities.
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Affiliation(s)
- M F Price
- St. Luke's Episcopal Hospital, Houston, TX, USA
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25
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Abstract
A total of 260 feces samples from children with confirmed rotavirus infection collected during 1999-2002 were serotyped, using enzymoimmunoassay with VP7 specific monoclonal antibodies for G1-G4 serotypes. The serotypes were identified in 185 feces, i.e. 71.2 %. Individual serotypes occurred in 43, 2, 16 and 2 %; 8 % samples reacted with 2 type-specific monoclonal antibodies. The G1 serotype was prevalent over the whole period. The G3 type occurred with a statistically higher significance in children of up to 36 months (chi2 = 4.6, p = 0.028). In 4 children a different serotype was demonstrated in the first and second, or in the second and third stools, respectively. No dominant serotype was found in children with nosocomial infection.
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Affiliation(s)
- P Pazdiora
- Institute of Epidemiology, Medical Faculty, Charles University, 305 99 Pilsen, Czechia.
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26
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Abstract
Acute infectious diarrhea is a yearly occurrence for most Americans, and is associated with 1 million hospitalizations and about 6000 deaths in the United States annually. Up to 80% of acute infectious diarrhea is caused by noroviruses, which produce a clinically mild illness with a predictable short course and good outcome that make laboratory testing and antimicrobial treatment unnecessary. Most diarrhea-causing bacteria and protozoa can cause a clinical illness "like norovirus"; when they do so in healthy adults neither specialized testing nor antimicrobials is required. The presence or absence of epidemiologic evidence (such as travel, hospitalization, antibiotic use, other exposures)and clinical evidence (such as diarrhea frequency and duration, severity of abdominal pain and fever, character of stool, presence of chronic illness or immune deficiency) can change the probability of "not norovirus" from as low as 8% to as high as 100%. Such probabilities guide the use of laboratory testing and antimicrobial therapy in patients who have acute infectious diarrhea.
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Affiliation(s)
- Richard Goodgame
- Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Room 525-D, Houston, TX 77030, USA.
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28
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Hongo M, Adachi M. [Diagnostic tests for gastrointestinal tract in diabetics]. Nihon Rinsho 2005; 63 Suppl 6:599-603. [PMID: 15999777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Michio Hongo
- Department of Comprehensive Medicine, Tohoku University Hospital
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Calderaro A, Bommezzadri S, Piccolo G, Zuelli C, Dettori G, Chezzi C. Rapid isolation of Brachyspira hyodysenteriae and Brachyspira pilosicoli from pigs. Vet Microbiol 2005; 105:229-34. [PMID: 15708820 DOI: 10.1016/j.vetmic.2004.10.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2001] [Revised: 10/07/2004] [Accepted: 10/31/2004] [Indexed: 11/24/2022]
Abstract
The aim of this study was to compare and evaluate the time required to isolate Brachyspira hyodysenteriae and Brachyspira pilosicoli from porcine faeces. This was done using previously described selective media (spectinomycin) S400, (colistin, vancomycin and spectinomycin) CVS and (spectinomycin, vancomycin, colistin, spiramycin and rifampin with swine faecal extract) BJ, compared with the method based on blood agar modified medium, with spectinomycin and rifampin (BAM-SR), including a pre-treatment step. Fourteen spirochaetal strains were obtained in pure cultures after 5 days (48 h in BAM-SR primary plate and three passages every 24 h in brain heart infusion (BHI) without antibiotics) pre-treating simulated samples in brain heart infusion broth with spectinomycin (400 microg/ml) and rifampin (15 microg/ml), before streaking on the selective BAM-SR medium. Spirochaetes from samples in S400, CVS and BJ, with and without pre-treatment, were obtained in pure cultures only after repeatedly transferring on plates of the same selective medium requiring 15-18 days according to the strain. BAM-SR used after the pre-treatment step showed a detection limit ranging from 3.5 x 10(2) to 6.7 x 10(7) cells/g faeces and was the only method able to support the growth of spirochaetes after 48 h.
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Affiliation(s)
- A Calderaro
- Department of Pathology and Laboratory Medicine, Section of Microbiology, University of Parma, Viale A. Gramsci, 14-43100 Parma, Italy.
