Detection of cholera toxin gene in stool specimens by polymerase chain reaction: comparison with bead enzyme-linked immunosorbent assay and culture method for laboratory diagnosis of cholera

Stool specimens obtained from 123 hospitalized patients with acute secretory diarrhea admitted to the Infectious Diseases Hospital, Calcutta, India, were examined for isolation of Vibrio cholerae O1 by direct or enrichment plating on selective media for cholera toxin (CT) by bead enzyme-linked immunosorbent assay (bead-ELISA) and for the CT gene by polymerase chain reaction (PCR). V. cholerae O1 was isolated either by direct culture or by enrichment culture from 70 stool specimens, all of which gave positive results by PCR. Eleven specimens which were culture negative and bead-ELISA positive also gave positive results by PCR. In addition, 13 more specimens which were negative by both the culture method and bead-ELISA, were positive by PCR. With the combined results of both the culture method and the CT bead-ELISA, a confirmed laboratory diagnosis of cholera could be made from 81 stool specimens, while the combined results of the three methods, including PCR, yielded a positive result for 94 specimens examined. From these data, we conclude that PCR provides a more sensitive and specific assay for rapid diagnosis of cholera than currently available methods.

Virulence patterns of Vibrio cholerae non-O1 strains isolated from hospitalised patients with acute diarrhoea in Calcutta, India

A collection of 28 strains of Vibrio cholerae non-O1 isolated during a 3-year period (1989-1991) from hospitalised patients with acute diarrhoea in Calcutta, India, were examined with regard to virulence-associated factors. Of the 28 isolates (each representing a case), 18 were isolated as the sole infecting agent; the remaining 10 were recovered as co-cultures from cases infected with V. cholerae O1. Of the strains isolated in this study, 82% could be serotyped, with serovars O5 (32.1%), O11 and O34 (14.3% each) predominant. Serovars O7, O14, O34, O39 and O97 were associated exclusively with sole infections. Two strains of V. cholerae non-O1 produced anti-cholera toxin IgG-absorbable cholera toxin (CT). Both CT-producing V. cholerae non-O1 strains hybridised with the DNA probe specific for the zonula occludens toxin (ZOT) but none of the remaining 26 strains hybridised with the ZOT probe. The majority of the strains were cytotoxic for CHO, HeLa and Vero cells, with end-point titres of 4-512. Fewer strains produced a cytotonic effect, with end-point titres of 2-16. Of the 28 strains of V. cholerae non-O1 examined, 75%, 75%, 25% and 14.3% produced haemolysin that was active against erythrocytes of rabbit, sheep (Eltor haemolysin), chicken and man, respectively. Strains that produced a haemolysin active against both rabbit and sheep erythrocytes were dominant (35.7%). Ten (35.7%) of the 28 strains examined showed cell-associated haemagglutinating activity on human blood. Of the 10 strains, nine were isolated as sole pathogen and only one strain was associated with mixed infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute secretory travellers' diarrhoea caused by Vibrio cholerae non-01 which does not produce cholera-like or heat-stable enterotoxins

An Australian tourist suffering from severe acute watery diarrhoea and dehydration due to Vibrio cholerae non-01 was studied. The V. cholerae strain isolated from the patient belonged to serovar 05. The organism did not produce any of the conventional enterotoxins including cholera-toxin (CT) or heat-stable toxins (NAG-ST) that are known to be associated with intestinal secretion. This report suggests that toxin(s) other than CT-like or NAG-ST may be involved in the pathogenesis of diarrhoea by some V. cholerae non-01 strains.

Reassessment of the prevalence of heat-stable enterotoxin (NAG-ST) among environmental Vibrio cholerae non-O1 strains isolated from Calcutta, India, by using a NAG-ST DNA probe

