- Volume 37, Issue 5, 1992

Thirty-five Helicobacter pylori isolates, 21 H. mustelae isolates and four strains of H. felis were compared for their ability to agglutinate red blood cells (RBCs). Isolates were examined in a slide haemagglutination assay with RBCs from 11 animal species, including rodents, carnivores and primates, as well as man. RBCs were agglutinated by 65–90% of H. mustelae isolates and 16–57% of H. pylori isolates. Treatment of H. mustelae with pronase and heat inhibited haemagglutination (HA) whereas heating only of H. pylori inhibited HA. Treatment of all strains of H. mustelae with trypsin inhibited agglutination of human RBCs; 75% of the treated strains did not agglutinate ferret RBCs. These results suggested that protein(s) may be important haemagglutinins for these bacteria. Variable HA profiles together with varying results after treatment of RBCs with fetuin, D-mannose, and neuraminidase suggested that multiple receptors may be involved in HA reactions with H. pylori and H. mustelae. The observation that H. mustelae and H. pylori agglutinated RBCs of several species and closely adhered to gastric epithelium supported the hypothesis that adherence plays a role in the colonisation and pathogenicity of H. mustelae and H. pylori, H. felis did not adhere to gastric epithelium and did not agglutinate RBCs of any species; nevertheless, H. felis can readily colonise and produce gastritis in several mammals.

Verocytotoxin-producing Escherichia coli (VTEC) have been recognised recently as an important cause of human disease. The adherence of VTEC to rabbit intestinal tract and the relationship between adherence and other virulence traits were studied. Twenty clinical isolates of VTEC (O157:H7 and other serotypes) and a control, commensal E. coli strain, were examined. Bacteria were evaluated for the presence of surface fimbriae, plasmid profile and hybridisation with a 3.4 kb DNA probe derived from the 60-MDa plasmid of such strains. Adherence was determined by electronmicroscopy and quantitatively with radiolabelled bacteria. Of the VTEC strains, 12 (60%) had surface fimbriae; all O157:H7 and 10 (70%) of 14 of the non-O157:H7 strains hybridised with the probe. No isolate was negative for both of these virulence traits and there was no correlation between their presence. The plasmid profiles varied among the strains, with no correlation to virulence traits. The adherence of VTEC strains differed significantly, ranging from 0.3 to 34.0 bacteria/intestinal cell. The mean adherence of fimbriate strains was greater than that of non-fimbriate strains (3.9 versus 2.7 bacteria/cell), although marked variability was noted in both groups. This study showed that VTEC strains differed markedly in their adherence capability and that neither the presence of fimbriae nor hybridisation with the 3.4-kb probe was essential for adherence. Several distinct mechanisms probably play a role in VTEC adherence.

Seven strains of Hafnia alvei isolated from diarrhoeal stools of children resembled enteropathogenic Escherichia coli (EPEC) in that they produced attaching-effacing (AE) lesions in rabbit ileal loops and fluorescent actin staining in infected HEp-2 cells. In addition, a DNA probe from a chromosomal gene required by EPEC to produce AE lesions, hybridised to chromosomal DNA from all seven H. alvei strains. These findings indicate that there is a sharing of virulence-associated properties at the phenotypic and genetic levels by H. alvei and EPEC. H. alvei strains with these properties should be considered diarrhoeagenic.

During a 15-year period, 146 strains of Aeromonas spp. were isolated from 32810 faecal specimens from 13820 hospitalised patients up to 13 years of age. These isolates constituted 4% of all the pathogenic bacterial strains cultured. For the years 1978–1988, the files of children with gastro-enteritis revealed 81 whose faeces yielded Aeromonas spp. Most of them (94%) were < 3 years of age, 78% < 1 year old. The peak incidence was at 2–6 months, involving severe morbidity including dehydration and vomiting with acidaemia and azotaemia; the mean duration of illness and length of hospitalisation at this age were longer than at other ages. Bloody diarrhoea was found in 7% of the children. Almost all the strains of Aeromonas were resistant to ampicillin. We conclude that Aeromonas spp. are of aetiological significance in gastro-enteritis in small children; culture for this pathogen should be routine in the bacteriological examination of faeces.

A collection of 44 Campylobacter isolates (37 C. jejuni and seven C. coli) from children with colitis (21 strains) or watery diarrhoea (23 strains) was analysed for toxin production, association with HeLa cells, and invasion of differentiated Caco-2 cell cultures. There was no obvious association of clinical symptoms with species, biotype or enterotoxin production. All colitis strains and most of the isolates from watery diarrhoea were cytotoxic for Chinese hamster ovary cells. Measurements of bacterial association indices with HeLa cells varied with time, and were considered to be unreliable for discriminating between isolates from the two diagnostic groups. Statistically significant differences were observed between the two groups (all colitis strains and 65% of strains from non-inflammatory diarrhoea) with respect to invasion of both HeLa and Caco-2 cell monolayers. However, among the strains from non-inflammatory diarrhoea that did invade, numbers of internalised bacteria were similar to the range observed for colitis strains. Of the colitis strains, 86% were able to transcytose through polarised Caco-2 monolayers grown on filters, compared with 48% of isolates from non-inflammatory disease. We propose the use of Caco-2 cells as a model for studying invasion of intestinal epithelia by C. jejuni and C. coli.