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31
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Affiliation(s)
- Lawrence J Brandt
- Montefiore Medical Center, 111 East 210 Street, Bronx, NY 10467, USA.
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32
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Naumann M, Schaum B, Oremek GM, Hanisch E, Rösch W, Mössner J, Caspary WF, Stein J. [Faecal pyruvate kinase type M2--a valid screening parameter for colorectal cancer? Preliminary results from a multicenter comparative study]. Dtsch Med Wochenschr 2004; 129:1806-7. [PMID: 15314744 DOI: 10.1055/s-2004-829033] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M Naumann
- Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt
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33
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Affiliation(s)
- Anna C Casburn-Jones
- Department of Medicine, Gardiner Institute, Western Infirmary, University of Glasgow, Glasgow, UK.
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34
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Anderson TL, McGregor A. Evaluation of the Clearview Clostridium difficile Toxin A Test and various selective culture media in comparison with the cytotoxin assay for the diagnosis of Clostridium difficile-associated diarrhoea. Pathology 2003; 35:244-7. [PMID: 14506970 DOI: 10.1080/0031302031000123236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM Clostridium difficile is the major pathogen associated with nosocomial diarrhoea. We evaluated the performances of a commercially available toxin A enzyme immunoassay (EIA; Clearview C. difficile Toxin A Test), culture and tissue culture cytotoxin assay in the diagnosis of C. difficile-associated diarrhoea. METHODS Comparative test performance was determined from data obtained from 166 faecal samples. The initial analysis compared the performance of toxin A EIA and culture with that of cytotoxin assay, this being defined as a 'laboratory gold standard'. A second analysis compared the individual performance of the toxin A EIA, culture and cytotoxin assay using a combined clinical and laboratory diagnostic assessment as a 'clinical gold standard'. In a parallel, study three selective culture media were compared. RESULTS From the initial analysis, the sensitivity and specificity of the methods were, respectively, 84.6 and 65.4% for the toxin A EIA, and 38.5 and 93.5% for culture. From the second analysis, the sensitivity and specificity of the methods were, respectively, 100 and 67.5% for the toxin A EIA, 63.6 and 96.7% for culture and 72.7 and 98.0% for cytotoxin assay. Media containing d-cycloserine 250mg/L and cefoxitin 8mg/L performed best, growing 88.2% of the isolates. CONCLUSION The toxin A EIA we evaluated had poor specificity in the diagnosis of C. difficile-associated diarrhoea. We conclude that in our laboratory the combination of culture and cytotoxin assay is a preferred approach to the diagnosis of C. difficile-associated diarrhoea.
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Affiliation(s)
- Tara L Anderson
- Department of Microbiology and Infectious Diseases, Royal Hobart Hospital, Hobart, Tasmania, Australia
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35
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La T, Hampson DJ. Serologic detection of Brachyspira (Serpulina) hyodysenteriae infections. Anim Health Res Rev 2001; 2:45-52. [PMID: 11708746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Swine dysentery (SD) caused by the intestinal spirochete Brachyspira hyodysenteriae is an economically important disease in pig-producing countries throughout the world. To date, no specific serologic assay is commercially available for the diagnosis of pigs with SD. Several serologic techniques have been identified in the past; however, these tests have all used either whole-cell proteins or lipopolysaccharide (LPS) as the antigen. Whole-cell antigens are plagued with false-positive reactions due to cross-reactivity with common proteins shared with other spirochetes. LPS antigens produce fewer false-positives; however, false-negatives may result due to LPS components being serogroup-specific. Generally, these techniques are useful for detecting infected herds, but are unreliable for the detection of individual infected pigs. In order to develop improved serologic tests it will be necessary to identify suitable diagnostic antigens, in particular immunogenic cell-surface structures which are specific to B. hyodysenteriae but common amongst different strains of the species. Recently, we identified and cloned a 30-kDa outer membrane lipoprotein (BmpB) which is specific to B. hyodysenteriae and is recognized by experimentally and naturally infected pigs. In this review we summarize the available serologic tests for SD, and speculate on the use of recombinant BmpB as an antigen for future development of an improved serologic test for SD diagnosis.