A collection of 521 environmental isolates of Vibrio cholerae which were previously examined by the suckling mouse assay and found to be negative for the heat-stable enterotoxin NAG-ST were reassessed by a recently developed DNA probe for NAG-ST. A total of 12 (2.3%) of the isolates hybridized with the NAG-ST probe. By using a cholera toxin (CT) DNA probe, the CT gene was detected in six of the strains in the collection, although none of the isolates of V. cholerae non-O1 hybridized with both of the toxin probes. All of the NAG-ST and CT probe-positive strains were hemolysin positive. Thirty-fold-concentrated supernatants of the three representative NAG-ST DNA probe-positive V. cholerae non-O1 strains gave positive fluid accumulation ratios in the suckling mouse assay even after heating (100 degrees C for 5 min) and also inhibited the binding of a NAG-ST monoclonal antibody to the bound NAG-ST in a competitive enzyme-linked immunosorbent assay (ELISA). Likewise, all six CT probe-positive V. cholerae non-O1 strains produced in vitro CT when examined by the CT bead ELISA. HindIII digest patterns of chromosomal DNA from the representative NAG-ST gene-positive strains were visually indistinguishable. Between the groups of NAG-ST probe-positive strains examined, there was a variation in the hybridizable fragments, with one group of strains exhibiting a hybridizable fragment similar to that of the NRT 36 reference strain; a smaller HindIII fragment hybridized with the NAG-ST probe in the other group of strains.(ABSTRACT TRUNCATED AT 250 WORDS)

Serovar, biotype, phage type, toxigenicity & antibiotic susceptibility patterns of Vibrio cholerae isolated during two consecutive cholera seasons (1989-90) in Calcutta

Characteristics of V. cholerae isolated from patients of acute secretory diarrhoea admitted to the Infectious Diseases Hospital, Calcutta during two consecutive cholera seasons (1989 and 1990), with special emphasis on biotyping and toxigenicity, were investigated. The isolation rates of V. cholerae during 1989 and 1990 were 78 and 85.1 per cent respectively, with Inaba serotype dominating in 1989 and Ogawa in 1990. All the V. cholerae 01 strains isolated in this study belonged to biotype Eltor with phage type 4 dominating (48.8%). Most of the strains of V. cholerae were resistant to 10 and 150 micrograms/ml of 0/129 vibriostatic agent. Similarly, majority of the V. cholerae strains were resistant to furazolidone (95.7%), cotrimoxazole (83%) and tetracycline (63.1%) and several resistance patterns were encountered. All the V. cholerae 01 strains examined produced cholera toxin (CT) in amounts ranging between greater than 70 pg/ml and greater than 2.5 ng/ml. In contrast, all but one of the non-01 strains isolated in this study did not produce CT. Further studies are required to elucidate the mechanism involved in the pathogenesis of non-01 V. cholerae mediated diarrhoea.

Taxonomical implications of the emergence of high frequency of occurrence of 2,4-diamino-6,7-diisopropylpteridine-resistant strains of Vibrio cholerae from clinical cases of cholera in Calcutta, India

Of the 110 consecutive isolates of Vibrio cholerae recovered from cholera patients admitted to the Infectious Diseases Hospital, Calcutta, India, between July 1989 and October 1990, 90 and 82.7% were resistant to 10 and 150 micrograms of 2,4-diamino-6,7-diisopropylpteridine (O/129), respectively. Additionally, all O/129-resistant strains of V. cholerae were multiply resistant to antimicrobial agents. Except in the cases of four strains, resistance to O/129 was invariably linked with resistance to co-trimoxazole. Although O/129 susceptibility is still a useful test for Vibrio identification, resistance of V. cholerae to this compound in local areas might occasionally pose a problem.

Virulence traits of Aeromonas strains in relation to species and source of isolation

The virulence traits of 39 well-defined clinical (29 strains) and environmental (10 strains) isolates of Aeromonas (16 A. hydrophila, 12 A. sobria and 11 A. caviae) were examined by a variety of assays to delineate differences, if any, in the enteropathogenic potential in relation to species and the source of isolation. The distribution of enterotoxin (ent), cytotoxin (cyt) and haemolysin (hae) producing strains of Aeromonas did not correlate to species and source of isolation. The extracellular virulence phenotype Ent+ Cyt+ Hae+ was the most common one among all the three species although unique phenotypes associated prominently with either A. hydrophila or A. sobria were also discernible. None of the cytotoxin or haemolysin producing strains hybridized with the vt1/vt2 or the tdh/trh gene probes, respectively, indicating that these two factors of Aeromonas were distinct. Haemagglutination of human O group erythrocytes was not related to the source of isolation or production of enterotoxin, cytotoxin or haemolysin but appeared to be related to species. The strains which did not exhibit cell-associated haemagglutination belonged to either A. hydrophila or A. caviae. Haemagglutination unaffected by fucose, mannose and galactose was the dominant inhibition pattern exhibited mainly by the clinical haemagglutinating strains of the three species. Only one clinical strain of A. caviae showed a diffuse pattern of adherence to HeLa cells. Expression of the 5 bacterial enzymes by strains of Aeromonas did not fall into a readily discernible pattern in relation to species or source of isolation. From this study, it is clear that the mechanism of the pathogenesis of Aeromonas is a multifactorial one.

