Pathogenicity of Campylobacter jejuni for turkeys and chickens

A Campylobacter jejuni isolate obtained from a turkey liver, designated C101, and a C. jejuni isolate obtained from the feces of a chicken, designated C111, were used to inoculate their respective hosts. Isolate C101 depressed weight gain by 20% when inoculated into newly hatched poults or 4-day-old poults. It also caused death, hepatic necrosis, and generalized hemorrhages in turkey embryos. The chicken-derived isolate, C111, did not reduce weight gain in newly hatched chicks, but it did induce mortality in chicken embryos. The supernatant of the cultures of both C. jejuni isolates also caused mortality in embryos.

Experimental reproduction of porcine proliferative enteritis

A campylobacter-like bacterium, isolated from the terminal ileum of a pig with porcine proliferative enteritis (PPE), was used to initiate PPE in healthy crossbred pigs. Post-mortem examinations of pigs infected orally with the bacterium revealed thickening of the terminal ileum, haemorrhage within the ileum, degeneration of ileal villi and large quantities of bile and mucous in the ileal contents. Histopathological examination revealed that the terminal ileum, ileo-caecal valve and caecum from infected pigs had partial or total loss of mucous membrane, hyperplasia of the crypt and glandular epithelial cells, campylobacter-like organisms in and around the Peyers' patches and lymphoid aggregates in the mucosa. The causative organism was re-isolated from the intestinal specimens of infected animals post-mortem. In control animals, kept under the same conditions, no evidence of abnormality was observed in the terminal ileum, ileo-caecal valve or caecum.

Experimental infection of the mouse mammary gland with Campylobacter coli

Campylobacter coli strains of bovine and avian origin were inoculated into the mammary gland of mice. A bovine strain isolated from a case of mastitis produced gross and histological changes in most of the glands; one bovine and one avian faecal isolate did not. Histologically, lesions were characterised by neutrophil infiltration in the alveolar spaces and necrosis and oedema in the interalveolar tissue. On bacteriological examination, the bovine mastitis strain could be isolated from most of the glands, but neither of the faecal strains. The mouse, therefore, appears to provide a convenient model for studying campylobacter mastitis.

Campylobacter jejuni infected bursitis

Campylobacter jejuni is a common cause of enteritis, and has been isolated from patients with bacteremia, meningitis, and cholecystitis. We describe here an unusual case of a chronically inflamed bursitis infected with C. jejuni.

Isolation of Campylobacter from livers of broiler chickens with and without necrotic hepatitis lesions

Injured and normal livers from broiler chickens sent to slaughter plants were collected for bacterial examination. A total of 223 macroscopically abnormal livers and 50 normal livers were received. Forty-seven thermophilic Campylobacter isolates were obtained from the livers with necrotic lesions; 39 isolates were identified as Campylobacter jejuni and eight as C. coli. In normal livers, six C. jejuni isolates were obtained. C. jejuni biotype 2 was the most common isolate recovered from injured livers, and C. jejuni biotype 1 was the most frequent isolate found in normal livers. On some occasions, Campylobacter spp. could be isolated from both the liver parenchyma and bile of the same bird. Results indicated that different species and biotypes of Campylobacter can be found in the livers of broiler chickens with and without lesions of necrotic hepatitis.

The Helicobacter (Campylobacter) pylori-colonized duodenal mucosa and gastric metaplasia

Biopsies were obtained from non-ulcerated sites of the duodenum from 100 dyspeptic patients. Helicobacter (Campylobacter) pylori was cultivated from 19 of these biopsies. Active chronic duodenitis (ACD) was found in 17 biopsies and more than 5% gastric metaplasia in 20 biopsies. H. pylori as well as ACD occurred with a significantly increased frequency when more than 5% gastric metaplasia was found in the duodenal biopsies. H. pylori on metaplastic tissue without ACD was, however, seen in two cases. H. pylori was cultivated from 9% and ACD was found in 5% of the biopsies with less than 5% gastric metaplasia. Gastric metaplasia in the duodenum was found significantly more frequently in patients with endoscopic duodenitis or duodenal ulceration than in patients with normal endoscopy. No association between gastric metaplasia in the duodenum and gastric pH or serum antibodies against H. pylori was seen. This study indicates that there is an established, but not exclusive, connection between gastric metaplasia and the colonization of the duodenum by H. pylori, the most important role being played by the antral gastric mucosa rather than the duodenum.