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Affiliation(s)
- T La
- Division of Veterinary and Biomedical Sciences, Murdoch University, Western Australia, Australia
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36
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Verspohl J, Feltrup C, Thiede S, Amtsberg G. [Diagnosis of swine dysentery and spirochaetal diarrhea. III. Results of cultural and biochemical differentiation of intestinal Brachyspira species by routine culture from 1997 to 1999]. Dtsch Tierarztl Wochenschr 2001; 108:67-9. [PMID: 11367884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
A survey is given on the occurrence and distribution of different Brachyspira species in pigs, in the northwest of Germany. In total 2975 specimen (feces, fecal swabs, colon) were taken and sent for laboratory analysis during the years 1997 to 1999. 1218 Brachyspira (B.) strains were found by cultural analysis. 1757 samples (59%) were negative. The cultural and biochemical differentiation revealed 720 (59.1%) strains B. hyodysenteriae (77.5% were indole negative), 22 (1.8%) B. pilosicoli, 29 (2.4%) B. intermedia, 167 (3.7%) B. innocens and 114 (9.4%) B. murdochii. 166 (13.6%) strains could not be identified. These strains could either not be compared with any of the described species by the methods used or it was impossible to achieve a pure culture from these isolates. The results demonstrate the wide spread of B. hyodysenteriae in pig herds in the northwest of Germany with a very high prevalence of indole negative strains. The most frequent strain was B. hyodysenteriae. B. pilosicoli which causes spirochaetal diarrhoea was rarely isolated and seems not to play an important role in Germany. Experience from routine cultures for Brachyspira give evidence that it is more useful to examine faeces from single pigs instead of pooled samples from a herd. It is recommended to use special transport media for the transport of the specimen.
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Affiliation(s)
- J Verspohl
- Institut für Mikrobiologie und Tierseuchen, Tierärztlichen Hochschule Hannover
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37
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Cho KO, Hasoksuz M, Nielsen PR, Chang KO, Lathrop S, Saif LJ. Cross-protection studies between respiratory and calf diarrhea and winter dysentery coronavirus strains in calves and RT-PCR and nested PCR for their detection. Arch Virol 2001; 146:2401-19. [PMID: 11811688 PMCID: PMC7087283 DOI: 10.1007/s007050170011] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 1-step RT-PCR assay, targeting a 730 bp fragment of the nucleocapsid (N) gene of bovine coronavirus (BCV), and a nested PCR assay, targeting a 407 bp fragment of the N gene, were developed to detect BCV in nasal swab and fecal samples of calves experimentally exposed to BCV. Both 1-step RT-PCR and nested PCR recognized cell culture passaged isolates of 10 bovine respiratory coronavirus (BRCV), 5 calf diarrhea (CD) and 8 winter dysentery (WD) strains of BCV, but not transmissible gastroenteritis coronavirus or bovine rotavirus. The sensitivity of the 1-step RT-PCR and nested PCR was compared to that of an antigen-capture ELISA. The lowest detection limit of the 1-step RT-PCR and nested PCR as determined by using tenfold serial dilutions of the BRCV 255 and 440 strains in BCV negative nasal swab suspensions from preexposure gnotobiotic calves was 2 x 10(4) and 2 x 10(2) TCID50/0.1 ml for each strain, respectively. The lowest detection limit of the antigen-capture ELISA as determined by using the same serially diluted samples was 1 x 10(6) TCID50/0.1 ml for each strain. Therefore, the 1-step RT-PCR and nested PCR assays were 50 and 5000 times, respectively more sensitive than the antigen-capture ELISA to detect BRCV in nasal swab suspensions. To investigate in vivo cross-protection between the BRCV and CD or WD strains of BCV and to detect nasal and fecal shedding of BCV using the 1-step RT-PCR, nested PCR and antigen-capture ELISA, 6 colostrum-deprived and two gnotobiotic calves were inoculated with a BRCV, a CD or a WD strain of BCV and then challenged 3-4 weeks later with either BRCV, CD or WD strains of BCV. All calves developed diarrhea after inoculation and BCV antigen (ELISA) or RNA (RT-PCR) was detected in the diarrheic fecal samples or the corresponding nasal swab samples. In addition, low amounts of BCV were also detected only by nested PCR in the fecal and nasal swab samples before and after diarrhea. No respiratory clinical signs were observed during the entire experimental period, but elevated rectal temperatures were detected during diarrhea in the BCV-inoculated calves. All calves recovered from infection with the BRCV, CD, or WD strains of BCV were protected from BCV-associated diarrhea after challenge exposure with either a heterologous or homologous strain of BCV. However, all calves challenged with heterologous BCV strains showed subclinical BCV infection evident by detection of nasal and fecal shedding of BCV RNA detected only by nested PCR. Such results confirm field and experimental data documenting reinfection of the respiratory and enteric tracts of cattle, suggesting that, in closed herds, respiratory or enteric tract reinfections may constitute a source of BCV transmissible to cows (WD) or neonatal or feedlot calves. In addition, the present 1-step RT-PCR and nested PCR assays were highly sensitive to detect BCV in nasal swab and fecal specimens. Therefore, these assays should be useful to diagnose BCV infections in calves and adult cows.