Propagation of Costus speciosus (Koen.) Sm. through in vitro rhizome production

Rhizomes developed in vitro on shoots of Costus speciosus (Koen.) Sm. which were initiated from zygotic embryos. The effect of different hormonal and nutritional additions to Schenk and Hildebrandt' s (SH) basal nutrient medium on rhizome development was studied. Rhizomes developed on SH basal salts but formed with increased frequency on medium supplemented with adenine sulfate, casamino acids (CA) and various combinations of cytokinins and auxins. Incubation in light was necessary for rhizome formation. Isolated basal as well as nodal (aerial) rhizomes formed and produced new shoots. In basal medium without any growth additives (control) the average number of shoots produced per inoculum was 3.3 ±0.73 whereas in the best suited medium i.e. supplemented with 250 mg l(-1) CA the number of shoots obtained was 22.7±1.92. There was no dormancy period for rhizomes under the cultural conditions investigated. Rhizome-sprouts were easily transplanted from the in vitro conditions to the field. More than five hundred propagules (i.e. sprouted-rhizomes) were obtained within 5 months and it has been estimated that more than 2.4 × 10(5) propagules could be achieved per year through four subsequent in vitro rhizomes-generation cycles. Thus, a rapid method of propagation has been established.

Embryo culture of Costus speciosus (Koen.) Sm. to regenerate variable diosgenin yielding clones

Mature embryos of Costus speciosus were excised and cultured on Schenk and Hildebrandt's (1972) nutrient medium containing auxins and cytokinins either alone or in combination. Multiple shoots were obtained when kinetin and indole-3-butyric acid were supplemented each at 0.1 mg 1(-1) concentration. Embryo-derived plantlets were multiplied through propagation of rhizomes and the propagules derived from a single embryo were designated as an embryoclone. Twenty such embryo-clones were maintained in the field. Variations in rhizome biomass yield and diosgenin contents of these embryoclones were noted. Thirty-six percent of the embryo-clones studied were high diosgenin yielding types. Diosgenin contents at the intraclonal level were uniform. The in vitro raised plants were morphologically uniform and indistinguishable from their parent.

Transformation and regeneration of mung bean (Vigna radiata)

The procedure relied on a protocol in which shoot organogenesis was induced on cotyledons of mung bean genotypes selected for susceptibility to agrobacterium seems to work reproducibly if not efficiently. Approximately 4-5% of the shoots produced on the kanamycin selected cotyledons are transgenic based on assays on kanamycin resistance and GUS activity. This demonstrated that transformation and regeneration in mung bean are possible. However, raising the transformed plants in field condition is yet to be perfected.

Evaluation of direct agglutination test (DAT) and ELISA for serodiagnosis of visceral leishmaniasis in India

The direct agglutination test (DAT) and the enzyme-linked immunosorbent assay (ELISA) were used for serodiagnosis of parasitologically confirmed Indian visceral leishmaniasis (VL) cases. All the sera of VL cases were positive by both the methods. DAT titres of VL cases were greater than or equal to 1:3,200, and ELISA values were greater than or equal to 0.55 1:400 dilution. In the control group, sera of widely prevalent diseases of India, such as leprosy, tuberculosis, malaria, and liver cirrhosis, were included. Both tests could discriminate between VL and other patients of the control group. The sera of post-kala-azar dermal leishmaniasis (PKDL) patients gave OD values of greater than 0:55 and had DAT titres of 1:1,600. Both tests are sensitive and specific for the diagnosis of VL cases. DAT, being simpler and more economical, will be suitable for diagnosis and epidemiological studies for VL under rural conditions of India.

