Search

Recent publications were compared and analysed in addition to novel surveillance data to assess the hypothesis that fluoroquinolone-resistant Campylobacter infections are causing more severe disease than susceptible infections. The available data did not support this hypothesis. There was no significant difference in duration of disease between susceptible and resistant infections. However, both for resistant and susceptible infections, disease symptoms were prolonged by on average 1–2 days for Campylobacter cases acquired during foreign travel. Nevertheless, the likelihood and duration of hospitalisation were not increased for cases related to foreign travel. These observations were confirmed by a new analysis of almost 11000 cases. We conclude that fluoroquinolone-resistant Campylobacter infections are not more severe than susceptible infections.

Summary Background The effect of Helicobacter-pylori status on survival after curative resection for gastric adenocarcinoma is unknown. We aimed to follow-up patients who were positive or negative for infection with H pylori who had curative (ie, R0) resection for gastric adenocarcinoma to assess differences in relapse-free survival and overall survival. Methods Before surgery, we assessed the H pylori status of 166 patients who had R0 resection for gastric adenocarcinoma between 1992 and 2002 with bacterial culture, histological analyses (ie, staining with haematoxylin and eosin and with Warthin-Starry), and serological analyses. Findings At a median follow-up of 53·0 months (range 1–146), relapse-free survival was 56·7 months (95% CI 4·7–108·7) and overall survival was 61·9 months (13·0–110·9) in patients positive for H pylori , compared with 19·2 months (12·7–25·6) and 19·2 months (7·1–31·3), respectively, in patients negative for H pylori (p=0·0009 for difference in relapse-free survival between groups, and p=0·0017 for difference in overall survival between groups). In multivariate analyses, H pylori was an independent prognostic factor for relapse-free survival (hazard ratio 2·16 [95% CI 1·33–3·49]) and overall survival (2·00 [1·22–3·27]). Depth of tumour invasion (2·60 [1·66–4·08]), lymph-node metastasis (2·11 [1·25–3·57]), and patient age 67·5 years or older (1·75 [1·11–2·75]) were also independent prognostic factors for overall survival. Interpretation Tumour-specific immune responses might be downregulated in patients who are negative for H pylori , and these patients should be followed up carefully because of a poor outlook.

C. jejuni serogroup PEN O:19 was isolated from a stool specimen from a patient with Guillain-Barre syndrome (GBS). Flagellar protein was isolated and purified from reference strain C. jejuni PEN O:19, ATCC 43,446, as well as from a homologous patient strain. Antibodies against flagellar protein were detected by means of immunoblotting, enzyme-linked immunosorbent assay (ELISA) and tube agglutination test. The antibody titres were found to be directly correlated at the beginning and in the recovery phase of GBS. Antibodies of IgG and IgA classes were present from the very onset of the disease as well as 5 months later, but with a lower titre population. However, antibodies of the IgM class were persistent only at the onset of the infection and disappeared during the following 5 months. Our results strongly support the hypothesis that in GBS patients, antiflagellar antibodies are induced during C. jejuni infection and can be used in the diagnosis of C. jejuni-associated GBS.

Summary The groEl homologue of Helicobacter pylori was isolated and characterized by means of immunoelectron microscopy, after cryosectioning. The 60 k protein was isolated from Helicobacter pylori by treatment of the cells with 2-butanol and purified by anion exchange chromatography. The native molecular weight of the 60 k protein was estimated to be 420 k by size exclusion chromatography. The purified 60 k protein showed the typical rotational symmetry of chaperonins when analyzed by electron microscopy. Ultrathin sections of Helicobacter pylori were immunostained by a polyclonal antibody directed against the hsp65 of Mycobacterium tuberculosis . The label revealed a clustered localization of the 60 k protein on the cell surface as well as in the periplasmic space.

Methods: Twelve patients with active duodenal ulcer (DU), and 10 patients with non-ulcer dyspepsia (NUD) were enrolled upon detection of H. pylori infection at endoscopy. Seven matched dyspeptic patients with normal endoscopic and histological findings were also enrolled as controls. Biopsy specimens were utilised for H. pylori and histological assessments, and for antral lymphocytes density assessment by an histomorphometric method. A blood sample was obtained from each patient to determine basal gastrin levels. All patients were controlled 4 weeks after concluding H. pylori treatment by a further endoscopy. Results: DU and NUD patients had both antral lymphocyte density (5464 ± 1328 and 5635 ± 1186 vs 2267 ± 557 lymphocytes/mm2; p

1 Ashkenazi S, Dan M. Extraintestinal manifestations of gastrointestinal tract infections. Semin Pediatr Infect Dis 1994; 5: 210–11. 2 Wiley RG, Donahue-Rolfe A, Keusch GT. Axonally transported Shigella cytotoxin is neurotoxic. J Neuropathol Exp Neurol 1985; 44: 489–506. 3 Ashkenazi S, Cleary KR, Pickering LK, Murray BE, Cleary TG. The association of Shiga toxin and other cytotoxins with the neurologic manifestations of shigellosis. J Infect Dis 1990; 161: 961–65. 4 Perles Z, Bar-Ziv J, Granot E. Brain edema: an underdiagnosed complication of Shigella infection. Pediatr Infect Dis J 1995; 14: 1114–15. 5 Sears CL, Kaper JB. Enteric bacterial toxins: mechanisms of action and linkage to intestinal secretion. Microbiol Rev 1996; 60: 167–215.

Guinea-pigs developed systemic and local humoral responses after intraperitoneal immunization with the isolated adhesin (168 kDa protein) of Mycoplasma pneumoniae cells. Hilar lymphocytes of these animals showed proliferation after in vitro stimulation with the 168 kDa protein or sonicated M. pneumoniae whole cell antigen. Animals preimmunized and subsequently infected with M. pneumoniae showed increased M. pneumoniae-specific IgG, IgA and adherence inhibiting antibody activities. Nevertheless these animals developed severe lung lesions of lympho-histiocyte infiltrations. Furthermore hilar lymph nodes were depleted of immunocompetent lymphocytes, suggesting a cell transfer of specific stimulable lymphocytes to the inflammation sites.