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Affiliation(s)
- K O Cho
- Department of Veterinary Preventive Medicine, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster 44691, USA
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38
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Waldmann KH, Wendt M, Amtsberg G. [Investigations on Brachyspira--diagnostic and therapeutic strategies in swine dysentery]. Dtsch Tierarztl Wochenschr 2000; 107:486-9. [PMID: 11155518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The infectious agent of swine dysentery, Brachyspira (Br.) hyodysenteriae, seems to be widespread in German pig herds. Due to different reasons the eradication is increasingly difficult. Not only the success of therapeutic procedures but also the possibilities of diagnostics are unsatisfactory. Although only the bacteriological investigation of faeces or intestinal probes by culture techniques allows the typing of Brachyspira strains and the testing of drug resistance, however, the rate of false negative results is relatively high. In comparison with the cultural method an easy, prompt and cheap immunofluorescent test (IFT) resulted in a good sensitivity (90%). The higher rate of negative results by culture techniques can not be attributed to a lower specificity of the IFT, but to an insufficient transport of samples to the laboratory. The IFT therefore has to be considered as a valuable supplement to the cultural diagnostic of Br. hyodysenteriae. It is absolutely necessary to establish strategies in eradication of swine dysentery which result in pig breeding herds free of Br. hyodysenteriae. Only weaner pigs which are reliable free of this germ guarantee a fattening period sufficiently free of swine dysentery. The principles of different measures in effective eradication are described.
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Affiliation(s)
- K H Waldmann
- Klinik für kleine Klauentiere und forensische Medizin und Ambulatorische Klinik
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39
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Cho KO, Halbur PG, Bruna JD, Sorden SD, Yoon KJ, Janke BH, Chang KO, Saif LJ. Detection and isolation of coronavirus from feces of three herds of feedlot cattle during outbreaks of winter dysentery-like disease. J Am Vet Med Assoc 2000; 217:1191-4. [PMID: 11043691 DOI: 10.2460/javma.2000.217.1191] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Clinical signs of a winter dysentery-like syndrome in 6- to 9-month-old cattle in 3 feedlots included acute onset of diarrhea with high morbidity and low mortality, respiratory tract problems that included dyspnea, coughing, and nasal discharge, and high rectal temperatures. Bovine coronavirus was detected by use of an ELISA and immune electron microscopy in fecal and nasal swab samples and by immunohistochemical analysis of intestinal sections collected from calves during necropsy. Bovine coronavirus should be considered in the differential diagnoses for diseases that cause acute onset of bloody diarrhea in feedlot cattle.