Direct enzyme-linked immunosorbent assay: a simple immunoassay using Leishmania donovani promastigote for diagnosis of kala-azar

For immunodiagnosis of kala-azar enzyme-linked immunosorbent assay (ELISA) and immunofluorescence testing (IFAT) are commonly used. In IFAT, whole parasite antigen and in ELISA the soluble antigen have been used. Preparation of ELISA antigen has certain inherent difficulties. We have developed a simple, specific, and quantitative immunoassay, "direct ELISA" for diagnosis of kala-azar. Intact formalinized promastigote suspension has been used to combine with the antibodies of the patient sera. The colour developed in the supernatant by the enzyme conjugate combined on the parasite surface was measured with a spectrophotometer. The test was able to detect kala-azar-specific antibodies at very high serum dilution and could discriminate between kala-azar and the common diseases prevalent in Asia. The optical densities of the sera of different control groups were significantly low. The method has potential for use as a diagnostic tool in less well equipped laboratories.

Gastric carcinoma in a child associated with nodular lymphoid hyperplasia of the colon

We report a 12 year old boy of Nepalese origin with gastric adenocarcinoma and associated nodular lymphoid hyperplasia of the colon, with hemoglobin E trait and normal serum immunoglobulins. The boy underwent a curative resection and is free of recurrence or metastasis nine months after diagnosis.

A novel tubulin from Mimosa pudica. Purification and characterization

From Mimosa pudica fresh leaves and pulvinar callus cells, we have purified tubulin protein using an anion-exchange resin, DEAE-Sephadex A-50, followed by ammonium sulfate fractionation and Sephadex G-200 gel filtration. The purified protein consisted of alpha and beta subunits and trace quantities of other proteins. When analysed by sodium dodecyl sulfate/polyacrylamide gel electrophoresis at pH 8.8, both alpha and beta subunits of tubulin almost comigrated with their counterparts from goat brain. Two-dimensional electrophoresis revealed that this tubulin contains one major alpha-tubulin having a pI value of 7.1 and three beta species having pI values of 6.70, 6.46 and 6.40. Morphologically normal microtubules were observed by electron microscopy; self-polymerization in vitro, even in the cold, can also be achieved. Radioimmunoassays, and also immunoblotting with the antibodies raised against alpha- and beta-tubulins of this plant, showed that the nature of alpha-tubulin is different from that obtained from other sources. This is an example of plant tubulin where strong colchicine binding at 1 microM was observed. This protein constitutes 5-6% of the total extractable protein in the leaves. We propose that movement of the leaves of this plant may be regulated by the presence of a high amount of this protein.

Cronkhite-Canada syndrome with hypothyroidism

An elderly man with non-familial gastrointestinal polyposis, malabsorption and progressive hypoproteinemia is reported. Associated alopecia, cutaneous hyperpigmentation and nail dystrophy with loss of nails were consistent with the diagnosis of Cronkhite-Canada syndrome. Hypothyroidism was present in this patient and the rare association of these two conditions is discussed.

Ultrasonographic evaluation of carcinoma of the gall bladder

Out of 6018 patients who were evaluated ultrasonographically for gastrointestinal problems over a four-and-a-half year period, 201 patients with a mean age of 53 years were diagnosed to have carcinoma of the gall bladder (3.3%). In 191 of these the diagnosis was confirmed by laparotomy and histopathological examination and in 3 other patients ultrasound guided fine needle aspiration cytology yielded malignant cells. In the remaining 7 patients the diagnosis was not confirmed by tissue examination-3 had metastases and 4 refused further investigation. Two sets of features were detected on ultrasonography: type I-a mass occupying the gall bladder fossa and obliterating the lumen (144 patients), and type 11-a polypoid lesion projecting into the gall bladder lumen (57 patients). Gallstones were present in 157 patients (78%) but more often in patients with the type I features. Associated ultrasonographic features such as liver and lymph node involvement, dilatation of intrahepatic bile ducts and ascites were also assessed. We conclude that abdominal realtime ultrasonography is a reliable method for diagnosing carcinoma of the gall bladder.

An ELISA for quantitation of tetanus toxin

A sandwich ELISA for quantitation of tetanus toxin was devised using commercially available horse antitetanus antiserum and its HRP-conjugate. With commercial toxoid as a standard the assay had a lower sensitivity of 100 ng/ml and was linear up to 100 micrograms/ml. In terms of Lf equivalents the ELISA assay was linear from 0.02 to 20 Lf/ml. The Lf activity in 20 preparations of tetanus toxin as determined by ELISA was comparable to the activity measured by conventional flocculation tests (r = 0.987).