Cytodiagnosis of Campylobacter pylori in Papanicolaou-stained imprints of gastric biopsy specimens

The use of Papanicolaou-stained touch preparations of gastric antral biopsies for the identification of Campylobacter pylori was examined using specimens obtained from 63 consecutive patients with endoscopic evidence of antral gastritis, with the results compared to routine histologic examination and Warthin-Starry silver staining. Organisms were readily identifiable in the Papanicolaou-stained imprints of the gastric mucus. The sensitivity in detecting organisms was 92.5% for the Warthin-Starry-stained sections, 71.4% for the Papanicolaou-stained imprints and 100% for both techniques combined. False-negative imprints were attributed to poor smears and/or the submission of duodenal tissue rather than antral biopsies. Properly performed touch preparations stained by the Papanicolaou method are a cost-effective adjunct to Warthin-Starry-stained section for improving the sensitivity of gastric biopsies for the diagnosis of C pylori.

Helicobacter pylori and gastric carcinoma

A retrospective study was performed on gastric carcinomas to establish the prevalence of Helicobacter pylori infection in gastric epithelium adjacent to the tumour. A total of 105 carcinomas were studied. The overall prevalence of Helicobacter pylori infection was 59%. The prevalence in different age cohorts from patients with gastric carcinoma was compared with that in patients suffering from non-ulcer dyspepsia and, based on serological testing, with that in healthy blood donors. The presence of Helicobacter pylori in cancer patients aged 41-50 and 51-60 was significantly higher than in blood donors. No difference was seen in comparison with non-ulcer dyspepsia patients. The presence of Helicobacter pylori showed an inverse correlation with the extent of intestinal metaplasia. The intestinal type of carcinoma was associated with a higher bacterial load than the diffuse type. These data suggest that the presence of Helicobacter pylori in gastric mucosa could play a role in the pathogenesis of gastric carcinoma, especially in the young age group.

Experimental infection of pig-tailed macaques (Macaca nemestrina) with Campylobacter cinaedi and Campylobacter fennelliae

Campylobacter cinaedi and C. fennelliae have been associated with proctocolitis, bacteremia, and asymptomatic rectal infection, primarily in homosexual men. To more directly assess the pathogenic role of these organisms, we studied their disease-producing potential in 12- to 25-day-old pig-tailed macaques (Macaca nemestrina). Four infant monkeys were challenged with 10(8) to 10(9) C. cinaedi, three were challenged with C. fennelliae, two were challenged with C. jejuni, and one received no microorganisms. Watery or loose stools without associated fever or fecal leukocytes developed 3 to 7 days postinoculation in all of the animals given C. cinaedi, C. fennelliae, and C. jejuni, but not in the control animal. Stool cultures were simultaneously positive and remained so in the animals challenged with C. cinaedi or C. fennelliae for 3 weeks after inoculation despite the resolution of clinical illness. All of the animals challenged with C. cinaedi and C. fennelliae became bacteremic, and three had clinical evidence of septicemia. Histopathologic evaluation of rectal biopsies (five animals) and necropsy (one animal) showed no evidence of mucosal disruption. Specific immunoglobulin M and immunoglobulin G antibody responses occurred in all of the animals challenged with C. cinaedi and C. fennelliae, as determined by enzyme-linked immunosorbent assay and immunoblotting. We conclude that C. cinaedi and C. fennelliae consistently produce a diarrheal illness accompanied by bacteremia and followed by prolonged gastrointestinal colonization in M. nemestrina.

Histologic characteristics of Campylobacter pylori (Helicobacter pylori) mediated gastritis

One hundred-nineteen specimens were reviewed to determine whether or not there were histologic changes specific for Campylobacter pylori (CP), (Helicobacter pylori) mediated gastritis. Hematoxylin and eosin (H&E), Brown-Hopp, and Wright-Giemsa stained sections were examined independently by two pathologists for (a) the presence of acute cryptitis, (b) percent and degree of crypt involvement, and (c) spectrum of inflammatory cells within the lamina propriae. The amount of mucus was quantified on the Periodic Acid Schift (PAS)-Alcian Blue stain sections. Changes in the character of the mucus were noted by using both the PAS-Alcian Blue and the High Iron Diamine-Alcian Blue. A positive specimen for Campylobacter pylori (CP+), (Helicobacter pylori) was defined as one in which curved or spiral shaped microbes were identified on Wright-Giemsa and Brown-Hopp stain. Seventy-eight specimens were CP+ and 41 CP-. Statistically significant histologic findings included the extent and degree of superficial cryptitis and the preponderance of plasma cells in CP+ cases. These findings confirm aspects seen in an animal model and suggest that there is an histologic pattern consistent with C. pylori (Helicobacter pylori) mediated gastritis.