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MESH Headings
- Animals
- Antigens, Viral/analysis
- Cattle
- Cattle Diseases/diagnosis
- Cattle Diseases/epidemiology
- Cattle Diseases/virology
- Cells, Cultured
- Coronavirus Infections/diagnosis
- Coronavirus Infections/veterinary
- Coronavirus Infections/virology
- Coronavirus, Bovine/immunology
- Coronavirus, Bovine/isolation & purification
- Coronavirus, Bovine/ultrastructure
- Diagnosis, Differential
- Disease Outbreaks/veterinary
- Dysentery/diagnosis
- Dysentery/veterinary
- Dysentery/virology
- Enzyme-Linked Immunosorbent Assay/veterinary
- Feces/virology
- Female
- Intestine, Large/pathology
- Intestine, Large/virology
- Lung/virology
- Lymph Nodes/virology
- Male
- Microscopy, Immunoelectron/veterinary
- Rectal Neoplasms
- Respiratory Tract Infections/diagnosis
- Respiratory Tract Infections/veterinary
- Respiratory Tract Infections/virology
- Tumor Cells, Cultured
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Affiliation(s)
- K O Cho
- Department of Veterinary Preventive Medicine, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster 44691-4096, USA
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40
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Affiliation(s)
- T Shibahara
- Hokkaido Research Station, National Institute of Animal Health, Sapporo, Japan
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41
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Dutta P, Mitra U, Saha DR, Niyogi SK, Manna B, Bhattacharya SK. Mucoid presentation of acute enterocolitis in children: a hospital-based case-control study. Acta Paediatr 1999; 88:822-6. [PMID: 10503679 DOI: 10.1080/08035259950168720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
A hospital-based case-control study was carried out to clarify the characteristics of mucoid presentation of acute enterocolitis in children. One hundred sixty-eight cases of acute mucoid enterocolitis (study population) were compared with 200 cases of watery diarrhoea and 118 cases of blood dysentery (control groups) on the basis of clinical characteristics and findings on stool examination. Study and control groups were comparable with respect to age, body weight and nutritional status. There was no significant difference in clinical characteristics (duration of diarrhoea, stool frequency, presence of vomiting, fever and dehydration) between patients suffering from mucoid enterocolitis and blood dysentery. However, watery diarrhoea patients had significantly high frequencies of vomiting (p=0.00001) and dehydration (p=0.00001). High numbers of microscopic red blood cells (mean +/- SD: 40.8 +/- 16.8) and white blood cells (40.6 +/- 18.0) were present in faecal samples of the patients with mucoid enterocolitis, which is indicative of infection caused by enteroinvasive enteropathogens. Shigella was a commonly identified enteropathogen in patients with mucoid enterocolitis (40.5%) and in patients with dysentery (46.6%), with no statistically significant difference (p = 0.30). Isolation of Salmonella was statistically similar in study and control groups. However, Entamoeba histolytica was detected in significantly high frequency in patients with mucoid enterocolitis as compared to the patients with dysentery (p = 0.0004) and watery diarrhoea (p = 0.00004). Our results indicate that mucoid enterocolitis patients are infected with enteroinvasive enteropathogens, and that stool examination is useful in establishing the aetiological diagnosis.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Calcutta, India.
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42
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Feltrup C, Franz B, Rohde J, Verspohl J, Amtsberg G. [Diagnosis of swine dysentery and spirochaetal diarrhea. 2. Effort of macrorestriction analysis for differentiation of intestinal Serpulina relative to determination by culture-biochemical markers following species classification]. Dtsch Tierarztl Wochenschr 1999; 106:234-41. [PMID: 10422370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Genotypic differentiation by means of macrorestriction fragment profile analysis using Mlul restriction enzyme was carried out differentiating 41 Serpulina field strains from swine (38), dog (2) and a rat as well as ten type and reference strains into 40 electrophoretic types. A dendrogram was created using the average linkage between groups method. At a level of 50% similarity the patterns could be divided into six groups that roughly corresponded to the results yielded by cultural and biochemical methods formerly (FELTRUP et al. 1999). Five of these clusters corresponded to the five known porcine Serpulina species, one cluster contained the S. pilosicoli isolates from dog and rat included in this study. Interestingly all nine investigated indole negative, strongly haemolytic isolates were clustered together in one group with the S. hyodysenteriae strains, so that incidence of indole negative variants of S. hyodysenteriae was confirmed. Because of being grouped together with two S. intermedia isolates, the suitability of B 256 as S. innocens type strain is--in accord to investigations carried out by PETTERSSON et al (1996)--called in question.