Intragastric inoculation with hepatotoxigenic strains of Campylobacter jejuni led to the death of mice during the late phase of infection. Histological study disclosed a massive infiltration of mononuclear cells in the liver, mimicking intrahepatic hypersensitivity. Neither enterotoxigenic nor enteroinvasive Escherichia coli induced such a lesion. However, the same histopathological change was induced by injecting the hepatotoxic factor of hepatotoxigenic C. jejuni intravenously on two occasions separated by 14 days. Neither a single injection of an increased dose of the hepatotoxic factor nor two injections, the second of which was heat-inactivated, induced this change. Pre-treatment with rabbit antibody to the hepatotoxic factor inhibited the development of the hepatic lesion. These results suggest that C. jejuni-induced hepatic lesions in mice may be caused, at least in part, by the active moiety of the hepatotoxic factor. The possible mechanisms by which the toxic factor induces hepatitis as a consequence of hypersensitivity are discussed in relation to Guillain-Barré syndrome and Reiter’s syndrome associated with C. jejuni enteritis.

A biphasic culture system, the MB Check, was compared with conventional culture on Löwenstein-Jensen egg (LJ) solid medium and with Bactec broth culture for primary isolation of mycobacteria from clinical samples. A total of 104 mycobacterial isolates was detected from 985 samples examined by the three methods. The most sensitive primary isolation was with LJ culture and MB Check; these methods detected 93% and 87% of all positive cultures, respectively. MB Check allowed a somewhat more rapid detection than LJ culture. The presence of atypical mycobacteria was demonstrated most rapidly with the Bactec system.

The effects of purified Pseudomonas cepacia lipase on rat pulmonary alveolar function and morphology were examined. Lipase (2.5–20 μg/ml) adversely effected the phagocytic function of rat pulmonary alveolar macrophages in a dose-dependent manner. The lipase itself was not directly cytotoxic to these cells. Alveolar macrophages, in the absence of lipase, phagocytosed c. 35% of a given population of opsonised P. cepacia in 30 min when the ratio of bacteria: phagocyte was 10:1. Phagocytosis of P. cepacia by rat pulmonary alveolar macrophages was significantly reduced when the cells were either pre-incubated with the lipase or when phagocytosis occurred in the presence of the lipase. This was confirmed by transmission electronmicroscopy. These functional changes were associated with marked alterations of the macrophage morphology. Scanning electronmicroscopy showed that macrophages exposed to the P. cepacia lipase had fewer specialised surface structures and did not spread on plastic surfaces as well as untreated macrophages. The effects of the lipase were lost after heat inactivation, which indicates that the effects of the P. cepacia lipase were due to its enzymic activity. These results suggest that, if sufficient quantities of the enzyme are produced in vivo, lipase may be an important virulence factor for P. cepacia, allowing the organism to evade phagocytic cells.

An enzyme-linked ligand binding assay (ELBA) was devised to measure the interaction between bacteria and human (H) or bovine (B) lactoferrin (Lf) linked to horseradish peroxidase. Reagents were calibrated for optimum colour development with o-phenylenediamine as chromophore and organisms that were either positive or negative in a radioisotope-labelled ligand binding assay (RLBA) with 125I-Lf. Good correlation of Lf binding (r = 0.89) was found between ELBA and RLBA with 169 randomly selected strains of Escherichia coli. A semi-quantitative scoring system for ELBA, corresponding to a similar system for RLBA, was established and shown to be valid for 517 strains from seven species of bacterial pathogens. ELBA was used to measure bacterial Lf binding-saturation and displacement kinetics and shown to be comparable with RLBA. ELBA may be a suitable method for examining the binding of Lf to bacteria without the need for radioactive isotopes.

Two DNA fragments cloned from the genome of Candida albicans ATCC 10261 may be useful in the rapid diagnosis of disseminated candidosis. One sequence (probe EOB1) was specific for C. albicans (positive hybridisation with 45 strains tested). The second sequence (probe EOB2) detected C. albicans, as well as five other pathogenic Candida spp. and Saccharomyces cerevisiae, but did not react with human or bacterial DNA. Both probes were repetitive sequences in the genome of C. albicans. Probe EOB1 was used to detect, without DNA amplification, 500 C. albicans yeast cells in 1 ml of human blood.

Fifty-eight isolates of Clostridium difficile from two distinct outbreaks were examined for inter-strain similarity by pyrolysis mass spectrometry (PMS). The first outbreak began on a geriatric acute unit and spread to a long stay geriatric facility. PMS analysis showed that most isolates from both sites were indistinguishable. Isolates obtained in the preceding year from the long stay facility were found to be closely similar to these outbreak isolates. In the second, smaller outbreak on a female medical ward in another general hospital, PMS again showed that a single strain was probably responsible. Representative isolates from these two different outbreaks were shown to be distinct. The ability to compare rapidly large numbers of isolates of C. difficile makes PMS attractive for initial screening in suspected outbreaks, providing important information for outbreak management and allowing conventional typing methods to be concentrated on relevant isolates.

Two sets of oligonucleotide primers were used to amplify the genomic DNA of Rickettsia tsutsugamushi, the causative agent of scrub typhus (tsutsugamushi disease), by the polymerase chain reaction. Each set of primers amplified 538-bp and 109-bp products, representing part of a gene encoding a possible major 58-kDa immunogenic protein, from whole genomic DNA extracted from R. tsutsugamushi strains Karp, Kato, Gilliam, Kuroki and Kawasaki. No amplification was observed from R. sibirica, R. rickettsii, mouse and human genomic DNA. DNA amplification was observed from crude lysates of peripheral whole blood, tissue homogenates and paraffin-embedded skin biopsy sections obtained from patients with scrub typhus disease. Southern blot analysis demonstrated the specificity of the amplified DNA fragments following hybridisation with a DNA probe generated from R. tsutsugamushi strain Karp. By means of this procedure, a rapid and sensitive diagnosis of scrub typhus disease can be made during the acute stage of this infection.