The gastric juice urea and ammonia levels in patients with Campylobacter pylori

The authors studied gastric juice ammonia and urea nitrogen levels to determine how they are altered by gastric Campylobacter pylori (CP) infection. Patients with chronic gastritis (20), peptic ulcer (24), hepatic cirrhosis (10), chronic renal failure (13), or gastric remnant (20) were included. Endoscopic biopsy specimens stained with the Warthin-Starry stain were evaluated for the presence of CP. Blood and gastric juice analysis was performed for 11 of the patients with chronic renal failure and 37 patients from the remaining groups. CP was identified in gastric biopsies from 50 of 87 (57.5%) patients, including 87.5% with peptic ulcer and 40-50% of those with chronic gastritis, cirrhosis, chronic renal failure, or gastric remnant. CP infection had no effect on blood urea nitrogen or blood ammonia levels in any group of patients. The urea nitrogen level of gastric juice was higher in patients with chronic renal failure than in other groups but was not related to CP infection. CP infection was associated with a significant increase in gastric juice ammonia levels, both in patients with chronic renal failure (23.3 mmol/L vs. 2.90 mmol/L; [P less than 0.05]) and in other groups (5.48 mmol/L vs. 1.26 mmol/L [P less than 0.0001]). The authors conclude that elevation of gastric juice ammonia level is an indicator of gastric CP infection.

Helicobacter pylori-related gastroduodenal disease in children. Diagnostic utility of enzyme-linked immunosorbent assay

To evaluate the accuracy of IgG and IgA serological tests in establishing a diagnosis of Helicobacter (Campylobacter) pylori gastric infection, 60 children presenting with chronic abdominal pain were prospectively studied. Endoscopic antral biopsies were obtained and analyzed for the presence of H. pylori using three standard methods: culture and identification of bacterial isolates, microscopic examination for morphologically characteristic bacteria, and urease production by the biopsy specimen. Concomitantly obtained serum samples were analyzed for the presence of IgG and IgA antibodies against H. pylori surface antigens using enzyme-linked immunosorbent assay (ELISA). Thirty-four of 60 (56.6%) had histological evidence of chronic active gastritis, eight of whom (13.3%) also had evidence of H. pylori infection by at least one criteria. Six of the eight infected patients had H. pylori demonstrated by all three methods. Of the eight infected patients, seven had IgG antibodies against H. pylori (sensitivity of 87%) and six had IgA antibodies (sensitivity of 75%). Among the six patients who had H. pylori infection confirmed by all three methods, all had IgG antibodies (sensitivity of 100%). In the patients without evidence of H. pylori infection, the IgG ELISA had a specificity of 96% (50/52), and the IgA ELISA had a specificity of 100% (52/52). Our data suggest that serological testing for the presence of antibodies against H. pylori may be a useful diagnostic tool in screening children with chronic abdominal pain for the presence of gastric infection with H. pylori.

Non-steroidal anti-inflammatory drugs, hiatus hernia, and Helicobacter pylori, in patients with oesophageal ulceration

The frequency of oesophageal ulceration in 55 patients undergoing endoscopy for dyspeptic symptoms and who had recently used NSAIDs was studied, and compared with 86 patients seen in the same clinic who had not recently used these drugs. Oesophageal ulceration was significantly more common in those who had used NSAIDs (P = 0.012), and also showed a highly significant association with the presence of a hiatus hernia (P less than 0.001). No association was found between the presence of gastric Helicobacter pylori and either oesophageal ulceration or histological oesophagitis. Patients receiving NSAIDs, especially those with a hiatus hernia, are at risk of oesophageal ulceration and presumably subsequent stricture formation. This should be borne in mind when prescribing these agents.

Nodular gastritis and Helicobacter pylori

Numerous reports have established the association of Helicobacter pylori and peptic ulcer disease in adults. Recently, this association has also been demonstrated in children. We investigated 14 children and adolescents with recurrent abdominal pain. In six patients, endoscopy revealed gastritis and Helicobacter pylori was identified. Giemsa stain was more sensitive than culture or urease testing in identifying the bacteria. In four of the six, a nodular appearance of the antral mucosa was observed. The histological examination suggests lymphoid hyperplasia as the cause of the nodularity. All of the patients became symptomless after combined treatment with amoxicillin and bismuth subsalicylate. We conclude that nodular gastritis is a peculiar type of gastritis in children. It is frequently found in association with Helicobacter pylori infection.