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Affiliation(s)
- C Feltrup
- Institut für Mikrobiologie und Tierseuchen, Tierärztlichen Hochschule Hannover
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43
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Boye M, Jensen TK, Møller K, Leser TD, Jorsal SE. Specific detection of the genus Serpulina, S. hyodysenteriae and S. pilosicoliin porcine intestines by fluorescent rRNA in situ hybridization. Mol Cell Probes 1998; 12:323-30. [PMID: 9778458 DOI: 10.1006/mcpr.1998.0193] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A fluorescent-labelledin situ hybridization method targeting rRNA was devised to facilitate specific identification and diagnosis of diarrhoea and colitis in pigs caused by the genus Serpulina, as well as to distinguish the species Serpulina hyodysenteriae and Serpulina pilosicoli in formalin-fixed colon tissue sections. A genus-specific oligonucleotide probe SER1410 targeting the five species of porcine Serpulina was thus designed. Furthermore, species specific oligonucleotide probes (Hyo1210, Pilosi209 and Pilosi1405) were also designed to detect, identify and differentiate S. hyodysenteriae and S. pilosicoli. These probes clearly demonstrated and possessed the desired specificity, when evaluated by whole cell hybridization on five reference strains and 20 isolates covering the five species of porcine Serpulina. Furthermore, the oligonucleotide probes were specific when used both, for the detection of Serpulina isolates at genus level as well as for specific detection of S. hyodysenteriae and S. pilosicoli in formalin-fixed colon tissue sections from pigs suffering from swine dysentery and porcine colonic spirochaetosis, respectively. Tissue sections were also used from pigs without any intestinal disorders as controls for estimating the specificity of the probes. The probes developed in this study thus had the potential of specific identification and histological recognition obtained in the formalin-fixed tissue samples.
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Affiliation(s)
- M Boye
- Danish Veterinary Laboratory, DK-1790 Copenhagen V, Denmark
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44
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Borisov AE, Kotliar VL, Levin LA, Iukhimik FE, Labasanov VM. [Acute appendicitis in patients with salmonellosis and dysentery]. Vestn Khir Im I I Grek 1998; 157:73-6. [PMID: 9611323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Results of 214 appendectomies in patients with acute intestinal diseases were analyzed. The clinical course and results of treatment of acute appendicitis against the background of salmonellosis and dysentery were discussed. It was shown that the theory of infectious nature of acute appendicitis is rightful and that valuable etiotropic therapy is necessary for prevention of chronicity of the intestinal infection.
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45
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Schneider S, Hebuterne X, Rampal P. [Acute diarrhea in adults: diagnostic trends and management in emergencies]. Rev Prat 1998; 48:887-91. [PMID: 11767335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- S Schneider
- Service de gastro-entérologie et nutrition, CHU, hôpital de l'Archet, B.P. 3079, 06202 Nice
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46
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Atyeo RF, Oxberry SL, Combs BG, Hampson DJ. Development and evaluation of polymerase chain reaction tests as an aid to diagnosis of swine dysentery and intestinal spirochaetosis. Lett Appl Microbiol 1998; 26:126-30. [PMID: 9569695 DOI: 10.1046/j.1472-765x.1998.00294.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Polymerase chain reaction (PCR) tests were established for detection of Serpulina hyodysenteriae, the agent of swine dysentery, and S. pilosicoli, the agent of intestinal spirochaetosis. Both reactions were specific when tested with DNA from 107 strains of various intestinal spirochaetes. For diagnostic use, faeces were plated to selective medium, and diatomaceous earth extraction used to obtain DNA prior to PCR. This procedure detected 10(3)-10(4) cells of either organism seeded into 0.2 g of faeces. When applied to 63 samples from pigs of eight piggeries naturally infected with either S. hyodysenteriae or S. pilosicoli, both PCRs were specific, more rapid, and detected more positive samples than did routine faecal culture and isolation.
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Affiliation(s)
- R F Atyeo
- Division of Veterinary and Biomedical Sciences, Murdoch University, Perth, Australia
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47
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Gupta DN, Saha DR, Sengupta PG, Mondal SK, Ghosh S, Saha MR, Bhattacharya SK, Sircar BK. Value of faecal leucocyte count as an indicator of invasiveness in mucoid diarrhoea. J Commun Dis 1997; 29:329-32. [PMID: 10085638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Importance of faecal leucocyte count as an indicator of invasiveness in mucoid diarrhoea was studied. A total of 290 faecal specimen, 170 from mucoid diarrhoea and 120 from watery diarrhoea were examined for faecal leucocyte count under high power field (hpf) from rural children below four years of age during the period from November 1992 to October 1995. Faecal leucocyte count > 10/hpf was noted in 45.9% of mucoid diarrhoea as against 19.2% of watery diarrhoea (p < 0.0001) samples. From faecal samples with > 10 faecal leucocyte count, invasive pathogens could be recovered in 19 (24.5%) to none of 23 patients with watery diarrhoea (p < 0.006 Fisher exact test). This sample test appears to be of value as an indicator of invasiveness in mucoid diarrhoea in the absence of culture facility.
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Affiliation(s)
- D N Gupta
- National Institute of Cholera and Enteric Diseases, Calcutta
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48
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Kramomtong I, Neramitmansook W, Whipp SC, Joens LA, Limawongpranee S. Comparison of ELISA and selective culture in the diagnosis of swine dysentery in Thailand. Vet Rec 1996; 138:332-3. [PMID: 8730676 DOI: 10.1136/vr.138.14.332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- I Kramomtong
- National Animal Health and Production Institute, Bangkok, Thailand
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49
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Rico-Martínez MG. [Molecular biology in the pathogenesis of Shigella sp. and enteroinvasive Escherichia coli]. Rev Latinoam Microbiol 1995; 37:367-85. [PMID: 8900572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Shigella sp and Escherichia coli (EIEC) are casual agents of bacillary dysentery, mainly in developing countries. Shigella and EIEC share biochemical, antigenic and genetic properties and probably they have the same mechanism of pathogenicity. Both species harbor a 120-140 megadalton plasmid, which is associated to the virulence and whose expression is regulated by chromosomal genes. Shigella sp and EIEC invade colonic epithelium and present virulence auxiliary factors, such as mucinases, superoxide dismutase and aerobactine production. On the other hand, cytotoxin production contributes to the illness' severity. The first step in invasion of the colonic mucosa is epithelium adherence, followed by endocytosis, lysis of the phagocytic vacuole, intracellular multiplication, intra-intercellular spread and killing of the host cell. Identification of these invasive organisms is carried out with the Sereny test, chicken embryo lethality and invasion to culture cells assays, DNA probe hibridization, polimerase chain reaction, ELISA, Congo red binding, and biochemical and serological tests.
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Affiliation(s)
- M G Rico-Martínez
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, IPN, México
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50
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Westerman RB, Phillips RM, Joens LA. Production and characterization of monoclonal antibodies specific for lipooligosaccharide of Serpulina hyodysenteriae. J Clin Microbiol 1995; 33:2145-9. [PMID: 7559965 PMCID: PMC228352 DOI: 10.1128/jcm.33.8.2145-2149.1995] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Serpulina (Treponema) hyodysenteriae is the causative agent of swine dysentery, a contagious mucohemorrhagic disease of the colon. Diagnosis of swine dysentery is extremely difficult because of the presence of cross-reactive antibodies to the proteins of S. hyodysenteriae and Serpulina innocens, a nonpathogenic inhabitant of the porcine large intestine. Therefore, monoclonal antibodies (MAbs) against the serotype-specific lipooligosaccharide (LOS) antigens of S. hyodysenteriae were produced to rapidly differentiate S. hyodysenteriae from S. innocens. Whole-cell preparations of S. hyodysenteriae serotypes 1 through 7 were used as antigens. MAbs were characterized by an indirect enzyme-linked immunosorbent assay with whole-cell or LOS antigen and by Western blot (immunoblot) analysis with whole-cell lysates as antigen. A total of 12 LOS-specific MAbs which could identify and differentiate the seven original serotypes of S. hyodysenteriae were produced. The MAb serospecificities are as follows: MAb 9G8, serotype 1; MAb 31D9, serotype 2; MAb 7D3, serotypes 2 and 7; MAb 24B7, serotype 3; MAb 13C2, serotype 4; MAb 18E9, serotype 4; MAb 2B7, serotype 6; MAb 1D2, serotypes 2, 5, and 7; MAb 9C5, serotypes 2, 5, and 7; MAb 11C9, serotype 7; MAb 11E10, serotype 7; and MAb 6G11, serotype 7.
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Affiliation(s)
- R B Westerman
- Department of Veterinary Diagnostic Investigation, College of Veterinary Medicine, Kansas State University, Manhattan 66506, USA
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