Helicobacter pylori and gastritis in Peruvian patients: relationship to socioeconomic level, age, and sex. The Gastrointestinal Physiology Working Group

Studies in 1,120 Peruvian adults suffering from upper gastrointestinal symptoms and stratified according to socioeconomic level, age, and sex have shown the following: Rates of Helicobacter pylori infection range from 3% in patients with normal gastric mucosa to 92% in cases of chronic active gastritis. Age-specific infection rates do not vary with the severity of active gastritis and are similar in men from low and high socioeconomic levels. Women from higher socioeconomic backgrounds show a significantly lower age-specific rate of infection than women from lower levels or from men from either level. In addition, a seroepidemiologic survey of children, predominantly from families from lower socioeconomic levels, demonstrates that infection begins for many of them in the first years of life.

Helicobacter pylori-like microorganisms and chronic active gastritis in ferrets

To determine the prevalence and histology of Helicobacter pylori (HP) associated gastritis in young ferrets, we examined 36 normal 2- to 4-month old ferrets. Identification of HP-like microorganisms included Warthin Starry stains of tissue sections, rapid urease test on fresh tissue, and culture. HP-like microorganisms were found in the stomachs of 35/36 ferrets. The highest density of microorganisms was seen in the antrum, where HP-like microorganisms were present in the pits and in deep glands. HP-like microorganisms were also seen in the cardia and on the foveolar epithelium of the fundus, but not in fundic glands. Chronic active gastritis was seen in all animals with HP-like microorganisms, but involved only the antrum. The distal antrum was most severely involved. One animal had no evidence of HP-like microorganisms on tissue sections or by rapid urease test. Gastric tissue sections from this animal showed only minimal infiltration of the lamina propria by polymorphonuclear leukocytes and lymphocytes. Gastritis associated with HP-like microorganisms is common in ferrets and is acquired at a young age. It is associated with chronic active antral gastritis similar to that seen in humans, suggesting that ferrets should provide a useful experimental model for HP-associated gastritis and peptic ulcer.

Preliminary study on the microbiology of Campylobacter pyloridis and gastric histopathology

Biopsy samples were taken endoscopically from the antral-mucosa of 693 patients with peptic ulcer and chronic gastritis presenting dyspepsia symptoms. Campylobacter pyloridis cultures were positive in 59 of 98 (60.2%) cases and histopathologically the organisms were found in 411 of 693 cases (59.3%). Pathologically, Campylobacter pyloridis was positive in 273 out of 300 patients with chronic superficial gastritis (91.0%), in 102 of 249 patients with chronic atrophic gastritis (40.9%), in 36 out of 144 patients with chronic atrophic gastritis with intestinalization or dysplasia (25.0%). We found that there was a significant association between the presence of Campylobacter pyloridis and chronic superficial gastritis, also the degree of lymphocyte infiltration showed a strong inverse association with the presence of Campylobacter pyloridis, suggesting that a local immune response might exert an important action in the eradication of this organism. These findings support the view that Campylobacter pyloridis, may be etiologically related to chronic gastritis and peptic ulceration, even though its role still remains to be determined.

Inoculation of barrier-born pigs with Helicobacter pylori: a useful animal model for gastritis type B

At the age of 8 weeks, 15 barrier-born pigs, specific pathogen free, were inoculated intragastrically with suspensions of 10(7) to 10(10) CFU of Helicobacter pylori after pretreatment with omeprazole. The pigs were observed for up to 12 weeks, endoscopic biopsy specimens were taken, and serum samples were drawn. H. pylori was identified by routine culturing and by staining with an H. pylori-specific monoclonal antibody on cryostat sections of gastric biopsy specimens. In 11 of 15 inoculated pigs, H. pylori was detected throughout the observation period. In these infected pigs, there was an antibody response to H. pylori, as determined in serum by an enzyme immunoassay. Furthermore, the development of superficial, focal gastritis with infiltrates of mononuclear class II antigen-expressing lymphocytes was observed immunohistologically. H. pylori was never detected and an antibody response to H. pylori was not observed in two control pigs. The development of gastritis and the systemic antibody response to H. pylori support the usefulness of this animal model for studies of H. pylori-related human diseases.